1 Introduction

SNOMED CT terminology provides a common language that enables a consistent way of indexing, storing, retrieving, and aggregating clinical data across specialties and sites of care.

The International Health Terminology Standards Development organisation (IHTSDO^®), trading as SNOMED International, maintains the SNOMED CT technical design, the content architecture, the SNOMED CT content (includes the concepts table, the descriptions table, the relationships table, a history table, and ICD mappings), and related technical documentation.

2 Background

This document provides a summarized description of the content changes included in the November 2019 release of the SNOMED Clinical Terms^® Managed Service Sweden Extension package.

It will also includes technical notes detailing the known issues which have been identified (should any of these exist). These are content or technical issues where the root cause is understood, and the fix has been discussed and agreed, but has yet to be implemented.

This Sweden Extension package is dependent upon, and should therefore be consumed in conjunction with the SNOMED CT® July 2019 International Edition release.

2.1 Scope

This document is written for the purpose described above and is not intended to provide details of the technical specifications for SNOMED CT or encompass every change made during the release.

3 Content Development Activity

3.1 Summary

Content from the SNOMED CT® July 2020 International Edition release has been translated and additional concepts and synonyms for use in Sweden have been added. The main areas for which new concepts and synonyms have been added are:

• Chief complaint
• Healthcare occupations
• National medication list
• Alert information
• Decision-support for insurance medicine

3.2 New and Updated Content

Concept statistics

New concepts: 282

Table 1 New concepts by hierarchy

No concepts from the Swedish extension were inactivated.

Changes to existing concepts in the Swedish extension: 1

Descriptions statistics

New synonyms added: 1 216
Inactivated descriptions: 517
New translations: 4 878

Some concepts have not been translated into Swedish. The reasons for non-translation can vary and include concepts not relevant in a Swedish context and concepts were the name in Swedish and English is equivalent (e.g. the Latin names of organisms).

Table 2 Non-translated concepts by hierarchy

Reference sets

Ten reference sets were added in this release, including a reference set for chief complaints, a new reference set for the National Medication List (Nationella läkemedelslistan), a new reference set supporting the Inera laboratory medicine information specification, as well as reference sets supporting coding of healthcare occupations.

4 Technical notes

4.1 Known Issues

Known Issues are content or technical issues where the root cause is understood, and the resolution has been discussed and agreed but has yet to be implemented.  This can be due to a number of reasons, from lack of capacity within the current editing cycle, to the risk of impact to the stability of SNOMED CT if the fix were to be deployed at that stage in the Product lifecycle.  

For the SNOMED CT Managed Service - Sweden Extension May 2019, the following Known Issues were identified, and agreed to be resolved in the next editing cycle:

4.2 Technical notes

Migration to full OWLExpression file

In line with the July 2019 International Edition release, this release sees the full migration to OWL, replacing the Stated Relationship content with the OWLAxiom and OWLOntology refsets in the OWLExpression file.

All Stated Relationship records have therefore been inactivated, in lieu of the new content in the combined OWLExpression files.

Promoted concepts

Some concepts from the Swedish extension have been promoted to the international release (900000000000207008 | SNOMED CT core module (core metadata concept) |). The concepts have been added to the international release files with an effectiveTime which supersedes the latest effectiveTime in the Swedish extension release files. The concepts will be retained in the Swedish extension snapshot files in perpetuity as per SNOMED International recommendations and anyone using these files will have to manage the possibility of duplicated ids (with different effectiveTime) across release files. The risk of issues can be mitigated by filtering to only use Swedish extension records with effectiveTime:s greater than their International counterparts. These Links to relevant documentation will be added to these release notes will be updated once the relevant SNOMED International documents clarifying this topic have once that documentation has been updated.

The promoted concepts in the November 2020 release are: