Conflicts of interest and agenda review

Distill Distilled background from below:

Per Ed:  I see a lot of ‘mRNA’ [in new COVID-related codes].  Outside the realm of clinical imaging and organisms, does SI publish a list of acronyms and abbreviations that do not need to be accompanied by expansions in synonyms?  If not, what is your process for approving internationally distributed exceptions to the published editorial rules?

Per Jim:  We currently only have exceptions for the addition of acronyms for a few items and do not have a comprehensive list.  For descriptions, in this case we are following the guidance related to the use of acronyms in FSNs, which is "An acronym is allowed in a [description] when it has become a word in its own right, i.e., included in dictionaries; understood without expansion to its original full form." A search on Google as well as searches in various dictionaries does not provide an alternative meaning for mRNA other than "messenger ribonucleic acid". It would be useful for us to create a section where approved abbreviations and acronyms are listed.  

Per Ed:  My query relates to the presence of mRNA (without accompanying expansion) in the synonyms listed in the briefing note. It’s confusing if the approach taken is justified by reference to the FSN guidance. Substituting ‘…a [description]…’ in place of ‘…an FSN…’ (in the current editorial guide) is unhelpful. Is the member community free (or indeed expected) to make this substitution anywhere in SNOMED CT’s documentation? 

The Acronyms subsection ‘Preferred terms and synonyms’ guidance begins “…Acronyms are allowed in a Preferred Term or Synonym when followed by the expanded term’ which seems pretty clear to me (and our authoring team, who have spent hundreds of person hours defending this approach to customers). __ However, the international content added here (and plenty elsewhere – both old and new) is in conflict with this clause. Hence my question.

 Deep down I share the view that ‘mRNA’ is only likely have one interpretation in a health record setting (and I’m comfortable, for example, that the SARS-CoV-2 /COVID-19 train left a long time ago), but that is not the point.

A stated editorial stance creates expectations, and exceptions need to be explicit, justified and risk-managed. The current international documentation only gives us imaging modalities (acronyms) and organism names (abbreviations) as exceptions, but the data is full of them. Bafflingly, the second ‘organism abbreviation’ example is illustrated by an unexpanded acronym (‘CRM’) that is used in SNOMED CT to mean both ‘circumferential resection margin’ and ‘cross-reacting material’ and I would wager is NOT ‘understood without expansion to its original full form’ by the majority of readers.

Both these quotes are served by the spirit of the international editorial rules, but sadly not by the data.

June 23, 2021 1730 UTC