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COVID-19 Content

Content relating to COVID-19 can be viewed here SNOMED CT COVID-19 Related Content

January 2022 International Release and future releases

Browse Content Changes for the January 2022 Release

The daily build is available to review changes made to content for the July 2021 release https://dailybuild.ihtsdotools.org/

Forthcoming concept inactivations, new concepts and changes to existing concepts can be reviewed using the tab 'Daily build.'

Implementation of the new anatomy concept model

The completion of the revision of hierarchical relationships provides stable anatomy content and improves the quality of classification results in other hierarchies.

Over forthcoming releases, the plan is to implement the new anatomy concept model. There are almost 35,000 anatomy concepts and they will be modeled by different types of 'part of' relationships. The new model will enable us to automatically generate hierarchies to further improve quality and consistency. 

Information about the work completed in previous release for revision of IS_A relationships can be viewed here: https://confluence.ihtsdotools.org/display/IAP/Revision+of+IS-A+relationships+for+anatomy

January 2022 International Release and future releases

MRCM Changes

Details of changes to the MRCM for the January 2022 release will be posted here when available.

Quality Initiative

Information about the project can found here - Quality Initiative - Progress

Note: There are changes to the Service Level Agreement for the CRS as a result of the Quality Initiative:

https://www.snomed.org/SNOMED/media/SNOMED/documents/Changes-to-SLA_202005_MHA.pdf

Concepts referencing substance structural groupers of form "X and X derivative" or "Y and Y compound"

Around 500 concepts in multiple hierarchies with FSNs that include either "X and X derivative" or "Y and Y compound" will have terming updated to "X and/or X derivative" and "Y and/or Y compound," respectively.

Please see the briefing note for more information.

Remodel 420721002 |Acquired immunodeficiency syndrome-associated disorder (disorder) and descendants

420721002 |Acquired immunodeficiency syndrome-associated disorder (disorder)| has been made primitive and its 73 subtypes have been remodeled. 

The |Associated with (attribute)| is eliminated and descriptions updated accordingly.  Role groups were added to support concept definition. The AIDS acronym has been annotated in expanded form as per Editorial Guidance. 

Review of tooth/teeth content

Changes are expected to approximately 120 concepts. Any concept which contains a mix of plural and singular descriptions will be changed so that the concept only represents a singular “tooth” or plural “teeth”. Where appropriate, new concepts will be created. An example concept to be changed is 36202009 |Fracture of tooth (disorder)| which has an incorrect plural description of “Broken teeth”.

Modeling will be reviewed to ensure that a plural FSN (teeth) has a plural finding site and a singular FSN (tooth) has a singular finding site. Changes to the modeling of concepts will be made where necessary. An example concept to be changed is 53963006 |Excessive attrition of teeth (disorder)|which is currently modeled with a singular finding site.

Revision Procedure X declined (situation)

131 Situation hierarchy concepts of the pattern "Procedure X declined (situation)" have been remodelled with DECLINED as both the FSN and the Preferred Term. 

Nutrition Content

• Addition of ~200 nutrition concepts. Most will be in the observable entity hierarchy (nutrition behaviors, social determinants, ability concepts), some in clinical findings (potable water access, nutrition activities of daily living findings) and a portion are regime/therapy concepts (infant feeding management). 
• Further information about the work of the Nutrition Care Process Clinical Project group is available here.

Inactivation and replacement of neoplastic morphology concepts containing ICD-O-3 classification terming

Some ICD-O version 3 morphology classification codes include Not Otherwise Specified (NOS), these concepts are not acceptable in SNOMED CT as per Editorial Guidance and are not meaningful outside of the ICD-O classification context.

In the current 400177003 |Neoplasm and/or hamartoma (morphologic abnormality)| sub-hierarchy there are approximately 75 neoplastic morphology concepts containing  the terming "no International Classification of Diseases for Oncology subtype (morphologic abnormality)" and/or "no ICD-O subtype" originating from ICD-O-3 and they are utilized in the modeling of about 460 disorders in the 55342001 |Neoplastic disease (disorder)| hierarchy.

• The concepts "no International Classification of Diseases for Oncology subtype (morphologic abnormality)" and/or "no ICD-O subtype" will be inactivated with reason Outdated (pending the development of a specific inactivation reason for classification schema entities) and replaced with either a new concept or an existing suitable target concept. This work will be carried out in liaison with the Cancer Synoptic Reporting Clinical Project Group.
  • For example:18365006 |Adrenal cortical adenoma, no International Classification of Diseases for Oncology subtype (morphologic abnormality)| has been inactivated and replaced with 1156661006 |Adrenal cortical adenoma (morphologic abnormality)|. 
• Review and remodel of the neoplasm disorder concepts that utilize these morphologies. 
• Identify those neoplastic morphologic abnormalities in SNOMED CT which have non-synonymous descriptions originating from ICD-O-3. Inactivate these descriptions as non-semantically equivalent and recreate them as new subtype or sibling concept including remodel of relevant disorder concepts. 

Cancer Synoptic Reporting

Concepts representing cancer synoptic reporting content will be added to the International release starting with the July 2021 release. 

Cancer synoptic reports are used by many member countries to record pathology examination of cancer specimens including the College of American Pathologists (US and Canada), Royal College of Pathology (UK), Royal College of Pathology Australasia (Australia, New Zealand), PALGA (The Netherlands), Swedish Society of Pathology, and others.

This content primarily encompasses observable entity concepts and also includes supporting concepts from other hierarchies, e.g. property values.

Planned areas of promotion for the January 2022 release include margins, focality, depth, locations, immunohistochemistry and hematopoietic tumors. Additional promotion of content is planned for subsequent International releases.

For more information about this project, please see the Cancer Synoptic Reporting Clinical Project Group here

Disorder X without Disorder Y

The vast majority of existing X without Y concepts originated from ICD-9 with the specific meaning of "X disorder without mention of Y disorder".  As the phraseology indicates a lack of data about disorder Y as opposed to a specific exclusion, this type of concept has not been included in ICD-10, nor proposed for ICD-11, except in the case of "Traumatic brain injury without open intracranial wound".  

Addition of new X without Y concepts may only be made under the following conditions:

1. The request for new content must be accompanied by a rationale as to the difference between "X disorder without Y disorder" and "X disorder."
2. Approval for addition is given by the Head of Terminology.

For the most part, existing X without Y concepts will be inactivated as AMBIGUOUS with a historical MAY BE relationship to "X disorder".  Exceptions to inactivation will be made on a case-by-case basis.

Content Improvements in the Substance and Product Hierarchies

Please see briefing notes here Drugs Project 

Content Improvements in the Physical Object Hierarchy

Please see project roadmap and briefing notes here: https://confluence.ihtsdotools.org/display/IAP/Devices+Project

WAS_A

Inactivation reason of LIMITED/WAS_A is not allowed for any new content inactivations after the July 2018 release. The WAS_A association refset has not been updated thereafter.

At the Editorial Advisory Group meeting in April 2019, agreement was reached to discontinue the maintenance of WAS_A relationships when inactivating concepts that have a historical association to an inactive concept. When changes are made to a historical relationship for a concept that was previously inactivated using WAS_A, effort will be made to assign a new historical relationship that facilitates traceability of the concept (e.g. DUPLICATE or AMBIGUOUS) as opposed to NON-CONFORMANCE TO EDITORIAL POLICY.

Existing WAS_A relationships will be inactivated in a future release once a plan for batch reassignment of historical relationships has been developed. Until then, SNOMED International will not continue to use or maintain WAS_A relationships.