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| Items | Proposed improvement | Planned Release timing (*this is provisional only and is subject to change) | Confirmed Release Date | |||
|---|---|---|---|---|---|---|
| 1 | COVID-19 Content Content relating to COVID-19 can be viewed here SNOMED CT COVID-19 Related Content | 2022 International Release and future releases | 2 | Browse Content Changes for the International Release The daily build is available to review changes made to content for the International release https://dailybuild.ihtsdotools.org/ Forthcoming concept inactivations, new concepts and changes to existing concepts can be reviewed using the tab 'Daily build.' MRCM changes that have been implemented into the production environment and will be published in the next monthly release cycle (subject to completion of final release validation processes) can be viewed here https://dailybuild.ihtsdotools.org/mrcm/?branch=MAIN | ||
| 3 | Changes to Concept Inactivation Values Please see new editorial guidance for changes to inactivation values here | 2022 International Release | April 2022 | |||
| 2 | 4 | 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 | 2022 2023 International Release and future releases | 5 | MRCM Changes for July 2022 Release Details for forthcoming changes can be seen here | July 2022 |
| 6 | MRCM Cardinality Changes for July 2022 Release All historical content issues where two or more finding sites were included in a single role group have been resolved in the International release as part of the QI project. There are two MRCM rules for finding site to accommodate the historical content. One MRCM is applicable to all content, it allows more than one finding site in a role group. The other MRCM is only applicable for 'All new precoordinated SNOMED CT content'. The existing MRCM rules will be updated to only allow at most one finding site in a role group from the July 2022 release. This early visibility notice is intended to provide additional time for content updates in national extensions. | July 2022 International Release | July 2022 | |||
| 7 | MRCM Change for September 2022 Release Extend the range 370135005 |Pathological process (attribute)| to include < < 1495041000004108 |Proliferation of neoplasm (qualifier value)| | September 2022 International Release | September 2022 | 8 | Quality Initiative Information about the project can found here 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 | 2022 International Release and future releases | 9 | Measurement Findings 1) Concepts which include 'high,' 'elevated,' 'raised,' 'low,' 'decreased,' normal,' etc. in the FSN will have their FSN updated to 'above reference range,' 'below reference range,' or 'within reference range.' See the briefing note "20221103 BN Reference range measurement findings.pdf" (https://confluence.ihtsdotools.org/x/5OB4C) for more information. These changes are planned for the December 2022 release. Additional changes to measurement findings concepts will occur over several releases. Upcoming changes for each future release will be posted here as the work progresses. | December 2022 International Release | 10 | Planned Changes to Findings/Disorders of Gravid Uterus The scope of changes to findings/disorders (over 100 concepts) modelled by the gravid uterus. These concepts can be identified by the ECL << 404684003 |Clinical finding (finding)| : * = (9258009 |Gravid uterus structure (body structure)| or 362253003 |Entire gravid uterus (body structure)|) These concepts will be remodeled by using finding site of |Uterine structure| and occurrence in |Maternal pregnancy period (qualifier value)| or more specific |Maternal antepartum period|. The updated model pattern will address the missing subsumptions of conditions modeled by parts of the uterus during pregnancy. | Q4 2022 International Release |
| 11 | Update Hierarchy 17322007 |Disease caused by parasite (disorder)| 370135005 |Pathological process (attribute)| with value 442614005 |Parasitic process (qualifier value) will be added where it is missing to descendants of 17322007 |Disease caused by parasite (disorder)| and any relevant clinical findings concepts. | November 2022 International Release | November 2022 | 12 | Update Hierarchy 90708001 |Kidney disease (disorder)| As part of the Quality Initiative Project, work has commenced on 90708001 |Kidney disease (disorder)|. Work is being undertaken in stages and upcoming sub-hierarchies will be posted here as the work progresses:
| Q4 2022 International Release and future releases |
| 13 | Update for 363101005 |Drug withdrawal (disorder)| Review of the modeling and terming of 363101005 |Drug withdrawal (disorder)| and child concepts to reflect the associated meaning. See the briefing note submitted to the Member Forum for details. | October 2022 International Release | October 2022 | |||
| 14 | Description Update for 191816009 |Drug dependence (disorder)| and Associated Concepts The terming for concepts including "drug dependence" will be updated to reflect "substance dependence": the word “drug” in the existing terms is ambiguous and does not have a universal definition or a consistent international representation; it can refer to illicit drugs and/or prescription medications. Additionally, dependence can occur with the use of substances such as ethanol, which are not considered an illicit drug or a prescription medication. | October 2022 International Release | October 2022 | |||
| 15 | Poisoning Caused by Organism As part of the Quality Initiative project, the modelling for concepts of type poisoning caused by organism, including the following sub-hierarchies, will be reviewed and updated where applicable:
| October 2022 International Release | October 2022 | 16 | Update for Inactive Concepts Without Semantic Tag Remaining cases of the legacy issue inactive concepts with active FSN without a semantic tag (Content Tracker IHTSDO-645) will be addressed to assign a semantic tag. The number of inactive concepts requiring this update is 351. | Q4 2022 International Release and future releases | 17 | Review of Clinical Finding Hierarchy Epilepsy Content Review of << 313287004 |Seizure related finding (finding)| and << 84757009 |Epilepsy (disorder)| (excluding Orphanet related content) for currency and clinical correctness with the addition of missing clinically relevant content. Work is being undertaken in stages. Initial and current focus is on epileptic seizure finding content. | 2022 International Release and future releases expected completion by mid 2024 |
| 18 | Inactivation of "X of person (person)" concepts Based on a consensus decision by the SNOMED International Editorial Advisory Group, concepts of the form "X of subject (person)" will be inactivated and concepts using these as the value for SUBJECT RELATIONSHIP CONTEXT relationships will be replaced by analogous "X (person)" concepts. | August 2022 International Release | August 2022 | |||
| 19 | Legal/Illegal Abortion Concept Inactivation As approved by the SNOMED Editorial Advisory Group, concepts referring to "legal" and "illegal" termination of pregnancy (abortion) will be inactivated from the international release with reason non-conformance to editorial policy and replaced by concepts agnostic as to the legality of the procedure. | May 2022 International Release | May 2022 | |||
| 20 | Inactivation of 116223007|Complication (disorder)| After consultation with the SNOMED Editorial Advisory Group, the ambiguous primitive concept 116223007 |Complication (disorder)| has been inactivated. Subtypes of this concept continue to classify under their other existing inferred parents except for a few high level grouper concepts that now classify directly under 64572001 |Disease (disorder)|. | 2022 International Release | March 2022 | |||
| 21 | Inactivation and Replacement of 76981001|Discogram (procedure)| and Subtypes 76981001|Discogram (procedure)| and subtypes will be inactivated and replaced with concepts that explicitly state the use of contrast and injection into the intervertebral disc. The replacement concepts will follow the pattern 'Discography with injection of contrast into intervertebral disc'. | Q3 2022 International Release | September 2022 | 22 | Inactivation of Concepts that state Delivered/Not delivered Obstetric content that conflates the delivery status with the disorder of the mother that prompted the admission to hospital will be inactivated. There are 250 concepts that state the delivery status of the mother within the FSN:
These concepts are classification derived and are used to record whether the baby was, or was not delivered during that inpatient stay for the care of the mother who has placenta previa with a hemorrhage. | Q4 2022 International Release / Q1 2023 International Release |
| 23 | Inactivation of Walker Concepts Concepts 705404007 |Walker/Walking frame (physical object)| and 705406009 |Walker (physical object)| will be inactivated with reason ambiguous, as the term 'walker' is being used to represent both walking frames and wheeled walkers (rollators). A new concept Wheeled walker (physical object)| will be created with a text definition added to both that concept and also 266731002 |Walking frame (physical object)|. Concepts that were previously subtypes of 705406009 |Walker (physical object)| will be inactivated with an inactivation replacement value to a new explicit wheeled version of those concepts and where applicable a pre-existing subtype of 266731002 |Walking frame (physical object)| in addition. | November 2022 International Release | November 2022 | 24 | Inactivation of 108290001 |Radiation oncology AND/OR radiotherapy (procedure) 108290001 |Radiation oncology AND/OR radiotherapy (procedure)| will be inactivated and replaced via the reactivation of 61757002 |Radiation therapy (procedure)|. 61757002 |Radiation therapy (procedure)| will gain a synonym of radiotherapy. Related concepts will undergo structural quality improvement. | 2022 International Release | 25 | Q3 and Q4 2022 International Release |
| 26 | Primary and Metastatic Project - Inactivation of Neoplastic Morphologies Stated as 'Primary' in the FSN 86049000 |Malignant neoplasm, primary (morphologic abnormality)| is to be inactivated and replaced with a new concept 1240414004 |Malignant neoplasm (morphologic abnormality)|. Similarly, neoplastic morphologies with 'primary' in their FSN will be inactivated. 367651003 |Malignant neoplasm of primary, secondary, or uncertain origin (morphologic abnormality)| 1187469002 |Squamous cell carcinoma of primary, secondary, or uncertain origin (morphologic abnormality)| 86049000 |Malignant neoplasm, primary (morphologic abnormality)| 450594004 |Primary malignant adenomatous neoplasm (morphologic abnormality)| 252988009 |Malignant squamous tumor, primary (morphologic abnormality)| 400156001 |Malignant blood vessel neoplasm, primary (morphologic abnormality)| 719952009 |Primary sarcoma (morphologic abnormality)| 734095001 |Primary solid type intraosseous squamous cell carcinoma (morphologic abnormality)| 733913003 |Primary intraosseous squamous cell carcinoma derived from keratocystic odontogenic neoplasm (morphologic abnormality)| 278411006 |Primary intra-osseous carcinoma (morphologic abnormality)| 733912008 |Primary intraosseous squamous cell carcinoma derived from odontogenic cyst (morphologic abnormality)| 720346009 |Primary seminoma (morphologic abnormality)| 133850008 |Primary synovial chondromatosis (morphologic abnormality)| These inactivations will impact around 2,400 concepts in the disorder hierarchy, and approximately 1200 observable entity concepts (2,000 disorders will be impacted following inactivation of 86049000 |Malignant neoplasm, primary (morphologic abnormality)|) and all concepts will be restructured as outlined in the circulated Briefing Notes. The reason for inactivation is Nonconformance to Editorial Policy, and the replacement inactivation target for 86049000 |Malignant neoplasm, primary (morphologic abnormality)| and 367651003 |Malignant neoplasm of primary, secondary, or uncertain origin (morphologic abnormality)| will be new concept 1240414004 |Malignant neoplasm (morphologic abnormality)|. There may be some inconsistencies as this large project develops, including certain adenocarcinoma disorders that are modeled with 1186968006 |Malignant adenomatous neoplasm (morphologic abnormality)| in order to ensure that there is no change to the hierarchical subsumption and the assignment of subtypes by the classifier. As the project develops, and in particular the pathology group give their expert input to update the neoplastic morphologies in SNOMED CT, these inconsistencies will be addressed. | November 2022 International Release | November 2022 | 27 | Quality Initiative: Inactivation of Disjunctive Concepts in 363346000 |Malignant neoplastic disease (disorder)| HierarchyNovember 2022 International Release | November 2022 | 28 | Primary and Metastatic Project - Addition of 415 New Primary Malignancy Disorder Subtypes "Agnostic” malignancy disorders (i.e. not specified as primary or metastatic) that can not be correctly modeled using the current “agnostic” morphologic abnormalities that are subtypes of 86049000 |Malignant neoplasm, primary (morphologic abnormality)|, precisely because they are subtypes of a primary malignant neoplasm morphology parent will be made subtypes of a non-primary parent following the inactivations flagged above. The majority of the changes will be by inactivation of 86049000 |Malignant neoplasm, primary (morphologic abnormality)| and replacement with Malignant neoplasm (morphologic abnormality) with 'primary' being defined in disorders and observable entities by 370135005 |Pathological process (attribute)| (704321009|Characterizes (attribute)| for observable entities) and target value 1234914003 |Malignant proliferation of primary neoplasm (qualifier value)|. Approximately 415 current agnostic malignancy disorders inferring a primary designation through their hierarchy parent, will have a new primary malignancy concept added as a subtype that will be available for use in implementations as a subtype of 372087000 |Primary malignant neoplasm (disorder)|. | December 2022 International Release | 29 | Primary and Metastatic Project - New Metastatic Morphologic Abnormality Concepts Metastatic disorders will be defined by their specific metastatic neoplastic morphologic abnormality concepts, and new metastatic morphologies are being added to the international edition of SNOMED CT as needed. In cooperation with the Netherlands extension of SNOMED CT, SNOMED International will be promoting certain of their existing metastatic morphology concepts to the International release to be used to model new metastatic disorder concepts. | Ongoing monthly commencing January 2023 International Release |
| 30 | Primary and Metastatic Project - Inactivation of Metastatic Disorder Content 7 concepts termed ‘Malignant tumor involving an organ by separate metastasis from X’ and 20 concepts termed ‘Metastasis from malignant neoplasm of X’ are to be inactivated. Metastasis ‘involving an organ’ and metastasis concepts that are unspecified as to site of the metastatic neoplasm are not clinically useful as in most cases there will already be a record of the site of the primary malignant tumor and the actual site of the metastasis will also be recorded as a separate concept. Going forward, metastatic malignant neoplasm ‘to X site’ and ‘from X site’ will not be precoordinated in one concept but recorded separately as 2 concepts. | September 2022 International Release | September 2022 | |||
| 31 | Primary and Metastatic Project - Descriptions update for 128462008 |Secondary malignant neoplastic disease (disorder)| Hierarchy For consistency of descriptions, 128462008 |Secondary malignant neoplastic disease (disorder)| and its subtypes will have their Fully Specified Name and Preferred Term with 'secondary' changed to 'metastatic' retaining the 'secondary' description as a synonym. The descriptions with 'secondary' will be inactivated and not the concept. Editorial Guidance will be provided. | July 2022 International Release | July 2022 | |||
| 32 | Inactivation of 365753005 |Finding of presence of drug (finding)| 365753005 |Finding of presence of drug (finding)| will be inactivated and replaced with an appropriate concept that includes “substance” in the FSN due to a mismatch between this concept's FSN and logical definition. In addition, “drug” does not have a universal definition or a consistent international representation. | 2022 International Release | March 2022 | |||
| 33 | Description Updates Haemophilus influenzae types “a” to “f" Terming for descriptions containing Haemophilus influenzae types “a” to “f” are being updated such that concepts in other hierarchies are consistent with the terming of associated concepts in the Organism hierarchy, which is the source of truth as specified in the general naming guidelines. | July 2022 International Release | July 2022 | 34 | Drug Measurement Findings Measurement finding concepts that include the term "drug" in the FSN are being reviewed and considered for inactivation in future releases. | 2022 International Release |
| 35 | Inactivation of Metadata Concepts The following metadata concepts will be inactivated for the July 2022 Release:
| July 2022 International Release | July 2022 | |||
| 36 | Inactivation of subtypes of 717234006 |Allergy to animal protein (finding) Following the Briefing Note submitted to the MF in March 2022, current subtypes of the “717234006 |Allergy to animal protein (finding)|” sub-hierarchy that represent allergy to "animal part" are being considered for inactivation and will be replaced by concepts representing “Allergy to X animal protein”. | 2022 International Release | April 2022 | 37 | Inactivation of "X by body site" concepts in various hierarchies Concepts that include "X by body site" in multiple hierarchies are being inactivated, e.g., 371571005 |Imaging by body site (procedure)| and 301810000 |Infection by site (disorder)|, because they are classification groupers with no clinical use. | 2022 International Release and future releases |
| 38 | Dupuytren Content Changes The Dupuytren content will be remodeled. The following concepts will be inactivated for the September 2022 Release:
| September 2022 International Release | September 2022 | |||
| 39 | Remodeling of 74799003 |Flap graft (procedure)| hierarchy and 256683004 |Flap (substance)| hierarchy QI work has commenced on the area of flap procedures, previously placed under 74799003 Flap graft (procedure), which has been inactivated and replaced with 1202017008 |Surgical procedure using flap (procedure)|. The work is still ongoing, and a new model has been developed and remodeling is now in process. Work has commenced on improvements to the sub-hierarchy of 256683004 |Flap (substance)| (including planned inactivations). The redesign involves adding new qualifier values as subtypes of 360032005 |Flap reconstruction - action (qualifier value)|. For the April 2022 release there are continuing updates to the sub-hierarchy of 256683004 |Flap (substance)| (including planned inactivations to address the conflation of body structure and flap substance). The redesign will involve remodeling qualifier values as subtypes of 360032005 |Flap reconstruction - action (qualifier value)|. Editorial Guidance has been drafted ready for publication. | 2022 International Release | April 2022 | |||
| 40 | Remodeling of Descendants of 1202017008 |Surgical procedure using flap (procedure)| As part of the Quality Initiative project to improve the 1202017008 |Surgical procedure using flap (procedure)| subhierarchy, a new more comprehensive template is under development, and as a result approximately 50 complex flap procedures have subsequently newly been included in the QI project and will be remodeled for the June 2022 release. | June 2022 International Release | June 2022 | 41 | Change for Clinical Drug Concepts Containing Pancreatic Enzymes Clinical drug concepts in the International Release containing pancreatic enzymes will be modeled based on the discrete enzymes; because of variability between real clinical drugs, synonyms representing a total amount in a particular product will not be included in the International Release. The editorial guide and existing content will be reviewed and updated accordingly in a future release. | 2022 International Release and future releases |
| 42 | Administrative Concept Inactivations Seven situation hierarchy concepts are being inactivated due to the lack of unambiguous meaning and reproducible use case among healthcare systems:
| 2022 International Release | April 2022 | 43 | Planned Inactivation of Concepts in the 260299005 |Number (qualifier value)| Hierarchy Following the deployment of the concrete domain functionality in SNOMED CT, concepts in the 260299005 |Number (qualifier value)| hierarchy are no longer necessary and plans have been made for their inactivation. To provide adequate time for any national extension or implementation affected by this change, concepts in the 260299005 |Number (qualifier value)| hierarchy will be inactivated in the January 2023 International Release. Concepts will be inactivated with reason “Non-conformance to editorial policy” and no historical relationship or replacement concept will be provided. Exceptions: 118586006 |Ratio (property) (qualifier value)| and descendants have been relocated to 118598001 |Property (qualifier value)| hierarchy. 272070003 |Ordinal number (qualifier value)| and descendants have been relocated to 362981000 |Qualifier value (qualifier value)| hierarchy. A briefing note will also be distributed to selected Advisory and Project Groups. Please contact info@snomed.org with any inquiries. | January 2023 International Release | 44 | Nutrition Content Information about the work of the Nutrition Care Process Clinical Project group is available here. | 2022 International Release | 45 | Cancer Synoptic Reporting - Project Information 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 2023 release include observable entity concepts for genomics, molecular pathology, immunohistochemistry, treatment effect and intactness/quality of specimen. For more information about this project, please see the Cancer Synoptic Reporting Clinical Project Group here | 2022 International Release and future releases |
| 3 | Quality Initiative Information about the project can found here 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 | 2023 International Release and future releases | ||||
| 4 | Measurement Findings Additional changes to measurement findings concepts will occur over several releases. Upcoming changes for each future release will be posted here as the work progresses. | 2023 International Release and future releases | ||||
| 5 | Update Hierarchy 90708001 |Kidney disease (disorder)| As part of the Quality Initiative Project, work has commenced on 90708001 |Kidney disease (disorder)|. Work is being undertaken in stages and upcoming sub-hierarchies will be posted here as the work progresses:
| 2023 International Release and future releases | ||||
| 6 | Update for Inactive Concepts Without Semantic Tag Remaining cases of the legacy issue inactive concepts with active FSN without a semantic tag (Content Tracker IHTSDO-645) will be addressed to assign a semantic tag. The number of inactive concepts requiring this update is 351. | 2023 International Release and future releases | ||||
| 7 | Review of Clinical Finding Hierarchy Epilepsy Content Review of << 313287004 |Seizure related finding (finding)| and << 84757009 |Epilepsy (disorder)| (excluding Orphanet related content) for currency and clinical correctness with the addition of missing clinically relevant content. Work is being undertaken in stages. Initial and current focus is on epileptic seizure finding content. | 2023 International Release and future releases Expected completion by mid 2024 | ||||
| 8 | Inactivation of Concepts that state Delivered/Not delivered Obstetric content that conflates the delivery status with the disorder of the mother that prompted the admission to hospital will be inactivated. There are 250 concepts that state the delivery status of the mother within the FSN:
These concepts are classification derived and are used to record whether the baby was, or was not delivered during that inpatient stay for the care of the mother who has placenta previa with a hemorrhage. | Q1 2023 International Release | ||||
| 9 | Primary and Metastatic Project - New Metastatic Morphologic Abnormality Concepts Metastatic disorders will be defined by their specific metastatic neoplastic morphologic abnormality concepts, and new metastatic morphologies are being added to the international edition of SNOMED CT as needed. In cooperation with the Netherlands extension of SNOMED CT, SNOMED International will be promoting certain of their existing metastatic morphology concepts to the International release to be used to model new metastatic disorder concepts. | Ongoing monthly commencing January 2023 International Release | ||||
| 10 | Inactivation of "X by body site" concepts in various hierarchies Concepts that include "X by body site" in multiple hierarchies are being inactivated, e.g., 371571005 |Imaging by body site (procedure)| and 301810000 |Infection by site (disorder)|, because they are classification groupers with no clinical use. | 2023 International Release and future releases | ||||
| 11 | Change for Clinical Drug Concepts Containing Pancreatic Enzymes Clinical drug concepts in the International Release containing pancreatic enzymes will be modeled based on the discrete enzymes; because of variability between real clinical drugs, synonyms representing a total amount in a particular product will not be included in the International Release. The editorial guide and existing content will be reviewed and updated accordingly in a future release. | 2023 International Release and future releases | ||||
| 12 | Nutrition Content Information about the work of the Nutrition Care Process Clinical Project group is available here. | 2023 International Release and future releases | ||||
| 13 | Cancer Synoptic Reporting - Project Information 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. For more information about this project, please see the Cancer Synoptic Reporting Clinical Project Group here | 2023 International Release and future releases | ||||
| 14 | 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:
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. | 2023 International Release and future releases | ||||
| 15 | Content Improvements in the Substance and Product Hierarchies Please see briefing notes here Drugs Project | 2023 International Release and future releases | ||||
| 16 | ||||||
| 46 | Cancer Synoptic Reporting - Protein Substances Around 40 new protein concepts will be added to the substance hierarchy which are needed to model the immunohistochemistry neoplasm observables. In addition, around 10-15 existing protein substance concepts will be remodeled to align their terming with the authoritative source for protein nomenclature and to assign parents and other relationships based on the current guidelines for the substance hierarchy. Guidelines for protein substance concepts will be incorporated into the Editorial Guide following completion of this work. These substance concepts will be added starting with the May 2022 release and may continue for the June and/or July 2022 releases. | Q2 - Q3 2022 International Release | July 2022 | 47 | 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:
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. | 2022 International Release and future releases | 48 | Content Improvements in the Substance and Product Hierarchies Please see briefing notes here Drugs Project | 2022 International Release and future releases |
| 49 | Inactivation of 360215002 |Pharmaceutical excipient (substance)| Hierarchy The 360215002 |Pharmaceutical excipient (substance)| hierarchy will be inactivated with descendant grouper concepts (e.g. 418403001 |Drug preservative (substance)|, 412307009 |Drug vehicle (substance)|) being inactivated as duplicates of existing or new concepts in the 43747001 |Drug excipient (product)| hierarchy. Concepts representing discrete substances will remain in the Substance hierarchy. One concept, 438784000 |Adverse reaction caused by pharmaceutical excipient (disorder)|, will be remodeled using the corresponding product concept, with classification results consistent with the pattern for vaccine products. | September 2022 International Release | September 2022 | |||
| 50 | Change for Groupers in Substance Hierarchy - Analyte Groupers in the Substance hierarchy that refer to analyte (e.g. 259988005 |Transplantation analyte (substance)|, 312273006 |Microbiology analyte (substance)|) will be inactivated with reason Meaning unknown; no potential replacement concept will be provided. | July 2022 International Release | July 2022 | |||
| 51 | Addition of New Grouper Concepts in the Pharmaceutical Dose Form and Medicinal Product hierarchies As per the Briefing Note titled Editorial Guideline and Content Changes for Concepts Referring to “Infusion” or “Injection”, new grouper concepts for “infusion and/or injection” will be added to the Pharmaceutical Dose Form and Medicinal Product hierarchies beginning in the 2022-April Release. (The Briefing Note is located on the Drug Project space https://confluence.ihtsdotools.org/display/IAP/Drugs+Project). | May 2022 International Release | May 2022 | |||
| 52 | Dose Form-Related Changes - June 2022 Release
| June 2022 International Release | June 2022 | |||
| 53 | Dose Form-Related Changes - July 2022 Release
| July 2022 International Release | July 2022 | |||
| 54 | Inactivation of Poisoning by medicinal product role groupers Following the Briefing Note submitted to the MF and the CMAG in August 2021, and based on the members’ feedback, the poisoning concepts that are defined by a causative agent that is of type “medicinal product role” or “Medicinal product role + structure” that are not in use will be inactivated. | 2022 International Release | March 2022 | |||
| 55 | Planned changes to 'Co-occurrent and due to' pattern During the implementation of the new Description Logic features a conflict was uncovered between the modeling of 'Co-occurrent and due to' and General Concept Inclusions (GCIs). This has resulted in the need to reconsider the modeling of "Co-occurrent and due' and update the Editorial Guide for this area. The plan is to update the Editorial Guide and all concepts that are currently modeled as 'Co-occurrent and due to' starting from the July 2019 release. | 2022 International 2023 International Release and future releases | ||||
| 5617 | 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. | 2022 International 2023 International Release and future releases | ||||
| 5718 | Planned changes to Implantation and Insertion procedures Work commenced on content tracker IHTSDO-175. Ongoing structural changes for the Procedure concepts related to the content tracker, more information is available here | 2022 International 2023 International Release and future releases | ||||
| 5819 | Inactivation of 6920004|Defect (morphologic abnormality)| 6920004|Defect (morphologic abnormality)|is planned for inactivation. 286 concepts currently modelled with 6920004|Defect (morphologic abnormality)| will be reviewed and remodelled; this may include inactivation and replacement. Please see the briefing note submitted to the Member Forum for further details. | Q1 2023 International Release | ||||
| 5920 | Inactivation of 118222006 |General finding of observation of patient (finding)| 118222006 |General finding of observation of patient (finding)| is a high level finding with little clinical value. The concept will be inactivated with an inactivation target of Clinical finding. Descendants count is 4237 concepts. | February 2023 International Release | ||||
| 6021 | Update for 399248000 |Procedure related to anesthesia and sedation (procedure)| 26402001 Nerve block anesthesia (procedure) and its 211 descendants along with 745638006 |Injection of anesthetic agent (procedure)| and its 283 descendants will acquire the proximal primitive parent of 399248000 |Procedure related to anesthesia and sedation (procedure)|. | January 2023 International Release |
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