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 for further details.

2.

Remodeling of 771527003|Structure of synovial sac (body structure)| and Subtypes

The content in this area is being updated to align with this model.

3.

Neoplasm of Connective and Soft Tissue Disorders

Around 30 concepts which include “neoplasm of connective and soft tissue" in their FSN will be inactivated as "Classification derived component." 

Measurement Findings

The next set of changes for measurement findings content will involve the positive and negative results content (~150 concepts). Measurement findings concepts which include 'positive' or 'negative' in the FSN will be updated as follows:

1) The FSN and PT will be updated to include 'detected' or 'not detected.' Existing descriptions with 'positive' or 'negative' will be retained as synonyms.
2) The Has interpretation value of 10828004 |Positive (qualifier value)| or 260385009 |Negative (qualifier value)| will be updated to 260373001 |Detected (qualifier value)| or 260415000 |Not detected (qualifier value)|.

Please see the briefing note (20221116 BN Positive_Negative measurement findings.pdf) for more information.

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:

• 236423003 |Renal impairment (disorder)| -  In progress

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. 

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. 

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.

9.

Update to 307159006|Pregnancy time period (qualifier value)| and Subtypes

Concepts referring to temporal periods for pregnancy and birth (307159006 Pregnancy time period (qualifier value) and subtypes) will be updated with the addition of a small number of concepts to make this area of content more comprehensive.

A new concept which explicitly covers 'maternal antenatal and/or intrapartum and/or postpartum period’ will be added.

Definitions will be added to aid modeling and interpretation.

Planned Inactivation of Subtypes of 129284003 |Surgical action (qualifier value)|

As part of the Quality Initiative, a review has been undertaken of the 129284003 |Surgical action (qualifier value)| hierarchy which has identified:

• 36 concepts with no usage or descendants.
• 4 concepts with 3 or less descendants and no usage.
• 5 concepts with low usage and less than 2 descendants with no usage.

As a result of this review, 45 concepts in the qualifier value hierarchy that are descendants of 129284003|Surgical action (qualifier value)| will be inactivated. The complete list of concepts can be accessed here.

Update to MRCM

Extend the range of 719722006 |Has realization (attribute)| by including 71388002 << |Procedure (procedure)|, << 272379006 |Event (event)|, << 404684003 |Clinical finding (finding)|.

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.

Concepts in various hierarchies (including Procedure, Clinical finding, Observable entity, Event and Specimen), which are defined by the stated attribute value of "105590001 |Substance (substance)|" are being reviewed.

Many of these concepts are being remodeled by removing the attribute/value relationship—provided that this change doesn’t result in a change to the meaning of the associated concepts. Some of these concepts may need to be remodeled with a more specific substance.

Some of the grouper concepts will be inactivated—specifically the groupers that are classification derived and/or have only one subtype. This change is part of the Substance-Drug project and will allow for the correct subsumption of the subtypes, if and once the attribute values are changed to subtypes of 373873005 |Pharmaceutical / biologic product (product)|.