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| Items | Hierarchy/Topic | EARLY VISIBILITY OF PROPOSED CONTENT CHANGES | Planned Release timing (*this is provisional only and is subject to change) |
|---|---|---|---|
| 1. | Release Schedule | Proposal to Move the International Monthly Release Date to the First of Each MonthAfter initial consultation with the community, SNOMED International are proposing to change the dates of the International Edition from the end of each month, to the first of each month. This would mean that in addition to all of the other months, the “January” release would move from 31st January to the 1st January, and the “July” release would move from 31st July to 1st July each year. Further details of this proposal are to follow, however if you have any concerns in the meantime please provide feedback to release@snomed.org as soon as possible. | Q3 2023 |
| 2. | Body Structure | Inactivation of 9258009|Gravid uterus structure (body structure)| This concept will be inactivated, content that is modeled with this concept will be remodeled with a site of 35039007|Uterine structure (body structure)| along with occurrence <<307159006|Pregnancy time period (qualifier value)|. The domain of 246454002 |Occurrence (attribute)| will be extended to include << 71388002 |Procedure (procedure)| to support these content changes. Content areas that will be updated include 386811000|Fetal procedure (procedure)| and 386637004|Obstetric procedure (procedure)|. | Q2/Q3 2023 International Release |
| 3. | Clinical Finding | 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 |
| 4. | Clinical Finding | Update for Concepts Using 'Caused by' Clinical finding concepts containing "Caused by" in their FSN will be reviewed and will be updated (if applicable) according to the editorial guidelines related to causation here. The main focus of the review will be the following category of concepts:
Additional content update may become applicable while reviewing these concepts for example:
| Q3 2023 International Release |
| 6. | Product | 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 |
| 7. | Product | Drug Content Analysis Project (DCAP) - Addition of Anti-Infective Clinical Drug Concepts DCAP was launched in September 2022 to identify clinical drug concepts that are published in participating National Release Center extensions and that are eligible for promotion to the international release (supported by appropriate references to authoritative source material). Concepts that are already published in the Norwegian drug extension have been reviewed by multiple countries participating in the group and content eligible for promotion to the international release of SNOMED CT has been identified. Approximately 100 concepts will be promoted to the international release and corresponding concepts for Medicinal Product (MP) 'containing only', and Medicinal Product Form (MPF) 'containing only' imported from Norway if missing. MP 'containing' concepts will be created in the international release as required. | Q2 2023 International Release |
| 8. | Qualifier Value | Addition of AJCC Cancer Staging Content New subtypes of 1222584008 |American Joint Committee on Cancer allowable value (qualifier value)| Based on requests from several member countries through the Content Managers Advisory Group, AJCC have now approved addition to SNOMED CT of new cancer staging content as part of a joint collaborative process agreed between both organizations. | Q2/Q3 2023 International Release |
| 9. | Procedure | Dental "Fit X" concept updates Dental procedure concepts in the format "Fit X” e.g. 234856007 |Fit removable orthodontic retainer (procedure)| will be inactivated with reason “ambiguous". This change has been agreed by the Dentistry CRG and will affect approximately 50 concepts. This work is part of Content Tracker IHTSDO-122 | Q2/Q3 2023 International Release |
| 10. | Procedure | Inactivation of Concepts of the Type “Administration of substance via X specific route (procedure)” Concepts of the type “Administration of substance via X specific route (procedure)” will be replaced with concepts of type “Administration via X specific route (procedure)”. This change is part of the Substance-Drug project and will allow for the unambiguous subsumption of the subtypes, if and once instances of 363701004 |Direct substance (attribute)|are modeled with subtypes of 373873005 |Pharmaceutical / biologic product (product)|. The only remaining concept of this type will be the parent concept, 433590000 - Administration of substance via specific route (procedure). The change for this concept is is pending required MRCM changes, and will be applied once the required MRCM change is complete. | June 2023 International Release |
| 11. | Procedure | Remodel for Heart Valve Replacement Procedure Concepts Heart valve replacement concepts will be remodeled as a surgical replacement procedure. Distinction will be made between replacement of native valves and implanted prosthetic valves. Updates for concepts with a prosthetic valve will include both mechanical and biological valves. Surgical REMOVAL and REPLACEMENT may not occur at the same point in time so a surgical replacement procedure may not subsume under surgical REMOVAL. These surgical methods are at the same level within the hierarchy. | Q2/Q3 2023 International Release |
| 12. | Content Improvement | Updates to the Inactivation Reason and Historical Association for 'On Examination' and 'Complaining of' Inactive Content Many of the 'on examination' and 'complaining of' concepts were previously inactivated with the inactivation reason of |Moved elsewhere| with a historical association value |Extension Namespace 1000000|. This content will be updated with an inactivation reason of |Non-conformance to editorial policy| and a historical association of |Alternative| to a suitable international concept. | Q3 2023 International Release |
| 13. | MRCM | Update to MRCM Extend the domain of 246454002 |Occurrence (attribute)| by including << 71388002 |Procedure (procedure)|. The following is the expected MRCM range after the change. 246454002 |Occurrence (attribute)| << 272379006 |Event (event)| OR << 404684003 |Clinical finding (finding)| OR << 71388002 |Procedure (procedure)| | Q2/Q3 2023 International Release |
| 14. | MRCM | Update to MRCM The domain and proximal primitive refinement will be updated to the MRCM of situations of findings and procedures. The existing exclusion constraints for domains will be removed. The "associated finding" and "associated procedure" will be added as mandate requirements, and the contexts will be removed. Further details are available | June 2023 International Release |
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Project Information and Work in Progress
Item | Hierarchy/Topic | INFORMATION ABOUT PROJECTS AND WORK IN PROGRESS | Planned Release timing (*this is provisional only and is subject to change) |
|---|---|---|---|
| 1. | General Information | Browse Content Changes for the International Release For content changes that are ready for publication in the next release please browse here Concept Inactivation For concept inactivations that are for publication in the next release please browse here MRCM Changes Forthcoming MRCM changes can be viewed here Quality Initiative Information about the project can found here Content Request Service (CRS) Please see Guidance for Requesting Changes to SNOMED CT Further information about CRS is available here. Content Development Information can be accessed here. | |
| 2. | Project Information | 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. For more information about this project, please see the Cancer Synoptic Reporting Clinical Project Group here | 2023 International Release and future releases |
| 3. | Project Information | Epilepsy Content ILAE Collaboration 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. Please refer to the project status report for further information. | 2023 International Release and future releases Expected completion by mid 2024 |
| 4. | Project Information | Nutrition Content Information about the work of the Nutrition Care Process Clinical Project group is available here. | 2023 International Release and future releases |
| 5. | Project Information | Content Improvements in the Substance and Product Hierarchies Please see briefing notes here Drugs Project | 2023 International Release and future releases |
| 6. | Content Improvement | 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 | 2023 International Release and future releases |
| 7. | Content Improvement | 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. | Q2 2023 International Release |
| 8. | Content Improvement | 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 |
| 9. | Content Improvement | 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 | 2023 International Release and future releases |
| 10. | Content Improvement | 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. | 2023 International Release and future releases |
| 11. | Content Improvement | 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. | 2023 International Release and future releases |