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ItemsHierarchy/TopicEARLY VISIBILITY OF PROPOSED CONTENT CHANGES

Planned Release timing

(*this is provisional only and is subject to change)

1.Release Schedule

Plan to Move the International Monthly Release Date to the First of Each Month

After consultation with the community, SNOMED International will be changing the dates of the International Edition from the end of each month, to the first of each month.  This will mean that in addition to all of the other months, the “January” release will move from 31st January to the 1st January, and the “July” release will move from 31st July to 1st July each year.  

Further details of this proposal can be found here (https://www.snomed.org/news/blog%3A-the-snomed-ct-international-edition-to-be-published-on-first-day-of-each-month), however if you have any concerns in the meantime please provide feedback to release@snomed.org as soon as possible. 

1st September 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)|.

Q3/Q4 2023 International Release
3.Body Structure

Inactivation of Concepts Specified Male/Female in Descriptions

Subtypes of 67770001 |Male mammary gland structure (body structure)| and 91532001 |Female mammary gland structure (body structure)| and their associated disorder and specimen concepts.  Please see Briefing noteFurther information is available here (Confluence log in required).

Q4 2023 International Release
4.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:

  • 236423003 |Renal impairment (disorder)| -  In progress
2023 International Release and future releases
5.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:

  • Concepts containing "Caused by" in their FSN that have a synonym (including PT), which contains “Due to”
  • Concepts where FSN contains "Caused by" and "Due to"

Additional content update may become applicable while reviewing these concepts for example: 

  • Concepts that do not contain “Caused by” or “Due to” in their FSN, but contain one of these terms as their preferred terms
  • Concepts containing “Due “to in their FSN that have a preferred term which contains “Caused by”.
Q3/Q4 2023 International Release
6.Clinical Finding

"Did not attend X" or "Attended X" Clinical Finding Concepts

Around 30 "did not attend X" or "attended X" findings concepts, e.g., 390923003 |Did not attend cardiac clinic (finding)|, will be inactivated from the international release as they are administrative concepts.

Q3/Q4 International Release
7.Clinical Finding

Measurement Findings

The six false positive and false negative measurement findings, e.g., 274684006 |False-positive serological test for syphilis (finding)|, will be inactivated with reason of Nonconformance to editorial policy.

September 2023 International Release
8.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.

September 2023 International Release
9.Product

Clinical drugs modeled with dose form 421366001 |Tablet for conventional release oral suspension (dose form)|

The dose form 421366001 |Tablet for conventional release oral suspension (dose form)| will be updated with the new Preferred Term 'Dispersible oral tablet'. This aligns with the EDQM standard.

37 clinical drugs that are defined with a dose form of  421366001 |Tablet for conventional release oral suspension (dose form)|  will have a new Preferred Term created for 'dispersible oral tablet' and the existing PT made a synonym.

September 2023 International Release
10.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.

Q3/Q4 2023 International Release
11.Procedure

Update Hierarchy 363680008|Radiographic imaging Procedure (procedure)|and Descendants

It is proposed that the FSN and preferred term are updated to comply with a new template and also the modeling pattern for published concepts updated to align with the template.

The scope of the proposed work will be:

  1. Review the inconsistent descriptions of ‘Radiography of X’ , ‘X-ray of X’ , ‘Plain X-ray of X’ concepts that are subtypes of 363680008|Radiographic imaging procedure (procedure) in the procedure hierarchy.

  2. Update these descriptions without concept inactivation in order to align the representation of these concepts.

  3. Review the inconsistent modeling of concepts with descriptions ‘Radiography of X’, ‘X-ray of X’ , ‘Plain X-ray of X’ that are subtypes of 363680008|Radiographic imaging procedure (procedure).

  4. Create a template to implement a consistent modeling approach for these concepts in order to improve subsumption and remove duplication.

  5. Draft new editorial guidance for the addition of future content of this type.

A briefing note has been shared with the Editorial Advisory Group, Content Managers Advisory Group, Member Forum and Clinical Leads group (Confluence log in required to access link).

Please contact info@snomed.org with any feedback or questions about these changes.

Commencing Q4 2023 International Releases until completion.

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

1142142004 |Has pack size (attribute)|is an attribute that is used for modeling real clinical drugs in a national extension (not for use in the international edition of SNOMED CT). The current MRCM prevents national extensions from using a decimal to define a pack size (for example, a 3.5 milliliter bottle) as it limits the attribute range to whole integers only.

The MRCM will be changed for Has pack size (attribute)|from Integer to Decimal.

Q3 2023 International Release
15.Qualifier Value

Resolution of Dose Form Inconsistency for 421366001 | Tablet for conventional release oral suspension (dose form)

The Preferred Term (PT) of 421366001 | Tablet for conventional release oral suspension (dose form) | will be updated from “tablet for oral suspension” to “dispersible oral tablet.”

This is in line with EDQM (also national data sets) where a dispersible tablet is equivalent to a tablet for oral suspension.

The PT of 37 clinical drugs (CDs) that currently have a mixture of names will be updated to all use “dispersible oral tablet”. Therefore, users will be able to search for and translate these CDs more effectively.

Q3 2023 International Release
16.Observable Entity

Review of CRS Requests in “Awaiting agreement compliance” Status from SNOMED CT – LOINC Cooperation Project

CRS requests in “Awaiting agreement compliance” status due to the previous cooperative agreement between SNOMED International and Regenstrief Institute, Inc. have been reviewed in light of the new cooperative agreement, the latest SNOMED CT Editorial Guide, and the latest CRS guidance documents. Concepts deemed in scope are being added.

Q1-Q3 2023 International Release
17.Substance

New Subtypes of 1155866009 |Messenger ribonucleic acid of severe acute respiratory syndrome coronavirus 2 encoding spike protein (substance)|

New subtypes will be added to 1155866009 |Messenger ribonucleic acid of severe acute respiratory syndrome coronavirus 2 encoding spike protein (substance)| including:

  • "SARS-CoV-2 mRNA encoding B lineage spike protein" (i.e. "SARS-CoV-2 mRNA encoding original strain spike protein")
  • Severe acute respiratory syndrome coronavirus 2 mRNA encoding BA.1 lineage spike protein
  • Severe acute respiratory syndrome coronavirus 2 mRNA encoding BA.4/BA.5 lineage spike protein

These concepts will be created to meet the requirement for creation of bivalent vaccines (usually containing original strain + an omicron variant). In addition, creation of "SARS-CoV-2 mRNA encoding original strain spike protein" will allow for accurately representing monovalent vaccines containing "SARS-CoV-2 mRNA encoding B lineage spike protein" (original strain)."

September 2023 International Release
18.Social Context

Ethnic/Racial Group Social Context Content Inactivation

The subtypes of 372148003 |Ethnic group (ethnic group)| and 415229000 |Racial group (racial group)| will be inactivated as they are out of scope for the International Edition.

Q4 2023 International Release

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