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2024 Proposed Content Changes

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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.	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)| has been extended in the October 2023 release 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)|.	Q1 2024 International Release
2.	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.  Further information is available here (Confluence log in required).	Q1 2024 International Release
3.	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.  There is one area where work is still in progress:   Clinical finding caused by radiation.	2024 International Release
4.	Procedure	Update Hierarchy 363680008|Radiographic imaging Procedure (procedure)|and Descendants A Briefing Note documenting the proposed changes for the hierarchy 363680008|Radiographic imaging procedure (procedure)| and descendants was shared with the Editorial Advisory Group, Clinical Leads Group, Member Forum, Content Managers Advisory Group, and other key stakeholders in July 2023. Feedback was received from a wide range of stakeholders. In response to this feedback, the proposed changes to the hierarchy have been modified. These modifications will address issues raised in the feedback. This Informational Briefing Note summarizes the changes that will be implemented. Implementation of the content changes will commence in Q4 2023. The updates will be implemented in sub-hierarchies and promoted over a number of international monthly releases until complete.	First phase of content updates planned for promotion Q1 2024.
5.	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.	Q1 2024 International Release
6.	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.  A briefing note is available here.	Q1 2024 International Release
7.	Clinical Finding/Procedure	Patient/Subject concepts in the Clinical finding and Procedure Hierarchies Concepts in the Clinical finding and Procedure hierarchies that contain the explicit context of patient or subject will be inactivated and replaced with concepts without this explicit context. For further information please see briefing note.	Q1 2024 International Release
8.	Procedure/Observable Entity	Evaluation Procedure vs Observable Entity The Senior Management Team (SMT) recently agreed on a proposed solution to resolve the duplication between the evaluation procedure and observable entity hierarchies. The resolution includes moving the majority of the evaluation procedures to the observable entity hierarchy while retaining the original concept id during the move. The semantic tag will be updated from evaluation procedure to observable entity, and updates in terming and modeling to align with the observable entity model are expected. This move will allow for concepts of multiple granularities to be classified in a single hierarchy. Non-defining annotations for “order only,” “observation only,” or “both order and observation” may be added to the concepts to assist with certain use cases. Note that some content areas of evaluation procedures such as panels and procedure methods will not be addressed at this time. A projected timeline of changes will be developed and shared with the community. Editorial and implementation guidance will be provided with this project. Please see the briefing note for further information.	To be determined
9.	Procedure	Inactivation of 277132007|Therapeutic procedure (procedure) The concept 277132007 |Therapeutic procedure (procedure) will be inactivated with the inactivation reason of Outdated and a replacement association target of 71388002 |Procedure (procedure)|. The nearly 2000 descendants will be reviewed as to the appropriateness of either the Has intent (attribute) of Therapeutic intent, or a Method (attribute) of Therapy - action. For further information please see briefing note.	Q1 2024 International Release
10.	Content Improvement	Urinary Bladder Following feedback from translation, descriptions for concepts that contain the word 'bladder' and the site of 89837001|Urinary bladder structure (body structure)| will be updated to include 'urinary' in the FSN and PT, for example: 126885006|Neoplasm of bladder (disorder) will be updated to 126885006|Neoplasm of urinary bladder (disorder).	January 2024 International Release
11.	Procedure	Update for 73632009 |Laparoscopy (procedure)| and Subtypes  There will be a bulk update to align 73632009 |Laparoscopy (procedure)| and subtypes with the template here: https://confluence.ihtsdotools.org/display/SCTEMPLATES/Laparoscopy+%28procedure%29+-+Draft These changes include the addition of INCISION ROLE GROUP and INSPECTION ROLE GROUP for all Laparoscopic procedures.	Q1 2024 International Release
12.	Product	International Unit in Descriptions for Clinical Drugs 'International Unit' as a description is arbitrary and to be understood each product requires reference to a particular bioefficacy specification for that entity. Therefore, 'international' is not meaningful or comparable as a description at Clinical Drug level. International unit will be represented as 'unit' in Clinical Drug descriptions and 20 concepts will have their descriptions changed to 'unit'  Note: abbreviations will not be used. Editorial Guidance has been drafted.	January 2024 International Release
13.	Procedure	Inactivation of  “RAST” and “RAST test” from subtypes of 104380004 |Allergen specific antibody measurement (procedure)| Based on a proposal by the Allergies and Hypersensitivities CRG, descriptions containing “RAST” and “RAST test” will be inactivated from the concepts in this sub-hierarchy as they are not considered real synonyms. Immunoassays for immunoglobulin specific to an allergen of interest are widely used in the diagnosis of allergic disease. These tests are often incorrectly referred to collectively as "radioallergosorbent tests" ("RAST") because they were the earliest immunoassays to be used extensively.	Q1 2024 International Release

2024 Published Content Changes

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With Confirmed Release Date

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