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This could for example be, if a group of orthopedic surgeons are developing a subset of SNOMED CT procedure concepts to be included in a certain pick list of their local Electronic Health Record. The group already know what options should be available in the pick list, so they choose to create their own reference set and add the required component references to this reference set, see Figure figure below.

Creating a new reference set without looking at any existing SNOMED CT reference sets

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