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As clinical practice evolves and adapts to meet the changing needs of healthcare advances, it is important that SNOMED CT reflects these changes, so that clinicians can content is updated to address these changes. Reference sets may also need to be updated to reflect content changes and to enable clinicians to adequately represent new and emerging techniques /and practices. For any implementation of SNOMED CT it It is therefore important to establish processes for end users and other stakeholders to submit requests for changes. Related to reference sets the types of changes that may be required include:

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