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The 2020-2025 SNOMED International draft strategy includes the proposal for the current identification of content in the International Edition to segmented into 2 components:

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that should be focus of active ongoing maintenance by SNOMED International. The identified content should be concepts that are a priority for use, important to keep clinically validated and needed for global use in an unambiguous manner.

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This content would be known as the clinical core and would be actively maintained.

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The remainder of the content in the International Edition would be maintained passively. 

CMAG has been asked to provide input on

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which concepts should be considered for inclusion in the

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Notes:

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actively maintained component of the International Edition. 

To support determining the key areas of content that should be

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included in the Clinical Core

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the following is some initial points to consider: 

• Are there specific

Some points to start the discussion: 

• Which hierarchies/ sub-hierarchies that should or should not be part of the clinical coreClinical Core?
  • Findings, Disorders, Procedures
  • Foundational hierarchies e.g. Body structure, Observables
  • Qualifier values e.g. Action values, Colours etc...
  • Events, Record artifact, Staging and scales?
• What types of content should be part of the clinical core?
  • Atomic componentsconcepts
    • Examples: Myocardial infarction, Internal fixation of femur
  • If atomic concepts are clinical validated and actively maintained is there a need to include:
    • Compound content e.g. X with Y, X without Y, X due to Y etc.
      Examples
      • Example: If the concept |Anemia| is clinical validated and actively maintained, does the subtype |Anemia caused by heat
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      • | also need to be actively maintained? 
      • Other examples: Stroke co-occurrent with migraine, Cholecystectomy and operative cholangiogram
      • Content with context
        Examples:  Nausea
        • Example: If the concept |Colonoscopy| is clinically validated and actively maintained does the concept |Colonoscopy planned| also need to be actively maintained? 
        • Other examples: Nausea present, No pain, History of burn,  Colonoscopy planned
          Relates
          • • • Content relating to someone other than the subject of the record e.g. Mother smokes, Family history of
          neoplasm 
        • Concepts used to define other concepts - Target values for concepts
          • Is this just within the clinical core and/or other editions
        • • • • • neoplasm
          • Lateralised content
            • If femoral hernia is actively maintained, is there a need to actively maintain left/right femoral hernia?
          Severity
          
          • Concepts that include severity in the meaning?
            •  Examples
            Examples
            • : Severe pain, Severe depression
        • Concepts used to define other concepts - Target values for concepts
          • Example: The subtypes of |Action (qualifier value)| are used as the target value for the |Method| attribute. Do they need to be actively or passively maintained? If they need review, should this be done and then they are passively maintained?  
      • Content with intellectual property considerations
      • Administrative content
        
        • Should content Statuses, Procedures
      • Content to support alignment with other Terminologies, Classifications and Standards
        • What if the meaning doesn't align with SNOMED Editorial Guidelines?
      • Grouping concepts e.g. Procedure by body site, Disorder of lung 

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