1 Introduction
SNOMED CT terminology provides a common language that enables a consistent way of indexing, storing, retrieving, and aggregating clinical data across specialties and sites of care.
The International Health Terminology Standards Development organisation (IHTSDO®), trading as SNOMED International, maintains the SNOMED CT technical design, the content architecture, the SNOMED CT content (includes the concepts table, the descriptions table, the relationships table, a history table, and ICD mappings), and related technical documentation.
2 Background
This document provides a summarized description of the content changes included in the November 2019 release 2020 release of the SNOMED Clinical Terms® Managed Service Sweden Extension package.
It will also includes technical notes detailing the known issues which have been identified (should any of these exist). These are content or technical issues where the root cause is understood, and the fix has been discussed and agreed, but has yet to be implemented.
This Sweden Extension package is dependent upon, and should therefore be consumed in conjunction with the SNOMED CT® July 2019 2020 International Edition release.
2.1 Scope
This document is written for the purpose described above and is not intended to provide details of the technical specifications for SNOMED CT or encompass every change made during the release.
3 Content Development Activity
3.1 Summary
Content from the SNOMED CT® July 2019 2020 International Edition release has been translated and additional concepts and synonyms for use in Sweden have been added. The main areas for which new concepts and synonyms have been added are:
- Chief complaint
- Healthcare occupationsReasons for encounter
- National medication list
- Medical alerts
- National knowledge base for reasons for prescription
- The national information structure
- Surgical procedures
- Alert information
- Decision-support for insurance medicineAssessment scales
3.2 New and Updated Content
Concept statistics
New concepts: 217282
Table 1 New concepts by hierarchy
217 | 282 |
| Social context (social concept) | 138 |
| Procedure (procedure) |
84Body structure body structure1| 2 |
| Situation with explicit context (situation) |
2| Physical object (physical object) | 2 |
| 4 |
| Staging and scales (staging scale) |
25 | | Qualifier value (qualifier value) |
23| 14 |
| Observable entity (observable entity) |
38| 10 |
| Clinical finding (finding) |
27| 69 |
| SNOMED CT Model Component (metadata) |
15 Inactivated No concepts from the Swedish extension : 2were inactivated.
Changes to existing concepts in the Swedish extension: 41
Descriptions statistics
New synonyms added: 2411 216
Inactivated descriptions: 194517
New translations: 4 634878
Some concepts have not been translated into Swedish. The reasons for non-translation can vary and include concepts not relevant in a Swedish context and concepts were the name in Swedish and English is equivalent (e.g. the Latin names of organisms).
Table 2 Non-translated concepts by hierarchy
| Total number of concepts | 17289 |
SNOMED CT Concept (SNOMED RT+CTV3) | 23 212 |
| Social context (social concept) |
733259| 256 |
| Body structure (body structure) |
12| 10 |
| Physical object (physical object) |
9 708| 3758 |
| Environment or geographical location (environment / location) | 6 |
| Qualifier value (qualifier value) |
2| 3 |
| Observable entity (observable entity) | 1 |
| Special concept (special concept) | 4 |
| Pharmaceutical / biologic product (product) |
1| 8 |
| Clinical finding (finding) |
8312 736| 12727 |
| SNOMED CT Model Component (metadata) |
361Reference sets
Thirty-three Ten reference sets were added in this release, including reference sets supporting medical alerts, reference sets a reference set for chief complaints, a new reference set for the National Medication List (Nationella läkemedelslistan), a new reference sets set supporting the Inera laboratory medicine information specification, as well as reference sets for National Information Modelssupporting coding of healthcare occupations.
4 Technical notes
4.1 Known Issues
Known Issues are content or technical issues where the root cause is understood, and the resolution has been discussed and agreed but has yet to be implemented. This can be due to a number of reasons, from lack of capacity within the current editing cycle, to the risk of impact to the stability of SNOMED CT if the fix were to be deployed at that stage in the Product lifecycle.
For the SNOMED CT Managed Service - Sweden Extension May 2019November 2020, the following Known Issues were identified, and agreed to be resolved in the next editing cycle:
| Jira |
|---|
| server | IHTSDO JIRA |
|---|
| columns | key,summary,description,priority |
|---|
| maximumIssues | 200 |
|---|
| jqlQuery | filter = "MS (SE) 20191130 20201130 - Known Issues" |
|---|
| serverId | b202d822-d767-33be-b234-fec5accd5d8c |
|---|
|
4.2 Technical notes
Migration to full OWLExpression file
In line with the July 2019 International Edition release, this release sees the full migration to OWL, replacing the Stated Relationship content with the OWLAxiom and OWLOntology refsets in the OWLExpression file.
All Stated Relationship records have therefore been inactivated, in lieu of the new content in the combined OWLExpression files.
Some concepts from the Swedish extension have been promoted to the international release (900000000000207008 | SNOMED CT core module (core metadata concept) |). The concepts have been added to the international release files with an effectiveTime which supersedes the latest effectiveTime in the Swedish extension release files. The concepts will be retained in the Swedish extension snapshot files in perpetuity as per SNOMED International recommendations and anyone using these files will have to manage the possibility of duplicated ids (with different effectiveTime) across release files. The risk of issues can be mitigated by filtering to only use Swedish extension records with effectiveTime:s greater than their International counterparts. Links to relevant documentation will be added to these release notes once that documentation has been updated.
The promoted concepts in the November 2020 release are:
| 57671000052108 | Chronic Obstructive Pulmonary Disease Assessment Test scale (assessment scale) | |
| 58731000052100 | Intestinal route (qualifier value) | |
| 58751000052109 | Intraglandular route (qualifier value) | |
| 58761000052107 | Intracholangiopancreatic route (qualifier value) | |
| 58771000052103 | Intraportal route (qualifier value) | |
| 58811000052103 | Peritumoral route (qualifier value) | |
| 58821000052106 | Posterior juxtascleral route (qualifier value) | |
| 58831000052108 | Subretinal route (qualifier value) | |
| 64291000052106 | Radioactive iodine therapy (procedure) | |
