SNOMED CT Editorial Advisory Group

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k guidance

Inactivation ReasonAssociation TypeDescription

Erroneous

Erroneous Concept

REPLACED_BY

association reference set (foundation metadata concept)

ALTERNATIVE association reference set (foundation metadata concept)

No historical association required

Additional notes:

Examples:

Semantic meaning the same but FSN different:

235998001 Perinephric abscess (disorder) - inactivated
SAME_AS
80640009 Perirenal abscess (disorder)

Both concepts had an effective date of 2002-01-31 and so the decision was based on current clinical usage and the retained concept already had a synonym of Perinephric abscess.

Identical FSN but different semantic tag:

145857006 Soft tissue X-ray abnormal (situation) - inactivated
SAME_AS
168711005 Soft tissue X-ray abnormal (finding)

Managing incoming historical associations:

The inactivation reason “Erroneous Component” explicitly states that the inactivated concept (A) has an FSN which contains an error that when corrected potentially changes the semantic meaning of the concept and that in the judgment of the author/editor the true original meaning is now represented by the “REPLACED_BY” concept (B).

Note: this inactivation reason should not be used to correct punctuation, word order changes, or minor spelling mistakes that do not change the meaning of the FSN - these changes can be made by inactivation and replacement of the FSN.

Guidance
  • Annotation
    Provide detail on the nature of the error and where appropriate a reference source

  • Additional notes

    • Where a decision is taken to inactivate and replace the FSN:
      • Establish whether the changes that needed to correct the FSN do make a potential change to the meaning of the concept. If they do not, inactivate and replace the FSN but not also the entire concept.
      • Where the error gives rise to potential ambiguity, use the inactivation reason of “Ambiguous Concept”.
    • In some instances, the decision to use ‘Erroneous’ or ‘Non-conformance to editorial policy’ is not straightforward. Take for example an issue relating to CT angiography: we now understand that, empirically, ALL CT angiograms carried out today necessarily use contrast - but this is not stated in either the FSNs or the modeling of the relevant concepts. It may, however, become possible in the future to carry out CT angiography both with and without contrast. Technically, therefore, universally adding “with contrast” into the FSNs now for clarity would indicate an error in the original concepts and it would change the meaning, from the current future-proof broad category in which use of contrast is universally implied only by the realities of modern-day medical technology, to a narrower category in which use of contrast is explicit. Therefore, do not hesitate to seek guidance if there is any doubt as to the most appropriate solution.

Examples

Panel
titleIncomplete or erroneous drug description

Inactivate concept:

  • Concept
    t387831006 |Isoproterenol hydrochloride 1:50,000mg injection (product)|
    • REPLACED_BY 
      Concept
      t400309007 |Isoproterenol hydrochloride 1:50,000mg(0.2mg/mL) injection solution 1mL ampule (product)|
  • Annotation
    Drug description incomplete


Panel
titleIncorrect spelling of an organism

Although superficially some typographical errors can appear insignificant it is safer to inactivate and replace as the spelling differences between organism names can be small.

Inactivate concept:

  • Concept
    t58484007 |Infection caused by Madurella mycetomii (disorder)|
    • REPLACED_BY:
      Concept
      t715061003 |Infection caused by Madurella mycetomatis (disorder)|
  • Annotation
    Incorrect spelling of organism requiring inactivation

Resolving sequences of Historical Associations

The intention is that functionality to resolve sequences of Historical Associations will normally The intention is that this functionality will be seamlessly integrated into the tooling so as to present to the user the appropriate updated historically association to be allocated.

Whenever an already stated REPLACED_BY target itself also becomes inactive   - whether at the same release or later, identifying the replacement for the original concept, should follow the combinatorial logic stated below.

Combinatorial Logic

(A) REPLACED_BY (B) and (B) SAME_AS (C) implies (A) REPLACED_BY (C)

(A) REPLACED_BY (B) and (B) REPLACED_BY (C) implies (A) REPLACED_BY (C)

(AIntEd) REPLACED_BY (BIntEd) and (BIntEd) MOVED_TO (CNRC) implies (AIntEd) MOVED_TO (CNRC)

(A) REPLACED_BY (B) and (B) POSSIBLY_EQUIVALENT_TO (C, D) implies (A) POSSIBLY_EQUIVALENT_TO (C, D)

(A) REPLACED_BY (B) and (B) WAS_A (C AND D) implies (A) WAS_A (C AND D)

Note: Once MOVED_TO the NRC we (, SNOMED International ) have no knowledge of what has happened to BIntEdBIntEd