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Groupers based on both structure and disposition that are deemed to be clinically useful and that can be sufficiently defined will be included in the |Substance| hierarchy.

Note: This section applies to concepts representing a single structural parent and a single disposition. It does not apply concepts representing more than one structural parent or disposition.

Modeling

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Stated parent concept	The stated parent concept must be the concept that represents the structural grouper. If such a concept does not exist, it must be created and its stated substance descendants added before the grouper based on both structure and disposition can be created. Exceptions: none
Definition status	900000000000073002 |Sufficiently defined concept definition status (core metadata concept) Exceptions: none	Defined
Attribute: Has disposition	Range:  726711005 <726711005 |Disposition (disposition)  - descendants only NOTE: While the allowed range is broader, the Substance Groupers based on both Structure and Disposition should only use descendants of the concept <726711005 |Disposition (disposition) as the attribute value. Exceptions: none identified Cardinality: 1..1 Exceptions: none identified

Exemplar for Grouper Concept Based on both Structure and Disposition

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Inferred view of 438942000 |Piperidine derivative with histamine receptor antagonist mechanism of action (substance)|

Terming

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FSN	Use the following pattern for the FSN, with X representing the structure and Y representing the disposition. The FSN should align with the FSN for the substance grouper and disposition used as the stated parent and attribute value respectively. X with Y mechanism of action (substance) Example: For example, Piperazine derivative with histamine H1 receptor antagonist mechanism of action (substance) Substance with dihydropyridine derivative structure and calcium channel blocker mechanism of action (substance) Substance with organophosphorus structure and acetylcholinesterase inhibitor mechanism of action (substance)
Preferred Term	Use the following pattern for the Preferred Term, with X representing the structure and Y representing the disposition. The FSN should align with the FSN for the substance grouper and disposition used as the stated parent and attribute value respectively. X Y Example: For example, Piperazine derivative histamine H1 receptor antagonist Dihydropyridine derivative calcium channel blocker Organophosphorus acetylcholinesterase inhibitor
Synonyms	A synonym to match the FSN is not required. Additional synonyms are allowed only if they are consistent with the synonyms for the corresponding structure grouper and disposition.

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