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Intermediate primitive groupers add a substantial management burden, thus, are discouraged. They may however be added on a case-by-case basis with approval from the Chief Terminologist or the Principal Terminologist Head of Terminology when, for example:

• • The concept model is not robust enough to support the full definition of a subset of terms, e.g. genomics (i.e. genetic diseases for which we cannot state, the majority of cases of this disease present with X).
  • There are variances in the clinical manifestations.

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