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When components in SNOMED CT are inactivated, it is useful to understand the reason for the inactivation, to support appropriate change managementa component that is a member of a reference set is inactivated, the person maintaining the reference set needs to decide whether a change is required.  This depends on the intended use of the reference set being maintained. In the case of a reference set that is being used to constrain data entry, inactive concepts need to be removed from the reference set or replaced by an appropriate active concept. In other reference sets it may be permissible, or even required, to retain an inactive concept in a reference set (for example if a reference set is used in the criteria for a report which may be applied to historical data).

The following figure and subsequent description introduce the overall process for identifying inactive components and using released reference sets to determine reasons for activation inactivation and potential replacements. 

  Illustration of the process of determine reasons for inactivation and alternative replacements

Process of determine reasons for inactivation and alternative replacements

1. One  One approach to identify the components that have been inactivated since the last release, is to compare snapshot of previous release with current delta release.

2.  The The reasons for inactivation can be looked up in the

   Concept

   scg-expression

   t 900000000000480006

   |

   Attribute

   value

   type

   reference

   set

   |

    for the particular component type, for example the

   Concept

   scg-expression

   t 900000000000489007

   |

   Concept

   inactivation

   indicator

   attribute

   value

   reference

   set

   |

   . The reason is represented by the value of the valueId attribute. For further information, see  3.2.6.3.1. Representing Reasons for Component Inactivation.

3. The possible replacements for the components that have been inactivated can be determined in the appropriate 

   Concept

   scg-expression

   t 900000000000522004

   |

   Historical

   association

   reference

   set

   |

   . For further information, see 3.2.6.3.2. Representing Historical Associations. 

4. The preferred approach to manage inactivation of a component depends on the situation and the use of the reference set. However, a typical approach would be to update the reference set to apply the replacement concept instead of the inactivated concept. Please note, that some changes to the reference set may require additional updates to be performed to ensure correct use, see  6.6.2. Managing Reference Set Changes.

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