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To support implementers who prefer to process string-based representations of the rules, three MRCM attributes have been provided that concatenate information from other fields (as per the table below). These attributes have been populated automatically to avoid inconsistencies between the structural and string-based representations of the rules. The MRCM attributes that may be generated from other attributes are:

In addition, the quality of the international SNOMED CT MRCM is checked using a range of mechanisms, including:

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1. Determine which domains the expression , constraint or query belongs to using the 

   Concept
   ShowParts term t 723589008 |MRCM domain reference set|

   • An expression belongs to a given domain if all any focus concepts are concept is either:
     1. Valid when tested against the associated domainConstraint; or
     2. Valid when tested against the associated proximalPrimitiveConstraint and all required refinements in the proximalPrimitiveRefinement either match a defining relationship on the given focus concept, or match a refinement condition added to the expression being authored;
2. Determine the set of valid attributes for the given domains using the 

   Concept
   ShowParts term t 723604009 |MRCM attribute domain reference set|

    and allow refinements to be added using attribute concepts from this set;
3. For each attribute used to define the concept, ensure that the grouping and cardinality are valid according to the rules specified in 

   Concept
   ShowParts term t 723604009 |MRCM attribute domain reference set|

    for the given attribute and parent domain;
4. Determine the valid range for each attribute using the rangeConstraint in 

   Concept
   ShowParts term t 723592007 |MRCM attribute range reference set|

   .

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1. Determine which domains the constraint or query belongs to using the 

   Concept
   ShowParts term t 723589008 |MRCM domain reference set|

   • An expression constraint or query belongs to a given domain if either:
     
     1. All Any focus concepts are concept is valid when tested against the associated proximalPrimitiveConstraint; or
     2. The constraint or query belongs to a parent domain of the given domain.
        
        • Please note: The concept model requirements for constraints and queries are more relaxed than those for postcoordinated expressions, because their role is to define the membership of a set of concepts or expressions, rather than restrict the manner in which a single concept or expression may be defined.
2. Determine the set of valid attributes for the given domains using the 

   Concept
   ShowParts term t 723604009 |MRCM attribute domain reference set|

    and allow refinements to be added using attribute concepts from this set;
3. For each attribute used to define the concept, ensure that the grouping and cardinality are consistent with the rules specified in 

   Concept
   ShowParts term t 723604009 |MRCM attribute domain reference set|

    for the given attribute and parent domain. In particular:
   • An attribute should only be grouped in an expression constraint or query if it specified as grouped = 1 for that domain in

     Concept
     ShowParts term t 723604009 |MRCM attribute domain reference set|

     . Any attribute can appear as ungrouped in an expression constraints.
   • A cardinality constraint used in an expression constraint or query should be the same, or stricter than the cardinality specified for the given attribute and domain in

     Concept
     ShowParts term t 723604009 |MRCM attribute domain reference set|

     .
4. Determine the valid range for each attribute using the rangeConstraint in 

   Concept
   ShowParts term t 723592007 |MRCM attribute range reference set|

   .

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