SNOMED CT Editorial Advisory Group

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title
Inactivation ReasonAssociationDefinition

Concept Moved Elsewhere 

ALTERNATIVE 

The inactivation reason “Component Moved Elsewhere” with association type ALTERNATIVE is the mechanism by which SNOMED records when jurisdictional control of a concept passes between extensions, or between the international core and an extension.

Guidance
  • Consultation with the Community of Practice
    Moving content from SNOMED International Edition to a local NRC must always be done in consultation with the recipient authority. Consideration should also be given to wider consultation with the community of practice to establish whether the proposed inactivation of the concepts causes significant concern.
  • Provision of an ALTERNATIVE target concept
    It is possible that the concept moved from the International Edition to a local NRC may have been used by other members of the Community of Practice, therefore, where possible a suitable alternative, where it exists, should be provided.
    • This would normally be a single "Alternative"
    • The use of 2 or more alternatives would indicate that there is some ambiguity in the inactivated concept but this does not imply that the sum of the “Alternatives” is semantically equivalent e.g. this is not “POSSIBLY_EQUIVALENT_TO”.
    • Where no "alternative" is chosen this implies that the concept is so specific to the recipient jurisdiction that its use in any other jurisdiction would be deemed inappropriate. A drop-down box stating “No suitable alternative exists” with an additional text field to give the reason why no historical association is deemed appropriate.
  • Dropdown list  (Where no replacement is appropriate)
    No suitable replacement concept identified
  • Annotation
    Describe the reasons for moving the concept elsewhere e.g., Veterinary content or forms only relevant to the UK, etc.
    If the return of the content results from a change in Editorial Policy state the policy.
Info
iconfalse
Note Title

Dropdown list (Where no replacement is appropriate): No suitable replacement concept identified

Examples

...

Panel
titleRemoval of O/E concepts and return to the UK NRC

Concept Moved Elsewhere: 

  • Inactivate 
    Concept
    t
114457004 |Klebsiella ornithinolytica (organism
  • 141188002 |O/E - retinal exudates (finding)|
ALTERNATIVE:
    • ALTERNATIVE 
      Concept
      t
416832000 |Raoultella ornithinolytica (organism)|
39832008 |Cotton wool spots (disorder)|
  • Annotation
    Editorial Policy to remove all O/E concepts. Many of these concepts are represented by existing Findings and the inactivated concepts returned to the UK.


    • ALTERNATIVE:

    Panel
    titleTransfer of UK specific administration concepts back to the UK

    Concept Moved Elsewhere: 

    • Concept
      t
    		114457004 |Klebsiella ornithinolytica (organism)|
    Concept
    t416832000 |Raoultella ornithinolytica (organism)|

    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:

    ...

    • 152287007 |Patient reg. form sent to: [FPC] or [HB] (situation)|
       Inactivated
      • ALTERNATIVE: No suitable replacement concept identified
    • Dropdown list  (Where no replacement is appropriate)
      No suitable replacement concept identified
    • Annotation
      This is a UK specific form for registering new patients.

    Resolving sequences of Historical Associations

    The intention is that functionality to resolve sequences of Historical Associations will normally 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 ALTERNATIVE 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) ALTERNATIVE (B) and (B) SAME_AS (C) implies (A) ALTERNATIVE (C)

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

    (

    ...

    AIntEd) ALTERNATIVE (

    ...

    BIntEd) and (

    ...

    BIntEd) MOVED_TO (

    ...

    CNRC) implies (

    ...

    AIntEd) MOVED_TO (

    ...

    CNRC)

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

    (A) ALTERNATIVE (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 BIntEd