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Narrative description | This may arise for the following reasons: - Identical FSNs with slightly different logical definition
- The FSNs have different word order but the implied meaning is the same
- The FSNs contains word equivalents or an eponym
- Where an organism has multiple equivalent names e.g. common and scientific name
- The FSNs are slightly different but the 2 concepts
- Identical FSNs but with a different semantic tag
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Details | What is being inactivated (concept/description/any component)? | The duplicate concept is being inactivated |
What is the reason for inactivation (description)? | The 2 concepts are considered to be semantically equivalent |
Which inactivation value should be used? | Duplicate component |
Which historical association reference set should be used? | SAME_AS association reference set (foundation metadata concept) SAME_AS means A is semantically equivalent to B
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Known issues | - Establishing semantic equivalence is key and may be difficult. If there is doubt consider using ambiguous as the inactivation reason.
- If the ancestors and descendants of the concept are inconsistent with what is implied by the FSN then consider inactivating as ambiguous.
- Ensure that the synonyms are appropriate and represented within the active concept.
- To reduce the impact on users/vendors consider keeping the concept with the oldest effective date as this is likely to have had the most usage.
- they are all present as subtypes of the active concept.
- Where the modelling indicates significant semantic difference establish whether these differences impact other concepts and analytics. If there is doubt consider using ambiguous as the inactivation reason.
- Question: Where the FSN is the same but the semantic tags are: disorder and finding OR procedure and regime/therapy is it acceptable to call these duplicates?
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Examples | Simple Example |
235998001 Perinephric abscess (disorder) SAME_AS 80640009 Perirenal abscess (disorder) |
Complex Example | 136852007 Computer operator (occupation) SAME_AS 8651002 Electronic computer operator (occupation)232141000 Cycloplegic paralysis of accommodation (finding) SAME_AS 68158006 Cycloplegia (disorder) |
Erroneous Examples | 312186009 L-Phenylalanine (substance) SAME_AS 63004003 Phenylalanine (substance)274374000 Endoscopic surgical procedure (procedure) SAME_AS 363687006 Endoscopic procedure (procedure)156240002 Primary postpartum haemorrhage (disorder) SAME_AS 27214003 Atonic postpartum hemorrhage (disorder) |
Impact | | - Requirement to establish true semantic equivalence
- Ensure that the active concept has an FSN which adheres to editorial guidance
- Ensure that all of the concepts descriptions are appropriately assigned/reassigned or inactivated
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| - Review and update Refsets and ECL queries
- Where the developer makes extensive use of ECL, identify the impact of the changed modelling of the active component and loss of the concept implied by the modelling of the inactivated concept
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| - Generally minimal, when the inactivated concept points to the duplicate.
- The change may require terminology merging or remapping of local Refsets.
- Recognise that any loss of descriptions which were deemed non-synonymous may impact accessibility
- Reinstate within the local edition descriptions which were inactivated because they were deemed to be region specific
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Potential improvement
| No changes proposed |
Supporting resources
| SNOMED CT Editorial Guide guidance on creation of the Fully Specified Name | <comment> |
Metrics for historical inactivations | Usage over time 20020131 to 20200731 - 38,862 Most recent usage: - 20200731 - 312
- 20200131 - 274
- 20190731 - 330
- 20190131 - 357
| Link to table |
Review of historical inactivations | 100 inactivations reviewed | Error rate |
Managing incoming inactivations | Duplicate | Original inactivation A SAME_AS B New inactivation B SAME_AS C Therefore A SAME_AS B SAME_AS C and A SAME_AS C |
Outdated | Original inactivation A REPLACED_BY B New inactivation B SAME_AS C Action required: Check to a establish whether there is a better replacement (D) YES: Change A REPLACED_BY B with A REPLACED_BY D and then B SAME_AS C NO: Change A REPLACED_BY B with A REPLACED_BY C |
Ambiguous |
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Erroneous | Original inactivation A REPLACED_BY B New inactivation B SAME_AS C Action required: Check to a establish whether there is a better replacement (D) YES: Change A REPLACED_BY B with A REPLACED_BY D and then B SAME_AS C NO: Change A REPLACED_BY B with A REPLACED_BY C |
Limited |
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Moved elsewhere |
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Nonconformance to editorial policy |
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