SNOMED CT Editorial Advisory Group

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

Examples:

Removal of O/E concepts and return to the UK NRC

Concept Moved Elsewhere: 

141188002 | O/E - retinal exudates (finding)|

ALTERNATIVE:

39832008 | Cotton wool spots (disorder)|


Transfer of UK specific administration concepts back to the UK

Concept Moved Elsewhere: 

152287007 | Patient reg. form sent to: [FPC] or [HB] (situation)|

ALTERNATIVE:

  • No suitable replacement concept identified


Managing incoming historical associations:

The intention is that this functionality will 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 - the combinatorial logic of associations should be:

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

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