SNOMED CT Editorial Advisory Group

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Inactivation ReasonAssociationDefinition

Classification Concept 

REPLACED_BY

The inactivation reason “Classification Concept” explicitly states that the inactivated concept originates from the “closed world” classification paradigm and as such is inappropriate content for use within the clinical record. The inactivated concept (A) may be linked to one or more active concepts (B and/or C…) using historical associations as determined by the type of classification concept and associated guidance given below.

Please note that this inactivation reason replaces "Limited Component" and historical association "WAS_A".

Guidance
  • Identification of "Closed World content"
    The donor 'terminologies' to SNOMED CT were often themselves an early evolution of classifications of mortality and morbidity used for statistical analysis and reporting. To support the closed world view it was necessary to include options that catered for disorders that were known but not currently included within the classification. These concepts can usually be identified by the inclusion of “other specified”,  “not otherwise specified”, or “not elsewhere classified”, etc. While many of these concepts have already been inactivated, a few remain, and others such as "...without.." and concepts that are complex combinations of clinical phenomena still exist and will over time be removed.

    Each of the classification 'types' will be identified within the authoring tool inactivation process by a drop-down list e.g.:
    • The concept contains "Not Otherwise Specified"
    • The concept contains "Not elsewhere Specified"
    • The concept contains "Without"
    • etc.
  • Editorial guidance for specific classification types
    As each classification type is identified editorial guidance will be provided giving the reasons for inactivation and advice on how to assign an appropriated "REPLACED_BY" historical association. See the example below:
  • Inactivation of concepts containing "Not Otherwise Specified"


Note Title

  • Insert additional note

Additional notes:

Examples:

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:

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.


Note: Once MOVED_TO the NRC we (SNOMED International) have no knowledge of what has happened to BIntEd

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