Content Managers Advisory Group

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Summary

The 2020-2025 SNOMED International draft strategy includes the proposal for the identification of content in the International Edition that should be focus of active ongoing maintenance by SNOMED International. The identified content should be concepts that are a priority for use, important to keep clinically validated and needed for global use in an unambiguous manner. This content would be known as the clinical core and would be actively maintained. The remainder of the content in the International Edition would be maintained passively. 

CMAG has been asked to provide input on which concepts should be considered for inclusion in the actively maintained component of the International Edition. 


To support determining the key areas of content that should be included in the Clinical Core the following is some initial points to consider: 

  • Are there specific hierarchies/ sub-hierarchies that should or should not be part of the Clinical Core?
    • Findings, Disorders, Procedures
    • Foundational hierarchies e.g. Body structure, Observables
    • Qualifier values e.g. Action values, Colours etc...
    • Events, Record artifact, Staging and scales?
  • What types of content should be part of the clinical core?
    • Atomic concepts
      • Examples: Myocardial infarction, Internal fixation of femur
    • If atomic concepts are clinical validated and actively maintained is there a need to include:
      • Compound content e.g. X with Y, X without Y, X due to Y etc.
        • Example: If the concept |Anemia| is clinical validated and actively maintained, does the subtype |Anemia caused by heat| also need to be actively maintained? 
        • Other examples: Stroke co-occurrent with migraine, Cholecystectomy and operative cholangiogram
      • Content with context
        • Example: If the concept |Colonoscopy| is clinically validated and actively maintained does the concept |Colonoscopy planned| also need to be actively maintained? 
        • Other examples: Nausea present, No pain, History of burn,  Colonoscopy planned
            • Content relating to someone other than the subject of the record e.g. Mother smokes, Family history of neoplasm
      • Lateralised content
        • If femoral hernia is actively maintained, is there a need to actively maintain left/right femoral hernia?
      • Concepts that include severity in the meaning?
        •  Examples: Severe pain, Severe depression
    • Concepts used to define other concepts - Target values for concepts
      • Example: The subtypes of |Action (qualifier value)| are used as the target value for the |Method| attribute. Do they need to be actively or passively maintained? If they need review, should this be done and then they are passively maintained?  
  • Content with intellectual property considerations
  • Administrative content
    • Should content Statuses, Procedures
  • Content to support alignment with other Terminologies, Classifications and Standards
    • What if the meaning doesn't align with SNOMED Editorial Guidelines?
  • Grouping concepts e.g. Procedure by body site, Disorder of lung 

Suggested approach:

  • Brainstorm what aspects (such as above) need to be considered? (May)
  • Identify which hierarchies should be included (even if not all the content should be included in the clinical core) (May)
  • Look at hierarchies identified for inclusion using the aspects to be considered (still at a high level) (June - August)
  • Develop response and provide to SNOMED International (September)

 

Relevant documents

Working sheet: https://docs.google.com/spreadsheets/d/1qv3aB1TVXRCuzkb-xGY-xwhW7nLGlQAIdrVQBylWad0/edit?usp=sharing 

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CMAG response

 

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