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Duplicate Concept

SAME_AS association reference set (foundation metadata concept)

Definition:

The inactivation reason “Duplicate Concept” with association type “SAME_AS ”explicitly states that the inactivated concept (A) semantically represents exactly the meaning of the remaining active concept (B). Implicitly it also means that (A) SAME_AS (B) always, by definition implies (B) SAME_AS (A).

The definition includes the requirement to ensure any analysis expressed in terms of (A) returns the same subtypes as would have been present had the concept (B) been substituted into the query logic, and vice versa.

  • The meaning of the concept is based on the FSN.
  • If any of the concept’s synonyms are considered to be non-synonymous, these should first be inactivated and re-assigned to either the concept that matches the meaning or if not available a new concept created.
  • The target component identifies the active concept that this concept duplicates.
  • Where possible consider keeping the concept with the oldest effective date as this is likely to have had the most usage.
  • Where the FSN is the same but the semantic tag differs between the 2 concepts, then if the pair of semantic tags are within the following permitted pairs then an inactivation reason of "Duplicate" may still be used:
    • Disorder and Finding
    • Procedure and Regime/Therapy
    • Finding and Situation
    • Procedure and Situation
    • Procedure and Observable 

AnnotationProvide evidence/reference to support the concepts are duplicates

Additional notes:

  1. The requirement to ensure any analysis expressed in terms of (A) returns the same result as it would if the same logic was applied to (B) is contingent on both concepts being modeled correctly.
  2. The choice of which concept should be inactivated may not always be straightforward. 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. Where the existing FSN for the older concept does not comply with current naming conventions, it may be possible to assign a newer and compliant FSN "in its place" i.e., without inactivating the concept. However, if the newer concept already carries the ideal, compliant FSN then it will not be possible to also assign that same FSN to the older concept, and so there may be no other option than to inactivate the older concept in favor of the newer, with its better FSN.

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.

Whenever an already stated “SAME_AS” target itself also becomes inactive - whether at the same release or later - the combinatorial logic of associations should be:

(A) SAME_AS (B) and (B) SAME_AS (C) implies (A) SAME_AS (C)

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

(AIntEd) SAME_AS (BIntEd) and (BIntEd) MOVED_TO (CNRC) implies (AIntEd) MOVED_TO (CNRC)

(A) SAME_AS (B) and (B) POSSIBLY_EQUIVALENT_TO (C OR D) implies (A) POSSIBLY_EQUIVALENT_TO (C OR D)

(A) SAME_AS (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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