© 2024 International Health Terminology Standards Development Organisation. All rights reserved. SNOMED CT® was originally created by the College of American Pathologists.
This document forms part of the SNOMED CT® Sweden Extension release distributed by International Health Terminology Standards Development Organisation, trading as SNOMED International, and is subject to the SNOMED CT® Affiliate License, details of which may be found at https://www.snomed.org/snomed-ct/get-snomed
No part of this document may be reproduced or transmitted in any form or by any means, or stored in any kind of retrieval system, except by an Affiliate of SNOMED International in accordance with the SNOMED CT® Affiliate License. Any modification of this document (including without limitation the removal or modification of this notice) is prohibited without the express written permission of SNOMED International.
Any copy of this document that is not obtained directly from SNOMED International [or a Member of SNOMED International] is not controlled by SNOMED International, and may have been modified and may be out of date. Any recipient of this document who has received it by other means is encouraged to obtain a copy directly from SNOMED International [or a Member of SNOMED International. Details of the Members of SNOMED International may be found at http://www.snomed.org/members/].
Page At A Glance
1. Introduction
SNOMED CT terminology provides a common language that enables a consistent way of indexing, storing, retrieving, and aggregating clinical data across specialties and sites of care.
The International Health Terminology Standards Development organisation (IHTSDO®), trading as SNOMED International, maintains the SNOMED CT technical design, the content architecture, the SNOMED CT content (includes the concepts table, the descriptions table, the relationships table, a history table, and ICD mappings), and related technical documentation.
2. Background
This document provides a summarized description of the content changes included in the May 2021 release of the SNOMED Clinical Terms® Managed Service Sweden Extension package.
It will also includes technical notes detailing the known issues which have been identified (should any of these exist). These are content or technical issues where the root cause is understood, and the fix has been discussed and agreed, but has yet to be implemented.
This Sweden Extension package is dependent upon, and should therefore be consumed in conjunction with the SNOMED CT® July 2021 International Edition release.
2.1. Scope
This document is written for the purpose described above and is not intended to provide details of the technical specifications for SNOMED CT or encompass every change made during the release.
2.2. Recall Replacement release
IMPORTANT NOTICE
An issue has been identified in the Sweden Extension content, impacting Concept 113811000052109 |Pediatric early warning score (observable entity)| and all of its related components. This was caused by an unfortunate sequence of events which led to the Concept being promoted before it had been formally versioned. This resulted in both Concepts (in the Sweden and International modules) being versioned with the same effectiveTime of 20211130.
The severity of this issue was deemed to be significant enough to warrant a Recall of the original November 2021 and May 2022 Sweden Extension packages, and the deployment of replacement release packages containing the relevant improvements, as follows:
-
Both Full and Snapshot Concept files were updated to update the record in question to a 20211129 effectiveTime, thus allowing the corresponding International record to become the primary version:
< 113811000052109 20211130 1 45991000052106 900000000000073002
> 113811000052109 20211129 1 45991000052106 900000000000073002
- All other components related to this Concept (Description, Language refset, Relationship records) were also updated in conjunction with the Concept.
New and improved validation assertions are being added to the extensive Sweden NRC Test Suite, in order to identify and resolve any similar primary key constraint errors in future authoring cycles.
3. Content Development Activity
3.1. Summary
Content from the SNOMED CT® Jan 2022 International Edition release has been translated and additional concepts and synonyms for use in Sweden have been added. Some areas for which new concepts and synonyms have been added are:
- Concepts to support recording of lifestyle factors, use of care services and assessment scale, and to support reporting to the Senior Alert quality register have been added.
- Collaborative work with professional societies (Dietisternas Riksförbund, Svensk sjuksköterskeförening) has been done to improve the quality of the Swedish translations.
-
Work has been done to reduce duplicate terms and address other quality issues in the Swedish translation.
-
Working with the healthcare regions to develop content in the Swedish extension.
3.2. Concept statistics
New and Updated Content
New concepts: 91
Table 1 New concepts by hierarchy
| Total | 91 |
| Procedure (procedure) | 53 |
| Substance (substance) | 1 |
| Staging and scales (staging scale) | 1 |
| Physical object (physical object) | 1 |
| Environment or geographical location (environment / location) | 2 |
| Qualifier value (qualifier value) | 3 |
| Observable entity (observable entity) | 10 |
| Clinical finding (finding) | 16 |
| SNOMED CT Model Component (metadata) | 4 |
14 concepts from the Swedish extension were inactivated for this release, 5 concepts were changed, and 6 were promoted to the International edition.
3.2.1. Descriptions statistics
New decriptions: 6 549
Inactivated descriptions: 378
Re-activated descriptions: 3
New translations: 4 690
Some concepts have not been translated into Swedish. The reasons for non-translation can vary and include concepts not relevant in a Swedish context and concepts were the name in Swedish and English is equivalent (e.g. the Latin names of organisms).
Table 2 Non-translated concepts by hierarchy
| Total | 14050 |
| Social context (social concept) | 45 |
| Procedure (procedure) | 62 |
| Substance (substance) | 256 |
| Body structure (body structure) | 69 |
| Specimen (specimen) | 1 |
| Situation with explicit context (situation) | 9 |
| Physical object (physical object) | 3277 |
| Event (event) | 2 |
| Environment or geographical location (environment / location) | 8 |
| Qualifier value (qualifier value) | 6 |
| Observable entity (observable entity) | 18 |
| Special concept (special concept) | 3 |
| Pharmaceutical / biologic product (product) | 10 |
| Clinical finding (finding) | 85 |
| Organism (organism) | 9740 |
| SNOMED CT Model Component (metadata) | 464 |
3.2.2. Reference sets
No new reference sets.
Updated simple reference sets:
- 500221000057105 | Care service reference set (foundation metadata concept) |
- 59821000052101 | Medical conditions, alert information reference set (foundation metadata concept) |
- 500061000057107 | Microorganism result reference set (foundation metadata concept) |
- 64641000052102 | Severe mental disorder simple type reference set (foundation metadata concept) |
- 113461000052109 | Presence of implant, alert information reference set (foundation metadata concept) |
- 59831000052104 | Treatments, alert information reference set (foundation metadata concept) |
- 500121000057102 | Specimen type reference set (foundation metadata concept) |
Updated language reference sets:
- 46011000052107 | Swedish [International Organization for Standardization 639-1 code sv] language reference set (foundation metadata concept) |
- 83461000052100 | ICNP Swedish language type reference set (foundation metadata concept) |
- 113491000052101 | Care service context language type reference set (foundation metadata concept) |
- 500191000057100 | Laboratory medicine context language type reference set (foundation metadata concept) |
- 900000000000508004 | Great Britain English language reference set (foundation metadata concept) |
- 900000000000509007 | United States of America English language reference set (foundation metadata concept) |
4. Technical notes
4.1. Known Issues
Known Issues are content or technical issues where the root cause is understood, and the resolution has been discussed and agreed but has yet to be implemented. This can be due to a number of reasons, from lack of capacity within the current editing cycle, to the risk of impact to the stability of SNOMED CT if the fix were to be deployed at that stage in the Product lifecycle.
For this cycle of the SNOMED CT Managed Service - Sweden Extension, the following Known Issues were identified, and agreed to be resolved in the next editing cycle:
4.2. Technical notes
4.2.1. Promoted concepts
Some concepts from the Swedish extension have been promoted to the international release (900000000000207008 | SNOMED CT core module (core metadata concept) |). The concepts have been added to the international release files with an effectiveTime which supersedes the latest effectiveTime in the Swedish extension release files. The concepts will be retained in the Swedish extension snapshot files in perpetuity as per SNOMED International recommendations and anyone using these files will have to manage the possibility of duplicated ids (with different effectiveTime) across release files. The risk of issues can be mitigated by filtering to only use Swedish extension records with effectiveTime:s greater than their International counterparts. Links to relevant documentation will be added to these release notes once that documentation has been updated.
The promoted concepts in the May 2022 release are:
- 58841000052102 |Bathe (administration method)|
- 72531000052105 |Counseling for contraception (procedure)|
4.2.2. Deprecated Refsets
The following refset(s) are being deprecated from the Sweden Extension Release package:
- 113461000052109 |urval förekomst av implantat, uppmärksamhetsinformation| - the use of this refset within Uppmärksamhetsinformation (UMI) has been deprecated and has been replaced with an information model referring to this refset: 59841000052105 |urval implantat, uppmärksamhetsinformation|. Please refer to the specification for details: https://www.socialstyrelsen.se/kunskapsstod-och-regler/omraden/e-halsa/tillampning/uppmarksamhetsinformation/.
For the May 2022 Release, this involved inactivating all records in the refset(s), and retaining the Refset file(s) in the Sweden Extension Release package.
For the next Release in November 2022, the inactive Refset file(s) will then be completely removed from the Sweden Extension Release package.
Note: However, the RefsetDescriptor record(s) for these deprecated Refsets will remain in the package (and will remain active), as the Descriptor patterns themselves are still valid, and therefore standard practice dictates that they remain in place.
Please contact the Sweden National Release Centre for any further details, or if you need assistance with these deprecations.
4.2.3. Notice of changes to the International Edition Release Schedule
As you may already know SNOMED International have transitioned to a monthly delivery schedule for the International Edition of SNOMED CT. The move towards more frequent releases of SNOMED CT realizes several benefits, including:
- The potential to be able to get content changes into the terminology in a shorter time frame.
- The fostering of better interoperability, as a result of entities being able to consume release content that is more aligned with other organizations.
- The prevention of circular dependencies that occur in longer projects, due to the move towards smaller, more manageable authoring projects.
- More automated validation services, as a result of the inherent removal of the Alpha/Beta stages in the Release cycle.
Whilst most users will continue unaffected (as they can simply continue to download the releases every 6 months as always), this transition will necessarily involve a few changes to process/packages:
- Delta files have been removed from both International and Managed Service release packages, including the Sweden Extension. A Delta Generation service will be provided for those who need it. The Delta Generation Tool allows users to create their own Delta between two fixed release dates - you can find it here:
- The ICD-O/ICD-10 Maps will continue to be published in each Monthly International Edition release package (in line with that month's content) for the foreseeable future, unless we experience issues with the new process in Production, and they need to be removed at a later date.
The first monthly Release of the SNOMED CT International Edition was published on the 28th February 2022 with the Delta files having been removed, and therefore they will be removed from the Sweden Extension from the May 2022 Release onwards.
Please note - While the SNOMED CT International Edition is moving to monthly releases, the Sweden Extension of SNOMED CT will remain on the current bi-annual release schedule of May and November for 2022.
Approvals
Draft Amendment History
|
Version |
Date |
Editor |
Comments |
|---|---|---|---|
|
0.1 |
|
Andrew Atkinson | Initial draft created |
| 1.0 |
|
Daniel Karlsson | Final changes made in MSSP-1543 |