5.3.2.2 Adding Severity to Clinical Findings

At level 1, the terminology server will accept CTU expressions matching the following pattern:

This means that CTU expressions that includes the severity attribute will be accepted if the following criteria are met:

The focus concept is a subtype of |Clinical finding| (but not a subtype of 162465004 | Symptom severity (finding)| )
The attribute value must be a subtype of 272141005 | Severities (qualifier value)|
When applied as a loose attribute, only one instance of the attribute may be stated in the CTU expression
The severity attribute is not already present in the definition of the focus concept

As part of the transformation process, the terminology server will place the attribute in a group on its own, similar to the self-grouped attributes.

Important Notes

Please be aware that caution should be taken when adding |severity| to a focus concept, because severities are difficult to generalize and may be subject to individual interpretation, as stated in the Editorial Guide.

Table 5.3.2.2-1: Examples of CTU expressions candidates to this pattern, and their evaluation at level 1.

CTU expression	Accept/reject	Notes	Classifiable form
16331000 \|Heartburn\| : 246112005 \|Severity\| = 24484000 \|Severe\|	Accept	Focus concept is within the domain of the attribute and the attribute value is within the allowed range of the attribute.	=== 16331000 \|Heartburn\| : { 363698007 \|Finding site (attribute)\| = 32849002 \|Esophageal structure (body structure)\| } { \|Severity\| = 24484000 \|Severe\| }
25064002 \|Headache\| : 246112005 \|Severity\| = 162471005 \|Symptom very severe\|	Reject	Attribute value is not within the allowed range for the \|severity\| attribute.	N/A
717933005 \|Severe thinness in adulthood\| : 246112005 \|Severity\| = 442452003 \|Life threatening severity\|	Reject	Focus concept is already defined with a \|severity\| attribute, and the attribute value stated in the CTU is not a subtype of the value of the focus concept.	N/A

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