I'm writing this out of frustration with some of the changes myself, and our users are experiencing, and am interested to know how things are with other members...
I appreciate that changes happen in SCT but many recent changes seem unnecessary, inconsistent and sometimes just confusing?
For example: Deep third degree burn of finger, not thumb (disorder) Has been retired as ambiguous.
“Possibly”
- Full thickness burn of skin and/or subcutaneous tissue of finger (disorder)
- Deep full thickness burn of finger (disorder)
The second replacement concept appears identical to the first? (Arguably the original concept is less ambiguous around the finger/thumb problem ...)
Presumably the intent was updating to the current language used burn classification (full thickness vs third degree).
However in the same release (Jan 2019) the concept 771226008|Deep third degree burn of abdomen (disorder)| was created. (No "full thickness" synonym exists).
Even more cryptic is the retirement of 403676009| Non-healing surgical wound (disorder) | as Erroneous.;
Replaced by a new concept 781187003| Non-healing surgical wound (finding) |
I'm not sure how the original and new concept are different. There's numerous precedent for retaining ids when semantic tag change. (And in this case, all disorders ARE subtypes of Clinical finding already)
These are just the most recent two I've encountered today. We've (AU) raised this previously, but got the impression we were the only member with concerns around the processes and changes. (And if that's still the case, we'll (try 
) keep out of commenting further.
I know SCT is designed with full history mechanisms, but changes have real impacts on mappings, and longitudinal analytics - which from experience many(most?) implementers don't deal well with.
2 Comments
Monica Harry
Thank you for the feedback and appreciate the frustration you express. We constantly strive to improve our processes by creating rules and auto reports to catch errors, omissions or inconsistencies and will continue to do so. We are doing our best to continually improve the content and it is unfortunate that at times this causes some pain for implementers however we firmly believe that overall the changes we are making result in an improvement in the usefulness of SNOMED. sincerely, Monica Harry
Matt Cordell
Thanks Monica, I think the end result will produce a better product. But it's the process and path that is the problem.
Looking at the upcoming July Beta:
I can see the terms are different, but I'm not sure what the semantic difference is in practice.
If it's clarifying the 'skin is grafted to the skin' (which I think is implicit).
Why wasn't the same applied to 699576001|Full thickness skin graft of hand (procedure)| which is now renamed |Full thickness graft of skin to skin of hand (procedure)|
I don't understand why the new concept was even created?
All changes affect current users, and I accept some change is unavoidable. But the inconsistency and partial changes really do make things difficult manage.