Summary
Please be advised we are looking to inactivate the following content as it has been determined to be ambiguous at an international level. The concepts may mean <x> was looked for and not observed or was not looked for.
- 289346002 |Fetus not seen (finding)|
- 289401002 |Presenting part not seen (finding)|
- 289433006 |Fetal movements not observed (finding)| has synonym: Fetal movements not seen
- 289440007 |Fetal heart rate not observed (finding)| has synonym: Fetal heart rate not seen
- 300166005 |Ossicles not seen (finding)|
- 300174006 |Incus not seen (finding)|
- 300179001 |Stapes not seen (finding)|
- 300170002 |Malleus not seen (finding)|
- 247267005 |Tympanic membrane not visible (finding)| has synonym: Eardrum not seen
- 300121001 |Ear canal not seen (finding)|
- 300163002 |Middle ear not seen (finding)|
- 289468006 |Vulva not seen (finding)|
- 248865009 |Orifice of Bartholin's duct not seen (finding)|
- 289611004 |Hymen not seen (finding)|
- 289512004 |Vagina not seen (finding)|
- 300270009 |Pharynx not seen (finding)|
- 301959000 |Optic disc not seen (finding)|
- 300342009 |Gallbladder not seen (finding)|
- 289756001 |Uterine cervix not seen (finding)|
- 720446005 |Alveolar macrophage not seen (finding)|
O/E 'not seen' concepts already flagged for return to the UK in the July 2020 release.
If these concepts are used and and have a clear meaning within your country and this plan would impact you please advise Nicola Ingram from the SNOMED International Content Team by Friday 6th December.
Actions:
| Date | Requested action | Requester(s) | Response required by: | Comments |
|---|---|---|---|---|
| 20 November 2019 | Please see above. |
| Please post your final responses in the Country response table below. Discussion comments can be made as comments. |
Relevant documents
Links
Country response
| Country | Date | Response |
|---|---|---|
| Netherlands | 20-11-2019 | We asked about the meaning of this content, so I think that was the trigger to consider inactivation. We didn't know how to translate this content because of its ambiguity, so we agree with inactivation. |
| Norway | 27-11-2019 | We agree that the concepts are ambiguous, and agree to inactivate |
| United Kingdom | 27-11-2019 | Although many of these concepts have exceedingly low annual usage in the UK, a couple of them have significantly higher usage, for example 247267005 Tympanic membrane not visible (finding), which I presume is being recorded as part of a general ear examination, with the meaning that the examiner has been unable to visualize the tympanic membrane for whatever reason. This concept looks to be one of a set relating to degree of visibility of the tympanic membrane, and inactivating this one concept would result in a 'gap' in this set. Likewise 289433006 Fetal movements not observed (finding), which has steady usage in the UK, and which I interpret as meaning 'as part of e.g. an ultrasound examination, no fetal movements have been observed'. For these two, and possibly others, the intention is to convey the fact that an examiner has been unable to visualize a particular structure. If the plan is to inactivate these without replacement, this would cause us mapping problems (as many of these look to originate in CTV3). Inactivation of the 'not seen' descriptions, where other descriptions are active on a concept, would be preferable. I'll email Nicola Ingram as suggested above with comments. |
| Member countries without a CMAG rep |
CMAG response
| Date | CMAG Response | Next steps |
|---|---|---|
Final outcome:
Date:
2 Comments
Cathy Richardson
Sheree Hemingway , Elze de Groot , Jostein Ven . Thank you for your feedback. We will not be progressing with the inactivation at this point.
Olivier Bodenreider
Looking at this a bit late, sorry.
In addition to the "not seen" concepts listed above (none of which I could find evidence of use for in value sets), there are also negated "seen" findings, which should probably also be listed together (for which I found marginal use in value sets):
168230009 Sample direct microscopy no organism seen (finding)
27863008 No organisms seen (finding)
435151000124100 No acid fast organisms seen (finding)