The document "Concept Inactivation - Proposed Amendments" presents the work performed by the Concept Inactivation Working Group to review and analyse the current suite of inactivation reasons and historical associations with the objective to:

• Clarify the criteria for use of existing inactivation reasons and historical associations.
• Propose new inactivation reasons to fill existing identified gaps.
• Propose new historical associations to fill existing identified gaps.
• Define the purpose of each historical association and explain how authors should apply them and users interpret the impact on their data.
• Provide additional guidance for authors/editors.
• Recommend actions that should be taken when the concept to be inactivated has itself been the target of previous historical associations.

Instructions for review:

The layout of the main document gives an outline of the current definition, history, and current usage for each inactivation reason. These are presented so that you can see the context in which we have identified the key issues as they present themselves to authors/editors as they attempt to use the current suite of inactivation reasons and associated historical associations. With this background in mind, we have then presented our first draft proposals to improve the current process along with some additional guidance on their use so as to put the proposals into context.

In reviewing the document we would like you to read the sections up to the "proposals for change" and let us know if you think we have identified all of the issues. Then read the proposals and comment on whether you feel that they address the issues. First to help the authors/editors become more consistent in their application of the inactivation process e.g., are they more likely to choose the correct reason for inactivation and then be provided with the correct suite of historical associations to complete the process. Secondly, will the changes we have made make it easier for end-users and vendors to understand the reason for the inactivation of a given concept and the implication for them of using the historical association allocated.

Please either use the comment box below or send your responses directly to Paul Amos ( pam@snomed.org )

I hope that makes some sort of sense.

We appreciate your review of this document and your feedback on the proposed changes. Please complete your review before Friday 19th March 2021. Thank you.