SNOMED CT® Release Format 1 (RF1) Guide - ihtsdo

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122 | SNOMED CT Release Format 1 (RF1) Guide July 2012 3.2.7. Content History The content of SNOMED CT evolves with each release. The types of changes may include new Concepts, new Descriptions, and new Relationships between Concepts, new Cross-maps, new Subsets, as well as updates and retirement of any of these components. These changes are driven by changes in understanding of health and disease processes; introduction of new drugs, investigations, therapies and procedures; new threats to health; as well as proposals and work provided by SNOMED CT partners and licensees. To achieve the goals stated in the widely-accepted paper on the desiderata for clinical terminologies, 9 the evolution of SNOMED CT follows these principles: • Graceful evolution rather than radical change. • The meaning of a Concept does not change. If the Concept's meaning changes because it is found to be ambiguous, redundant or otherwise incorrect, the Concept is made inactive. One or more new Concepts are usually added to better represent the meaning of the old Concept. • Concepts may become inactive but are never deleted. Concept Identifiers are persistent over time and are never reused. • The link between a Description and a Concept is persistent. If a Description is no longer pertinent for a Concept, the Description is inactivated. A new corrected Description for the Concept may be added. • Recognition of redundancy: • The same information can be stated two or more different ways. SNOMED CT is designed with a recognition of this possibility and facilitates recognition of equivalent statements. • When a Concept is inactivated as a result of duplication, SNOMED CT provides a reference to the continuing, active representation of that Concept. A SNOMED CT Component is a Concept, Description or Subset. Changes to these components are included in the Component History. "Significant" changes generally require the component to be retired and replacement component(s) are added. The retirement and addition are recorded in the history records. Some changes have been designated as minor and only require a history record to record the change. Why is this history important? These components may have been used directly in healthcare applications, or to define the terms used. For example, an inactive Description or Concept may have been used in: • Patient records; • Data entry templates; • Decision support protocols; • Reusable searches, queries or analyzes A change in a Relationship may alter the interpretation of stored information by protocols, queries and Subsets that include clauses which propagate across these Relationships. The history of Relationship changes may be computed by comparing different releases of the Relationships File; the IHTSDO does not provide this type of history file. Note that the Relationships File contains data about the history of the evolution of Concepts and supporting information. Therefore, a SNOMED CT enabled applications may want to modify searches, software, or update data convention tables as the terminology evolves. The SNOMED CT History Mechanism provides not only a history of changes, but also references to the current components that may be used instead. These references may be used in different ways. • To map legacy data to a current equivalent Concept • To enable a query or protocol to include information represented using Inactive Concepts 9 Desiderata for Controlled Medical Vocabularies in the Twenty-First Century, J.J. Cimino, Methods of Information in Medicine 1998:37:394-403 © 2002-2012 International Health Terminology Standards Development Organisation CVR #: 30363434
The History Mechanism is also used to track when the maintenance responsibility for one or more concepts is transferred between organizations . This requires the concept to be transferred from the International Release to an Extension, from an Extension to the International Release, or between Extensions. See Rationale for Extensions (2.1.3.1) for more information. 3.2.7.1. History Mechanism The history mechanism involves these tables: • Component History Table • Component History References Table All SNOMED CT Components have a unique SNOMED CT Identifier. The structure of these Identifiers is discussed in detail in Component features - Identifiers (2.1.1.4.2). When a component is first added, it is allocated an Identifier, which is unique, permanent and cannot be changed. A component that is no longer required can be inactivated, and its Identifier will never be reused. A limited set of permitted minor changes may be made to a component as specified by the Component History Rules. A component may be replaced by another component to allow more significant changes. "Replace" means the original component is inactivated and one or more replacement components are added. 3.2.7.1.1. History Mechanism - Structure diagram Figure 40: History Mechanism Overview (RF1) Release File Formats | 123 © 2002-2012 International Health Terminology Standards Development Organisation CVR #: 30363434
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SNOMED CT ® Release Format 1 (RF1)
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Contents | 3 Release Format 1 - Det
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Chapter 1 Preface The purpose of th
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Table 3: Document Types Type Name a
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IHTSDO Glossary (DRAFT) • On line
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Chapter 2 Structure and Content Gui
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Figure 1: Multiple levels of granul
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Table 5: Example: Defining arthriti
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The full definitions of the concept
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Other components (i.e. Relationship
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2.1.2.2.1.3. Linking related Concep
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• Local content requirements that
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Consistent representation is a prer
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Figure 8: Abstract logical model of
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1. As originally stated: : • | Ha
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2.2.1.3.2.3.1. Supertype aspects of
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Figure 11: Example hierarchy with l
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Concept E F G H J K L M Note: Compr
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Concept M List of proximal primitiv
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Table 11: Non-redundant attribute v
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G. | Severe upper limb laceration |
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As a result of this limitation some
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2.2.1.4.3. Historical relationships
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2.2.2.1.1.2. Refinement attribute n
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2.2.2.1.4.3. Use of "unapproved att
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Interim recommendations 1. Wherever
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2.2.2.3.1. Close-to-user expression
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It is important to note that combin
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2.2.2.3.6.1. Example of equivalent
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Figure 25: Alternative expressions
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Figure 27: Possible expressions of
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Figure 28: SCTID Short Format - App
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PartitionId 05 Description A Cross
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SctId 999999990989121104 2.3.2.9. T
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2.3.3.2. Specification for Namespac
Page 71 and 72: 2.3.3.3.1.4. Procedures 2.3.3.3.1.4
Page 73 and 74: 1. Every Concept in an Extension:
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Page 91 and 92: 2.3.7.2.2.1. Single byte encoding C
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Page 99 and 100: version. It seems unwise to prevent
Page 101 and 102: Table DescDualKey Table ConcDualKey
Page 103 and 104: The IHTSDO recognizes that, while i
Page 105 and 106: 3.2.2. Release Format 1 - Structure
Page 107 and 108: 3.2.3.2. Core Tables Data - Structu
Page 109 and 110: Data Fields InitialCapitalStatus De
Page 111 and 112: 3.2.4.1. Subset Mechanism - Structu
Page 113 and 114: Data Fields ContextId 3.2.4.2.2. Su
Page 115 and 116: Subset SNOMED CT Top Level Navigati
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Page 119 and 120: Table 41: Cross Mapping Tables Cros
Page 121: Table 44: Cross Map Targets Table K
Page 125 and 126: In addition, the ReferencedId field
Page 127 and 128: Table Descriptions Descriptions Rel
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Page 143 and 144: As new concepts are added to SNOMED
Page 145 and 146: Table 73: DescriptionStatus Values
Page 147 and 148: 3.2.9.2.2.4. InitialCapitalStatus T
Page 149 and 150: 3.2.9.3. relationships tables Each
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Page 153 and 154: An integer value that expresses an
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Page 157 and 158: A string that identifies a Context
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Page 169 and 170: 3.2.9.4.2.8.1.3. MemberStatus Table
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3.2.9.5.1.2.3. MapSetSchemeId Table
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This discussion of rules is include
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3.2.9.5.1.3.2.3. MapRule Table 151:
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3.2.9.5.1.4.2.3. TargetRule Table 1
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RELAT_NMS = column in the LOINC tab
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The value of the SNOMED CT / LOINC
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The SNOMED CT Relationships Table e
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LOINC Analyte Name(s) DESMETHYLAMIO
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LOINC Analyte Name(s) COMPLEMENT IC
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The information provided includes d
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3.2.9.6.4.1.2. ReleaseVersion Table
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Value 6 7 8 9 10 11 Note: Name Limi
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3.2.9.6.5.1.1. ComponentId Table 17
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Release Format 1 is represents a sn
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RF1 Descriptions Table Descriptions
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Table 177: Concepts Table Use of re
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Use of recommended additional indic
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Use of recommended additional indic
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Table 184: Cross Map Sets Table Use
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Keys Partition Size Type Field Name
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Table 192: Word Equivalents Table U
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3.2.10. The Stated relationships ta
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Figure 41: Overview of Cross Map Sc
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Table 197: Cross Maps Sets Table Ma
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Table 201: Cross Maps Sets Table Ma
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Table 205: Cross Map Sets Table Map
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If this approach is followed, there
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This approach allows a more consist
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1. A record may contain many record
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• Temporally related to the selec
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CONCEPTID 95333004 7119001 95336007
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CONCEPTID 109778006 109788007 15270
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CONCEPTID 417163006 417746004 12820
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CONCEPTID 102706005 1677001 9145400
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CONCEPTID 399023006 399154007 39905
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CONCEPTID 399306005 399239005 39937
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CONCEPTID 125086000 78678003 388393
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CONCEPTID 339008 47002008 128419007
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CONCEPTID 16817006 15367004 1580700
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CONCEPTID 14509009 39250009 8627300
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CONCEPTID 122868007 122465003 78817
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CONCEPTID 19207007 74923002 6639100
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CONCEPTID 54305003 84100007 3216600
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CONCEPTID 255496004 255499006 24646
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CONCEPTID 62834003 5668004 34810001
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CONCEPTID 53224005 4150005 74636004
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CONCEPTID 47538007 19359003 3011000
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3.2.13. Enumerated values Value 0 1
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Table and Field Subsets SubsetType
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3.3. Release Format 2 Update Guide
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• The Release Format should minim
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3.3.3.4. Backward compatibility The
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3.3.4.5. Field Ordering Records in
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externalised structures such as Ref
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ContextId If either the RealmId fie
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eplaced by more descriptive ones if
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descriptions associated with concep
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Figure 45: Illustration of module d
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was inactivated. Each Reference ind
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Finally, add members to the Referen
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3.4.1. File Naming Convention - Ove
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• Test/Beta Release File("xsct",
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In certain cases, an RF1 data file
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VersionDate refers to the official,
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Example: Excluding the Fully Specif
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4.2.1.3. Pre-processing of distribu
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• Reject, highlight or apply othe
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Table 236: Essential concept Identi
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The purpose of this section of the
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Table 240: Example results for a Se
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• For each dual key, add rows to
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• Description104951019 is elimina
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4.4.1.4.1. Avoiding multiple hits o
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Table 248: Relationship Example Con
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• Since the depth of the hierarch
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4.4.2.5. Using navigation Subsets t
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Table 253: Concepts used in the Exa
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SubsetId Mem
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• 302402006 | radius and/or ulna
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Now we have tree nodes and their ch
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Subsets may be used to derive table
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• One Subset can be used as the b
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• A Context Concept Subset only r
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• A Navigation Subset specifies a
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• A RealmID identifies the specia
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4.5. Testing and traversing subtype
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This approach removes the need for
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4.5.5.2.4. Using the transitive clo
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Figure 55: Terminology server provi
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A field in the Component History Ta
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Cross maps table A data table consi
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• References Table Inactive compo
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A field in the Cross Maps Table tha
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A Subset that specifies sets of Nav
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A field in the Concepts Table that
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TargetId A SNOMED CT Identifier tha
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WordText A field in the Word Equiva
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