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

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18 | SNOMED CT Release Format 1 (RF1) Guide July 2012 Figure 7: Illustration of Defining Relationships 2.1.1.4. Common Features of Components This section describes common features of all SNOMED CT Components including identification and history management. 2.1.1.4.1. Component features - History The content of SNOMED CT evolves with each release. The types of changes made include new Concepts, new Descriptions, new Relationships between Concepts, new Cross Maps, and new Subsets, as well as updates and retirement of any of these components. Drivers of these changes include changes in understanding of health and disease processes; introduction of new drugs, investigations, therapies and procedures; and new threats to health, as well as proposals and work provided by SNOMED CT users. Once released, the unique Identifiers of SNOMED CT components are persistent, and their Identifiers are not reused. Concepts and Descriptions continue to be distributed even when they are no longer recommended for active use. This allows a current release to be used to interpret data entered using an earlier release. The ConceptStatus or DescriptionStatus fields are used to indicate the reason for inactivating a component.These reasons include errors, duplication of another component and ambiguity of meaning. Some SNOMED CT Concepts represent classification concepts that have imprecise and potentially changeable meanings. These are marked with the ConceptStatus"limited" and were considered active until the January 2010 release of SNOMED CT. All Limited (ConceptStatus = 6) concepts are now considered to be inactive. 2 2 Some Concepts derived from classifications such as ICD-10 include the abbreviations NOS (not otherwise specified) or NEC (not elsewhere classified). These are only valid in respect of a particular classification and change in their meaning if additional precisely defined codes are added to that part of the classification. © 2002-2012 International Health Terminology Standards Development Organisation CVR #: 30363434
Other components (i.e. Relationships, Subsets, Cross Map Sets, Cross Maps and Cross Map Targets) are not distributed if they are no longer in active use. When a component is added, inactivated or otherwise changes its status, this is noted in the Component History Table. When a Concept is no longer in active use, is replaced by or duplicates another component, this is indicated by an appropriate historical relationship. When a Description, Subset or Cross Map Set is replaced by or duplicates another component, this is indicated by a row in the References Table. 2.1.1.4.2. Component features - Identifiers Components within SNOMED Clinical Terms are identified and referenced using numeric Identifiers. These Identifiers have the data type SCTID (SNOMED CT Identifier). The SCTID data type is 64-bit integer which is allocated and represented in accordance with a set of rules. These rules enable each Identifier to refer unambiguously to a unique component.They also support separate partitions for allocation of Identifiers for particular types of component and namespaces that distinguish between different issuing organizations . 2.1.2. Derivatives This section describes derivatives that are specified by and distributed as part of SNOMED CT. Derivatives are artifacts which are either required or useful to support some aspect of SNOMED CT enabled implementation. These artifacts are known as derivatives because they are derived from SNOMED CT Components and either add properties to them or specify sets of related components. All SNOMED CT enabled applications need to support some derivatives. The set of derivatives that need to be supported by an implementation depend on user requirements for particular types of functionality. Important aspects of functionality that require support for relevant derivatives include: • Tracking changes to the status of components; • Filtering and prioritizing searches; • Representing alternative navigation hierarchies; • Adding annotations to components; • Cross mapping to and from other coding schemes and classifications. 2.1.2.1. Reference Sets Reference Sets represent groups of components that share specified characteristics that affect the way the components are displayed or otherwise accessible within a particular realm, specialty, application or context. Different types of Reference Set are used to represent: Structure and Content Guide | 19 • Language and dialect variations in the use of particular terms to describe a Concept; • Subsets of component that are included in or excluded from the set of values that can be used in a particular country, organization , specialty or context; • Frequency of use of Descriptions or Concepts in particular country, organization , specialty or context; • Suitability of particular Concepts for use in a particular context in a record or message; • Structure and ordering of hierarchies displaying Concepts for user navigation. Reference Sets can be represented using the Subset and SubsetMembers files of Release Format 1 or using the Refsets files specified by Release Format 2. In both cases, each rows in these tables represents a Furthermore, a Concept that is not otherwise specified in ICD-10 may well be more precisely represented by another SNOMED CT Concept and thus from a SNOMED CT perspective "otherwise classified." © 2002-2012 International Health Terminology Standards Development Organisation CVR #: 30363434
Page 1 and 2: SNOMED CT ® Release Format 1 (RF1)
Page 3 and 4: Contents | 3 Release Format 1 - Det
Page 5 and 6: Chapter 1 Preface The purpose of th
Page 7 and 8: Table 3: Document Types Type Name a
Page 9 and 10: IHTSDO Glossary (DRAFT) • On line
Page 11 and 12: Chapter 2 Structure and Content Gui
Page 13 and 14: Figure 1: Multiple levels of granul
Page 15 and 16: Table 5: Example: Defining arthriti
Page 17: The full definitions of the concept
Page 21 and 22: 2.1.2.2.1.3. Linking related Concep
Page 23 and 24: • Local content requirements that
Page 25 and 26: Consistent representation is a prer
Page 27 and 28: Figure 8: Abstract logical model of
Page 29 and 30: 1. As originally stated: : • | Ha
Page 31 and 32: 2.2.1.3.2.3.1. Supertype aspects of
Page 33 and 34: Figure 11: Example hierarchy with l
Page 35 and 36: Concept E F G H J K L M Note: Compr
Page 37 and 38: Concept M List of proximal primitiv
Page 39 and 40: Table 11: Non-redundant attribute v
Page 41 and 42: G. | Severe upper limb laceration |
Page 43 and 44: As a result of this limitation some
Page 45 and 46: 2.2.1.4.3. Historical relationships
Page 47 and 48: 2.2.2.1.1.2. Refinement attribute n
Page 49 and 50: 2.2.2.1.4.3. Use of "unapproved att
Page 51 and 52: Interim recommendations 1. Wherever
Page 53 and 54: 2.2.2.3.1. Close-to-user expression
Page 55 and 56: It is important to note that combin
Page 57 and 58: 2.2.2.3.6.1. Example of equivalent
Page 59 and 60: Figure 25: Alternative expressions
Page 61 and 62: Figure 27: Possible expressions of
Page 63 and 64: Figure 28: SCTID Short Format - App
Page 65 and 66: PartitionId 05 Description A Cross
Page 67 and 68: SctId 999999990989121104 2.3.2.9. T
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2.3.3.2. Specification for Namespac
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2.3.3.3.1.4. Procedures 2.3.3.3.1.4
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1. Every Concept in an Extension:
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Table 17: Processing Transfers betw
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In May 2008, the HL7 Version 3 Stan
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An expression supports combinations
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digitNonZero= %x31-39 The first cha
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excision of left fallopian tube. No
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This existential restriction is lab
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• In order to generate the OWL ve
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• Though there are many candidate
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2.3.7.2.2.1. Single byte encoding C
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9 0 9 Table 29: The full array for
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else {document.getElementById("out"
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http://www.augustana.ab.ca/~mohrj/a
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version. It seems unwise to prevent
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Table DescDualKey Table ConcDualKey
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The IHTSDO recognizes that, while i
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3.2.2. Release Format 1 - Structure
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3.2.3.2. Core Tables Data - Structu
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Data Fields InitialCapitalStatus De
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3.2.4.1. Subset Mechanism - Structu
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Data Fields ContextId 3.2.4.2.2. Su
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Subset SNOMED CT Top Level Navigati
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• as a combination of codes; •
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Table 41: Cross Mapping Tables Cros
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Table 44: Cross Map Targets Table K
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The History Mechanism is also used
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In addition, the ReferencedId field
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Table Descriptions Descriptions Rel
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Table 49: Relationships depending o
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Table 51: Changes to Relationships
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Table 52: Changes to Relationships
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• The only Relationships that it
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ComponentId ConceptId ReleaseVersio
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A readme.txt file is distributed wi
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Value 6 10 11 Limited Moved elsewhe
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As new concepts are added to SNOMED
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Table 73: DescriptionStatus Values
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3.2.9.2.2.4. InitialCapitalStatus T
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3.2.9.3. relationships tables Each
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3.2.9.3.2.3. ConceptId2 Table 84: -
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An integer value that expresses an
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3.2.9.4.1.2.4. SubsetType Table 95:
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A string that identifies a Context
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3.2.9.4.2.1.2. Data Fields Table 10
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• MemberStatus 3.2.9.4.2.3.1.1. S
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3.2.9.4.2.4.1.3. MemberStatus Table
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3.2.9.4.2.5.2. Data Fields Table 11
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3.2.9.4.2.7.1.1. SubsetId Table 124
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3.2.9.4.2.8.1.3. MemberStatus Table
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3.2.9.4.3. Subset Definition File P
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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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