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

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22 | SNOMED CT Release Format 1 (RF1) Guide July 2012 • Cross Map Target: a target scheme representation consisting of a single code or an expression consisting of several target codes. Note: In Release Format 2 cross maps are represented using Reference Sets. The type of Reference Set used varies according to the nature and complexity of the mapping. 2.1.2.4. Search support The Developer Toolkit, which is supplied as part of the SNOMED CT International Release, includes several tables that can be used to simplify and support for text searching. There are two WordKey Tables. These tables link each word used in SNOMED CT to every: • Description in which it is used; • Concept associated with an active description in which the word is used. There are also two Dualkey Tables. These tables link each abbreviated word pair to every: • Description in which that pair of words is used; • Concept in which the combined set of active descriptions contains that pair of words. These tables are provided to assist implementation. However, use of these tables is optional, as developers may generate and use alternative search support resources. An extended version of the Developer Toolkit, provides Java® programs to generate indexes that may be useful to organizations that develop SNOMED CT Extensions. 2.1.3. Extensions SNOMED CT is designed to allow the International Edition to be enhanced by adding Extensions that meet national or local requirements. Extensions are managed by IHTSDO Members or Affiliates who have been issued with a Namespace Identifier, which distinguishes the Identifiers of the Components they maintain. An Extension may contain Components of various types (e.g. Concepts, Descriptions, Relationships, and Derivatives including Reference Sets used for a variety of purposes). 2.1.3.1. Rationale for Extensions SNOMED CT is a detailed clinical terminology which covers a broad scope. However, some groups of users will need additional Concepts, Descriptions or Reference Sets to support national, local or organizational needs. This section explains the structures that enable IHTSDO Members (National Release Centers) and IHTSDO Affiliates to add Concepts, Descriptions, Relationships and Reference Sets to complement the SNOMED CT International Release. The Extension mechanism allows SNOMED CT to be adapted to address the terminology needs of a country or organization which are not met by the International Release. The mechanism provides a structure within which the components of each Extension are uniquely identified and attributed to a specific issuing organisation. This ensures that, when instance data containing content from different Extensions if communicated, the provenance of each referenced Concepts is clear and ambiguity is avoided. Since the International Release and all Extensions share the same common structure, the same application software can be used to enter, store and process information from different extensions. Similarly, Reference Sets can be constructed that refer to content from the International Release and a variety of Extensions. The common structure also means that, content developed by one organization can where relevant be easily submitted for possible inclusion in a National Edition or in the International Edition. Using the extension structure can also help organizations transfer responsibility for terminology to the IHTSDO or to another organization , subject to the terms of the Affiliate License . © 2002-2012 International Health Terminology Standards Development Organisation CVR #: 30363434
• Local content requirements that are likely to have wider applicability should be submitted to a National Release Center for consideration. • National requirements likely to have International value should be submitted to the IHTSDO so they can be considered for inclusion in the International Edition. 2.1.3.2. Practical uses of Extensions An Extension mechanism offers many advantages to developers, vendors, terminologists, national bodies and users. Such a mechanism allows: • Users to access the SNOMED CT International Release and one or more Extensions through a single user interface; • Developers to implement SNOMED CT Extensions without developing specialized software; • Vendors to develop and sell products to take advantage of both International Release content and Extensions; • Organizations to develop and share terminology that meet their business needs, without procuring software; • IHTSDO Affiliates to develop terminology that can be shared with other organizations and considered for addition to the International Release content; • IHTSDO Affiliates to use locally-developed terminology without potential overlap with the work of other organizations . This structure also enables specialized Concepts and Descriptions within an Extension to be related to Concepts and Descriptions distributed as part of SNOMED CT. • An Extension Concept may be: • A national or organizational definition of a concept, which is more rigorous or specific than that generally applied to the SNOMED CT Concept; • An experimental procedure that is not established sufficiently to merit the inclusion in the main body of SNOMED CT but which may be in a local controlled study. • Extension Descriptions may be colloquial synonyms for a SNOMED CT Concept or descriptions for an Extension Concept. • Extension Relationships may be required to allow analysis packages or decision-support protocols to access additional information about a SNOMED CT Concept or to describe relationships between Extension Concepts: • Links between local procedures and relevant administrative actions; • Links between local procedures and SNOMED CT Procedures. • Extension Subsets may group SNOMED CT Concepts in ways that are specific to data entry contexts of a particular application or communication specification. The Concepts, Descriptions, Relationship and Subsets that form an Extension must be: • Distinguishable from the main body of SNOMED CT, not only in the thesaurus, but also when stored in a patient record, query or decision support protocol; • Distinguishable from other Extensions, in the same way as they are distinguishable from the main body of SNOMED CT; • Able to be distributed and processed in the same way as equivalent components from the main body of SNOMED CT without requiring specific adaptations of SNOMED-enabled applications. The requirements for Extensions can be summarized as follows: Structure and Content Guide | 23 • Support for extra terminology components including Concepts, Descriptions, Relationships and Subsets: © 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 and 18: The full definitions of the concept
Page 19 and 20: Other components (i.e. Relationship
Page 21: 2.1.2.2.1.3. Linking related Concep
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
Page 69 and 70: 2.3.3.2. Specification for Namespac
Page 71 and 72: 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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