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

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284 | SNOMED CT Release Format 1 (RF1) Guide July 2012 3.3.4.8. Metadata hierarchy As the RF2 data structures and extensibility mechanism contain a number of concept enumerations, it is necessary to define concepts that represent these values. As well as the enumerated values, there are other machine-readable concept model structures not visible in the Release Format that require metadata (for example, the structures that define the format of a description type). To meet this need, a new top-level hierarchy has been defined as a sibling to the | SNOMED CT Concept |, called | SNOMED CT Model component |. Note that existing metadata concepts held within the | SNOMED CT Concept | sub-hierarchy (|Linkage| and | Namespace |) will be moved to the | SNOMED CT Model component | sub-hierarchy. The top level of the SNOMED CT Model component hierarchy is structured as follows: • 138875005 | SNOMED CT Concept (SNOMED RT+CTV3) | • 900000000000441003 | SNOMED CT Model Component (metadata) | • 900000000000442005 | Core metadata concept (core metadata concept) | ... • (Concept enumerations required to support SNOMED CT International Release data structures) • 900000000000454005 | Foundation metadata concept (foundation metadata concept) | ... • (metadata required by the Reference Set extensibility mechanism) • 106237007 | Linkage concept (linkage concept) | ... • 246061005 | Attribute (attribute) | ... • 416698001 | Link assertion (link assertion) | ... • 370136006 | Namespace concept (namespace concept) | ... Figure 44: SNOMED CT Model Component Hierarchy Note that only | is a | relationships will exist between concepts in the | SNOMED CT Model Component || hierarchy |. Other associations between concepts in this hierarchy can be modeled using an | Association type reference set (foundation metadata concept) | (see Association Reference Set). 3.3.4.9. SCTIDs and UUIDs UUIDs are unique universal Identifiers. These 128 bit unsigned integers can be used to identify all SNOMED CT components internally. SCTIDs will continue to be used as primary and foreign keys for concepts and descriptions, both to identify a component and to reference other components. This form is essential for vendors and implementers who will reference concepts in Clinical Information Systems and messages. SCTIDs will also be used to identify relationships. However, UUIDs will be used to identify Reference Set members. In addition, any UUIDs used in development can also be published as additional Identifiers via the Identifier file. 3.3.4.10. Description text The values permitted within the description term field have been extended to support arbitrary length content, and support mark-up content such as XHTML.The Description Type Reference Set allows a maximum length and format to be associated with each description type within the Description file. This mechanism allows descriptive text of different formats (other than Fully Specified Names and Synonyms) to be associated with concepts, while appropriately constraining existing description types. This enables all © 2002-2012 International Health Terminology Standards Development Organisation CVR #: 30363434
descriptions associated with concepts that may require translation to be held in one place in the Description file. 3.3.4.11. LanguageCode The languageCode field is retained in the Description file, but is restricted to contain only coarse-grained language information (e.g. "English" or "French"). Reference sets are used to indicate dialects and contexts, where required. As an example, the term "Bulldozer" would appear once in the Descriptions file with the language code en ("English"), but be listed separately in each of the Australian, UK and US English language national dialect Reference Sets as a valid term in all three dialects. The languageCode field in RF2 is a text field and is bound to the ISO 639-1 two-character language codes. 3.3.4.12. Addition of a modifierId field The underlying semantics on which SNOMED CT is based assumes that all relationships are existential restrictions. In other words, a relationship in SNOMED CT implies that there be some instance of that relationship from each instance of the source concept to any instance of the target concept. Other types of relationship, such as universal restrictions do exist and have been studied extensively. For example, the existence of a universal relationship in SNOMED CT would require that all instances of that relationship from each instance of the source concept be to an instance of the target concept. As an example, take the following hypothetical relationship |Has child | between two concepts | Woman | and | Girl |: | Woman | | Has child | = | Girl | In SNOMED CT, the relationship is implicitly an existential relationship, that we can make explicit in the above syntax by adding the modifier "some:", as follows: | Woman | some: | Has child | = | Girl | This means that every instance of | Woman | has at least one | Has child | relationship that has as its target an instance of | Girl |. In other words, in our hypothetical world, every woman would have at least one daughter, but may also have any number of sons. If the existential relationship were changed to a universal relationship, as follows, then the meaning would be changed: | Woman | all: | Has child | = | Girl | This means that, for every instance of | Woman |, all its | Has child | relationships must have a target of | Girl | . In other words, in our hypothetical world, women could only have daughters or no children at all, and could not have sons. This has a very different meaning from the existential relationship currently implied within SNOMED CT. A new modifierId field has been added to the Relationship file to allow future expansion. This concept enumeration field will initially be set to | Some | to keep compatibility with the existing semantics of SNOMED CT. Widening the range of this field to include other values (such as | All |) would in future increase the expressive power of SNOMED CT. However, this is likely to come at the cost of an increase in reasoning complexity, leading to potential issues for classification tooling. Therefore, before extending the range of this field beyond | Some |, a test of the impact on tooling will need to be performed, and the results reviewed and approved. Notes: Formats | 285 1. The modiferId field has been included at this stage as the RF2 format is likely to be stable for at least a five year period, without addition or deletion of fields. Within that period it is anticipated that other modifierId values will be added. Therefore, although not fully implemented at this stage, this field has been included in the initial RF2 specification as it represents an integral part of the Description Logic used by SNOMED CT. © 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
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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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Page 267 and 268: 3.2.13. Enumerated values Value 0 1
Page 269 and 270: Table and Field Subsets SubsetType
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Page 275 and 276: 3.3.3.4. Backward compatibility The
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Page 279 and 280: externalised structures such as Ref
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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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