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

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300 | SNOMED CT Release Format 1 (RF1) Guide July 2012 Chapter 4 Terminology services Guide (RF1) 4.1. Representing SNOMED CT in an application One of the first steps in the design and development of a terminology server is to decide how the SNOMED CT resources will be stored and accessed. Options include use of a relational database, an object database or a proprietary file structure. The decision will be influenced by the experience of the developers and the technical environment in which development is undertaken. The following sections briefly outline some of the options and identify general issues that should be considered when making this decision. Those intending to use a third-party terminology server are unlikely to be faced directly with the decision of how to represent the information. However, they will be interested in the consequences of these decisions in terms of performance and the overall size of the installed SNOMED CT resource. If a terminology server uses a particular relational database with an additional licensing or technical support cost this may also affect its suitability. 4.1.1. Direct use of release files in a relational database The distributed release files can be imported directly into a database schema that matches the distribution file specification. This data then provides core resource at the heart of a terminology server. This direct use of distributed files in a relational database has the advantage of allowing simple installation. However, it may not be the most efficient approach in terms of performance or file size. Some terminology services require relatively complex queries with multiple joins, and need to be completed in fractions of a second to provide an acceptable user interface. Example: To display the set of subtype children of a concept with their preferred terms in a specified language or dialect requires several joins between concepts, Relationships, Descriptions and a language refset. To search for a term matching a supplied pattern in a concept that represents a type of procedure also requires multiple joins to link the Descriptions with matching terms to the relevant concept and test whether it is a subtype of the 71388002 | Procedure (procedure) | concept. The performance criteria of searches and joins in very large relational databases vary significantly.Therefore, different optimizations may need to be used to achieve acceptable response times according to the nature of the relational database system. 4.1.2. Alternative relational structure There is no requirement to use the data structure as distributed. Other structures can be used provided they are able to deliver the range of Terminology services required. Options include: • More normalized representations of the model. © 2002-2012 International Health Terminology Standards Development Organisation CVR #: 30363434
Example: Excluding the Fully Specified Name field from the Release Format 1 Concepts table increases normalization of the data, since the Fully Specified Name is also available in the Description table. • Less normalized representations of the model. Example: Replicating the | is a | Relationships with the source and target ConceptId fields reversed decreases normalization of the data but might have some performance benefit. • Omission of some of the tables. Example: If a terminology server is not required to support cross mapping, the components required for this functionality may be omitted. • Replacement of some of the supporting tables with proprietary alternatives. Example: The word search support tables could be completely replaced by other tables or indices generated by the terminology server when loading the distribution files. 4.1.3. Non-relational structures Although the primary distribution format is relational, this does not require terminology servers to utilize a relational database as the primary or only storage format. The requirements for terminology services may also be met by representing some or all of the distributed data in other forms including object-oriented databases, Extensible Mark-up Language (XML) and/or proprietary data structures. These structures may be used separately or, in some cases, in combination with a relational database. A possible conclusion from analysis is that most terminology services are concept-centered. One structure that reflects this is a hierarchical design in which all the information about each concept is bound together as a discrete unit. Table 235: Representing SNOMED CT in a hierarchical structure SNOMED CT [1..n] Concepts [1..n] Descriptions [1..n] Subsets related to the Description) Including support for language and term usage subsets. [1..n] Relationships [1..n] Subsets related to the concept) Including support for subsets and crossmaps. Terminology services Guide (RF1) | 301 Such a structure needs support from indices and/or other data access tools to allow searches. However, it has the merit that whenever a concept is accessed, all the relevant information is immediately at hand without following relational joins to multiple rows in other tables. © 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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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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Page 267 and 268: 3.2.13. Enumerated values Value 0 1
Page 269 and 270: Table and Field Subsets SubsetType
Page 271 and 272: 3.3. Release Format 2 Update Guide
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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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