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

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318 | SNOMED CT Release Format 1 (RF1) Guide July 2012 4.4.2.2. Using | is a | Relationships for hierarchy navigation 4.4.2.2.1. What is the SNOMED CT hierarchy? The "SNOMED CT hierarchy" refers to the organization of concepts in SNOMED CT from the general, at the top of the hierarchy, to the more specific or "granular" at the bottom. The concepts that make up the very top level of the hierarchy are shown in Table 247. All other SNOMED CT concepts fall under one or more of these categories. Table 247: Top Level Concepts • | Clinical finding | • | Procedure | • | Observable entity | • | Body structure | • | Organism | • | Substance | • | Pharmaceutical / biologic product | • | Specimen | • | Special concept | • | Linkage concept | • | Physical force | • | Event | • | Environment or geographical location | • | Social context | • | Situation with explicit context | • | Staging and scales | • | Physical object | • | Qualifier value | • | Record artifact | Several levels of increasingly fine categorization may exist between the top level of the hierarchy and concepts that have sufficient detail to be recorded in a patient's medical record. Figure 46 shows the levels of hierarchy that exist between the top-level Concept "Finding/disorder" and the finding "Catatonic reaction." Figure 46: Hierarchy example: Catatonic Reaction 4.4.2.2.2. How is hierarchical information represented in the relationships table? The SNOMED CT relationships table represents Relationships between one SNOMED CT concept and another by including a row in the table for each such Relationship. The columns ConceptId1, Relationship Type and ConceptId2 define the source of the Relationship, the kind of Relationship that exists and the target of the Relationship respectively. Each of these fields, including Relationship Type, is a SNOMED CT concept Identifier. Hierarchical Relationships are expressed by linking the source concept to its "parents" i.e. the concept or concepts immediately above it in the hierarchy.The Relationship Type used to make this hierarchical link is known as the | is a | Relationship. For example, we can say | Catatonic reaction | | is a | | Psychological finding |, this would be expressed in the relationships table as follows: © 2002-2012 International Health Terminology Standards Development Organisation CVR #: 30363434
Table 248: Relationship Example ConceptId1 102909009 Where: Relationship Type 116680003 • 102909009 is the Concept Identifier for | Catatonic reaction |; ; • 116680003 is the Concept Identifier for the | Is a | Relationship; ; • 116367006 is the Concept Identifier for | Psychological finding |. . ConceptId2 116367006 Conversely, by inverting the | is a | Relationship we can find the children of the target Concept, i.e. the Concept or Concepts immediately below it in the hierarchy. 4.4.2.2.3. Using | is a | Relationships to enhance search capabilities This section is concerned with the ways in which the hierarchy can be used to help a SNOMED CT user when they are searching or browsing the terminology. Note: The primary use of the SNOMED CT subtype hierarchy is to support effective retrieval and aggregation of data. This is discussed elsewhere in Testing and traversing subtype relationships (4.5). It is possible to start at the top of hierarchy and navigate from parent to child in order to find a Concept or term in SNOMED CT. A more efficient approach, however, is to use the hierarchy to supplement a keyword search by enabling the user to look at related Concepts in order to consider them as alternative matches, or to check the context of a search result. The examples below illustrate these two uses of the SNOMED CT hierarchy. 4.4.2.2.4. Example: Using the hierarchy to check context A user wishes to find a description that relates to the condition of a patient who is hypersensitive to an allergen. The user performs a search on the keyword "Hypersensitivity" and finds an exact match. Before the user selects the description for inclusion in the patient record, they check the fully specified name, which is "Sensitivity (finding)." The user then checks the hierarchy and discovers that the selected Concept has "Psychological finding" as an ancestor, which indicates that this is not the correct description to use in this context. 4.4.2.2.5. Example: Using the hierarchy to check related Concepts Terminology services Guide (RF1) | 319 A user wishes to find a description that relates to the condition of a patient who is hypersensitive to an allergen, as in the example above.This time, a different approach is taken.The user searches for the keyword "allergy," and finds one Concept having a description that is an exact match. The user then looks at the children of the Concept, i.e. those concepts immediately below it in the hierarchy. One of the children has the preferred description"Contact Hypersensitivity" which matches the user's intended meaning. The user selects this Concept for inclusion in the patient record. 4.4.2.2.6. Using | is a | Relationships to display hierarchical information in applications Most visual application development tools contain a component designed to display hierarchical information as a tree in which branches can be expanded or collapsed. Tree views are well-suited to displaying SNOMED CT hierarchical Relationships (see Figure 47). These views are used in many different user-interfaces where information needs to be represented as a hierarchy (e.g. displaying a file-system as a hierarchy of folders or providing a collapsable outline of a document or help file). Therefore, most users will already be familiar this paradigm. © 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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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
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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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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Page 351 and 352: A field in the Component History Ta
Page 353 and 354: Cross maps table A data table consi
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Page 357 and 358: A field in the Cross Maps Table tha
Page 359 and 360: A Subset that specifies sets of Nav
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Page 363 and 364: TargetId A SNOMED CT Identifier tha
Page 365: WordText A field in the Word Equiva
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