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

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336 | SNOMED CT Release Format 1 (RF1) Guide July 2012 4.4.3.5. Practical uses of Subsets Subsets can be used for many different purposes. This section outlines some of the ways in which the mechanism specified in this guide can be used to meet different practical requirements. The uses outlined are illustrative examples and do not represent all possible applications of Subsets. 4.4.3.5.1. Controlling data entry Many clinical applications include facilities for data entry to be controlled or assisted by protocols, templates or structured data entry forms. Different sets of candidate Terms or Concepts may be appropriate to each data entry field. The sets of candidate Terms or Concepts for a field may be very large (e.g. any operative procedure) or very small (e.g. the possible observations from a particular examination). The Subset mechanism allows Concepts relevant to particular uses to be specified as follows: • A Context Concept Subset or Context Description Subset can be specified for each data entry field. • A Context Concept Subset refers to all the Concepts that are applicable to a particular category of use: • A Context Concept Subset allows any Description associated with the set of permitted Concepts to be used (i.e. a Preferred Term or a Synonym). • Context Description Subset refers to all the Descriptions that are applicable to a particular field: • A Context Description Subset only allows a specified set of Descriptions to be used. The permitted set of Concepts is implicitly any Concept associated with permitted Description. A SNOMED CT enabled application can make use of Context Subsets if it is able to associate data entry fields with an identifiable Context Domain. There are several alternative ways of using Context Subsets. These include: • For fields associated with a Context Subset containing only a small number of permitted values, the members of the Subset may be used to populate a drop-down list or another similar option selection tool; • For fields associated with a larger range of options, a Context Subset may be used as a filter for searches; • When using automated text encoding tools a Context Subset may limit the scope of possible encoding and thus should accelerate and improve the accuracy of parsing. 4.4.3.5.2. Using terminology in electronic health records When a user searches SNOMED CT, they should only see Descriptions associated with Concepts that are usable in the context in which they are working. The Concepts that form part of SNOMED CT have various different uses.There are many examples of Concepts that are meaningless if used in an inappropriate context. These include: • Concepts that are used purely to structure and organize the terminology but which would be meaningless in a patient record (e.g. the root Concept, top-level Concepts). • Concepts that may be useful as headings for sections in a record but which convey no clinical meaning (e.g. general Concepts like "Laboratory results," "Medication"). • Concepts that refer to an organism or material which are only meaningful in the context of other information (e.g. "Aspirin" is meaningful in a patient record only as part of, or in relation to, another Concept such as "Overdose," | Allergic reaction | or "Prescribed"). • Concepts that refer to disorders are meaningless or misleading if used to record a procedure. The Subset mechanism allows Concepts relevant to particular uses to be specified as follows: • A Context Concept Subset can be specified for any distinct category of use associated with a set of Concepts. • A Context Concept Subset contains a RealmID and ContextID which identify the Context Domain to which it applies. • A Context Concept Subset refers to all the Concepts that are applicable to a particular category of use. © 2002-2012 International Health Terminology Standards Development Organisation CVR #: 30363434
• A Context Concept Subset only refers to Concepts. However, it also affects the availability of Descriptions. A Description associated with a Concept that is not used in a particular context is not accessible. A SNOMED CT enabled application should be able to recognize usage categories that are relevant to it and should apply the appropriate Context Concept Subsets to: • Restrict access to Concepts (and associated Descriptions) so that only those referred to by the Context Concept Subsets are accessible. 4.4.3.5.3. Languages and Dialects SNOMED CT is designed as a multilingual terminology. The Subset mechanism enables SNOMED CT to support different Languages and Dialects in the following way: • There is a Language Subset for each supported Language and Dialect. • The LanguageCode identifies the Language or Dialect. • A Language Subset refers to all the Descriptions that contain Terms expressed in that Language or Dialect. • Each member of a Language Subset has a MemberStatus. This indicates the use of the Description in relation to its associated Concept. In each Language or Dialect, a Description may represent a: • Preferred Term • Synonym • Language -specific Fully Specified Name A SNOMED CT enabled application should be able to: • Allow a selection of a particular Language Subset as a configuration option; • Restrict access to Descriptions so that only those referred to by a selected Language Subset are accessible; • Treat the Preferred Terms and language -specific Fully Specified Name referred to by a selected Language Subset in a manner appropriate to their specified usage. Some applications may also support multiple Languages or Dialects allowing selection of combinations of Language Subset. 4.4.3.5.4. Managing duplicate terms A Fully Specified Name in a given Language or Dialect is uniquely associated with one and only one Active Concept. However, this requirement does not apply to other Terms (i.e. Preferred Terms and Synonyms). SNOMED CT permits the same Term to occur in more than one Active Descriptions each associated a different Active Concept.This enables Preferred Terms and Synonyms to be phrased in the natural languages of clinicians without discriminating between those in different disciplines or specialties who use the same words or phrases to mean different things. Example: • "Liver" - may refer to a foodstuff (dietitian ) or to a body organ (surgeon); • "Fundus" - may refer to part of the eye, stomach or uterus depending on specialty and context; • "Aspiration of stomach content" - may refer to a procedure (following poisoning) or a complication of anesthesia or childbirth; • "Hypertension" - may refer to a finding (raised blood pressure) or to a recognized diagnosis with particular diagnostic criteria. Similarly the same words or phrases may be used to refer to the Concept with different levels of precision. Example: Terminology services Guide (RF1) | 337 | Arm | - may refer to the entire arm (as in "amputation of arm") or to part of the arm (as in "injury to the arm"). © 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
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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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Page 343 and 344: 4.5. Testing and traversing subtype
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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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