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

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340 | SNOMED CT Release Format 1 (RF1) Guide July 2012 • Restrict access to Concepts so that only those referred to by a selected Realm Concept Subset are accessible; • Restrict access to Descriptions so that only those associated with Concepts referred to by a selected Realm Concept Subset are accessible; • Restrict use of Relationships so that any Relationship that refers to a Concept that is not referred to by the Realm Concept Subset is rendered unusable. Example: • An oncology subspecialty organization Realm Concept Subset may refer to the hierarchical descendants of a general Concept representing "Grant funding for cancer research"; • A UK NHS Realm Concept Subset may refer to the hierarchical descendants of a general Concept representing " NHS National Service Frameworks.". 4.4.3.5.7. Regional variations in disease prevalence There are substantial differences in the prevalence of diseases in different regions in which SNOMED CT may be used. Users will expect to find the conditions they commonly deal with, without being distracted by long lists of conditions they rarely see. In the main body of SNOMED CT, all Concepts are equally visible irrespective of their relative prevalence. The Subset mechanism can be used for prioritizing the Concepts in the following way: • Realm Concept Subset can be specified for a region with a particular pattern of disease prevalence. • A RealmID identifies the region. • A Realm Concept Subset refers to all the Concepts used in that region. For each of these Concepts, the Subset may specify a MemberStatus that assigns a priority to that Concept. Concepts that are used most frequently in a region are assigned first priority (MemberStatus =1). There are nine priority levels (MemberStatus =1 to 9).The least frequently used Concepts are assigned the lowest priority (MemberStatus =9). • A Realm Concept Subset only refers to Concepts. However, the assigned priority also affects the Descriptions associated with those Concepts. A SNOMED CT enabled application should be able to: • Prioritize access to Concepts relative to one another according to the MemberStatus specified by a selected Realm Concept Subset; • Prioritize access to Descriptions relative to one another according to the MemberStatus assigned to the associated Concepts by a selected Realm Concept Subset. The way in which access is prioritized depends on the nature of the application and its operating environment. However, examples of prioritization include: • Showing Descriptions associated with high priority Concepts before those with lower priority when searching for word or phrases; • Showing Concepts with high priority before their less highly prioritized siblings in hierarchical displays; • Initially listing Concepts and associated Descriptions with priority above a specified threshold and requiring an additional step to access those assigned lower priority. 4.4.3.5.8. Specialty and discipline-dependent variations in use of Concepts SNOMED CT contains Concepts used by many different groups of health professionals. The frequency of use of these Concepts depends on the professional discipline and/or clinical specialty of the user. It is important to ensure that the user is able to access the Concepts that they use frequently, without being distracted by thousands of textually similar Concepts they rarely require. The Subset mechanism can be used for prioritizing the Concepts in the following way: • A Realm Concept Subset can be specified for each clinical specialty and/or discipline. © 2002-2012 International Health Terminology Standards Development Organisation CVR #: 30363434
• A RealmID identifies the specialty. • A Realm Concept Subset refers to all the Concepts used in that specialty. For each of these Concepts, the Subset may specify a MemberStatusthat assigns a priority to that Concept. There are nine priority levels from 1 (highest priority) to 9 (lowest priority). • A Realm Concept Subset only refers to Concepts. However, the assigned priority also affects the Descriptions associated with those Concepts. 4.4.3.5.9. Local needs of organizations or individual users The previous sections have dealt with requirements of countries, regions and specialties. Organizations and individual users may also have similar requirements for restricting or prioritizing access to particular Concepts. The Realm Concept Subsets described in the previous sections may also be applied at a more local level to meet the needs of an organization , user or group of users. In practice , a localorganization or individual user will often need a Realm Concept Subset derived by merging or refining other Realm Concept Subsets. Example: A cardiologist, working in "Any Town General Hospital," an NHS hospital in the UK, may be best served by a Subset derived from a combination of the existing Realm Concept Subsets specified for: • UK NHS • Cardiology specialty. • Any Town General Hospital. • With modifications for any local factors (e.g. special research interests of the local cardiology department or clinician). 4.4.3.5.10. National, organizational and specialty variations in term preferences In addition to requirements for different Concepts, a country, organization or specialty may have different preferences for the Terms to be used to describe identical Concepts. The Subset mechanism meets the requirement for national and region variations in the use of Terms in the following way: • Any Realm that requires a specialized refinement of a Language or Dialect may specify a Realm Description Subset. • A Realm Description Subset is similar to a Language Subset but differs in two ways: • It contains a RealmID that identifies a Realm within which it applies; • It must not be used to override the language -specific Fully Specified Name role assignments made by a Language Subset. • Support for Term variations is Language or Dialect dependent. Therefore, in a multilingual country or organization , there may be a single Realm Concept Subset but several separate Realm Description Subsets. A SNOMED CT enabled application should be able to: • Use a selected Realm Description Subset, in place of a Language Subset, to restrict access to terms and to assign the Preferred Term and Synonym roles to different Descriptions. 4.4.3.5.11. Managing the coded content of messages Terminology services Guide (RF1) | 341 Healthcare messages include fields that can be populated with codes from clinical coding schemes. SNOMED CT provides Concept Identifiers as a means of encoding Concepts. These concept Identifiers are suitable for use in appropriate fields of many clinical messages. © 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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descriptions associated with concep
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Figure 45: Illustration of module d
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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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