SNOMED CT July 2016 International Edition - IHTSDO Release notes
Date | 20160731 |
Document Version | 1.00 |
Release Status | PRODUCTION |
1 Introduction
1.1 Background
SNOMED CT terminology provides a common language that enables a consistent way of indexing, storing, retrieving, and aggregating clinical data across specialties and sites of care.
The International Health Terminology Standards Development organisation (IHTSDO®) maintains the SNOMED CT technical design, the content architecture, the SNOMED CT content (includes the concepts table, the descriptions table, the relationships table, a history table, and ICD mappings), and related technical documentation.
1.2 Purpose
This document provides a summarized description of the content changes included in the July 2016 release of SNOMED Clinical Terms® (SCT) International Release.
It also includes technical notes detailing the known issues which have been identified. These are content or technical issues where the root cause is understood, and the fix has been discussed and agreed, but has yet to be implemented.
This document is available as part of the July 2016 International Edition release.
1.3 Scope
This document is written for the purpose described above and is not intended to provide details of the technical specifications for SNOMED CT or encompass every change made during the release.
1.4 Audience
The audience includes National Release Centers, WHO-FIC release centers, vendors of electronic health records, terminology developers and managers who wish to have an understanding of changes that have been incorporated into the July 2016 International Edition release.
2 Content Development Activity
2.1 Summary
Continuous quality improvement and enhancement of existing content is ongoing based on requests received via the SNOMED International Request Submission System (SIRS). Over 900 requests have been successfully edited using the new Single Concept Authoring (SCA) Tool. In addition, specifically, the July 2016 International Edition release has seen a continuation of the work driven by contributions from the Kaiser Permanente Convergent Medical Terminology (CMT), Global Medical Device Nomenclature Agency (GMDNA) and Orphanet to add new content to SNOMED CT. Further, member-identified priority projects, have driven enhancements in the anatomy hierarchy, while other project-driven changes have resulted in over (to be confirmed) edits in total, including new content additions and enhancements to existing content.
2.2 New and Updated Content
In total: 2602 new concepts were authored with an additional 2019 changes made to existing concepts.
2.2.1 Anatomy
Over 100 new anatomy concepts have been added for representation of different sections of the prostate to support annotation for clinical imaging. The new codes are included in the DICOM subset for structured reporting.
2.2.2 Assessment Scale
750 requests for new assessment scales and associated concepts e.g. procedures and observables to record scores have been added.
2.2.3 Convergent Medical Terminologies (CMT)
New concepts added continuously.
2.2.4 Dentistry
To continue improvements in coverage of the periodontal domain, over 90 new concepts to support the Dentistry subset have been added.
2.2.4.1 Cephalometry
23 new concepts added for cephalometry a specialist domain for dentistry, subtypes of 698965000|Immaterial anatomical entity (body structure)
2.2.5 Diagnostic Imaging Procedures
48 new concepts added for cone beam CT imaging procedures;
23 new concepts added as site specific subtypes of 430447002|Computed tomography for radiotherapy planning (procedure)
2.2.6 LOINC
Added 6 new concepts to support LOINC-SNOMED CT cooperation project: 1 Metadata; 1 Concept Model Attribute; 1 Technique; 1 Physiological process; 2 Measurement property.
2.2.7 Medical Devices
The medical devices content has been updated to align with the GMDN monthly release up to an including April 2016. This resulted n the addition of 208 new concepts. The linkage to GMDN is provided as a simple mapping file and is also current through the April 2016 GMDN monthly update. Future work will include the resolution of conceptual duplicates.
2.2.8 Organisms
Added: 205 new concepts for microbiology reporting (in organism and finding hierarchies). These change resulted from review of SIRS requests, NRC RefSet gap analysis (part of post closure task for the Microbiology Reporting project), and recommendation by the Organism and Infectious Disease Redesign reporting project.
2.2.9 Pharmaceutical/biologic products
Minor maintenance only.
2.2.10 Procedures
New subtypes of 228615008|Provision of transport (procedure) added.
2.2.11 Substances
Minor maintenance only.
2.2.12 Disorders
As a result of collaboration with Orphanet (http://www.orpha.net/consor/cgi-bin/index.php) over 500 new concepts have been created to represent rare diseases.
2.2.13 Various
Based on SIRs requests a number of new concepts were added in various hierarchies.
2.3 Content Quality Improvement
2.3.1 Anatomy
2.3.2 Disorders
2.3.3 Findings
A number of changes were made as quality improvements based on SIRs requests.
2.3.4 Substances
Minor maintenance only
2.3.5 Various
Where concepts include "Human papilloma virus" in the FSN, these have been inactivated and the FSN replaced with the new spelling of "Human papillomavirus". The current terminology for Papillomavirus as described by the International Committee on Taxonomy of Viruses (ICTV) is a single word string, i.e. Papillomavirus. Additional descriptions with 'papilloma virus' have not been inactivated; new descriptions that use 'papilloma virus' were not added where they did not already exist.
2.4 SNOMED CT derived products
2.4.1 ICD-10 map
The SNOMED CT to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (© World Health organisation 1994) 2010 Version map (SNOMED CT to ICD-10 Map) is included in the SNOMED CT International release as a Baseline. The SNOMED CT to ICD-10 Map was created to support the epidemiological, statistical and administrative reporting needs of IHTSDO member countries and WHO Collaborating Centres.
The SNOMED CT to ICD-10 Map is released in Release Format 2 (RF2) only. It is located in the file der2_iisssccRefset_ExtendedMapFull_INT_20160731.txt, which is in the Map folder under Refset, in each of the three RF2 Release Type folders.
The SNOMED CT to ICD-10 Map is released as Refset 447562003 |ICD-10 complex map reference set (foundation metadata concept)|.
2.4.1.1 Content development activity summary
The map is a directed set of relationships from SNOMED CT source concepts to ICD-10 target classification codes. The SNOMED CT source domains for the MAP are limited to subtypes of 404684003 |clinical finding|, 272379006 |event| and 243796009 |situation with explicit context|. The target classification codes are ICD-10 2010 release.
2.4.1.2 Mapped content for July 2016
The map provided for the July 2016 release has been updated, and now represents a complete map from SNOMED CT International release to ICD-10 2010 version. We would welcome feedback on any issues that users of the map may detect when using the map. Issues should be submitted via mapping@ihtsdo.org
2.4.2 ICD-9-CM map
IHTSDO produced a SNOMED CT to ICD-9-CM Epidemiological and Statistical Map with each SNOMED CT International Release. The artifact provided a map from a clinical statement expressed in SNOMED CT to a target code(s), or in some cases no target, in the ICD-9-CM classification. The SNOMED CT to ICD-9-CM Epidemiological and Statistical Map includes maps from the SNOMED CT Clinical Findings to ICD-9-CM 2012, the last updated version.
The World Health organisation stopped maintenance of ICD-9 in the 1990s when ICD-10 came into use by the WHO Member States. The United States (U.S.) National Center for Health Statistics (NCHS) is responsible for maintenance of the clinical modification (CM) of ICD-9. The last regular, annual update to ICD-9-CM code was on October 1, 2011.
In view of the legacy nature of the classification, a deprecation process has been followed, to remove the SNOMED CT to ICD-9-CM Epidemiological and Statistical Map from the International edition. The deprecation notice and documents can be found here: https://snomed.atlassian.net/wiki/display/PL/Deprecation
The SNOMED CT to ICD-9-CM map has therefore been deprecated without support, as of the July 2016 International edition. The Static version of the map (based on the January 2016 content) is available on the IHTSDO MLDS distribution site (https://mlds.ihtsdotools.org/#/ihtsdoReleases), for any users who wish to access it during their transition to SNOMED CT or ICD-10-CM.