Page At A Glance

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.

SNOMED International 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 January 2017 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 alongside the January 2017 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 January 2017 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 Content Request System (CRS). The January 2017 International 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.  Additionally, member-identified priority projects, have driven enhancements in the anatomy hierarchy, while other project-driven changes have resulted in new content additions and enhancements to existing content detailed below.

2.2 Content Quality Improvement

• In total: 5123 new concepts were authored with an additional 13899 changes made to existing concepts. 

  
  
  

2.2.1 Anatomy 

Included with this release is the first release of the Lateralizable Body Structure Reference Set as a simple type refset. The refset includes all body structures that can be lateralized. The primary purpose is to support RF2 to RF1 conversion. It can also be used for the MRCM specification for quality assurance. The post-coordination of laterality can be supported by the new refset. It can help with the identification of concepts in hierarchies, e.g. finding/disorder, procedure, situation, which are lateralizable based on their concept modelling.

2.2.2 Clinical finding

• 23 new nutrition and dietetics concepts to support clinical documentation, care planning and research for nutrition. 

• 45 new laboratory finding concepts to support microbiology, chemistry and pathology

2.2.3 Convergent Medical Terminologies (CMT)

• 619 concepts were added for the January 2017 release, updating domains in Cardiology, Ophthalmology and Radiology.

2.2.4 Diagnostic Imaging Procedures

• 10 new concepts, Dual energy computed tomography and body site specific subtype concepts added

2.2.5 Functioning

• Disambiguation of the "Interpretation value (qualifier value)" hierarchy, with correction of approximately 600 findings using this as a target for an attribute

2.2.6 Disorders

2.2.7  LOINC

• 215 new concepts among the substance, Techniques, body structure hierarchies added to support antibody, antigen, DNA and RNA components needed to map to LOINC Parts. 

2.2.8 Observables

• Fully modelled more than 150 physiological measurement concepts (body temperature, respiratory rates, heart rates, blood pressure) based on the IHTSDO-979 Vital Signs Observables Inception/Elaboration document. 

• Created 10 required, metadata, attribute and range concepts in different hierarchies

2.2.9 Organisms

• 250 concepts to support microbiology reporting.

2.2.10 Physical objects

•  Concepts representing test kits were relocated from the Substance hierarchy to the Physical object hierarchy. Because the meaning of the concept was not changed, the concept IDs were retained. Duplicates were resolved; new FSNs were created. 
   

2.2.11 Procedures

• Dual energy computed tomography and body site specific subtype concepts added.
   

2.2.12 Social concept

• 10 new concepts, subtypes of 125676002|Person (person)| different types of relatives 

2.2.13 Substances

• Concepts representing test kits were relocated from the Substance hierarchy to the Physical object hierarchy. Because the meaning of the concept was not changed, the concept IDs were retained. Duplicates were resolved; new FSNs were created.

2.2.14 Various

• Based on SIRs requests a number of new concepts were added in various hierarchies.  

2.3. Internal Quality Improvement

• Over 300 concepts with redundant IS A relationships were revised to remove redundancy

• Combined/compound allergy concepts inactivated as ambiguous

• Drug indicated (situation)| sub-hierarchy reviewed and modeling updated.

• Inactivated disjunctive substance concepts

• Created around 10 required metadata, attribute and range concepts in different hierarchies.

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_20170131.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 January 2017

The map provided for the January 2017 release has been updated, and now represents a complete map from SNOMED CT International release to ICD-10 2010 version.

• 315 new concepts added

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