2020 Use of navigational concepts

4 December 2019

Provision of input on the use of navigational concepts

@Cathy Richardson

Please post your final responses in the Country response table below. Discussion comments can be made as comments.

 Norway

04.12.2019

 It is to early to say how vendor might use these concepts. It is not unthinkable that they could be used sensibly, but my guess is that it will vary very much from implementation to implementation.

 Australia

16.12.2019

 I've always struggled with the navigational concepts, and how they should be used...

There's a lot of probably"useful" concepts in there, but implementing them in a meaningful way seems to be to complex and difficult such that it becomes difficult. I'm not aware of anyone using them in AU.

I get the impression they are clinically relevant concepts, but too difficult to model/outside model, so they've been relegated to the navigational hierarchy. Very similar concepts in the proper hierarchy now...

For example, Arbovirus infection (disorder). This could be a supertype of "Mosquito-borne infectious disease". There's not much difference between these two concepts.
Of course concepts like 'Vibrio species a-m (navigational concept)' are clearly navigational. However, I'm aware of it being used as such.

CSIRO's shrimp browser creates it's own 'navigational type' things, to just group stuff (example) - I think they autogenerate when a concept has too many subtypes.

Our internal tool (Lingo), also uses a few arbitrary "concepts" so that tree view/taxonomy doesn't crash. But these are build into the tool. (0-1, A-E, F-J etc...)

Maybe, they could "be refsets"? But I don't like creating more implementation hurdles.

 USA

24.12.2019

Use of navigational concepts in value sets seems extremely marginal (and possibly erroneous). I only found 2 value sets in which navigational concepts are used:

• 276886008 Peripheral body temperature (navigational concept) used in a Body Temperature value set (among a vast majority of 'observable entity' concepts – possibly an error)

• 395171002 Histology laboratory test (navigational concept) used in a Pathological Assessment value set (among 2 'procedure' concepts – possibly an error)

 Sweden

2020-01-07 

As far as we know no navigation concepts are used and (so far) we recommend our users against using them. No system in use that we know of can make use of navigation hierarchies.

 The Netherlands

 2020-01-8

 I agree with Australia about the complexity of using them. They are outside the model in a separate hierarchy. If we need a concept that is a navigational concept than we make a new concept in the model and don't use the navigational concept.

In our guidelines we recommend not to use them.

Canada

 2020-01-21

We did not receive feedback from our SNOMED CT Community. We are not aware if the navigational concepts are being used in systems. Like AU, we have always struggled with the navigational concepts, and how they should be used... we also think there's a lot of probably"useful" concepts in there, but implementing them in a meaningful way seems to be THE difficulty. From the end user, if SI would provide more useful guidance, this would probably be very helpful for them to "organise" their drop down lists.

Member countries without a CMAG rep