Outdated Component

Narrative description:

The concept has been made inactive because it is an outdated concept that is no longer considered to be clinically acceptable or semantically interoperable internationally.

Details:

What is being inactivated (concept/description/any component)?

The outdated concept is being inactivated

What is the reason for inactivation (description)?

There may be a number of reasons why a concept may become outdated:

• A disorder, procedure or organism may have undergone a change in name following international agreement

• The evolution of disease name over time e.g. Phthisis, Scrofula, The White Plague and Consumption are all historical names for tuberculosis

Which inactivation value should be used?

Outdated component

Which historical association reference set should be used?

REPLACED_BY association reference set (foundation metadata concept)

Known issues:

1. Current tooling only supports a single REPLACED BY concept. There are instances where a single organism has been reclassified into multiple organisms

2. It is sometimes difficult to establish whether a potentially out dated component is simply a true synonym of an existing concept or an accepted "local term"

3. It is possible that the concept is outdated and has no appropriate internationally agreed replacement

Examples:

Simple Example

113929009 Pseudomonas luteola (organism)
REPLACED BY
33919008 Chryseomonas luteola (organism)

43089000 Erwinia carotovora ss. atroseptica (organism)
REPLACED BY
421190009 Pectobacterium atrosepticum (organism)

Complex Example

Erroneous Example

301017003 Decubitus ulcer of breast (disorder)
REPLACED BY
699212006 Pressure ulcer of breast (disorder)

356206000 Diltiazem hydrochloride+thiazide diuretic (product)
WAS A
373873005 Pharmaceutical / biologic product (product)

Impact:

• Often requires careful research to establish evidence

• Need to ensure that there is a clear differentiation between a concept being outdated and a potential synonym or a local synonym.

• Inform users/developers that the changes have occurred

• Provide a mechanism that informs their users of the changes

• Be aware that the search term may no longer be available

Potential improvement:

• Update tooling to support more than one REPLACED BY concept

• Consider using "MAYBE REPLACED BY", especially where more than one option may be available

• Add additional information by having a drop down list:

  • No suitable replacement

  • One appropriate replacement concept

  • More than one appropriate replacement

Supporting resources:

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