SNOMED CT Jostein Ven, KITH, 02.11.2004. SNOMED CT viewed as a reference terminology Jostein Ven,...

SNOMED CT • Jostein Ven, KITH, 02.11.2004


SNOMED CT viewed as a reference terminology

Jostein Ven, advisor, KITH


Systemized Nomenclature of Medicine – Clinical Terms

• System of Health Care concepts and associated terms developed by the College of America Pathologists

• 344.000 concepts

• 1.361.960 relations between concepts

• 19 top concepts in the system of concepts

• 12 ”axes” (or ”independent” modules)


Some history

• SNOP (Systemized Nomenclature of Pathology)

• Snomed (I/II) –six axes

• ”The Norwegian SNOMED” - Den norske SNOMED

• Used in Norway today in the area of pathology

• SNOMED III (SNOMED International) – eleven axes

• SNOMED RT

• SNOMED CT

• SNOMED RT + Clinical Terms v3 (Read Codes)


Translation of SNOMED CT into Norwegian?

• Nordic cooperation, 2nd meeting i December

• Method for automatic translation (Iver Nordhuus, KITH)

• Based on already translated coding schemes such as ICD-10 and NCSP.

• Evaluation of translation

• Maintenance of Norwegian translation

• Correspondence between the content of SNOMED CT, the cost of translating and maintaining the translation, and the actual need of the Norwegian Health Sector?


Top concepts in SNOMED CT


Axes in SNOMED I and II

• Topography

• Morphology

• Aetiology

• Function

• Disease/diagnosis

• Procedure


Akser i SNOMED III (”SNOMED International”)

• Kilde: Coding matters, Vol. 8, No. 2, September 2001.


SNOMED RT code structure

• Kilde: Coding matters, Vol. 8, No. 2, September 2001.


Relationship names ranked by occurence in SNOMED CT

Relation name Number

Is a 447123

Onset 114555

Finding site 106394

Course 64202

Severity 64144

Episodicity 63952

Method 62667

Associated morphology 58642

Priority 50319

Procedure site 50284

Part of 47821

Access 43237

Causative agent 32967

Interprets 18185

Has active ingredient 17360

Laterality 16418

Occurrence 10639


Relasjoner og akserRelation name A C D F G J L M P R S T

Is a 9703 29629 114309 56779 6775 5059 27192 6058 91226 57507 1413 41473

Onset 112349 2123 14 6 62 1

Finding site 88017 17969 12 3 57 20 308 4 4

Course 63043 1113 7 3 36

Severity 62967 1121 7 3 5 40 1

Episodicity 62848 1059 7 3 33 2

Method 8 1 103 12 62512 31

Associated morphology 21 58274 313 3 31

Priority 7 1 89 12 50173 36 1

Procedure site 1 110 15 50142 15 1

Part of 67 11 87 32 47624

Access 1 80 12 43122 22

Causative agent 32844 112 6 2 1 2

Interprets 342 1124 15577 4 34 208 182 100 611 3

Has active ingredient 17202 143 4 10 1

Laterality 5 1 7 19 16386

Occurrence 10260 368 10 1


Semantisk nettverk (is-a-relasjonen)


Procedures in SNOMED CT

• Norwegian coding scheme for non-surgical procedures (MEDPROS)

• Procedures concept are connected to other defining concepts via relations.

• SNOMED CT as a source for procedures

• Examples


Example of procedureSNOMED CT concept Associated concepts Relation

Cerebral blood flow radionuclide study (procedure)

Brain structure (body structure) Procedure site


Introduction - action (qualifier value) Method


Diagnostic - procedure intent (qualifier value)

Has intent


Priorities (qualifier value) Priority


Intracranial vascular structure (body structure)

Procedure site


Surgical access values (qualifier value) Access


Radionuclide imaging - action (qualifier value)

Method


Brain imaging with vascular flow (procedure)

Is a


Imaging - action (qualifier value) Method


Blood vessel structure (body structure) Procedure site


Radioactive isotope (substance) Direct substance


Use of SNOMED CT

• Encoding of documentation

• Can be used instead of other coding schemes, or as a common ground

• Automatic mapping into other coding schemed: ICD-10, NANDA, NIC and possibly more in the future (ICF, NCSP, …)


Mapping across coding schemes

• Arrive at a better inter-professional problem understanding by mapping coding schemes that are specific to a profession onto each other.

• Doctors: ICD-10, NCSP, ICPC-2

• Nurses: NANDA, NIC, Perioperativ Nursing Data Set

• Physical therapists: ICF, …


Overlap between coding schemes:

SNOMED

ICD-10

ICF NANDA

Common domain:

Problem/illness


Cross Mapping

• Metodologi og tabeller for mapping fra begreper i SNOMED CT til en eller flere koder andre kodeverk

• One way only!

• Coverage and level of detail varies, mapping is a real challenge

• Information loss is very possible in many cases


Tables involved in cross mapping


Cross mapping SNOMED CT to ICD-9-CM


Goal of mapping between coding schemes:

• Common problem understanding

• Prerequisites

• Translation SNOMED CT into Norwegian

• More extensive use of non-doctor coding schemes.

• More cross-mappings

• Feasability analysis of bi-directional mapping, i.e. mapping from coding scheme into SNOMED CT

SNOMED CT Jostein Ven, KITH, 02.11.2004. SNOMED CT viewed as a reference terminology Jostein Ven,...

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