SNOMED CT
The Systematized Nomenclature of Medicine ( SNOMED ) (English: Systematized Nomenclature of Human and Veterinary Medicine ) is one of the most important classifications of medicine. The aim is to medical statements to index so that the substantive elements of the statement are fully covered, making very specific queries with high recall ( completeness ) and high precision (relevance) can be answered. Furthermore, cross- links to knowledge bases and literature databases exist. Other benefits include decision support for further clinical approach, the degree of high detailing and their language independence.
History
SNOMED has its origins in SNOP, the Systematized Nomenclature of Pathology. 1974, a first test version of SNOMED from the College of American Pathologists (CAP ) was issued. The extension to SNOMED II in 1979, followed by an update in 1982, published. SNOMED II was adapted for German-speaking by Friedrich Wingert and expanded and published in 1984 - hence SNOMED II has in German speaking still of some importance. After the death of Frederick Wingert the rights were transferred to the German version of SNOMED II at the Friedrich- Wingert - Foundation. 1993 SNOMED 3 was released, which is also known as SNOMED International and the first time integrated the veterinary medicine. In 1997, the LOINC codes have been fully integrated into SNOMED. Appeared in 1998 SNOMED 3.5 ( 12 axes ). With the update SNOMED RT ( Reference Terminology ) in 2000, the possibilities for the representation of concept relations have been greatly expanded. A significant expansion experienced SNOMED RT 2002 through the addition of the so-called Read- codes (also known as Clinical Terms ) of the National Health Service ( NHS) in the UK. The combined nomenclature has been called SNOMED CT ( Clinical Terms ). A Spanish and a German version followed. End of 2003, SNOMED CT has been integrated into the Unified Medical Language System ( UMLS ). Since April 2007, are the rights to SNOMED CT in the International Healthcare Terminology Standards Development Organization ( IHTSDO ).
Versions
SNOMED II
SNOMED II contains 7 axes, each with its own systematic reference system ( T topography, morphology M, etiology, E, F function, disease D, J work, Procedure P), within the axes, the descriptors are hierarchically structured. In addition, SNOMED II contains synonyms and cross-references to other axes. The German version contains about 81,000 entries.
Notation: Achsenbezeichner ( ex. T) and duodecimal, five-digit number (where X = 10, Y = 11), ( ex. T8X500, F80000 )
Furthermore, there Qualifier: FH ( family history ), CC ( chief complaint ), SD ( diagnosis ), etc. ( ex. FH d73450 )
3 SNOMED ( SNOMED International)
For SNOMED 3, the previous axes of SNOMED was further divided or new axes set up so that SNOMED 3 can boast a total of 11 axes with about 150,000 entries. Instead duodezimaler notation known from the IT sector hexadecimal notation was used. For the first time allowed SNOMED 3 Cross -references to ICD-9. From SNOMED 3 translations exist in about ten languages. A German translation was planned, but was never realized.
SNOMED CT
SNOMED CT contains 18 axes approximately 800,000 concepts ( terms), which is about 300,000 concepts describe ( multiple terms per concept ). In addition, SNOMED CT contains about 1 million relationships between concepts.
SNOMED CT translations exist into Spanish and into German. The German translation was published in 2003, but since then no longer maintained and is therefore obsolete. The English and Spanish versions are available in the UMLS under certain conditions free of charge.
Criticism
SNOMED provides with the described 7 ( SNOMED II ) to 11 ( SNOMED 3) axes a multi largely orthogonal classification. Their connection with the default for the billing classifications ICD, OPS and DRG is weak in all known information technology products.
Without that, the relationship between the duty as classifications to be used (ICD, OPS and DRG ) and a best possible medical classification methodology is amplified, each additional classification is just only one of many.
In particular, the suspicion remains that science-based completeness and practical utility not serve the same objective criteria. When a German translation was planned several times, but not even the government-funded DIMDI within more than three decades after the first definition of SNOMED (1974 ) was implemented, it is possible that the German interest again a takeover of Australia (DRG, ICHI ) or the Netherlands ( OPS) have to admit, but in the future do not bring your own expression about. However, this requires the integration of SNOMED into a productive relation with the clinical routine.