Folks here are some comments from the UVic Health Terminologies Group regarding FSN changes. We have attached a short document since we included some examples in table entries- see link Suggestions on FSN Changes

Thanks -francis

SNOMED International Content Manager Advisory Group is seeking feedback from its community on what types of changes to FSN's would be acceptable without requiring inactivation and replacement of the concept.

As part of the Quality Initiative, there has been an increase of inativated concepts for aligning FSNs and concept definition to the new editorial guidelines. For many of those changes, the concept was inactivated and replaced by new concept because the change in the FSN wasn’t minor.

As per the SNOMED CT Editorial Guide: Minor changes, those changes that do not change the meaning of the FSN, are allowed without inactivation of the concept. They may include:

• Capitalizing, i.e. from lower to upper case or upper to lower case
• Changing punctuation
• Changing spelling
• Replacing an acronym with its expansion (only if it is commonly understood and not ambiguous)
• Expanding an abbreviation
• Correcting word order without changing the meaning (only for an error)
• Correcting typos
• Removing articles, such as 'the', from concept string
• Aligning with editorial policy, e.g. changing appendectomy to excision of appendix
• Where a change to the FSN does not result in a change to the preferred term

Here are examples of recent inactivation and replacement:

• 602001|Ross river fever (disorder) Outdated component REPLACED BY 789400009|Disease caused by Ross River virus (disorder)|
• 360068000|Deep full thickness burn (disorder) Ambiguous component POSSIBLY EQUIVALENT TO 771247007|Deep full thickness burn injury (disorder)|
• 258175000|Fluoroscopy with contrast injection (procedure) Ambiguous component POSSIBLY EQUIVALENT TO 763454007|Fluoroscopy using contrast (procedure)|
• 212929004|Frostbite with tissue necrosis of arm (disorder) Ambiguous component POSSIBLY EQUIVALENT TO 771449007|Frostbite with tissue necrosis of upper limb (disorder)|
• 428570002|Vaccination for human papillomavirus (procedure) Duplicate component SAME AS 761841000|Administration of human papilloma virus vaccine (procedure)|
• 35591002|Diastema of teeth (disorder) Erroneous component REPLACED BY 734009000|Diastema of teeth (finding)|

There also been other changes made in the last year that were done without inactivating the concept id. For example:

• 10137002 |Burn erythema of chin (disorder)| -> |Epidermal burn of chin (disorder)|
• 9350004|Enteropathic arthritis (disorder)| -> |Arthritis due to inflammatory bowel disease (disorder)|
• 1482004|Chalazion (disorder)| -> |Cyst of meibomian gland (disorder)|
• 26275000|Fort Bragg Fever (disorder)| -> |Fever due to Leptospira autumnalis (disorder)|
• 64137006|Pigskin graft (procedure)| -> |Porcine xenograft of skin to skin (procedure)|
• 72928007|Functional bone disorder (finding)| -> Functional bone disorder (disorder)
• 295034002|Debrisoquine allergy (disorder)| -> Allergy to debrisoquine (finding)

If you have been impacted by the above types of changes let us know. We'd like to hear your thoughts on this topic before May 29.

• Are the changes easier to manage through the inactivation process?
• What is the biggest challenge, the change of conceptID vs change of FSN, both?

Thank you!