1. SNOMED CT Jostein Ven, KITH, 02.11.2004

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

3. SNOMED CT Jostein Ven, KITH, 02.11.2004 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)

4. SNOMED CT Jostein Ven, KITH, 02.11.2004 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)

5. SNOMED CT Jostein Ven, KITH, 02.11.2004 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?

6. SNOMED CT Jostein Ven, KITH, 02.11.2004 Top concepts in SNOMED CT

7. SNOMED CT Jostein Ven, KITH, 02.11.2004 Axes in SNOMED I and II Topography Morphology Aetiology Function Disease/diagnosis Procedure

8. SNOMED CT Jostein Ven, KITH, 02.11.2004 Akser i SNOMED III (”SNOMED International”) Kilde: Coding matters, Vol. 8, No. 2, September 2001.

9. SNOMED CT Jostein Ven, KITH, 02.11.2004 SNOMED RT code structure Kilde: Coding matters, Vol. 8, No. 2, September 2001.

10. SNOMED CT Jostein Ven, KITH, 02.11.2004 Relationship names ranked by occurence in SNOMED CT Relation nameNumber Is a447123 Onset114555 Finding site106394 Course64202 Severity64144 Episodicity63952 Method62667 Associated morphology58642 Priority50319 Procedure site50284 Part of47821 Access43237 Causative agent32967 Interprets18185 Has active ingredient17360 Laterality16418 Occurrence10639

11. SNOMED CT Jostein Ven, KITH, 02.11.2004 Relasjoner og akser Relation nameACDFGJLMPRST Is a97032962911430956779677550592719260589122657507141341473 Onset 112349212314 6 621 Finding site 880171796912 3572030844 Course 6304311137 3 36 Severity 6296711217 35 401 Episodicity 6284810597 3 332 Method81 103 126251231 Associated morphology21 58274313 3 31 Priority71 89 1250173361 Procedure site 1 110 1550142151 Part of 6711 87 32 47624 Access 1 80 124312222 Causative agent 32844112 62 12 Interprets 3421124155774 342081821006113 Has active ingredient 17202 143 410 1 Laterality 51 7 19 16386 Occurrence 10260368 101

12. SNOMED CT Jostein Ven, KITH, 02.11.2004 Semantisk nettverk (is-a-relasjonen)

13. SNOMED CT Jostein Ven, KITH, 02.11.2004 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

14. SNOMED CT Jostein Ven, KITH, 02.11.2004 Example of procedure SNOMED CT conceptAssociated conceptsRelation Cerebral blood flow radionuclide study (procedure) Brain structure (body structure)Procedure site Cerebral blood flow radionuclide study (procedure) Introduction - action (qualifier value)Method Cerebral blood flow radionuclide study (procedure) Diagnostic - procedure intent (qualifier value) Has intent Cerebral blood flow radionuclide study (procedure) Priorities (qualifier value)Priority Cerebral blood flow radionuclide study (procedure) Intracranial vascular structure (body structure) Procedure site Cerebral blood flow radionuclide study (procedure) Surgical access values (qualifier value)Access Cerebral blood flow radionuclide study (procedure) Radionuclide imaging - action (qualifier value) Method Cerebral blood flow radionuclide study (procedure) Brain imaging with vascular flow (procedure) Is a Cerebral blood flow radionuclide study (procedure) Imaging - action (qualifier value)Method Cerebral blood flow radionuclide study (procedure) Blood vessel structure (body structure)Procedure site Cerebral blood flow radionuclide study (procedure) Radioactive isotope (substance)Direct substance

15. SNOMED CT Jostein Ven, KITH, 02.11.2004 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, …)

16. SNOMED CT Jostein Ven, KITH, 02.11.2004

17. 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, …

18. SNOMED CT Jostein Ven, KITH, 02.11.2004 Overlap between coding schemes: Common domain: Problem/ill ness

19. SNOMED CT Jostein Ven, KITH, 02.11.2004 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

20. SNOMED CT Jostein Ven, KITH, 02.11.2004 Tables involved in cross mapping

21. SNOMED CT Jostein Ven, KITH, 02.11.2004 Cross mapping SNOMED CT to ICD-9-CM

22. SNOMED CT Jostein Ven, KITH, 02.11.2004 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