This revised briefing note seeks approval to inactivate and replace 80 “sepsis caused by X organism” concepts. This proposal responds directly to issues and objections raised during the initial review.
| Date created | 06 May 2026 |
|---|---|
| Action | For comment |
| Status | Closed |
| Feedback by | 20th May 2026 |
20260506 BN Revision of sepsis caused by organism modelling and descriptions v2.0.pdf (259.1 KB)
Hi Sarah,
Thank you for the updated briefing note.
I would like to add one item to the Proposed Changes section of the document. Any concepts needed to represent the Due to value that is missing from the terminology will be authored at the time of this work so that the sepsis concepts may be authored as sufficiently defined.
With that one exception, the U.S. agrees with the scope of work and does not have any additional feedback at this time.
Thanks
John
Hi Sarah,
This proposal looks sound. These changes will affect the Netherlands, as we have authored 8 concepts that will need to be replaced in the same way. When SNOMED International makes these changes, could you send the specific timing to our NRC in advance, so we can replace our concepts for publication in the same (monthly) edition?
Thanks @jsnyder. I like your suggestion and we can aim to sufficiently define as many concepts as possible as the work progresses. We can also look into the creation of new concepts for modelling and author them where it makes sense to do so.
Best wishes, Sarah
Thanks for your comment @fhielkema. Yes, I will make a note to do so.
Best wishes, Sarah
The consultation period has now concluded. We appreciate the feedback provided during the discussion and review of this work. The proposed approach will now proceed to implementation by the SNOMED International content team.
Early visibility communications will be issued in advance of release, and all changes will be documented in the corresponding release notes to support transparency and member awareness.
Sorry, I missed the deadline on this one (I didn’t see it was a much shorter period).
But for the record, I also support the changes (option 1) 
My only initial hesitation was around the 80 1:1 inactivation/replacements. If the underlying clinical concept hasn’t changed, replacement feels like a blunt instrument for what is essentially a modelling correction and FSN alignment. But I’ll concede that where there’s a major FSN change alongside a substantive remodelling, a clean retire/replace with direct “Replaced by” associations is the more defensible approach, and the associations make the migration tractable.
And a couple of other observations.
On the septicemia handling - quiet removal of a non-synonymous description might not be sufficient where implementers may have used these concepts as septicemia rather than sepsis. It would be good to account for how these concepts were actually used in practice, not just how the FSN represents them.
The statement “There will be no changes made to 91302008 |Sepsis (disorder)| or the 59 subtypes of this concept not listed in Appendix A” took me a couple of reads; I initially read it as the entire subhierarchy being out of scope. Worth rephrasing for clarity.
On compositional expressions; I’m sceptical of the framing. Real-world post-coordination in production systems is very limited as far as I know, and any modelling change affects extensions and maps regardless. The more practical impact is on pre-coordinated code references in value sets and information models, which deserves equal concern.
Hi Matt,
Thanks for your thoughts on this, especially around the briefing note clarity and implementation impacts. Your support for the changes has been noted.
Best wishes, Sarah