List of semantic duplicates

SNOMED Groups Translation User Group
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We have discussed if an AI tool could be used to identifiy semantic duplicates, but meanwhile we have to do this manually.

I just came across one example:

405262001 |Point of care testing (procedure)|

405264000 |Bedside testing (procedure)|

There are multiple sources identoifying bedside and point-of-care as referring to the same setting:

NCBI: “Point-of-care ultrasound (POCUS), ultrasound imaging acquired and interpreted by a treating clinician at the bedside”

Biovendor group: “Point-of-care testing (POCT, bedside testing) is defined as medical diagnostic testing at (or near) the point of care, at the time and place of patient care”

UNAhealth (UK): “Point-of-care, near-patient, bedside, decentralised, patient-centred, over-the-counter (OTC), self- or home testing are words and phrases that may be used when talking about point-of-care testing; they are often used interchangeably and without a clear definition.”

My collegue has also been struggling with 3 SCTID, all translated as “vagitorium” in Swedish:

767059009 Conventional release vaginal pessary (dose form)

733007009 Pessary (unit of presentation)

385174007 Pessary (basic dose form) with definition: A solid single-dose form usually prepared by moulding consisting of active substance(s) dispersed or dissolved in a suitable basis that may be soluble or dispersible or may melt at body temperature.

Here Pessary is a term in 3 different subhierarchies. Specified as Vaginal pessary once, but they are all for vaginal use. So not duplicates, per se. In Swedish we have the term “pessar” for birth control (in English: Contraceptive diaphragm, device (physical object), but “vagitorium” for a substance used in the vagina which disolves.

To complicate this further, we also have SCTID: 464585004 Vaginal pH suppository (physical object). In Swedish, this is still a vagitorium, but here it is defined as a suppository.

Do you agree that the duplicate warning should not be applied for these? The last example is trickier, as the same term is used in different settings, but a vaginal pessary and a pessary are the same thing, as is a vaginal suppository and a pessary.

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Hi Katarina,

Concerning the first topic: 405262001 |Point of care testing (procedure)| is a parent of 405264000 |Bedside testing (procedure)| ; we are also struggling in Germany with these concepts especially to distinguish these from 405263006 | Near patient testing |
point-of-care testing. ISO/TS 22583:2024(en) Requirements and recommendations for supervisors and operators of point-of-care testing (POCT) equipment gives following definition:

“POCT / near-patient testing: testing that is performed near or at the site of a patient (3.10)” - meaning that they would more or less merge these two concepts at least in the context of this ISO standard.
I see 405262001 |Point of care testing (procedure)| as a grouper concept in SNOMED.

Concerning topic 2: Is it a challenge arising from Swedish, as there a not several words available to properly distinguish these concepts? In German, a “Pessar” is a vaginal item used 1) either in the conservative treatment of uterine prolapse (different forms or pessary are existing") or 2) as contraceptive object (here also following concepts a. o. would be pessaries 268460000 | Intrauterine contraceptive device (physical object) | or 336688002 | Vaginal contraceptive cap (physical object) |).

No idea if this helps, but happy to follow the discussion :slight_smile:

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The plot thickens!

For the vaginal contraceptive device= vaginalpessar in Swedish, but a pessary was always only for vaginal use so weird. Intrauterine contraceptive device on the other hand seems semantically more like a grouper concept, but with no child concepts specifying the type of contraceptive devices…

And unlike German, “pessar” could only be used for a contraceptive device in Swedish. Your 1st example for uterine prolapse, we seem to use “ring” (“framfallsring”= uterine prolapse ring).

I had missed the near patient testing - added to my list now and definitely a semantic duplicate! They all have one thing in common: the patient does not have to move. The equipment or the lab technician is coming to the patient.

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Regarding Point of Care Testing: I think what is also relevant, is the notion that the evaluation/processing of a sample is done near the patient. So e.g. healthcare staff on an ICU might take a blood sample at the bedside and then go to a blood gas analyzer (as one example of a point of care testing device) somewhere else within the ICU. The sample doesn’t leave the ICU and does not require evaluation by the central hospital lab.
To be a bedside evaluation or testing, I would see the entire process being conducted in the patient room at bedside - examples include glucose testing, blood group testing/screening using bedside cards or bedside compatibility tests (such as Serafol® or EldonCard), or some imaging procedures (including X ray or ultrasound).

For the pessary discussion: I see also 46625003 | Pessary, device (physical object) | which is modelled with Has device intended site → Structure of genitourinary system; while it is a vaginal device, it might also help to support other organs such as the bladder, urethra, uterus…

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@sklopfenstein - the concept of a POC lab is probably valid internationally. same here with at least 3 levels for lab.

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I propose that Point of Care Testing, Bedside Testing, and Near-Patient Testing are semantically equivalent. Their defining characteristic is the decentralization of the testing process—specifically, testing performed outside the infrastructure of a clinical or specialty laboratory.

Historically, these terms were distinguished by perceived differences in analytical precision; however, modern diagnostic parity renders this distinction obsolete. The intent of all three is to minimize the ‘specimen-to-result’ interval by performing the procedure at the site of the clinical encounter. Consequently, ‘Point of Care Testing’ should serve as the primary concept, with the others treated as duplicates or synonyms, as the specific sub-location (e.g., a bed vs. a clinic room) is ancillary to the core clinical meaning.

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I agree @jcase those terms should be regarded semantically equivalent. Though I think there is still some distinction in the analytical precision between lab vs POCT (this also includes specimen handling and analyser maintenance etc) - so it’s not totally obsolete (at least the pathologists will argue that)

But the “blood gas analyzer” mentioned above is a great example of minimising the “specimen-to-result interval” you mention - the ICU and Lab likely use identical analysers.

Somebody could say that “Bedside Testing” is a more specific environment… But I don’t think that has much relevance.