Topic based on our discussion during the TUG meeting of 20260310.
Please use this post to submit concepts that you think do not belong in the international edition because they are bound to specific national contexts. This includes concepts derived from legal definitions that only apply to the US/UK.
We could potentially add this topic to agenda for the SNOMED Business Meetings in Vienna, 2026.
Person/jobs
1269519005 |Deputy (person)|
54056000 |Trustee (person)|
1340167007 |Ward (person)|
159670000 |County court bailiff (occupation)|
158876002 |Water bailiff (occupation)|
<<265914006 |Adjudicator (occupation)| (e.g. 158771001 |Adjudicator N.I. regulations (occupation)|, specific to Northern Ireland)
159661003 |Police constable (occupation)|
<<158990003 |Nursing officer (occupation)|
158996009 |State enrolled nurse (occupation)|
<<224572003 |Nursing sister (occupation)|
***Difference between Nursing aid, Nursing assistant and Auxiliary nurse?
<309453006 |Registered midwife (occupation)| (descendants only, not self)
309452001 |Midwifery grade (occupation)|
158972004 |House officer (occupation)|
224532007 |Senior house officer (occupation)|
397903001 |Staff grade obstetrician (occupation)|
397908005 |Staff grade practitioner (occupation)|
309444004 |Outreach nurse (occupation)| (UK)
305754009 |Seen by outreach nurse (finding)|
306725009 |Referral by outreach nurse (procedure)|
306339006 |Referral to outreach nurse (procedure)|
306520002 |Discharge by outreach nurse (procedure)|
305584003 |Under care of outreach nurse (finding)|
158997000 |District nurse (occupation)| (and all procedure/finding/situation concepts with the term “district nurse”, UK term)
Housing-related findings
160745002 |Lives in lodgings (finding)|
224216008 |Lives under a landlady scheme (finding)|
224217004 |Lives in tied accommodation (finding)|
224219001 |Lives in independent group home (finding)|
412769006 |Lives in mother and baby unit (finding)|
160732001 |Resident in part III accommodation (finding)|
160736003 |Lives in a welfare home (finding)|
<<270469004 |Lives in warden attended accommodation (finding)|
160712002 |Multiple occupancy (finding)|
160750008 |Rehoused (finding)|
609239004 |Lives in noninstitutional accommodation (finding)|
160729004 |Lives in sheltered housing (finding)|
16094681000119103 |Long term custodial care facility patient (finding)|
Types of housing: some of these may have loose equivalents in other countries, but the names are bound to English-speaking countries, so the best thing to do would be to replace them with local concepts based on each country specific housing types.
224645004 |Link-detached house (environment)|
224647007 |Mews house (environment)|
1363570008 |Residential shack (environment)|
261770009 |Domestic (environment)|
224664005 |Bed-sitting room (environment)|
257638006 |Lodging house (environment)|
257692005 |Rooming house (environment)|
224639007 |Tenement (environment)|
310207003 |Sheltered housing (environment)|
309999004 |Warden controlled accommodation (environment)|
Environment (others)
257591007 |Commodity market (environment)|
257711008 |Sylvatic (environment)| (maybe just obsolete)
284563001 |Hamlet (environment)|
223910003 |English health authorities (environment)|
31154006 |Prepaid private physicians’ group office (environment)|
19602009 |Fee-for-service private physicians’ group office (environment)|
<<67190003 |Free-standing clinic (environment)| (not sure the “free-standing” detail is needed in most countries)
<<185483006 |Outreach clinic (environment)| (also a type of 310391008 |Community clinic (environment)| – the meaning of “community” is not clear to us (see below).
394759007 |Independent provider site (environment)| (“provider” of what?)
English-related
413309001 |No adult family member literate in English (finding)|
161140009 |English as a second language (finding)| (could be useful though)
Services (qualifier value)
736622005 |Aboriginal health service (qualifier value)|
310028002 |Diagnostic investigation service (qualifier value)|
714089006 |Community midwifery service (qualifier value)|
310065000 |Open access service (qualifier value)|
467101000210106 |Health and social navigation service (qualifier value)|
Concepts related to “young disabled service” – seems to be a UK term
310132005 |Young disabled service (qualifier value)|
309997002 |Young disabled unit (environment)|
307377006 |Referral to young disabled service (procedure)|
306804001 |Admission to young disabled unit (procedure)|
306809006 |Discharge from young disabled service (procedure)|
306811002 |Seen by service for young disabled people (finding)|
Concepts with community/community-based/community service – also UK-specific? Or perhaps it’s just unclear to us what “community” means. There are many, some examples:
306335000 |Referral to community-based nurse (procedure)|
416851006 |Referral to community matron (procedure)|
306335000 |Referral to community-based nurse (procedure)|
310111002 |Community orthotics service (qualifier value)|
1373823003 |Provision of community service (regime/therapy)|
704399003 |Knowledge level of community services (observable entity)|
424746008 |Unable to communicate concern to community service provider (finding)|
Others
308376004 |Police surgeon postmortem report (record artifact)|
310193003 | Coroner (occupation) |
Coroner is an occupation only for the anglo-saxon world.
Some of these concepts need to be translated in Canada (bilingual country with British-derived institutions), for example coroner and trustee.
Lodging houses are also a reality in Canada.
As for community health services, in a Canadian context, it means public health services provided in a non-hospital setting, for example a standalone clinic, a doctor’s practice, a local community service centre (public agency delivering primary health and social services, specific to the province of Quebec).
And maybe some of these concepts are relevant internationally for data gathering purposes in member countries that do not translate SNOMED and so are not members of the TUG?
Hi - yes these could be applicable for all countries with ties to the British system. But not for the rest of us. As we say that something can be promoted internationally if more countries use it, it would fit the bill but could we not add as a requirement that if it is not a truly international concept, a definition needs to be added. In this case, the definition could include something like “the legal term coroner is a part of the British legal system”, or something similar?
@mgagnon Indeed the main problem with these concepts is that they stem from countries of the Anglo-American sphere of influence. So it’s normal that they are relevant in Canada, but they aren’t in most countries with no ties to English or American institutions, and their meaning is unclear and/or the terms may cause confusion when they partially or totally overlap with local terms with similar or different meanings.
@klindve definitions would help understand the meaning, but we’d still have the problem of these irrelevant and potentially confusing concepts being distributed with our national editions. I’m wondering if it wouldn’t be easier to allow national editions to exclude concepts from the international edition or to hide the somehow. This would prevent clinicians for example in Belgium from accidentally using any of these “Anglo” concepts assuming they mean something they don’t, and therefore causing inconsistent registration.
This is something we’d have to push for together.
Agree @plammertyn - and the problem with a definition highlighting that this is a concept only to be used in British or ex-British environments, is that most users wont see the definition.
In Sweden, we unpublish these kind of concepts when we see them with strange translations, but that is manual work and we cannot guarantee that all SCTID in Swedish can or should be used in Sweden.
@klindve I would like to hear more about how you unpublish concepts–do you mean that you can decide which concepts of the international edition not to publish in the Swedish edition? That would solve a lot of problems for us, including lesion of concepts that we don’t need and whose translations we cannot disambiguate.
Hi - we are using a non-transparent solution: we just inactivate the translation. The English concept remains untranslated. If a user request a translation, we can refer to our inactivation reason but there might also be a good solution out there.
Why not make a “do not use in Belgium” refset Pedro? For all the concepts that should not by used, with a reason of non-use like for the deactivation of concepts. This way people could make the distinction between true inactivation and local inactivation. maybe providing possibly replaced by matches for crossborder sharing of data in EPS/IPS context?
Refsets imply extra maintenance work and, in this case, it would require new developments implementation-side to check if the concept belongs or not to the ‘forbidden’ refset. And the concept would still be available for any untrained user.
I see. Could you also benefit from being able to choose not to have those concepts in your national extension instead?