I hope you have been well over the TUG break period!
I would like some input regarding how you work with confusing word order versus modeling in terms of semantics. Recently, I was working on a task revising some translations and I have found an example of ambiguous word order in the FSN when it comes to translation.
The example concept: 68257007 |Repair of ruptured aneurysm with graft of splenic artery (procedure)
The word order, to me (non-native English speaker), seems to suggest that the ruptured aneurysm is being repaired with tissue grafted from the splenic artery. The modeling, however, makes clear that it is a repair of a ruptured aneurysm of the splenic artery with any graft material; the origin of the graft is not specified.
SNOMED International has a policy that the FSN is the source of truth; how do you translate the concepts in such cases?
Without modeling, I would have interpreted this concept the same way (“ruptured aneurysm is being repaired with tissue grafted from the splenic artery”) based on the word order. I think that even a native English-speaker would too. So SI should rephrase it more clearly. Meanwhile, I would align my translation on the modeling (“repair of ruptured aneurysm of splenic artery with graft”).
Just with the FSN, I would have understood it as there was a repair of an aneurysm and a graft of the splenic artery and in my mind I’d have thought it was about an aortic aneurysm involving the orifice for the splenic artery so a graft was needed of the splenic artery on top of the repair of the aorta, to reconnect the splenic artery to the aorta.
I would have never imagined the aneurysm might be on the splenic artery. I see the FSN pattern is “repair of aneurysm with graft” then the anatomic location, but I’d have welcomed a comma after that part to understand that is indeed one meaning block and then the anatomical structure it applies to. Here I find it highly ambiguous when seen without the hierarchy context and logical definition, even if I’m not sure how it could be written differently in English.
I (native English speaker) also interpret the FSN the same! A clinical expert in this field might consider it unambiguous if they naturally infer/exclude alternate meanings. Certainly worth a CRS.
Also agree that the SNOMED International editorial policy has been the FSN is the source of truth - though I’m not sure how strongly that still applies in practice.
I agree with the ambiguity of the FSN. In such cases, I tend to look at the modeling, since it is less ambiguous. In my opinion, the FSN must be modified with a new version along the lines of “Repair with graft of…” or “Repair of ruptured aneurysm of splenic artery using graft”.
Please let us know if you submit a CRS ticket and changes end up being implemented.
