In the Norwegian translation, we observe quite some inconsistencies regarding the Norwegian terms “ulcus” and “ulcerasjon” (and also a third variant, “sår”).
When looking at the international edition, it seems that there are inconsistencies whether “ulcer” or “ulceration” is the preferred term/FSN.
On one hand, there might be a difference between ulcus (state) and ulceration (process), but it’s hard to see if the differences are intentional.
See for example 26284000 |Ulcer of mouth (disorder)| and its descendants.
Has this been discussed in other countries?
Is therea meaningful distinction between “ulcer” and “ulceration” in English? In SNOMED CT?
In French, the original and true meaning of “ulceration” is the process (formation of an ulcer) and “ulcer” is the result, but the term “ulceration” has come to refer to the “ulcer” per se. Maybe that is also the case in English and this causes discrepancies.
I don’t know if SNOMED is intentionally making a distinction between the disorder as the process of lesion formation (ulceration of stomach) and the lesion (ulcer of stomach). One could also say that an ulcer is always in forming mode (ulceration) and that an ulcer is a finding.
There is not specific editorial guidance on whether to use “ulcer” or “ulceration” in the FSN, but looking at the history of many of these concepts, it appears that the use of ulcer vs. ulceration was viewed as synonymous as some ulceration concepts are subtypes of Ulcer parents.
I think you are correct that the proper view of ulceration should refer to the process, whereas the result of that process is the ulcer, which should be reflected in the clinical finding or disorder. The definition of a clinical finding for SNOMED is that it should be currently present in the subject. Thus, the ontologically correct representation would be “ulcer” and not “ulceration” in the FSN. To underscore this is the observation that all ulceration concepts are modeled with the ASSOCIATED MORPHOLOGY of 56208002 |Ulcer (morphologic abnormality)|.
So the answer to your question is that therre is no meaningful distinction in SNOMED and the differences in use are most likely historical accidents.
A follow-up question which maybe is most relevant for Sweden and Denmark, @klindve , @cdanielsen , @lbie
The question is not only related to inconsistencies between “ulcus” and “ulcerasjon” i Norwegian, but also the word “sår”, which on one hand might have a more general meaning, but seems to be the term used by clinicians. The word “ulcus” is being used in Norwegian, but mostly in Latin compouns such as “ulcus pepticum” and “ulcus ventriculi”. On the other hand “ulcerasjon” seems to be more common, ref. the discussion above.
One hypothesis we are looking into is that “ulcerasjon” is being used for gastrointestinal disorders, while “sår” is being used for skin. Is this something that Denmark or Sweden has discussed?
Unfortunately, we use “magsår” for stomach ulcer. The same for pressure ulcer= trycksår.
I can see that we sometimes have used ulceration and ulkus in the Swedish translation, but these would not be used by health care pofessionals as a rule.