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The Systematized Nomenclature of Medicine (SNOMED) is a systematic, computer-processable collection of
medical terms Medical terminology is a language used to precisely describe the human body including all its components, processes, conditions affecting it, and procedures performed upon it. Medical terminology is used in the field of medicine Medical terminolog ...
, in human and
veterinary medicine Veterinary medicine is the branch of medicine that deals with the prevention, management, diagnosis, and treatment of disease, disorder, and injury in animals. Along with this, it deals with animal rearing, husbandry, breeding, research on nutri ...
, to provide codes, terms, synonyms and definitions which cover
anatomy Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having its ...
,
diseases A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that ar ...
, findings, procedures,
microorganisms A microorganism, or microbe,, ''mikros'', "small") and ''organism'' from the el, ὀργανισμός, ''organismós'', "organism"). It is usually written as a single word but is sometimes hyphenated (''micro-organism''), especially in olde ...
, substances, etc. It allows a consistent way to index, store, retrieve, and aggregate medical data across specialties and sites of care. Although now international, SNOMED was started in the
U.S. The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territori ...
by the
College of American Pathologists The College of American Pathologists (CAP) is a member-based physician organization founded in 1946 comprising approximately 18,000 board-certified pathologists. It serves patients, pathologists, and the public by fostering and advocating ...
(CAP) in 1973 and revised into the 1990s. In 2002 CAP's SNOMED Reference Terminology (SNOMED RT) was merged with, and expanded by, the
National Health Service The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
's Clinical Terms Version 3 (previously known as the
Read codes Read codes are a clinical terminology system that was in widespread use in General Practice in the United Kingdom until around 2018, when NHS England switched to using SNOMED CT. Read codes are still in use in Scotland and in England are permitted ...
) to produce SNOMED CT. Versions of SNOMED released prior to 2001 were based on a multiaxial,
hierarchical classification Hierarchical classification is a system of grouping things according to a hierarchy. In the field of machine learning, hierarchical classification is sometimes referred to as instance space decomposition, which splits a complete multi-class pro ...
system. As in any such system, a disease may be located in a body
organ (anatomy) In biology, an organ is a collection of tissues joined in a structural unit to serve a common function. In the hierarchy of life, an organ lies between tissue and an organ system. Tissues are formed from same type cells to act together in a ...
, which results in a code in a topography axis and may lead to morphological alterations represented by a morphology code. In 2002 the first release of
SNOMED CT SNOMED CT or SNOMED Clinical Terms is a systematically organized computer-processable collection of medical terms providing codes, terms, synonyms and definitions used in clinical documentation and reporting. SNOMED CT is considered to be the mo ...
adopted a completely different structure. A sub-type hierarchy, supported by defining relationships based on description logic, replaced the axes described in this article. Versions of SNOMED prior to SNOMED CT are planned to be formally deprecated from 2017.Deprecation of Antecedent Versions of SNOMED by IHTSDO General Assembly
/ref> Therefore, readers interested in current information about SNOMED are directed to the article on
SNOMED CT SNOMED CT or SNOMED Clinical Terms is a systematically organized computer-processable collection of medical terms providing codes, terms, synonyms and definitions used in clinical documentation and reporting. SNOMED CT is considered to be the mo ...
.


Purpose

SNOMED was designed as a comprehensive
nomenclature Nomenclature (, ) is a system of names or terms, or the rules for forming these terms in a particular field of arts or sciences. The principles of naming vary from the relatively informal naming conventions, conventions of everyday speech to the i ...
of clinical medicine for the purpose of accurately storing and/or retrieving records of clinical care in human and
veterinary medicine Veterinary medicine is the branch of medicine that deals with the prevention, management, diagnosis, and treatment of disease, disorder, and injury in animals. Along with this, it deals with animal rearing, husbandry, breeding, research on nutri ...
. The metaphor used by
Roger A. Côté Roger is a given name, usually masculine, and a surname. The given name is derived from the Old French personal names ' and '. These names are of Germanic origin, derived from the elements ', ''χrōþi'' ("fame", "renown", "honour") and ', ' ...
, the first editorial chair, was that SNOMED would become the
periodic table of elements The periodic table, also known as the periodic table of the (chemical) elements, is a rows and columns arrangement of the chemical elements. It is widely used in chemistry, physics, and other sciences, and is generally seen as an icon of c ...
of medicine because of its definitional organization beyond the hierarchical design. Indeed, diseases and procedures were ordered hierarchically and are further referenced back to more elementary terms (see Reference Ontology and Multi-Axial Design, below).


History

SNOMED was originally conceived by Côté as an extension of the design of the Systematized Nomenclature of Pathology (SNOP) applicable for all medicine. SNOP was originally designed by Arnold Pratt to describe pathological specimens according to their morphology and anatomy (topography). The ambitious development of SNOMED required many more axes (see multi-axial design, below). SNOMED was jointly proposed for development to the
College of American Pathologists The College of American Pathologists (CAP) is a member-based physician organization founded in 1946 comprising approximately 18,000 board-certified pathologists. It serves patients, pathologists, and the public by fostering and advocating ...
by Côté and Pratt. The former was appointed as editorial chair of the Committee on Nomenclature and Classification of Diseases of the CAP and developed the SNOMED from 1973 to 1997. In 1998,
Kent Spackman Kent is a county in South East England and one of the home counties. It borders Greater London to the north-west, Surrey to the west and East Sussex to the south-west, and Essex to the north across the estuary of the River Thames; it faces th ...
was appointed to chair this committee and spearheaded the transformation of the multi-axis systems into a highly computable form (See
SNOMED CT SNOMED CT or SNOMED Clinical Terms is a systematically organized computer-processable collection of medical terms providing codes, terms, synonyms and definitions used in clinical documentation and reporting. SNOMED CT is considered to be the mo ...
): a
directed acyclic graph In mathematics, particularly graph theory, and computer science, a directed acyclic graph (DAG) is a directed graph with no directed cycles. That is, it consists of vertices and edges (also called ''arcs''), with each edge directed from one ve ...
anchored in formal representation logic. In 2007, the newly formed
International Health Terminology Standards Development Organisation The International Health Terminology Standards Development Organisation (IHTSDO), trading as SNOMED International, is an international non-profit organization that owns SNOMED CT, a leading clinical terminology used in electronic health records. ...
( IHTSDO) acquired all the Intellectual Property of
SNOMED CT SNOMED CT or SNOMED Clinical Terms is a systematically organized computer-processable collection of medical terms providing codes, terms, synonyms and definitions used in clinical documentation and reporting. SNOMED CT is considered to be the mo ...
and all antecedent SNOMED versions. Brief timeline: * 1965 SNOP * 1974 SNOMED * 1979 SNOMED II * 1993 SNOMED International 3.0 * 1995
SNOMED Microglossary of Signs and Symptoms The Systematized Nomenclature of Medicine (SNOMED) is a systematic, computer-processable collection of medical terms, in human and veterinary medicine, to provide codes, terms, synonyms and definitions which cover anatomy, diseases, findings, p ...
* 1993-98 SNOMED International versions 3.1-3.5 * 2002 First release of
SNOMED CT SNOMED CT or SNOMED Clinical Terms is a systematically organized computer-processable collection of medical terms providing codes, terms, synonyms and definitions used in clinical documentation and reporting. SNOMED CT is considered to be the mo ...
* 2007 All versions of SNOMED acquired by IHTSDO * 2017 All SNOMED versions except
SNOMED CT SNOMED CT or SNOMED Clinical Terms is a systematically organized computer-processable collection of medical terms providing codes, terms, synonyms and definitions used in clinical documentation and reporting. SNOMED CT is considered to be the mo ...
have been formally deprecated by IHTSDO


Reference ontology

SNOMED was designed from its inception with complex concepts defined in terms of simpler ones. For example, a disease can be defined in terms of its abnormal anatomy, abnormal functions and
morphology Morphology, from the Greek and meaning "study of shape", may refer to: Disciplines * Morphology (archaeology), study of the shapes or forms of artifacts * Morphology (astronomy), study of the shape of astronomical objects such as nebulae, galaxies ...
. In some cases, the
etiology Etiology (pronounced ; alternatively: aetiology or ætiology) is the study of causation or origination. The word is derived from the Greek (''aitiología'') "giving a reason for" (, ''aitía'', "cause"); and ('' -logía''). More completely, e ...
of the disease is known and can be attributed to an infectious agent, a physical trauma or a chemical or pharmaceutical agent.


Multi-axial design

The current concept uses eleven (11) axes that comprise terms organised in hierarchical trees. The axes and some examples are provided below:


T (Topography) – Anatomic terms

* (T-28000)
Lung The lungs are the primary organs of the respiratory system in humans and most other animals, including some snails and a small number of fish. In mammals and most other vertebrates, two lungs are located near the backbone on either side of t ...
* (T-32000)
Heart The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide t ...
* (T-51000)
Mouth In animal anatomy, the mouth, also known as the oral cavity, or in Latin cavum oris, is the opening through which many animals take in food and issue vocal sounds. It is also the cavity lying at the upper end of the alimentary canal, bounded on ...
* (T-D2500)
Hip In vertebrate anatomy, hip (or "coxa"Latin ''coxa'' was used by Celsus in the sense "hip", but by Pliny the Elder in the sense "hip bone" (Diab, p 77) in medical terminology) refers to either an anatomical region or a joint. The hip region is ...
* (T-D9600)
Heel The heel is the prominence at the posterior end of the foot. It is based on the projection of one bone, the calcaneus or heel bone, behind the articulation of the bones of the lower Human leg, leg. Structure To distribute the compressive for ...


M (Morphology) – Changes found in cells, tissues and organs

* (M-40000)
Inflammation Inflammation (from la, wikt:en:inflammatio#Latin, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or Irritation, irritants, and is a protective response involving im ...
* (M-44000)
Granuloma A granuloma is an aggregation of macrophages that forms in response to chronic inflammation. This occurs when the immune system attempts to isolate foreign substances that it is otherwise unable to eliminate. Such substances include infectious ...
* (M-54700)
Infarcted Infarction is tissue death ( necrosis) due to inadequate blood supply to the affected area. It may be caused by artery blockages, rupture, mechanical compression, or vasoconstriction. The resulting lesion is referred to as an infarct (from t ...
* (M-54701)
Microscopic infarct The microscopic scale () is the scale of objects and events smaller than those that can easily be seen by the naked eye, requiring a lens (optics), lens or microscope to see them clearly. In physics, the microscopic scale is sometimes regarded a ...
''For the Morphology axis, SNOMED ha
agreed
to collaborate and use the same harmonized codes shared with
International Classification of Diseases for Oncology The International Classification of Diseases for Oncology (ICD-O) is a domain-specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. This classification is widely used by canc ...
. Additional examples on topology are provided on that page.''


L (Living organisms) – Bacteria and viruses

* (L-21801)
Mycobacterium tuberculosis ''Mycobacterium tuberculosis'' (M. tb) is a species of pathogenic bacteria in the family Mycobacteriaceae and the causative agent of tuberculosis. First discovered in 1882 by Robert Koch, ''M. tuberculosis'' has an unusual, waxy coating on its c ...
* (L-25116)
Streptococcus pneumoniae ''Streptococcus pneumoniae'', or pneumococcus, is a Gram-positive, spherical bacteria, alpha-hemolytic (under aerobic conditions) or beta-hemolytic (under anaerobic conditions), aerotolerant anaerobic member of the genus Streptococcus. They are ...


C (Chemical) – Drugs

* (C-C137A) Bufferin
Analgesic An analgesic drug, also called simply an analgesic (American English), analgaesic (British English), pain reliever, or painkiller, is any member of the group of drugs used to achieve relief from pain (that is, analgesia or pain management). It ...
Tablets * (C-C137B) Bufferin
Analgesic An analgesic drug, also called simply an analgesic (American English), analgaesic (British English), pain reliever, or painkiller, is any member of the group of drugs used to achieve relief from pain (that is, analgesia or pain management). It ...
Caplets


F (Function) – Signs and symptoms

* (F-03003)
Fever Fever, also referred to as pyrexia, is defined as having a body temperature, temperature above the human body temperature, normal range due to an increase in the body's temperature Human body temperature#Fever, set point. There is not a single ...


J (Occupation) – Terms that describe the occupation

* Kindergarten teacher (13420) * Computer programmer (08420) * Doctor (06105) * Professional Nurse (General) (07110) * Beautician (57040)


D (Diagnosis) – Diagnostic terms

* (D-13510)
Pneumococcal pneumonia Pneumococcal pneumonia is a type of bacterial pneumonia that is caused by Streptococcus pneumoniae (pneumococcus). It is the most common bacterial pneumonia found in adults, the most common type of community-acquired pneumonia, and one of the ...
* (D-14800)
Tuberculosis Tuberculosis (TB) is an infectious disease usually caused by '' Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, in ...
* (D3-15000)
Myocardial infarction A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may ...


P (Procedure) – Administrative, diagnostic and therapeutic procedures


A (Physical agents, forces, activities) – Devices and activities associated with the disease


S (Social context) – Social conditions and important relationships in medicine

* (S-10120)
Mother ] A mother is the female parent of a child. A woman may be considered a mother by virtue of having given childbirth, birth, by raising a child who may or may not be her biological offspring, or by supplying her ovum for fertilisation in the cas ...


G (General) – Syntactic linkages and qualifiers


See also

*
Diagnosis code In health care, diagnosis codes are used as a tool to group and identify diseases, disorders, symptoms, poisonings, adverse effects of drugs and chemicals, injuries and other reasons for patient encounters. Diagnostic coding is the translation of w ...
*
Drug class A drug class is a set of medications and other compounds that have a similar chemical structures, the same mechanism of action (i.e. binding to the same biological target), a related mode of action, and/or are used to treat the same disease. In ...
*
DOCLE DOCLE (Doctor Command Language), is a non-numeric health coding and medical classification system. The DOCLE system is used in Health Communication Network's electronic medical record and patient management software package, Medical Director. Medic ...
*
Medical classification A medical classification is used to transform descriptions of medical diagnoses or procedures into standardized statistical code in a process known as clinical coding. Diagnosis classifications list diagnosis codes, which are used to track diseases ...
*
SNOMED CT SNOMED CT or SNOMED Clinical Terms is a systematically organized computer-processable collection of medical terms providing codes, terms, synonyms and definitions used in clinical documentation and reporting. SNOMED CT is considered to be the mo ...
*
Medical Dictionary for Regulatory Activities A subscription-based product of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH), MedDRA or Medical Dictionary for Regulatory Activities is a clinically validated international medical te ...
(MedDRA) *
Pathology Messaging Implementation Project Pathology Messaging Implementation Project (PMIP) is the project that introduced universal delivery of electronic pathology results to GPs in Great Britain. The standard used by the British National Health Service (NHS) to transmit pathology order ...


References


External links


Official page at snomed.org
(now redirects t
www.ihtsdo.org



SNOCat: the SNOMED Categorizer/Browser to automatically encode medical narratives - provided by the BiTeM group (http://bitem.hesge.ch) !
{{Medical classification Diagnosis classification Clinical procedure classification Anatomical terminology de:SNOMED