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Before submitting a Request for Change (RFC)

•  Verify that the content required does not already exist in the CA Edition (validate synonyms)

Search not only for the exact term but try different words or word combinations that may express the same clinical idea.

Search the Canadian Edition for the latest Canadian and International content. 

•  Verify that the content required does not already exist in SNOMED CT Core (validate synonyms)

Search not only for the exact term but try different words or word combinations that may express the same clinical idea.

•  Verify that content selected is 'current' or active. A concept that has a status of outdated, limited, duplicated, ambiguous, erroneous, moved elsewhere, retired should NOT be used

If a concept has been INACTIVATED, it should not be used.

To determine the replacement concept, on the SNOMED International Browser, search for the inactivated concept, select the "Refset" Tab and validate the associated concept which can in most cases be the replacement concept candidate.

•  Provide a proposed parent (and semantic tag)

Determine the correct hierarchy the content is part of, based on the context of use. The requested concept must be part of the same top-level hierarchy as the its parent. If a direct parent does not exist, use the nearest grandparent or more distant ancestor concept in the hierarchy in the proposed parent field.

•  Provide clinically valid references
•  Provide a clear justification for the request
•  Provide a text definition for new concepts
•  Provide the use case

Valid references are required for new content. 

All reference material must be publicly available, recent and authoritative. Wikis are not recognized as authoritative.

Provide the use case: how and where content will be used?

•  Provide the translation and supporting documentation as required

If a translated term is required, you may provide the term with the appropriate supporting information, or a request can be submitted for "New Description" if a translation of existing concept is required. In cases where English concepts or descriptions do not exist for the requested translation, English concepts and descriptions must first be finalized before translation to ensure semantic equivalency.

Note that in both use cases, it is important that the requests must comply to the French Canadian Editorial Guidelines.

Validate compliance to Editorial Guidelines

•  Acronym and abbreviation

Refer to SNOMED International Editorial Guide:

General Naming Conventions - Abbreviations (and Acronyms)

•  Article

Omit the inclusion of grammatical articles like “an” and “the”.

General Naming Conventions - Articles

•  Capitalization

For English descriptions, capitalize the first letter in the first word in each description and capitalize proper nouns, adjectives derived from proper nouns, and acronyms. Other words in the description should be lower case. For French descriptions, do not capitalize the first letter in the first word unless it is a proper noun or an acronym. The following is an example of the incorrect capitalization on an English term:

Diphtheria and Tetanus toxoids and Acellular pertussis (product)

Refer to capitalization sections of the SNOMED International Editorial Guide and the French Canadian Editorial Guidelines.

•  Eponym

Use the full description in the FSN. One of the synonyms (syn) will not include an apostrophe or final "s" (Ee.g. : Down syndrome). PS or syn will include the apostrophe "s".

*Descriptions should have one with apostrophe "s" AND one without.* If one is missing, add it.

This topic is covered in SNOMED International Editorial Guide:

General Naming Conventions - Eponyms

•  Lateralization

• Anatomy Concept Model
• Clinical Finding/Disorder Naming Conventions
• Procedure Modeling

•  Past tense verbal formverbs and sentence types

Must not be used. Existing terms containing past tense verbs will be moved to the (situation) hierarchy.

This topic is covered in SNOMED International Editorial Guide:

Past tense verbal forms verbs and sentence function types

•  Plural

The use of plural is to be avoided. Use singular.

Exceptions: "grouper" concepts may have a synonym that is plural.

EXAMPLE of exception: Procedures for splenic lesions

This topic is covered in SNOMED International Editorial Guide:

Plurals

•  Spacing

Use one space in front of an opening parenthesis and after a closing parenthesis, but not within parentheses

EXAMPLE: aaaa (bbbb) cccc

Where a name includes a ‘+’ symbol a space must be placed either side of the plus symbol.

EXAMPLE: Pediatric vaccine product containing only diphtheria standard dose + tetanus antigens (medicinal product)

•  Verbal nounAction verbs

The action word describing the clinical action is the verbal noun ending in "-ion" rather than "-ing".

EXAMPLE: Incision rather than Incising

Exception: When  When no other verbal form is available, the "-ing" form may be used or when common usage sanctions the noun form, it may be used (e.g. Suturing of tricuspid valve or cautery of wart).

This topic is covered in SNOMED International Editorial Guide:

Verbal nounsAction verbs

•  (&)

• Special character 

The special characters <, >, &, %, $, @, # are not allowed in FSNs and should be spelled out.Not to be used. To be replaced by ‘and’.

This topic is covered in SNOMED International Editorial Guide:

Special characterscharacter

•  Apostrophe ( ' )

No space between the apostrophe and the s, where applicable. For Eponyms, refer to 'Eponym' above.

This topic is covered in SNOMED International Editorial Guide:

ApostrophesApostrophe

•  Caret symbols ( ^ )

This is used as a pair of symbols to enclose character strings that properly should be displayed as superscript. Single caret symbols are not allowed. Note that no spaces are allowed in between the symbols.

EXAMPLE: Technetium Tc^99c^ medronate (substance)

This topic is covered in SNOMED International Editorial Guide:

Caret symbols (^)

•  Colons  Colon  ( : )

To separate acronyms from the rest of a name:  There is no space between the acronym and the colon, but a space must be added after the colon.

EXAMPLE: FH: Gout

NOTE: In French, there is a space before and after the ( : )Generally, colons are not allowed except in the FSNs of organisms, substances, or products where the colon is part of the name, tumor stages, and in non-FSN descriptions.

There is no space before or after a ratio.

EXAMPLE: lidocaine hydrochloride 1.5%/epinephrine 1:200,000 injection solution vial (product)

EXAMPLE: Empey index (observable entity) with Synonym: FEV1:PEF ratio

In French descriptions, there is a space before and after the colon ( : )

EXAMPLE: antécédents : tissu ou organe artificiel (situation)

This topic is covered in SNOMED International Editorial Guide:

ColonsColon

•  Dash ( - )

Avoid usage as much as possible.

This topic is covered in SNOMED International Editorial Guide:

Hyphens Hyphen and dashesdash

•  Hyphen ( - )

The hyphen is used to join words and to separate syllables. There should be no space either before or after the hyphen. Note that more and more words are written without the hyphen.

EXAMPLES:
intra-articular
Zollinger-Ellison syndrome

This topic is covered in SNOMED International Editorial Guide:

Hyphens Hyphen and dashesdash

•  Forward slash ( / )

Not to be used in FSNs other than units of measure and and/or type concepts. The 'assumed' meaning behind this symbol is ambiguous and may vary: may mean a ‘or', a 'and/or' and sometimes is part of an expression's abbreviation (O/E). Writing the whole term without the slash confirms it’s meaning without confusion or ambiguity. This symbol may be found in acronyms with findings concepts. No space either before or after the slash.EXAMPLES:
O/E - abdominal mass palpated
Bone structure of head and/or neck

This topic is covered in SNOMED International Editorial Guide:

Forward slashes

•  Plus sign ( + )

Use of plus signs is discouraged, though is used in (product), (disposition) and (substance) hierarchies. Insert a space before and after the sign when unifies two words. For combination drug products.

EXAMPLE: diphtheria + tetanus vaccine

This topic is covered in SNOMED International Editorial Guide:

Plus signssign

•  Semantic tag

The description ends FSNs end with a parenthesis that includes the hierarchy tag, to be uniquesemantic (hierarchy) tag in parentheses.

EXAMPLE: gout Gout (disorder)

•  Language dialect

The Canadian Edition uses US English spelling by default.

•  Avoid plural

Use the singular form unless the concept necessarily involves multiples.

EXAMPLEEXAMPLES: multiple Multiple lumps (finding) or function Function of specific cranial nerves (observable entity).

•  No eponym

Use full description as the FSN, and the eponymous term as a synonym.

EXAMPLE: 'Moro reflex' should be a synonym of FSN: “infant startle reflex”

Exception: exceptionally long and unwieldy.

•  No dash

The dash must be replaced with words that clarify the meaning.

•  Avoid colon

Exceptions: allowed in the FSNs of organisms, substances, or products where the colon is a proper part of the name such as in ratios and in tumor stages.

•  Avoid forward slash

Exceptions: A forward slash may be used for representing units of measure, as required in the pharmaceutical products hierarchy, and in laboratory test results and units of measure hierarchies.

Used in the construct “and/or” in FSNs.

There should be no space either before or after the slash.

•  No acronym

Acronyms are not permitted in FSNs and must be expanded if used in synonyms. See the SNOMED International Editorial Guide.

•  No abbreviation

Abbreviations are prohibited in FSNs and synonyms, with specified exceptions. See the SNOMED International Editorial Guide.

Terms containing abbreviations will not be accepted into the International Release.

•  Procedure: Diagnostic Imaging

Many concepts and descriptions have been created in the CA Edition. These concepts are part of the Procedure hierarchy.

Refer to this document for Canadian specific guidelines: Canadian Edition Editorial Guidelines for Clinical Imaging Procedures.

This topic is covered in SNOMED International Editorial Guide: Clinical Imaging Procedure Naming Conventions.

•  Substances

Many concepts and descriptions have been created in the CA Edition (i.e. antigens and immunoglobulins).

For Immunization, refer to the SNOMED International Editorial Guidelines - Vaccine Products.

This topic is covered in SNOMED International Editorial Guide:

Antibodies and antigens

Antivenin and descendants

•  Pharmaceuticals / biological product

Many concepts and descriptions have been created in the CA Edition (i.e. vaccine products).

For Immunization, refer to the SNOMED International Editorial Guidelines - Vaccine Products.

•  Microorganism (organism)

This topic is covered in SNOMED International Editorial Guidelines.

Refer to:  

• Microbiology Content Development – Canadian Editorial Guidelines SNOMED CT
• Observable Entity and Microbiology Test Results
• Organism Naming Conventions

•  Social context (occupation)

There are no There is currently no editorial guidance on this topic in the SNOMED International Editorial Guidelines.

Occupations in healthcare are often specific to jurisdictions, although there is a National Occupational Classification published by Government of Canada that provides the "generic" occupations that are available in Canada.

RFCs related with the occupation submitted by the jurisdictions must come from the authoritative sources like Colleges or Associations (e.g. CPSO, CNO).

National Occupational Classification (NOC)

CIHI (Canadian Institute for Health Information) - Health Workforce

Alternative references to recognized Public School (University, College, Cegep) can be provided as supporting documentation.

•  Clinical findings (finding)

.