Known Issues
Known issues include content or technical issues where the root cause is understood and the resolution has been discussed and agreed to but have yet to be implemented. This can be due to a number of reasons which include lack of capacity within the current editorial cycle and risk of impact to the stability of SNOMED CT if the fix were to be deployed at that stage in the product lifecycle.
Terminology issues
The following are known issues:
a. Concepts containing conjunctions AND/OR or OR that are potentially ambiguous:
When Editorial Guidelines were more « flexible » some « deviant » concepts were added to the CA Edition. These may be present in Communicable Disease and Canadian Partnership Against Cancer (CPAC) projects/subsets. Since then, the editorial criteria have matured and these types of concepts will no longer be added to the CA Edition. The following « deviant » concepts will be kept in the CA Edition until they are no longer required.
Examples: 10741000087101|Malignant tumor of ovary and/or fallopian tube (disorder)|
or 20721000087101|Meningitis or encephalitis (disorder)|
or 8141000087102|Anaphylaxis to previous dose or a constituent of this vaccine (situation)|
b. Duplicate concepts
There is the potential that CA Edition concepts duplicate existing concepts in the International Edition.
Example: 577191261000087109|Congenital rubella infection (disorder)| and 1857005|Congenital rubella syndrome (disorder)|
c. Concepts missing definitions and concepts missing refinements
Infoway does not « fully model » all concepts in the CA Edition because:
- When submitted to SNOMED International, they will fully model when applicable.
- International content must be completed and stable before the CA Edition content is modelled fully.
As a result, there may occasionally be missing defining relationships that could be added to better represent the full and unambiguous meaning of a concept through logical definition.
d. Incomplete coverage
Some concepts are missing and therefore there is incomplete content coverage.
Examples: 22231000087107|Structure of nail of all fingers (body structure)| is a child of 70327001|Structure of all fingers (body structure)|.
The concept 70327001|Structure of all fingers (body structure)| includes the following subtypes:
- 362779006|All fingers (body structure)|
- 22599004|Skin structure of all fingers (body structure)|
- 368364009|Entire skin of all fingers (body structure)|
- 88814004|Subcutaneous tissue structure of all fingers (body structure)|
- 368365005|Entire subcutaneous tissue of all fingers (body structure)|
- 22231000087107|Structure of nail of all fingers (body structure)|
It appears that a concept “Entire nail of all fingers” should also be created for completeness.
Technical fixed issues
- We received a report that the statistics provided through the Infographics were not the same as when using the ECL constraints on the SNOMED International Browser. The discrepancies in the numbers are due to the fact that the ECL queries the Edition content and ignore the inactivated concepts, and the statistics we shared were extracted from the authoring tool, which provides statistics on the extension, and therefore include the inactivated concepts. There is work in progress to enhance the statistics module for the Canadian Edition of SNOMED CT.
- - We received a report that there is a core concept that had two (2) preferred terms: 241677006. This is not a Canadian Edition issue and this issue was reported at SNOMED International. Also, two (2) Canadian extension concepts did not have fully specified names and preferred terms in the Language Refset. These were the concepts representing “module de la traduction française commune (concept de métadonnées de base)” and “ensemble de référence pour la langue française commune (concept de métadonnées fondamentales)”. We have promoted the 2 concepts to the SNOMED International Edition and these were published in the February 2022 release.
- During subsets testing for the March 2022 CA Edition publication, the RouteOfAdministration subset change log identified unexpected changes. Upon investigation, it was discovered that the subset had been updated and published November 1, 2021 with the following changes:
- an increase membership for a total of 164 concepts based on an intensional definition of <284009009|Route of administration value (qualifier value)|;
- a modified definition of the subset: This subset contains concepts that represent routes for medication and immunization administration, as well as routes in which individuals may be exposed to a substance. This is a broad data exchange subset that is intended to support semantic interoperability and conformance testing. It is recommended that jurisdictions define and implement more specific clinically curated subsets that contain a portion of these concepts for data capture at the point of care for their specific use case. This subset was defined using the intensional definition of <284009009|Route of administration value (qualifier value)| against the substrate SNOMED CT Canadian Edition.
As there was no mention of the changes outside the Terminology Gateway, i.e. no Requests for Change were submitted in InfoRMS, the Standards team had not been made aware of this change. Therefore, the subset, that is part of the SNOMED CT Canadian Edition, has been updated with the usual SNOMED CT Canadian Edition process. This resulted in the membership and the definition to be overwritten with the previous September 2021 information, and in the change log assessing that all concepts added in the November 2021 version had been inactivated in the March 2022 version.
Infoway is currently investigating for options to resolve this issue and ensure no recurrence of similar issues in the future.