Update to addition of Disorder of nervous system parent for Chronic fatigue syndrome and terms under Synonyms in SNOMED CT

Post #345 Shortlink: https://wp.me/pKrrB-4uk

In Post #342 (August 1, 2018), I confirmed that the addition of parent: Disorder of nervous system to Chronic fatigue syndrome was implemented for the July 31, 2018 release of the SNOMED CT International Edition.

The SNOMED CT Concept term for Chronic fatigue syndrome is SCTID 52702003 Chronic fatigue syndrome (disorder). Benign myalgic encephalomyelitis; and Myalgic encephalomyelitis are included in a list of terms under Synonyms.

SCTID: 52702003 Chronic fatigue syndrome (disorder) and the terms listed under Synonyms are now located under supertype SCTID: 118940003 Disorder of nervous system (disorder). This change to the International Edition is being incorporated into the national editions, as they release their next updates. These are released on a staggered schedule.

The rationale for requesting this additional supertype for Chronic fatigue syndrome and the terms listed under Synonyms is set out in this August 2018 document:

PDF: Statement on SNOMED CT and Chronic fatigue syndrome

Note that prior to July 2015, Postviral fatigue syndrome had been listed under Children to SCTID: 52702003 Chronic fatigue syndrome.

But for the July 2015 release, Postviral fatigue syndrome was removed from under SCTID: 52702003 Chronic fatigue syndrome and relocated under supertype: Post-viral disorder under: Post-infectious disorder and assigned the Concept code: SCTID: 51771007.

(A change that had not been requested by the Countess of Mar during her 2014-2015 engagement with SNOMED CT terminology managers for the removal of the Mental disorder parent. Provision of the rationale for relocating Postviral fatigue syndrome was not pursued by Forward-ME.)

Incorporation of addition of supertype Disorder of nervous system into national editions

SNOMED CT U.S. Edition incorporated the change for its September 01, 2018 release:

 

SNOMED CT Belgium Edition incorporated the change for its September 15, 2018 release:

 

SNOMED CT Danish Edition incorporated the change for its September 30, 2018 release:

 

SNOMED CT Netherlands Edition incorporated the change for its September 30, 2018 release:

Note on inclusion of “neurasthenie” in the Netherlands Edition: SNOMED CT International Edition and national editions used to include a Concept term SCTID: 192439005 Neurasthenia. This Concept was retired (Inactivated) a number of years ago. However, the Netherlands Edition retained the term “neurasthenie” under the list of Synonym terms. “Neurasthenie” is designated as an “Acceptable” term in the Netherlands Dutch language reference set (open “Details” tab to view Netherlands reference sets).

Details tab:

A Netherlands advocate has contacted Pim Volkert (Terminology Co-ordinator, Nictiz, and lead for the Netherlands SNOMED CT National Release Centre) with a request and rationales for consideration of the removal of the “neurasthenie” term, for consistency with the SNOMED CT International Edition and with the WHO’s ICD-10, which has an exclusion for G93.3 under F48.0 Neurasthenia. This request has been considered and accepted. I am advised that removal of the “neurasthenie” term is anticipated to be implemented for the March 2019 release of the Netherlands Edition.

 

SNOMED CT UK Edition incorporated the change for its October 01, 2018 release:

(Public browser hosted by NHS Digital. Browser can also be accessed from the landing page of the SNOMED CT International browser platform.)

Note: the UK Edition has three severity specifier options listed under “Children” that are specific to the UK Edition.

These are assigned the discrete codes: SCTID: 377181000000104 Mild chronic fatigue syndrome; SCTID: 377171000000101 Moderate chronic fatigue syndrome; and SCTID: 377161000000108 Severe chronic fatigue syndrome.

It has yet to be established from NHS Digital in which year these severity specifier options were added to the UK Edition, to what extent they are used, and by what means clinicians would determine which of the severities to apply.

The UK Edition includes the terms Myalgic encephalitis and Myalgic encephalopathy.

 

Updated to add screenshot of Canadian Edition

SNOMED CT Canadian Edition incorporated the change for its October 30, 2018 release:

 

Updated to add screenshot of Swedish Edition

SNOMED CT Swedish Edition incorporated the change for its November 30, 2018 release:

Note: the Swedish Edition includes a separately coded for Concept term:

SCTID: 55941000052101 | kronisk trötthet | [Chronic fatigue (finding)].

This is marked with the Swedish flag symbol to denote that this SNOMED CT Concept term is exclusive to the Swedish Edition. It can be viewed here:

 

Updated to add screenshot of Argentinian Edition

SNOMED CT Argentinian Edition incorporated the change for its November 30, 2018 release:

 

Updated to add screenshot of Australian Edition

The January 31, 2019 release of the Australian Edition has incorporated the change:

 

If your country is a member of SNOMED International but does not have a publicly accessible browser hosted on the International Edition platform or hosted on its own platform, please refer to your country’s SNOMED CT National Release Centre website for the release schedule.

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Media:

GP system updated to reflect M.E. as neurological, Action for M.E., August 01, 2018

NHS to update classification system to reflect that M.E. is neurological disease, ME Association, August 06, 2018

Chronic fatigue syndrome classified under Neurological disorder in SNOMED CT International Edition

Post #342 Shortlink: https://wp.me/pKrrB-4pK

SNOMED CT is a standardized electronic terminology system for recording and sharing symptoms, diagnoses, clinical findings, procedures etc. in primary and secondary care and across other health care settings.

Since April 2018, SNOMED CT UK Edition has been the mandatory terminology system for use in NHS primary care, replacing the Read Code (CTV3) terminology which is now retired. SNOMED CT UK Edition is scheduled for adoption across all NHS clinical settings by 2020.

In SNOMED CT terminology system, disease and disorder terms are not arranged in chapters, as they are in ICD-10 and ICD-11. Instead, terms are arranged within a hierarchical relationship of parent and children concepts (or supertypes and subtypes).

The SNOMED CT Concept term for Chronic fatigue syndrome is SCTID 52702003 Chronic fatigue syndrome (disorder). Benign myalgic encephalomyelitis; and Myalgic encephalomyelitis are included as Synonym terms.

Chronic fatigue syndrome has historically been located under the Parent Concept: Multisystem disorder.

Multisystem disorder Parent retired for January 2018 release

In 2017, SNOMED CT terminology managers decided that the Multisystem disorder concept term was not sufficiently specific for the purposes of their system and the term was inactivated (retired) for the January 2018 release.

There had been 90 Children terms under SCTID: 281867008 Multisystem disorder (disorder) and the retirement of this parent concept had implications for all of these 90 terms — not just for Chronic fatigue syndrome and its Synonym terms.

Many of these 90 Children terms were assigned under a more specific parent but a few, including Chronic fatigue syndrome, had no new parent assigned to them.

This presented an opportunity to request a more specific parent for Chronic fatigue syndrome.

In February 2018, a formal request and rationale for adding the supertype: Disorder of nervous system was submitted.

Chronic fatigue syndrome classified under Neurological disorder for July 2018 release

Following a peer review process, the addition of the parent: Disorder of nervous system for Chronic fatigue syndrome was provisionally approved for implementation in the next release, which has been finalized and published.

SCTID: 52702003 Chronic fatigue syndrome (disorder) is now classified under supertype SCTID: 118940003 Disorder of nervous system (disorder) in the July 2018 release of the SNOMED CT International Edition.

This change will be incorporated into the next update of the U.S. Edition (in September 2018), the UK Edition (in October 2018) and other National Editions, as they release their next updates.

Download a copy of the full report

PDF: Statement on SNOMED CT and Chronic fatigue syndrome

 

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SNOMED CT International Edition Release for July 2018 (v20180731) was published on the public SNOMED CT browser on July 31, 2018

Media:

GP system updated to reflect M.E. as neurological, Action for M.E., August 01, 2018

NHS to update classification system to reflect that M.E. is neurological disease, ME Association, August 06, 2018