Unified Medical Language System® (UMLS®)
New and Updated Sources (Expanded Representation Information) - 2013AA Release
General Information:
What's New to the Metathesaurus
For 2013AA, there are 4 new sources (LNC_ASQ_3, LNC_NPUAP, LNC_VR_12, SOP) and 66 updated sources (including subsources and translation sources).
LNC_ASQ_3 represents The Ages & Stages Questionnaire, an assessment questionnaire designed to screen the developmental performance of children in the areas of communication, gross motor skills, fine motor skills, problem solving, and personal-social skills. The target population is children between the ages of 4 months and 60 months. Users of this questionnaire are early childhood educators, social workers, nurses, pediatricians, and other early childhood professionals.
LNC_NPUAP represents the staging system of pressure ulcers designed by the National Pressure Ulcer Advisory Panel which is dedicated to the prevention and management of pressure ulcers.
LNC_VR_12 represents The Veterans RAND 12 Item Health Survey (VR-12). A self-administered survey used to measure health related quality of life, to estimate disease burden and to evaluate disease-specific benchmarks with other populations. The items in the questionnaire correspond to eight principal physical and mental health domains including general health perceptions; physical functioning; role limitations due to physical and emotional problems; bodily pain; energy-fatigue, social functioning and mental health.
SOP represents the Source of Payment Typology developed by The PHDSC Payer Typology Committee. The goal is to empower the healthcare and public health communities with health information technology standards.
For detailed information about sources that are new or have had changes made (e.g. new term types, new attribute names, etc.):
Current Procedural Terminology, CPT2013
Healthcare Common Procedure Coding System, HCPCS2013
International Classification of Diseases, Ninth Revision, Clinical Modification, ICD9CM_2013_2012_08_06
International Classification of Diseases, Tenth Revision, Clinical Modification, ICD10CM_2013
Logical Observation Identifiers Names and Codes (LOINC), LNC242
Medicomp Systems, MEDCIN [terminology files], MEDCIN3_2012_12_14
MedlinePlus Health Topics, MEDLINEPLUS_20130221
Descritores em Ciencias da Saude (Portuguese translation of the Medical Subject Headings), MSHPOR2013
Descritores en Ciencias de la Salud (Spanish translation of the Medical Subject Headings), MSHSPA2013
NeuroNames, NEU2012_08_23
RXNORM Vocabulary, RXNORM_12AB_130304F
US Extension to SNOMED CT, SCTUSX_2013_03_01
Source of Payment Typology, SOP5
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What's New to the Metathesaurus:
Attribute name (ATN):
BRAININFO_URL
CNID
CNIDTYPE
CPT_CLINICIAN_DESC_ID
CPTDTK_CONCEPT_ID
HL7_ATTACHMENT_STRUCTURE
IMPRINT_CODE
MP_GROUP_URL
MP_HEALTH_TOPIC_URL
MP_OTHER_LANGUAGE_URL
MP_PRIMARY_INSTITUTE_URL
Relationship attribute(RELA)| RELA inverse:
has_clinician_form|clinician_form_of
has_consumer_friendly_form|consumer_friendly_form_of
Term type (TTY):
CHISY
ETCF
ETCLIN
FRESY
GERSY
INDSY
ITASY
KORSY
LATSY
RUSSY
SPASY
TURSY
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Source: Current Procedural Terminology
SAB: CPT2013
This version includes:
MTHCH2013
1. New term type (TTY) | Suppressible value | Source(s):
ETCF|N|CPT2013
ETCLIN|N|CPT2013
2. New relationship | relationship attribute(RELA) | RELA inverse | Source(s):
RO|has_clinician_form|clinician_form_of|CPT2013
RO|has_consumer_friendly_form|consumer_friendly_form_of|CPT2013
3. New attribute name (ATN) | Source(s):
CPT_CLINICIAN_DESC_ID|CPT2013
GENE_FAM_DESC
Discussion:
1. Two new categories of descriptions were processed for inclusion in the Metathesaurus:
a. pub_clinician_descriptor_ids.txt - clinicial descriptors (CDs) that describe a procedure or service performed by a physician or qualified healthcare professional at the point of care.
b. pub_consumer_friendly_descriptor_terms.txt - consumer friendly descriptors which translate each code descriptor from the official CPT code set into language that is easily understood by the average patient and/or his or her caregiver.
2. TTY = ETCLIN indicate entry terms for clinician descriptions.
3. TTY = ETCF indicate entry terms for consumer friendly descriptions.
4. RELA = has_clinician_form/clinician_form_of connects the clinican form (TTY = ETCLIN) of the CPT descriptor to the preferred term (TTY = PT).
5. RELA = consumer_friendly_form_of/has_consumer_friendly_form connects the consumer friendly form (TTY = ETCF) of the CPT descriptor to the preferred term (TTY = PT).
6. ATN = CPT_CLINICIAN_DESC_ID represents the CPT clinician descriptor concept identifier.
7. ATN = CPTDTK_CONCEPT_ID represents the CPT DTK concept identifier.
------------------------------------------
Source: Healthcare Common Procedure Coding System
SAB: HCPCS2013
This version includes:
HCDT2013
HCPT2013
MTHHH2013
1. New term type (TTY) | Suppressible value | Source(s):
MTH_PT|N|HCPCS2013, HCPT2013
2. New relationship | relationship attribute(RELA) | RELA inverse | Source(s):
SY|mth_plain_text_form_of|mth_has_plain_text_form|HCPCS2013, HCPT2013
Discussion:
1. A new MTH_* term type and mth_* relationship was needed for plain ASCII text strings created during Metathesaurus processing.
2. The version of CDT was updated to HCDT2013.
------------------------------------------
Source: International Classification of Diseases, Ninth Revision, Clinical Modification
SAB: ICD9CM_2013_2012_08_06
This version includes:
MTHICD9_2013_2012_08_06
Discussion:
On August 8, 2012, CMS issued corrections to full descriptions which affected 41 diagnoses codes. These changes were incorporated into 2013AA.
------------------------------------------
Source: International Classification of Diseases, Tenth Revision, Clinical Modification
SAB: ICD10CM_2013
1. New term types (TTY) | Suppressible value:
MTH_AB|N
Discussion:
New TTY = MTH_AB for plain text version of short descriptions.
------------------------------------------
Source: Logical Observation Identifiers Names and Codes (LOINC)
SAB: LNC242
This version includes:
LNC242_AD8_2005
LNC242_ASQ_3_2009 (new)
LNC242_BRADEN_1988
LNC242_CAM_2003
LNC242_FACIT
LNC242_FLACC_1997
LNC242_MDS20
LNC242_MDS30
LNC242_MLHFQ_1986
LNC242_NEUROQOL_2010
LNC242_NPUAP_2012 (new)
LNC242_OASIS_2002
LNC242_OPTIMAL_2005
LNC242_PHQ_9_1999
LNC242_RHO_2008
LNC242_SPERTUS_2005
LNC242_VR_12_2004 (new)
LNC242_WHO_2006
1) New term type (TTY) | Suppressible value | Source(s):
LC|N|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
LN|N|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
MTH_LN|N|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
2) New relationship | relationship attribute (RELA) | RELA inverse | Source(s):
RO|has_class|class_of|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
RO|has_component|component_of|LNC242_ASQ_3_2009, LNC242_VR_12_2004
RO|has_evaluation|evaluation_of|LNC242_ASQ_3_2009, LNC242_VR_12_2004
RO|has_fragments_for_synonyms|fragments_for_synonyms_of|LNC242_VR_12_2004
RO|has_method|method_of|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
RO|has_property|property_of|LNC242_NPUAP_2012, LNC242_VR_12_2004
RO|has_scale|scale_of|LNC242_NPUAP_2012, LNC242_VR_12_2004
RO|has_supersystem|supersystem_of|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
RO|has_time_aspect|time_aspect_of|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
RO|measured_by|measures|LNC242_NPUAP_2012
SY|common_name_of|has_common_name|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
SY|has_expanded_form|expanded_form_of|LNC242_NPUAP_2012
SY|mth_expanded_form_of|mth_has_expanded_form|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
3. Dropped relationship | relationship attribute (RELA):
RQ|mapped_from
4. New attribute name (ATN) | Source(s):
COMMON_ORDER_RANK|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
COMMON_SI_TEST_RANK|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
COMMON_TEST_RANK|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
COPYRIGHT|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
EXAMPLE_UCUM_UNITS|LNC242_VR_12_2004
EXAMPLE_UNITS|LNC242_VR_12_2004
HL7_ATTACHMENT_STRUCTURE|LNC242
HL7_V2_DATATYPE|LNC242_VR_12_2004
LCL|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
LCN|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
LCS|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
LCT|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
LLR|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004/> LOINC_COMPONENT|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
LOINC_METHOD_TYP|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
LOINC_PROPERTY|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
LOINC_SCALE_TYP|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
LOINC_SYSTEM|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
LOINC_TIME_ASPECT|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
LOR|LNC242_NPUAP_2012
LQS|LNC242_VR_12_2004
LQT|LNC242_ASQ_3_2009, LNC242_VR_12_2004
LRN2|LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004
SOS|LNC242_ASQ_3_2009, LNC242_VR_12_2004
5. Dropped attribute name (ATN):
LMP
Discussion:
1. Three new subsources: LNC242_ASQ_3_2009, LNC242_NPUAP_2012, LNC242_VR_12_2004.
2. New ATN = HL7_ATTACHMENT_STRUCTURE. Valid values are STRUCTURED or UNSTRUCTURED. STRUCTURED terms are the allowed document type codes in the Consolidated CDA Implementation guide. UNSTRUCTURED terms are based on the PIUC guide.
3. New MTH_* term types are due to the creation of plain ASCII text strings during Metathesaurus processing.
4. Five subsources within the LNC source data are not included in the Metathesaurus:
a. Borderline Symptom List - 23 Item
b. Borderline Symptom List - Supplement
c. Edinburgh Postnatal Depression Scale
d. Patient Reported Outcomes Measurement (PROMIS)
e. Test of Infant Motor Performance (TIMP)
5. The 'MAP_TO' field in the source data was deprecated. The information in this field supplied the value for the dropped ATN=LMP.
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Source: Medicomp Systems, MEDCIN [terminology files]
SAB: MEDCIN3_2012_12_14
1) New relationship | relationship attribute(RELA) | RELA inverse:
RO|has_indirect_morphology|indirect_morphology_of
Discussion:
RELA = has_indirect_morphology indicates a relationship between a SNOMEDCT term and a MEDCIN term.
------------------------------------------------
Source: MedlinePlus Health Topics
SAB: MEDLINEPLUS_20130221
1. New attribute name (ATN):
MP_GROUP_URL
MP_HEALTH_TOPIC_URL
MP_OTHER_LANGUAGE_URL
MP_PRIMARY_INSTITUTE_URL
2. Dropped attribute name (ATN):
GROUPURL
URL
Discussion:
1. The format of the health topics code has changed. The prefix 'T' was deprecated. Previous code format was T3061. Current code format is 3061.
2. Some ATNs have been replaced with more descriptive names.
ATN = MP_GROUP_URL replaces GROUPURL.
ATN = MP_HEALTH_TOPIC_URL replaces URL.
3. New ATN = MP_OTHER_LANGUAGE_URL indicates the other language associated with the health topic.
4. New ATN = MP_PRIMARY_INSTITUTE_URL indicates the primary National Institutes of Health Institute assigned to the health topic.
----------------------------------------------
Source: Descritores em Ciencias da Saude (Portuguese translation of the Medical Subject Headings)
SAB: MSHPOR2013
1. New term type (TTY) | Suppressible value:
EN|N
PEN|N
Discussion:
1. New TTY = EN indicates entry term.
2. New TTY = PEN indicates preferred entry term.
----------------------------------------------
Source: Descritores en Ciencias de la Salud (Spanish translation of the Medical Subject Headings)
SAB: MSHSPA2013
1. New term type (TTY) | Suppressible value:
EN|N
PEN|N
Discussion:
1. New TTY = EN indicates entry term.
2. New TTY = PEN indicates preferred entry term.
----------------------------------------------
Source: NeuroNames
SAB: NEU2012_08_23
1. New term type (TTY) | Suppressible value:
ACR|Y
CHISY|N
FRESY|N
GERSY|N
INDSY|N
ITASY|N
KORSY|N
LATSY|N
PT|N
RUSSY|N
SPASY|N
SY|N
TURSY|N
2. New relationship | relationship attribute (RELA) | RELA inverse:
SY|has_expanded_form|expanded_form_of
3. New attribute name (ATN):
BRAININFO_URL
CNID
CNIDTYPE
Discussion:
1. New permanent numeric identifier called brainInfoID. IDs used prior to 2009 are mapped to ATN = CNID.
2. Synonyms are available in several languages (Chinese, Russian, French, etc) and are assigned specific termtypes: CHISY (Chinese), FRESY (French), GERSY (German), etc.
3. Latin atoms were previously assigned TTY=LSY (in NEU99). It is now TTY = LATSY to remain consistent with the 3 code language format of the other languages.
4. ATN = CNIDTYPE identifies whether an item is in the classical hierarchy of brain structures (value = h) or not (value = a for ancillary).
5. ATN = BRAININFO_URL identifies the URL of the central directory page in BrainInfo.
6. New species restrictions: guenon, rodent, mouse, primate, rat.
7. New relationship: SY|expanded_form_of created between the preferred term (TTY=PT) and the acronym (TTY=ACR).
----------------------------------------------
Source: RXNORM Vocabulary
SAB: RXNORM_12AB_130304F
This version includes:
GS_2013_02_01 (Gold Standard Drug Database)
MDDB_2013_01_30 (Master Drug Data Base. Medi-Span, a division of Wolters Kluwer Health)
MMSL_2013_02_01 (Multum MediSource Lexicon)
MMX_2013_02_04 (Micromedex RED BOOK)
MTHFDA_2011_06_01_13_03_04 (FDA National Drug Code Directory)
MTHSPL_2013_02_26 (FDA Structured Product Labels)
NDDF_2013_02_06 (FDB MedKnowledge)
NDFRT_2013_02_04 (National Drug File)
VANDF_2013_01_15 (Veterans Health Administration National Drug File)
1. Dropped term type (TTY):
AB
FN
HT
PT
2. Dropped relationship | relationship attribute(RELA):
RO|active_metabolites_of
RO|chemical_structure_of
RO|contraindicated_with_disease
RO|contraindicating_class_of
RO|contraindicating_mechanism_of_action_of
RO|contraindicating_physiologic_effect_of
RO|effect_may_be_inhibited_by
RO|has_active_metabolites
RO|has_chemical_structure
RO|has_contraindicated_drug
RO|has_contraindicating_class
RO|has_contraindicating_mechanism_of_action
RO|has_contraindicating_physiologic_effect
RO|has_mechanism_of_action
RO|has_participant
RO|has_pharmacokinetics
RO|has_physiologic_effect
RO|has_product_component
RO|has_therapeutic_class
RO|induced_by
RO|induced
RO|induces
RO|may_be_diagnosed_by
RO|may_be_prevented_by
RO|may_be_treated_by
RO|may_diagnose
RO|may_inhibit_effect_of
RO|may_prevent
RO|may_treat
RO|mechanism_of_action_of
RO|metabolic_site_of
RO|participates_in
RO|pharmacokinetics_of
RO|physiologic_effect_of
RO|product_component_of
RO|site_of_metabolism
RO|therapeutic_class_of
SY|has_print_name
SY|print_name_of
3. New attribute name (ATN) | Source(s):
IMPRINT_CODE|MTHSPL_2013_02_26
NST|MTHFDA_2011_06_01_13_03_04
RXO|MTHFDA_2011_06_01_13_03_04
TRN|MTHFDA_2011_06_01_13_03_04
4. Dropped attribute name (ATN):
APPROVED_DRUG_PRODUCT_MANUFACTURED_EXCLUSIVELY_FOR_PRIVATE_LABEL_DISTRIBUTOR
DRUG_CLASS_TYPE
EXCLUDE_DI_CHECK
FDA_UNII_CODE
IMPRINT CODE
LEVEL
MESH_DEFINITION
MESH_DUI
MESH_NAME
MESH_UI
NDFRT_KIND
NDF_UNITS CODE
NF_INACTIVATE
NUI
PARENT_CLASS
RXN_PRESCRIBABLE
SEVERITY
SNOMED_CID
STRENGTH
VA_IEN
VANDF_RECORD
VUID
Discussion:
1. New ATN = NST indicates the normalized strength and units for drugs with one active ingredient (e.g. 769 MG).
2. New ATN = RXO displays the NDF drug description. Valid values: R for Rx and O for OTC.
3. ATN = IMPRINT_CODE replaces ATN = IMPRINT CODE.
4. New ATN = TRN displays the product trade name.
5. MTHFDA is included in each Metathesaurus release as part of RxNorm, however, it was not updated in this version. MTHFDA was last updated in 2011.
6. Selected portions of MSH and SNOMEDCT are included in the RxNorm release files, however, they are not processed as part of RxNorm for the Metathesaurus except in assigning RXCUI and RXAUI attributes.
------------------------------------------------------------
Source: US Extension to SNOMED CT
SAB: SCTUSX_2013_03_01
1. New relationship | relationship attribute(RELA) | RELA inverse:
RO|has_finding_informer|finding_informer_of
RO|has_procedure_morphology|procedure_morphology_of
RO|has_procedure_site|procedure_site_of
RO|has_specimen_procedure|specimen_procedure_of
RO|occurs_after|occurs_before
RO|uses_energy|energy_used_by
RO|uses_substance|substance_used_by
Discussion:
1. The relationships while new to SCTUSX are already present in SNOMEDCT.
2. The SCTUSX hierarchy is designed as an extension to the SNOMEDCT hierarchy. Due to complications in representing a mixed-source hierarchy, the SCTUSX hierarchy is not represented in MRHIER.RRF, however, it is represented in MRREL.RRF as follows:
REL/REL_INVERSE: PAR/CHD
RELA/RELA_INVERSE: inverse_isa/isa
---------------------------------------------------------------
Source: Source of Payment Typology
SAB: SOP5
1. New term type (TTY) | Suppressible value:
PT|N
Discussion:
This is a new source.
