US Edition of SNOMED CT(R): March 2017 Release Introduction The US Edition of SNOMED CT is a combination of the full January 2017 SNOMED CT International Release and the US Extension to SNOMED CT. The US Edition eliminates the need for implementers to manually combine the US Extension and the International Release. In 2015, the IHTSDO announced the deprecation and withdrawal of support for RF1 format. The NLM has aligned with the deprecation timeline for the US Edition RF1 release and the September 2016 Release of the US Edition of SNOMED CT marked the last time that NLM made the RF1 release file available for download. From March 2017 on, users must download the RF2 version of the US Edition of SNOMED CT. March 2017 US Extension Statistics US Extension Statistics * New concepts added: 490 * (disorder) 202 * (situation) 88 * (procedure) 85 * (finding) 73 * (qualifier) 10 * (person) 9 * (regime/therapy) 7 * (event) 5 * (substance) 3 * (occupation) 3 * (assessment) 2 * (record) 1 * (product) 1 * (observable) 1 * Concepts inactivated 19 * Concepts moved to core (this release) 0 * Concepts moved to core (all time) 53 * Concepts promoted to core (this release) 0 * Concepts promoted to core (all time) 273 (and not defaulted back to extension) * Concepts defaulted to core (this release) 0 * Concepts defaulted to core (all time) 5 (and not promoted again back to extension) * Concepts moved from core (this release) 0 * Concepts moved from core (all time) 4 * Active concepts in US Extension 5827 * Retired concepts in US Extension 387 (including moved concepts) * Active descriptions in US Extension 14884 * Synonyms of International Edition concepts 463 * Active (inferred) rels in US Extension 23989 * Between of International Edition concepts 98 * Active (inferred ISA) rels in US Edition 865523 * Retired (inferred ISA) rels in US Edition 366394 The US Edition of SNOMED CT is provided in UTF-8 encoded tab-delimited flat files which can be imported into any database or other software application. The US Edition of SNOMED CT is not software. NLM performs quality assurance checks to ensure that US Edition data fully conform to RF2 specifications. File description Edition files are designed as tab-delimited text files to be used as relational tables with each line in the file representing a row in the table. The first row of each table contains column headings. All other rows contain data. The March 2017 US Edition is distributed in RF2 format in zip file: SnomedCT_USEditionRF2_Production_20170301T120000.zip (450 MB). Edition Files contain US Extension specific content and the full International release content providing a comprehensive compilation of the content from both sources. US Edition release in RF2 contains files that correspond to SNOMED CT files and are described in the "SNOMED CT(R) Technical Implementation Guide, International Release." The TIG is searchable on the IHTSDO SNOMED CT Documentation page: https://confluence.ihtsdotools.org/display/DOCTIG/Technical+Implementation+Guide. More information on the US Edition of SNOMED CT is available at https://www.nlm.nih.gov/healthit/snomedct/us_edition.html File Structure bytes Delta Refset Content der2_cRefset_AssociationReferenceDelta_US1000124_20170301.txt 64566 bytes der2_cRefset_AttributeValueDelta_US1000124_20170301.txt 187121 bytes der2_Refset_SimpleDelta_US1000124_20170301.txt 1398625 bytes Language der2_cRefset_LanguageDelta-en_US1000124_20170301.txt 6778789 bytes Map der2_iisssccRefset_ExtendedMapDelta_US1000124_20170301.txt 12993582 bytes der2_sRefset_SimpleMapDelta_US1000124_20170301.txt 1108769 bytes Metadata der2_cciRefset_RefsetDescriptorDelta_US1000124_20170301.txt 243 bytes der2_ciRefset_DescriptionTypeDelta_US1000124_20170301.txt 101 bytes der2_ssRefset_ModuleDependencyDelta_US1000124_20170301.txt 1157 bytes Terminology sct2_Concept_Delta_US1000124_20170301.txt 387963 bytes sct2_Description_Delta-en_US1000124_20170301.txt 3868229 bytes sct2_Identifier_Delta_US1000124_20170301.txt 92 bytes sct2_Relationship_Delta_US1000124_20170301.txt 5138398 bytes sct2_StatedRelationship_Delta_US1000124_20170301.txt 2984123 bytes sct2_TextDefinition_Delta-en_US1000124_20170301.txt 505152 bytes Full Refset Content der2_cRefset_AssociationReferenceFull_US1000124_20170301.txt 15382127 bytes der2_cRefset_AttributeValueFull_US1000124_20170301.txt 68841345 bytes der2_Refset_SimpleFull_US1000124_20170301.txt 1411281 bytes Language der2_cRefset_LanguageFull-en_US1000124_20170301.txt 339516634 bytes Map der2_iisssccRefset_ExtendedMapFull_US1000124_20170301.txt 92472844 bytes der2_sRefset_SimpleMapFull_US1000124_20170301.txt 92691620 bytes Metadata der2_cciRefset_RefsetDescriptorFull_US1000124_20170301.txt 13017 bytes der2_ciRefset_DescriptionTypeFull_US1000124_20170301.txt 619 bytes der2_ssRefset_ModuleDependencyFull_US1000124_20170301.txt 13158 bytes Terminology sct2_Concept_Full_US1000124_20170301.txt 32824870 bytes sct2_Description_Full-en_US1000124_20170301.txt 210601541 bytes sct2_Identifier_Full_US1000124_20170301.txt 92 bytes sct2_Relationship_Full_US1000124_20170301.txt 539384252 bytes sct2_StatedRelationship_Full_US1000124_20170301.txt 104043044 bytes sct2_TextDefinition_Full-en_US1000124_20170301.txt 1248573 bytes Snapshot Refset Content der2_cRefset_AssociationReferenceSnapshot_US1000124_20170301.txt 14194524 bytes der2_cRefset_AttributeValueSnapshot_US1000124_20170301.txt 49878433 bytes der2_Refset_SimpleSnapshot_US1000124_20170301.txt 1411281 bytes Language der2_cRefset_LanguageSnapshot-en_US1000124_20170301.txt 295582639 bytes Map der2_iisssccRefset_ExtendedMapSnapshot_US1000124_20170301.txt 71812415 bytes der2_sRefset_SimpleMapSnapshot_US1000124_20170301.txt 92449579 bytes Metadata der2_cciRefset_RefsetDescriptorSnapshot_US1000124_20170301.txt 10667 bytes der2_ciRefset_DescriptionTypeSnapshot_US1000124_20170301.txt 489 bytes der2_ssRefset_ModuleDependencySnapshot_US1000124_20170301.txt 4318 bytes Terminology sct2_Concept_Snapshot_US1000124_20170301.txt 26228959 bytes sct2_Description_Snapshot-en_US1000124_20170301.txt 170978851 bytes sct2_Identifier_Snapshot_US1000124_20170301.txt 92 bytes sct2_Relationship_Snapshot_US1000124_20170301.txt 288463801 bytes sct2_StatedRelationship_Snapshot_US1000124_20170301.txt 90204436 bytes sct2_TextDefinition_Snapshot-en_US1000124_20170301.txt 1225563 bytes License requirement The US Edition to SNOMED CT is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov. This material includes SNOMED CT(R) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO). All rights reserved. SNOMED CT was originally created by the College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHSTDO. You must have a UMLS license and UTS account to access SNOMED CT International and US Edition files. License information is available from the UTS at https://uts.nlm.nih.gov. Known Issues In addition to the known issues reported by the IHTSDO for the International Release of SNOMED CT (https://confluence.ihtsdotools.org/pages/viewpage.action?spaceKey=RMT&title=IHTSDO+Known+Issue+register), the following are known bugs for the US Edition of SNOMED CT: * Duplicated stated relationships. An issue within the authoring tooling platform leads to duplicated stated relationships in the Stated Relationships file. A technical fix in the future will correct the issues. * A large number of US Extension inferred relationships have an effectivetime later than the associated International release. The US NRC will continue to work with the IHTSDO on solutions. Currently there is no timeframe set for fix. * A small number of US Extension concepts with an ISA relationship to an inactive CORE concept. The US NRC is working with the IHTSDO on a fix which will be updated in future US Edition releases. * An inactive extension concept (1561000119105|20160901) without corresponding historical relationship. Found in the AttributeValue file. Currently no fix is planned. * An active extension concept (1561000119105) without an active ISA relationship. Transferred to core (20130731) and the core later inactivated (20150131). The US NRC is working with the IHTSDO on a fix which will be updated in future US Edition releases. * The SNOMED CT to ICD-10-CM map (6011000124106) data are not synchronized with the 21060901 data. A patch will be sent once the data are synchronized. * Discrepancy of relationship IDs in the RF1 20150901 and 20160301 releases. All relationshipids have been corrected in the 20160301 release. * A number of extension concepts are without an IS A relationships in the RF1 relationships file. The reported concepts have IS A relationships in the RF2 release. The error is due to the deprecation of RelationshipId data from the CORE (due to the deprecation policy). No fix is scheduled due to deprecation of RF1; it is advised that RF2 is used. Feedback and suggestions We welcome questions, comments or suggestions to improve the quality, accuracy and usability of the Edition. Please send feedback to NLM Customer Support https://support.nlm.nih.gov/ics/support/default.asp?style=classic&deptID=28054&category=snomed_ct U.S. National Library of Medicine March 1, 2017