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Unified Medical Language System® (UMLS®)

New and Updated Sources (Expanded Representation Information) - 2018AA Release

General Information:

What's New to the Metathesaurus

For 2018AA, there is one new source (MED-RT), one new subsource (NCI-CTRP-SDC), and 103 updated sources (including translation sources and subsources).

MED-RT is the successor to the Veterans Health Administration’s National Drug File – Reference Terminology (VHA NDF-RT™). Both are formal ontological representations of medication terminology and pharmacologic classifications. MED-RT preserves and publishes most of NDF-RT's asserted pharmacologic classification relationships and maintains the mechanisms of action (MoA) and physiologic effects (PE) hierarchy concepts.

NCI-CTRP-SDC, a subsource of the NCI Thesaurus, represents the Clinical Trials Reporting Program and is a comprehensive database of regularly updated information, including accrual, on all NCI supported clinical trials.

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, CPT2018
LOINC, LNC263
MEDCIN, MEDCIN3_2017__12_22
Medication Reference Terminology, MED-RT_2018_03_05
Manufacturers of Vaccines, MVX2018_02_05
NANDA-I Taxonomy II, NANDA-I_2018_2020
NCI Thesaurus, NCI2017_09D
RXNORM Vocabulary, RXNORM_17AB_180305F
SNOMED Clinical Terms, Spanish Language Edition, SCTSPA_2017_10_31
US Edition of SNOMED CT, SNOMEDCT_US_2018_03_01


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What's New to the Metathesaurus:

Attribute Name (ATN):
     CONCEPT_TYPE
     DATE_MODIFIED
     LOE
     SPECIALTY

Relationship Attribute (RELA) | RELA inverse:
     genetic_biomarker_related_to|related_to_genetic_biomarker_of
     has_associated_condition|associated_condition_of
     has_at_risk_population|population_at_risk_for
     has_basic_dose_form|basic_dose_form_of
     has_contraindicated_class|contraindicated_class_of
     has_contraindicated_mechanism_of_action|contraindicated_mechanism_of_action
     has_contraindicated_physiologic_effect|contraindicated_physiologic_effect_of
     has_disposition|disposition_of
     has_dose_form_administration_method|dose_form_administration_method_of
     has_dose_form_intended_site|dose_form_intended_site_of
     has_dose_form_release_characteristic|dose_form_release_characteristic_of
     has_dose_form_transformation|dose_form_transformation_of
     has_parent|parent_of
     has_snomed_child|snomed_child_of
     has_snomed_parent|snomed_parent_of
     has_snomed_synonym|snomed_synonym_of
     has_specialty|specialty_of
     has_state_of matter|state_of_matter_of
     temporally_related_to|temporally_related_to

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Source: Current Procedural Terminology
VSAB: CPT2018

1. New relationship attribute (RELA) | RELA inverse:
     has_add_on_code|add_on_code_for
     has_specialty|specialty_of

2. New attribute name (ATN):
     PLACE_OF_SERVICE_CODE
     SPECIALTY



Discussion:

ATN = SPECIALTY represents the "Specialty" relationship. These relationships are to NUCC codes or to AMA-created provider codes. The value for this attribute is created by concatenating the "Provider code", "Provider label" and the "percent utilization of the source code by the target specialty".

For example: CPT CODE "00100" has two SPECIALTY attributes:

207L00000X/Anesthesiology/59%
367500000X/Nurse Anesthetist, Certified Registered/39%
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Source: LOINC
VSAB: LNC263

Dropped attribute name (ATN):
     DOCUMENT_SECTION
     GLOBAL_ID
     GLOBAL_ID_CODE_SYSTEM


Discussion:

The following fields were not populated in this version of the data so the ATNs were deprecated:
     Document_Section
     GlobalID
     GlobalIDSystem
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Source: MEDCIN
VSAB: MEDCIN3_2017_12_22

New relationship attribute (RELA) | RELA inverse:
     during|inverse_during
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Source: Medication Reference Terminology
VSAB: MED-RT_2018_03_05

1. New term type (TTY) | Suppressible value:
     FN|N
     PT|N
     SY|N

2. New relationship attribute (RELA) | RELA inverse:
     contraindicated_class_of|has_contraindicated_class
     contraindicated_mechanism_of_action_of|has_contraindicated_mechanism_of_action
     contraindicated_physiologic_effect_of|has_contraindicated_physiologic_effect
     has_parent|parent_of
     has_snomed_child|snomed_child_of
     has_snomed_parent|snomed_parent_of
     has_snomed_synonym|snomed_synonym_of

3. New attribute name (ATN):
     CONCEPT_TYPE


Discussion:

MED-RT is the successor source to the Veterans Health Administration’s National Drug File – Reference Terminology (NDFRT).
---------------------------------------

Source: Manufacturers of Vaccines
VSAB: MVX2018_02_05

1. New attribute name (ATN):
     DATE_MODIFIED

2. Dropped attribute name (ATN):
     DATE_LAST_MODIFIED


Discussion:

ATN = DATE_LAST_MODIFIED changed to DATE_MODIFIED
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Source: NANDA-I Taxonomy II
VSAB: NANDA-I_2018_2020

1. New relationship attribute (RELA) | RELA inverse:
     associated_condition_of|has_associated_condition
     population_at_risk_for|has_at_risk_population

2. New attribute name (ATN):
     LOE
     SOS
--------------------------------------

Source: NCI Thesaurus
VSAB: NCI2017_09D

This version includes:
     NCI2017_BRIDG_1709D (Biomedical Research Integrated Domain Group Model)
     NCI2017_BioC_1709D (BioCarta online maps of molecular pathways, adapted for NCI use)
     NCI2017_CDC_1709D (U.S. Centers for Disease Control and Prevention)
     NCI2017_CDISC_1709D (Clinical Data Interchange Standards Consortium)
     NCI2017_CRCH_1709D (Cancer Research Center of Hawaii Nutrition Terminology)
     NCI2017_CTCAE_1709D (Common Terminology Criteria for Adverse Events)
     NCI2017_CTEP-SDC_1709D (Cancer Therapy Evaluation Program - Simple Disease Classification)
     NCI2017_CTRP-SDC_1709D (Clinical Trials Reporting Program)
     NCI2017_CareLex_1709D (Content Archive Resource Exchange Lexicon)
     NCI2017_DCP_1709D (NCI Division of Cancer Prevention Program)
     NCI2017_DICOM_1709D (Digital Imaging Communications in Medicine)
     NCI2017_DTP_1709D (NCI Developmental Therapeutics Program)
     NCI2017_FDA_1709D (U.S. Food and Drug Administration)
     NCI2017_GAIA_1709D (Global Alignment of Immunization Safety Assessment in pregnancy)
     NCI2017_GENC_1709D (Geopolitical Entities, Names, and Codes Standard)
     NCI2017_ICH_1709D (International Conference on Harmonization)
     NCI2017_JAX_1709D (Jackson Laboratories Mouse Terminology, adapted for NCI use)
     NCI2017_KEGG_1709D (KEGG Pathway Database)
     NCI2017_NCI-GLOSS_1709D (NCI Dictionary of Cancer Terms)
     NCI2017_NCI-HGNC_1709D (NCI HUGO Gene Nomenclature Committee)
     NCI2017_NCI-HL7_1709D (NCI Health Level 7)
     NCI2017_NCPDP_1709D (National Council for Prescription Drug Programs)
     NCI2017_NICHD_1709D (National Institute of Child Health and Human Development)
     NCI2017_PI-RADS_1709D (Prostate Imaging Reporting and Data System)
     NCI2017_PID_1709D (National Cancer Institute Nature Pathway Interaction Database)
     NCI2017_RENI_1709D (Registry Nomenclature Information System)
     NCI2017_UCUM_1709D (Unified Code for Units of Measure)
     NCI2017_ZFin_1709D (Zebrafish Model Organism Database)


1. New subsource:
     NCI2017_CTRP-SDC_1709D

2. New term type (TTY) | Suppressible value | Source(s):
     DN|N|NCI2017_CTRP-SDC_1709D
     PT|N|NCI2017_CTRP-SDC_1709D
     SY|N|NCI2017_CTRP-SDC_1709D

3. New relationship attribute (RELA) | RELA inverse:
     related_to_genetic_biomarker|genetic_biomarker_related_to

4. Dropped attribute name (ATN):
     GO_ANNOTATION


Discussion:

New subsource = CTRP-SDC (Clinicaal Trials Reporting Program)
-----------------------------------------------

Source: RXNORM Vocabulary
VSAB: RXNORM_17AB_180305F

This version includes:
     ATC_2018_18_03_05 (Anatomical Therapeutic Chemical Classification System)
     CVX_2018_01_18_18_03_05 (Vaccines Administered)
     DRUGBANK5.0_2018_01_29 (DrugBank)
     GS_2018_01_31 (Gold Standard Drug Database)
     MMSL_2018_02_01 (Multum MediSource Lexicon)
     MMX_2018_01_29 (Micromedex RED BOOK)
     MTHCMSFRF_2014_18_03_05 (Metathesaurus CMS Formulary Reference File)
     MTHSPL_2018_02_23 (Metathesaurus FDA Structured Product Labels)
     NDDF_2018_01_31 (FDB MedKnowledge)
     NDFRT_2018_02_05_18_03_05 (National Drug File)
     NDFRT_FDASPL_2018_02_05_18_03_05 (National Drug File - FDASPL)
     NDFRT_FMTSME_2018_02_05_18_03_05 (National Drug File - FMTSME)
     VANDF_2018_01_26 (Veterans Health Administration National Drug File)


Discussion:

Selected portions of MSH and SNOMEDCT_US 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: SNOMED Clinical Terms, Spanish Language Edition
VSAB: SCTSPA_2017_10_31

New relationship attribute (RELA) | RELA inverse:
     during|inverse_during
---------------------------------------------------------------------

Source: US Edition of SNOMED CT
VSAB: SNOMEDCT_US_2018_03_01

1. New relationship attribute (RELA) | RELA inverse:
     alternative_of|has_alternative
     basic_dose_form_of|has_basic_dose_form
     disposition_of|has_disposition
     dose_form_administration_method_of|has_dose_form_administration_method
     dose_form_intended_site_of|has_dose_form_intended_site
     dose_form_release_characteristic_of|has_dose_form_release_characteristic
     dose_form_transformation_of|has_dose_form_transformation
     during|inverse_during
     has_state_of_matter|state_of_matter_of
     temporally_related_to|temporally_related_to

2. New attribute (ATN):
     DESCRIPTION_FORMAT
     DESCRIPTION_LENGTH

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