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Unified Medical Language System® (UMLS®)

New and Updated Sources (Expanded Representation Information) - 2015AB Release

General Information:

What's New to the Metathesaurus

For 2015AB, there are 2 new sources (HPO, MVX), 1 new subsource (NCI_CareLex), 19 new translation sources (LNC-*), and 61 updated sources (including translation sources and subsources).

HPO (Human Phenotype Ontology) provides a standardized vocabulary of phenotypic abnormalities encountered in human disease. HPO is developed using the medical literature, Orphanet, DECIPHER, and OMIM. It contains approximately 11,000 terms and over 115,000 annotations to hereditary and common diseases.

MVX (Manufacturers of Vaccines) is recognized as the standard codeset for use in identifying the manufacturer of a vaccine. It is paired with the Vaccine Administered (CVX) code to obtain the specific trade named vaccine administered. It includes both active and inactive manufacturers of vaccines in the US.

The new subsource is NCI_CareLex (Content Archive Resource Exchange Lexicon). It contains filing plan industry classification terms used in the TMF Reference model and metadata terms that are sourced from published controlled vocabularies such as NCI Thesaurus, HL7 and other published sources to create a standards-based, controlled vocabulary for use in clinical trial content exchange and standards-based metadata tagging.

The 19 new translations are all linguistic variants of LNC (LOINC). The source abbreviation name of each translation includes the ISO language and country code.

  • LNC-DE-CH_252 (German, Switzerland)
  • LNC-DE-DE_252 (German, Germany)
  • LNC-EL-GR_252 (Greek, Greece)
  • LNC-ES-AR_252 (Spanish, Argentina)
  • LNC-ES-CH_252 (Spanish, Switzerland)
  • LNC-ES-ES_252 (Spanish, Spain)
  • LNC-ET-EE_252 (Estonian, Estonia)
  • LNC-FR-BE_252 (French, Belgium)
  • LNC-FR-CA_252 (French, Canada)
  • LNC-FR-CH_252 (French, Switzerland)
  • LNC-FR-FR_252 (French, France)
  • LNC-IT-CH_252 (Italian, Switzerland)
  • LNC-IT-IT_252 (Italian, Italy)
  • LNC-KO-KR_252 (Korean, Korea)
  • LNC-NL-NL_252 (Dutch, Netherlands)
  • LNC-PT-BR_252 (Portuguese, Brazil)
  • LNC-RU-RU_252 (Russian, Russia)
  • LNC-TR-TR_252 (Turkish, Turkey)
  • LNC-CN-TR_252 (Chinese, China)

For detailed information about sources that are new or have had changes made (e.g. new term types, new attribute names, etc.):

Code on Dental Procedures and Nomenclature 2016, CDT2016
Gene Ontology, GO2015_04_04
Human Phenotype Ontology, HPO2015_04_20
International Classification for Nursing Practice, ICNP_2015
LOINC, LNC252
LOINC, German, Switzerland Edition, LNC-DE-CH_252
LOINC, German, Germany Edition, LNC-DE-DE_252
LOINC, Greek, Greece Edition, LNC-EL-GR_252
LOINC, Spanish, Argentina Edition, LNC-ES-AR_252
LOINC, Spanish, Switzerland Edition, LNC-ES-CH_252
LOINC, Spanish, Spain Edition, LNC-ES-ES_252
LOINC, Estonian, Estonia Edition, LNC-ET-EE_252
LOINC, French, Belgium Edition, LNC-FR-BE_252
LOINC, French, Canada Edition, LNC-FR-CA_252
LOINC, French, Switzerland Edition, LNC_FR-CH_252
LOINC, French, France Edition, LNC-FR-FR_252
LOINC, Italian, Switzerland Edition, LNC-IT-CH_252
LOINC, Italian, Italy Edition, LNC-IT-IT_252
LOINC, Korean, Korea Edition, LNC-KR-KO_252
LOINC, Dutch, Netherlands Edition, LNC-NL-NL_252
LOINC, Portuguese, Brazil Edition, LNC-PT-BR_252
LOINC, Russian, Russia Edition, LNC-RU-RU_252
LOINC, Turkish, Turkey Edition, LNC-TR-TR_252
LOINC, Chinese, China Edition, LNC-ZH-CN_252
Japanese translation of the Medical Subject Headings, MSHJPN2014
Manufacturers of Vaccine, MVX2015_07_27
NCBI Taxonomy, NCBI2015_03_23
NCI Thesaurus, NCI2015_02D
Online Mendelian Inheritance in Man, OMIM2015_03_18
RXNORM Vocabulary, RXNORM_15AA_150908F
US Edition of SNOMED CT, SNOMEDCT_US_2015_03_01
USP Model Guidelines, USPMG_2014

------------------------------------------

What's New to the Metathesaurus:

Term Type (TTY):
      ETAL
      PHENO
      PHENO_ET

Attribute Name (ATN):
      ASSOC_OBSERVATIONS
      EXTERNALLY_DEFINED_CODE_SYSTEM
      EXTERNAL_LIST_LINK
      HPO_COMMENT
      MANUFACTURER_STATUS
      PANEL_TYPE
      UNITS_AND_RANGE

Relationship Attribute (RELA)| RELA inverse:
      happens_during|inverse_happens_during
      manufactured_by|manufactures
      phenotype_of|has_phenotype

Language:
      CHI (Chinese)
      EST (Estonian)
      GRE (Greek)
      KOR (Korean)
      TUR (Turkish)

------------------------------------------

Source: Code on Dental Procedures and Nomenclature 2016
VSAB: CDT2016


Discussion:

1. In the printed CDT book, some codes appear out of order. The order information is not available in electronic form, therefore the UMLS hierarchy varies slightly from the hierarchy in the printed book.

2. CDT in the Metathesaurus is extracted from a file provided by the American Dental Association (ADA). The Metathesaurus also includes the HCPCS version of CDT, which has RSAB = "HCDT." The CDT hierarchy is created from the data file provided by the ADA, while the HCDT hierarchy is created during Metathesaurus production using analysis of the HCPCS printed manual.

------------------------------------------

Source: Gene Ontology
VSAB: GO2015_04_04

New relationship | relationship attribute (RELA) | RELA inverse:
      RO|happens_during|inverse_happens_during

------------------------------------------

Source: Human Phenotype Ontology
VSAB: HPO2015_04_20

1. New term type (TTY) | Suppressible value:
      ET|N
      IS|O
      OP|O
      PT|N
      SY|N

2. New relationship | relationship attribute (RELA) | RELA inverse:
      RB|<blank>|<blank>
      RN|<blank>|<blank>
      RQ|consider|consider_from
      RQ|replaced_by|replaces
      RO|<blank>|<blank>
      SY|<blank>|<blank>

3. New attribute name (ATN):
      DATE_CREATED
      HPO_COMMENT
      HXR
      REF


Discussion:

1. New source.

2. ATN = HXR contains a cross reference describing an analagous term in another vocabulary.

3. ATN = REF contains optional cross references which were included in the synonym tag.

4. RELA = consider/consider_from creates a relationship to a term which may be an appropriate substitute or an obsolete term.

------------------------------------------

Source: International Classification for Nursing Practice
VSAB: ICNP_2015

1. Dropped relationship | relationship attribute (RELA):
      RB|mapped_from
      RN|mapped_from

2. Dropped attribute name (ATN):
      MAPSETXRTARGETID


Discussion:

1. "Mapping Notes" are no longer includeded in the ICNP-SCT mapping file. Everything was assumed to be an exact match and all XR, RB, or RN relationships were deprecated.

2. SCT mappings are now provided for both DC (Diagnosis/Outcome) and IC (Intervention). Previously there were only mappings for DC.

3. ATN = MAPSETXRTARGETID was deprecated since there were no "No match" values indicated.

------------------------------------------

Source: LOINC, German, Switzerland Edition
VSAB: LNC-DE-CH_252

New term type (TTY) | Suppressible value:
      OOSN|O
      OSN|N


Discussion:

1. New source.

2. TTY = OSN (Official short name) and OOSN (Obsolete official short name).

------------------------------------------

Source: LOINC, German, Germany Edition
VSAB: LNC-DE-DE_252

New term type (TTY) | Suppressible value:
      LN|N
      LO|O


Discussion:

1. New source.

2. TTY = LN (Official fully specified name) and LO (Obsolete official fully specified name).

------------------------------------------

Source: LOINC, Greek, Greece Edition
VSAB: LNC-EL-GR_252

New term type (TTY) | Suppressible value:
      LN|N
      LO|O


Discussion:

1. New source.

2. TTY = LN (Official fully specified name) and LO (Obsolete official fully specified name).

------------------------------------------

Source: LOINC, Spanish, Argentina Edition
VSAB: LNC-ES-AR_252

New term type (TTY) | Suppressible value:
      LN|N
      LO|O
      OOSN|O
      OSN|N


Discussion:

1. New source.

2. TTY = LN (Official fully specified name), LO (Obsolete official fully specified name), OOSN (Obsolete official short name), and OSN (Official short name).

------------------------------------------

Source: LOINC, Spanish, Switzerland Edition
VSAB: LNC-ES-CH_252

New term type (TTY) | Suppressible value:
      OOSN|O
      OSN|N


Discussion:

1. New source.

2. TTY = OSN (Official short name) and OOSN (Obsolete official short name).

------------------------------------------

Source: LOINC, Spanish, Spain Edition
VSAB: LNC-ES-ES_252

New term type (TTY) | Suppressible value:
      LN|N
      LO|O


Discussion:

1. New source.

2. TTY = LN (Official fully specified name), LO (Obsolete official fully specified name).

------------------------------------------

Source: LOINC, Estonian, Estonia Edition
VSAB: LNC-ET-EE_252

New term type (TTY) | Suppressible value:
      LN|N
      LO|O


Discussion:

1. New source and new language introduced into the UMLS system. LAT = EST.

2. TTY = LN (Official fully specified name), LO (Obsolete official fully specified name).

------------------------------------------

Source: LOINC, French, Belgium Edition
VSAB: LNC-FR-BE

New term type (TTY) | Suppressible value:
      LN|N
      LO|O


Discussion:

1. New source.

2. TTY = LN (Official fully specified name), LO (Obsolete official fully specified name).

------------------------------------------

Source: LOINC, French, Canada Edition
VSAB: LNC-FR-CA_252

New term type (TTY) | Suppressible value:
      LN|N
      LO|O


Discussion:

1. New source.

2. TTY = LN (Official fully specified name), LO (Obsolete official fully specified name).

------------------------------------------

Source: LOINC, French, Switzerland Edition
VSAB: LNC-FR-CH_252

New term type (TTY) | Suppressible value:
      OOSN|O
      OSN|N


Discussion:

1. New source.

2. TTY = OSN (Official short name) and OOSN (Obsolete official short name).

------------------------------------------

Source: LOINC, French, France Edition
VSAB: LNC-FR-FR_252

New term type (TTY) | Suppressible value:
      LC|N
      LN|N
      LO|O
      OLC|O


Discussion:

1. New source.

2. TTY = LN (Official fully specified name), LO (Obsolete official fully specified name), LC (Long common name), and OLC (Obsolete long common name).

------------------------------------------

Source: LOINC, Italian, Switzerland Edition
VSAB: LNC-IT-CH_252

New term type (TTY) | Suppressible value:
      OOSN|O
      OSN|N


Discussion:

1. New source.

2. TTY = OSN (Official short name) and OOSN (Obsolete official short name).

------------------------------------------

Source: LOINC, Italian, Italy Edition
VSAB: LNC-IT-IT_252

New term type (TTY) | Suppressible value:
      LN|N
      LO|O


Discussion:

1. New source.

2. TTY = LN (Official fully specified name) and LO (Obsolete official fully specified name).

------------------------------------------

Source: LOINC, Korean, Korea Edition
VSAB: LNC-KO-KR_252

New term type (TTY) | Suppressible value:
      LN|N
      LO|O


Discussion:

1. New source and new language introduced into the UMLS system. LAT = KOR.

2. TTY = LN (Official fully specified name) and LO (Obsolete official fully specified name).

------------------------------------------

Source: LOINC, Dutch, Netherlands Edition
VSAB: LNC-NL-NL_252

New term type (TTY) | Suppressible value:
      LN|N
      LO|O


Discussion:

1. New source.

2. TTY = LN (Official fully specified name) and LO (Obsolete official fully specified name).

------------------------------------------

Source: LOINC, Portuguese, Brazil Edition
VSAB: LNC-PT-BR_252

New term type (TTY) | Suppressible value:
      LC|N
      LN|N
      LO|O
      OLC|O
      OOSN|O
      OSN|N


Discussion:

1. New source.

2. TTY = LN (Official fully specified name), LO (Obsolete official fully specified name), OOSN (Obsolete official short name), OSN (Official short name), LC (Long common name), and OLC (Obsolete long common name).

------------------------------------------

Source: LOINC, Russian, Russia Edition
VSAB: LNC-RU-RU_252

New term type (TTY) | Suppressible value:
      LN|N
      LO|O


Discussion:

1. New source.

2. TTY = LN (Official fully specified name) and LO (Obsolete official fully specified name).

------------------------------------------

Source: LOINC, Turkish, Turkey Edition
VSAB: LNC-TR-TR

New term type (TTY) | Suppressible value:
      LN|N
      LO|O


Discussion:

1. New source and new language introduced into the UMLS system. LAT = TUR.

2. TTY = LN (Official fully specified name) and LO (Obsolete official fully specified name).

------------------------------------------

Source: LOINC, Chinese, China Edition
VSAB: LNC-ZH-CN_252

New term type (TTY) | Suppressible value:
      LN|N
      LO|O


Discussion:

1. New source and new language introduced into the UMLS system. LAT = CHI.

2. TTY = LN (Official fully specified name) and LO (Obsolete official fully specified name).

------------------------------------------

Source: LOINC
VSAB: LNC252

1. New attribute name (ATN):
      ASSOC_OBSERVATIONS
      EXTERNALLY_DEFINED_CODE_SYSTEM
      EXTERNAL_LIST_LINK
      PANEL_TYPE
      UNITS_AND_RANGE

2. Dropped attribute name (ATN):
      CURATED_RANGE_AND_UNITS
      HL7_V2_DATATYPE
      HL7_V3_DATATYPE
      LCA
      LCB
      LMM
      LNC
      LNE


Discussion:

1. Multiple fields were deleted from the LOINC source files which resulted in dropped or renamed ATNs.

Deleted fields and their corresponding ATNs:

Field Name ATN
MOLAR_MASS LMM
ACSSYM LCA
BASE_NAME LCB
CODE_TABLE LNE
HL7_V2_DATATYPE HL7_V2_DATATYPE
HL7_V3_DATATYPE HL7_V3_DATATYPE


The content from field NAACCR_ID was moved to SURVEY_QUEST_SRC with corresponding ATN = LQS and NAACCR_ID with its corresponding ATN = LNC was deleted.

2. Data field = CURATED_RANGE_AND_UNITS was renamed to UnitsandRange. New ATN = UNITS_AND_RANGE.

------------------------------------------

Source: Japanese translation of the Medical Subject Headings
VSAB: MSHJPN2014

1. Dropped term type (TTY):
      CE
      EN
      EP
      PCE
      PEN
      RSY

2. Dropped relationship | relationship attribute (RELA):
      RB|mapped_from
      RN|<blank>


Discussion:

New data format was submitted in the form of MRCONSO.RRF. This resulted in all termtypes being dropped except for TTY = PT and TTY = SY.

------------------------------------------

Source: Manufacturers of Vaccines
VSAB: MVX2015_07_27

1. New term type (TTY) | Suppressible value:
      OP|O
      PT|N

2. New relationship | relationship attribute (RELA) | RELA inverse:
      RO|manufactured_by|manufactures

3. New attribute name (ATN):
      DATE_LAST_MODIFIED
      MANUFACTURER_STATUS
      SEMANTIC_TYPE
      SOS


Discussion:

1. New source.

2. RELA = manufactured_by/manufactures connects vaccines (CVX) to manufacturers (MVX).

3. ATN = DATE_LAST_MODIFIED represents the last time the relation between the manufacturer and the vaccine was updated.

-----------------------------------------------

Source: NCBI Taxonomy
VSAB: NCBI2015_03_23

New term type (TTY) | Suppressible value:
      UE|N


Discussion:

TTY = UE represents the unique equivalent name.

-----------------------------------------------

Source: NCI Thesaurus
VSAB: NCI2015_02D

This version includes:
     NCI2015_BioC_1502D
     NCI2015_BRIDG_1502D
     NCI2015_CareLex_1502D
     NCI2015_CDC_1502D
     NCI2015_CDISC_1502D
     NCI2015_CRCH_1502D
     NCI2015_CTCAE_1502D
     NCI2015_CTEP-SDC_1502D
     NCI2015_DCP_1502D
     NCI2015_DICOM_1502D
     NCI2015_DTP_1502D
     NCI2015_FDA_1502D
     NCI2015_ICH_1502D
     NCI2015_JAX_1502D
     NCI2015_KEGG_1502D
     NCI2015_NCI-GLOSS_1502D
     NCI2015_NCI-HL7_1502D
     NCI2015_NCPDP_1502D
     NCI2015_NICHD_1502D
     NCI2015_PID_1502D
     NCI2015_RENI_1502D
     NCI2015_UCUM_1502D
     NCI2015_ZFIN_1502D

New term type (TTY) | Suppressible value | Source(s):
      AB|N|NCI2015_CareLex_1502D
      PT|N|NCI2015_CareLex_1502D
      SY|N|NCI2015_CareLex_1502D
      OP|O|NCI2015_NICHD_1502D
      HD|N|NCI2015_NICHD_1502D


Discussion:

New subsource = NCI2015_CareLex_1502D.

-----------------------------------------------

Source: Online Mendelian Inheritance in Man
VSAB: OMIM2015_03_18

1. New term type (TTY) | Suppressible value:
      ETAL|N
      PHENO|N
      PHENO_ET|N

2. Dropped term type (TTY):
      ETAV
      SYN

3. New relationship | relationship attribute (RELA) | RELA inverse:
      RQ|has_allelic_variant|allelic_variant_of
      RO|phenotype_of|has_phenotype

4. Dropped relationship | relationship attribute (RELA):
      RO|has_allelic_variant
      RO|related_to


Discussion:

1. TTY = ETAL (Entry term alias), PHENO (Phenotype), PHENO_ET (Phenotype entry term).

2. RELA = allelic_variant_of/has_allelic_variant connects the PTAV (Preferred allelic variant) to its PT atom.

3. RELA = phenotype_of/has_phenotype connects the PTAV (Preferred allelic variant) to the PHENO or PHENO_ET atom.

-----------------------------------------------

Source: RXNORM Vocabulary
VSAB: RXNORM_15AA_150908F

This version includes:
     ATC_2015_15_09_08 (Anatomical Therapeutic Chemical Classification System)
     GS_2015_08_07 (Gold Standard Drug Database)
     MDDB_2015_07_29 (Master Drug Data Base)
     MMSL_2015_08_01 (Multum MediSource Lexicon)
     MMX_2015_08_03 (Micromedex RED BOOK)
     MTHCMSFRF_2014 (Metathesaurus CMS Formulary Reference File)
     MTHSPL_2015_08_28 (FDA Structured Product Labels)
     NDDF_2015_08_05 (FDB MedKnowledge)
     NDFRT_2015_09_07 (National Drug File)
     NDFRT_FDASPL_2015_09_07 (National Drug File - FDASPL)
     NDFRT_FMTSME_2015_09_07 (National Drug File - FMTSME)
     VANDF_2015_07_16 (Veterans Health Administration National Drug File)

1. Dropped term type (TTY) | Source(s):
      NST|MTHFDA_2011_06_01_13_05_06
      OCD|RXNORM_15AA_150908F
      RXO|MTHFDA_2011_06_01_13_05_06
      TRN|MTHFDA_2011_06_01_13_05_06

2. Dropped attribute name (ATN) | Source(s):
      ORIG_AMBIGUITY_FLAG|RXNORM_15AA_150908F
      ORIG_TTY|RXNORM_15AA_150908F
      ORIG_VSAB|RXNORM_15AA_150908F


Discussion:

1. New dose form added: Jet Injector (part of the Injectable Product group).

2. MTHCMSFRF is included in each Metathesaurus release as part of RxNorm, however, it was not updated in this version. MTHCMSFRF was last updated in 2014.

3. The subsource MTHFDA (FDA National Drug Code Directory) has been deleted from the RXNORM files.

4. The OCD files have also been deleted from the RXNORM files.

5. 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: US Edition of SNOMED CT
VSAB: SNOMEDCT_US_2015_03_01

Dropped attribute name (ATN):
      GMDN_CODE

---------------------------------------------------------------

Source: USP Model Guidelines
VSAB: USPMG_2014

Dropped term type (TTY):
      HT


Discussion:

The data no longer includes a "Pharmacologic Class" column which results in the TTY = HT being deprecated.