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Unified Medical Language System® (UMLS®)

New and Updated Sources (Expanded Representation Information) - 2016AA Release

General Information:

What's New to the Metathesaurus

For 2016AA, there are 2 new sources (CCS, NANDA-I), 1 new translation source (LNC-DE-AT), and 93 updated sources (including translation sources and subsources).

CCS (Clinical Classifications Software) for ICD-10-CM and PCS is a diagnosis and procedure categorization scheme that can be employed in many types of projects analyzing data. CCS can be used to identify populations for disease- or procedure- specific studies or to develop statistical reports providing information (such as charges and length of stay) about relatively specific conditions. It can be a useful way to categorize conditions when exploring data and can serve as a tool for reporting statistical information on hospitalizations. CCS is based on the International Classification of Diseases, 10th Revision (ICD-10), a uniform and standardized coding system.

NANDA-I (NANDA-I Taxonomy II), which was previously named 'NAN' and officially became NANDA International and NANDA International, Inc. in the early 2000s, facilitates the development, refinement, dissemination and use of standardized nursing diagnostic terminology. NANDA-I provides evidence-based nursing diagnoses for use in practice and to determine interventions and outcomes. NANDA-I also contributes to patient safety through the integration of evidence-based terminology into clinical practice and clinical decision-making.

LNC-DE-AT (German, Austria) is a linguistic variant of LNC (LOINC). The source abbreviation name includes the ISO language and country code.

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

Clinical Classifications Software, CCS_10_2016
Current Procedural Terminology, CPT2016
Vaccines Administered, CVX2016_01_04
Human Phenotype Ontology, HPO2016_01_13
LOINC, LNC254
LOINC, German, Austria Edition, LNC-DE-AT_254
Medical Dictionary for Regulatory Activities Terminology (MedDRA), MDR18_1
Medical Dictionary for Regulatory Activities Terminology (MedDRA), Czech Edition, MDRCZE18_1
Medical Dictionary for Regulatory Activities Terminology (MedDRA), Dutch Edition, MDRDUT18_1
Medical Dictionary for Regulatory Activities Terminology (MedDRA), French Edition, MDRFRE18_1
Medical Dictionary for Regulatory Activities Terminology (MedDRA), German Edition, MDRGER18_1
Medical Dictionary for Regulatory Activities Terminology (MedDRA), Hungarian Edition, MDRHUN18_1
Medical Dictionary for Regulatory Activities Terminology (MedDRA), Italian Edition, MDRITA18_1
Medical Dictionary for Regulatory Activities Terminology (MedDRA), Japanese Edition, MDRJPN18_1
Medical Dictionary for Regulatory Activities Terminology (MedDRA), Portuguese Edition, MDRPOR18_1
Medical Dictionary for Regulatory Activities Terminology (MedDRA), Spanish Edition, MDRSPA18_1
MEDCIN, MEDCIN3_2015_12_21
Medical Subject Headings, MSH2016_2016_02_26
Manufacturers of Vaccine, MVX2015_07_27_16_02_24
NANDA-I Taxonomy II, NANDA-I_2015-2017
NCI Thesaurus, NCI2015_09D
RXNORM Vocabulary, RXNORM_15AB_160307F


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What's New to the Metathesaurus:

Term Type (TTY):
     LLT
     MTH_LLT

Attribute Name (ATN):
     IEEE_CF_CODE10
     IEEE_DESCRIPTION
     IEEE_DIM
     IEEE_REFID
     IEEE_UOM_UCUM
     PART_SEQ_ORDER
     RADLEX_PLAYBOOK_LONG_NAME
     RADLEX_PREF_NAME
     RPID
     SUBCATEGORY
     NICHD_HIERARCHY_TERM

Relationship Attribute (RELA)| RELA inverse:
     defining_characteristic_of|has_defining_characteristic
     has_action_guidance|is_action_guidance_for
     has_exam|is_exam_for
     has_imaging_focus|is_imaging_focus_of
     has_modality_subtype|is_modality_subtype_for
     has_object_guidance|is_object_guidance_for
     has_presence_guidance|is_presence_guidance_for
     is_aggregation_view_of|has_aggregation_view
     is_approach_guidance_for|has_approach_guidance
     is_given_pharmaceutical_substance_for|has_given_pharmaceutical_substance
     is_imaged_location_for|has_imaged_location
     is_lateral_anatomic_location_of|has_lateral_anatomic_location
     is_modality_for|has_modality
     is_pharmaceutical_route_for|has_pharmaceutical_route
     is_pharmaceutical_timing_of|has_pharmaceutical_timing
     is_presence_of_lateral_location|has_lateral_location_presence
     related_factor_of|has_related_factor
     risk_factor_of|has_risk_factor

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

Source: Clinical Classifications Software
VSAB: CCS_10_2016


1. New term type (TTY) | Suppressible value:
     HT|N
     MD|N
     MV|N
     SD|N
     SP|N
     XM|N

2. New relationship | relationship attribute (RELA) | RELA inverse:
     RQ|classified_as|classifies
     SY|has_single_level_category|has_multi_level_category

3. New attribute name (ATN):
     FROMRSAB
     FROMVSAB
     MAPSETRSAB
     MAPSETVERSION
     MAPSETVSAB
     MTH_MAPFROMCOMPLEXITY
     MTH_MAPFROMEXHAUSTIVE
     MTH_MAPSETCOMPLEXITY
     MTH_MAPTOCOMPLEXITY
     MTH_MAPTOEXHAUSTIVE
     TORSAB
     TOVSAB
     XMAP
     XMAPFROM
     XMAPTO


Discussion:

This source has not been updated since 2005 so it is being considered a new source. It is based on the CCS for ICD-9-CM.

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

Source: Current Procedural Terminology
VSAB: CPT2016

Dropped attribute name (ATN):
     ADDITIONAL_GUIDELINE


Discussion:

Dropped ATN = ADDITIONAL_GUIDELINE due to AMA restrictions.

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

Source: Vaccines Administered
VSAB: CVX2016_01_04


Discussion:

No changes to the data format, however, processing vaccines with a status "Inactive" was updated to reflect a clarification from the CDC. All CVX codes are considered 'active' except for when the vaccine status is 'NEVER ACTIVE', or the CVX code is 99, or 999.

This results in the following change when the value of the status field is "Inactive".
     Previously: the TTY = OP or OA had Suppress = O.
     Currently: the TTY = PT or AB and has Suppress = N for TTY = PT and Suppress = Y for TTY = AB.

Codes 99 and 999 are considered obsolete, so even though they may have an "Inactive" status, they are assigned TTY = OP or OA with Suppress = O. (No change from the previous version).

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

Source: Human Phenotype Ontology
VSAB: HPO2016_01_13

1. New attribute name (ATN):
     SID


Discussion:

ATN = SID represents the secondary GO identifier.

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

Source: LOINC, German, Austria Edition
VSAB: LNC-DE-AT_254

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
VSAB: LNC254

1. New relationship | relationship attribute (RELA) | RELA inverse:
     RT|has_action_guidance|is_action_guidance_for
     RT|has_exam|is_exam_for
     RT|has_imaging_focus|is_imaging_focus_of
     RT|has_modality_subtype|is_modality_subtype_for
     RT|has_object_guidance|is_object_guidance_for
     RT|has_presence_guidance|is_presence_guidance_for
     RT|is_aggregation_view_of|has_aggregation_view
     RT|is_approach_guidance_for|has_approach_guidance
     RT|is_given_pharmaceutical_substance_for|has_given_pharmaceutical_substance
     RT|is_imaged_location_for|has_imaged_location
     RT|is_lateral_anatomic_location_of|has_lateral_anatomic_location
     RT|is_modality_for|has_modality
     RT|is_pharmaceutical_route_for|has_pharmaceutical_route
     RT|is_pharmaceutical_timing_of|has_pharmaceutical_timing
     RT|is_presence_of_lateral_location|has_lateral_location_presence

2. New attribute name (ATN):
     IEEE_CF_CODE10
     IEEE_DESCRIPTION
     IEEE_DIM
     IEEE_REFID
     IEEE_UOM_UCUM
     PART_SEQ_ORDER
     RADLEX_PLAYBOOK_LONG_NAME
     RADLEX_PREF_NAME
     RID
     RPID


Discussion:

1. The RELAs are from the new LoincRsnaRadiologyPlaybook file which links LOINC radiology terms, the attribute values of the Unified Model as both LOINC Parts and RadLex terms, and applicable mappings to RadLex Playbook terms.

2. ATN = RID represents the RadLex ID.

3. ATN = RPID represents the RadLex Playbook ID.

4. 'VersionLastChanged' field, previously called 'DATE_LAST_CHANGED', will display the LOINC version number in which the record was last changed. The same ATN = LLR that was used with 'DATE_LAST_CHANGED' will continue to be used since LNC is the only source to use this ATN. The documentation will be updated to explain the change in the data value from a date to a version number.

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

Source: Medical Dictionary for Regulatory Activities Terminology (MedDRA)
VSAB: MDR18_1

1. New term type (TTY) | Suppressible value:
     LLT|N
     MTH_LLT|N

2. Dropped term type (TTY):
     LT
     MTH_LT


Discussion:

TTY = LT is being replaced by TTY = LLT.

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

Source: Medical Dictionary for Regulatory Activities Terminology (MedDRA), Czech Edition
VSAB: MDRCZE18_1

1. New term type (TTY) | Suppressible value:
     LLT|N

2. Dropped term type (TTY):
     LT


Discussion:

TTY = LT is being replaced by TTY = LLT.

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

Source: Medical Dictionary for Regulatory Activities Terminology (MedDRA), Dutch Edition
VSAB: MDRDUT18_1

1. New term type (TTY) | Suppressible value:
     LLT|N

2. Dropped term type (TTY):
     LT


Discussion:

TTY = LT is being replaced by TTY = LLT.

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

Source: Medical Dictionary for Regulatory Activities Terminology (MedDRA), French Edition
VSAB: MDRFRE18_1

1. New term type (TTY) | Suppressible value:
     LLT|N

2. Dropped term type (TTY):
     LT


Discussion:

TTY = LT is being replaced by TTY = LLT.

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

Source: Medical Dictionary for Regulatory Activities Terminology (MedDRA), German Edition
VSAB: MDRGER18_1

1. New term type (TTY) | Suppressible value:
     LLT|N

2. Dropped term type (TTY):
     LT


Discussion:

TTY = LT is being replaced by TTY = LLT.

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

Source: Medical Dictionary for Regulatory Activities Terminology (MedDRA), Hungarian Edition
VSAB: MDRHUN18_1

1. New term type (TTY) | Suppressible value:
     LLT|N

2. Dropped term type (TTY):
     LT


Discussion:

TTY = LT is being replaced by TTY = LLT.

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

Source: Medical Dictionary for Regulatory Activities Terminology (MedDRA), Italian Edition
VSAB: MDRITA18_1

1. New term type (TTY) | Suppressible value:
     LLT|N

2. Dropped term type (TTY):
     LT


Discussion:

TTY = LT is being replaced by TTY = LLT.

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

Source: Medical Dictionary for Regulatory Activities Terminology (MedDRA), Japanese Edition
VSAB: MDRJPN18_1

1. New term type (TTY) | Suppressible value:
     LLT|N
     LLTJKN|N
     LLTJKN1|N

2. Dropped term type (TTY):
     LT
     LTJKN
     LTJKN1


Discussion:

TTY = LT is being replaced by TTY = LLT. Similarly, TTY = LTJKN and LTJKN1 are replaced with LLTJKN and LLTJKN1, respectively.

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

Source: Medical Dictionary for Regulatory Activities Terminology (MedDRA), Portuguese Edition
VSAB: MDRPOR18_1

1. New term type (TTY) | Suppressible value:
     LLT|N

2. Dropped term type (TTY):
     LT


Discussion:

TTY = LT is being replaced by TTY = LLT.

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

Source: Medical Dictionary for Regulatory Activities Terminology (MedDRA), Spanish Edition
VSAB: MDRSPA18_1

1. New term type (TTY) | Suppressible value:
     LLT|N

2. Dropped term type (TTY):
     LT


Discussion:

TTY = LT is being replaced by TTY = LLT.

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

Source: MEDCIN
VSAB: MEDCIN3_2015_12_21

Dropped relationship | relationship attribute (RELA):
     RO|has_procedure_context

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

Source: Medical Subject Headings
VSAB: MSH2016_2016_02_26

1. New term type (TTY) | Suppressible value:
     ET|N

2. Dropped term type (TTY):
     EN
     EP
     PEN


Discussion:

Previously, TTYs were assigned algorithmically using the data field 'PrintFlagYN', however, this field has been deprecated and the TTYs = PEN (preferred non-print entry term), EN (non-print entry term), and EP (print entry term) can no longer be determined. With this version, the TTY assignment was simplified to accommodate this change:

Deprecated TTY | New TTY
EN  | ET (entry term)
EP  | ET (entry term)
PEN | PEP (preferred entry term)

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

Source: Manufacturers of Vaccines
VSAB: MVX2015_07_27_16_02_24

Dropped term type (TTY):
     OP


Discussion:

MVX codes are never deprecated although some of the codes may represent manufacturers that are long gone. The codes are kept so that historical records can have a manufacturer. All occurrences of the inactive codes (TTY = OP) has been changed to TTY = PT.

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

Source: NANDA-I Taxonomy II
VSAB: NANDA-I_2015-2017

1. New term type (TTY) | Suppressible value:
     HC|N
     HT|N
     PT|N
     RT|N

2. New relationship | relationship attribute (RELA) | RELA inverse:
      RO|defining_characteristic_of|has_defining_characteristic
      RO|related_factor_of|has_related_factor
      RO|risk_factor_of|has_risk_factor

3. New attribute name (ATN):
     DATE_CREATED
     DATE_LAST_MODIFIED
     SUBCATEGORY


Discussion:

1. This source which has not been updated since 2004 was previously named 'NAN2004'. Since then there has been a name change and significant updates to the data format and the processing. Essentially, this has become a new source.

Per the organization's documentation, the source officially became NANDA International and NANDA International, Inc. in the early 2000s in consideration of the significant growth outside of North America. The correct name of the organization is NANDA International, Inc. (no hypen) and the abbreviation is NANDA-I (with a hypen).

2. TTY = HC represents Classes.

3. TTY = HT represents Domains.

4. TTY = PT represesnts Diagnoses.

5. TTY = RT represents "Phrases".

6. Relationships are between "Phrases" (RT) and Diagnoses (PT).

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

Source: NCI Thesaurus
VSAB: NCI2015_09D

This version includes:
     NCI2015_BioC_1509D
     NCI2015_BRIDG_1509D
     NCI2015_CareLex_1509D
     NCI2015_CDC_1509D
     NCI2015_CDISC_1509D
     NCI2015_CRCH_1509D
     NCI2015_CTCAE_1509D
     NCI2015_CTEP-SDC_1509D
     NCI2015_DCP_1509D
     NCI2015_DICOM_1509D
     NCI2015_DTP_1509D
     NCI2015_FDA_1509D
     NCI2015_ICH_1509D
     NCI2015_JAX_1509D
     NCI2015_KEGG_1509D
     NCI2015_NCI-GLOSS_1509D
     NCI2015_NCI-HL7_1509D
     NCI2015_NCPDP_1509D
     NCI2015_NICHD_1509D
     NCI2015_PID_1509D
     NCI2015_RENI_1509D
     NCI2015_UCUM_1509D
     NCI2015_ZFIN_1509D

1. New term type (TTY) | Suppressible value | Source(s):
     SY|N|NCI2015_NCPDP_1509D

2. Dropped term type (TTY) | Source(s):
     AB|NCI2015_NICHD_1509D
     HD|NCI2015_NICHD_1509D

3. New attribute name (ATN) | Source(s):
     NICHD_HIERARCHY_TERM|NCI2015_NICHD_1509D

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

Source: RXNORM Vocabulary
VSAB: RXNORM_15AB_160307F

This version includes:
     ATC_2016_16_03_07 (Anatomical Therapeutic Chemical Classification System)
     GS_2016_02_01 (Gold Standard Drug Database)
     MDDB_2016_01_27 (Master Drug Data Base)
     MMSL_2016_02_01 (Multum MediSource Lexicon)
     MMX_2016_02_01 (Micromedex RED BOOK)
     MTHSPL_2016_02_26 (FDA Structured Product Labels)
     NDDF_2016_02_03 (FDB MedKnowledge)
     NDFRT_2016_03_07 (National Drug File)
     NDFRT_FDASPL_2016_03_07 (National Drug File - FDASPL)
     NDFRT_FMTSME_2016_03_07 (National Drug File - FMTSME)
     VANDF_2016_01_21 (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.