Skip Navigation Bar
NLM logo

Unified Medical Language System® (UMLS®)

New and Updated Sources (Expanded Representation Information) - 2021AA Release

General Information:

What's New to the Metathesaurus

For 2021AA, there is one new translation source (MEDLINEPLUS_SPA), three new subsources (NCI_CTDC, NCI_PCDC, NCI_caDSR), and 107 updated sources (including translation sources and subsources).

Three SABs have been updated to accurately reflect the official source name (CCSR_10 is now CCSR_ICD10CM, CCS_10 is now CCSR_ICD10PCS, and NUCCPT is now NUCCHCPT).

MEDLINEPLUS_SPA is the Spanish Edition of MedlinePlus Health Topics (MEDLINEPLUS).

NCI_CTDC (Clinical Trial Data Commons) provides access to clinical trial data between tumor molecular characterization, treatment, response and progression. The CTDC will aggregate data from multiple precision medicine studies that tailor treatment to the specific tumor in an individual patient.

NCI_PCDC (Pediatric Cancer Data Commons) is a common core data dictionary and common governance structure spanning seven pediatric cancers: neuroblastoma, soft tissue sarcoma, acute myeloid leukemia, acute lymphoblastic leukemia, germ cell tumors, bone tumors, and Hodgkin lymphoma. This dictionary will enable cross-disease research as well as set a standard for future cancer data commons endeavors.

NCI_caDSR (Cancer Data Standards Registry and Repository) defines a comprehensive set of standardized metadata descriptors for cancer research data, for both information collection and analysis. It is designed to integrate caCORE infrastructure and supports the development and deployment of data elements that are used as metadata descriptors, primarily for NCI-sponsored research.

MRREL.RRF SIB (sibling) relations have been removed.

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 Refined for ICD-10-CM, CCSR_ICD10CM_2021
Clinical Classifications Software Refined for ICD-10-PCS, CCSR_ICD10PCS_2021
HL7 Vocabulary Version 3.0, HL7V3.0_2020_11
LOINC, LNC269
MedlinePlus Health Topics, MEDLINEPLUS_20201125
MedlinePlus Spanish Health Topics, MEDLINEPLUS_SPA_20201125
NCI Thesaurus, NCI2020_09D
National Uniform Claim Committee - Health Care Provider Taxonomy, NUCCHCPT_20.1
SNOMED Clinical Terms, Spanish Language Edition, SCTSPA_2020_10_31
Veterinary Extension to SNOMED CT, SNOMEDCT_VET_2020_10_08


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

What's New to the Metathesaurus:

Attribute Name (ATN):
HL7LT
HL7UN
NSC_NUMBER

Relationship Attribute (RELA) | Inverse:
has_ctdc_value|is_ctdc_value_of
has_default_inpatient_classification|default_inpatient_classification_of
has_default_outpatient_classification|default_inpatient_classification_of
is_pcdc_aml_permissible_value_for_variable|has_pcdc_aml_permissable_value
value_set_is_paired_with|is_paired_with_value_set

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

Source: Clinical Classifications Software Refined for ICD-10-CM
VSAB: CCSR_ICD10CM_2021

1. Dropped termtype(s) (TTY):
HT|Hierarchical term
MV|Multi-level procedure category
SP|CCS single-level procedure categories

2. New relationship | relationship attribute (RELA) | RELA inverse:
RQ|has_default_inpatient_classification|default_inpatient_classification_of
RQ|has_default_outpatient_classification|default_inpatient_classification_of

3. Dropped relationship | relationship attribute (RELA) | RELA inverse:
SY|has_single_level_category|has_multi_level_category

Discussion:

1. CCSR_ICD10CM is a new source abbreviation and update for CCSR_10_2020.

2. Previously, CCSR_10 mapped ICD10CM codes to single CCSR categories. Now CCSR_ICD10CM maps ICD10CM codes to one or more (currently up to 6) CCSR_ICD10CM categories, and it defines a single default inpatient category and a single default outpatient category for each mapped ICD10CM code.

3. The default inpatient/outpatient categories are represented with two new RELAs:
has_default_inpatient_classification
has_default_outpatient_classification

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

Source: Clinical Classifications Software Refined for ICD-10-PCS
VSAB: CCSR_ICD10PCS_2021

1. Dropped termtype(s) (TTY):
MV|Multi-level procedure category
SD|CCS single-level diagnosis categories

2. Dropped relationship | relationship attribute (RELA) | RELA inverse:
SY|has_single_level_category|has_multi_level_category

Discussion:

1. CCSR_ICD10PCS is a new source abbreviation and update for CCS_10_2020.

2. Previously, CCS_10 mapped ICD10PCS codes to single-level and multi-level categories. Now CCSR_ICD10PCS maps ICD10PCS codes to CCSR_ICD10PCS categories, each of which is within one of 31 clinical domains.

3. For dropped TTY = MV, no multi-level system with additional procedure specificity has been developed for CCSR_ICD10PCS.

4. Dropped relationship = "SY|has_single_level_category" which previously connected a single-level CCS CATEGORY to MULTI CCS LVL 2 categories no longer exist.

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

Source: HL7 Vocabulary Version 3.0
VSAB: HL7V3.0_2020_11

1. New attribute name(s) (ATN) | Description:
HL7LT|HL7 license terms
HL7UN|HL7 usage notes

2. Dropped attribute name(s) (ATN) | Description:
HL7CO|HL7 contributor
HL7DH|HL7 default handling code
HL7DV|HL7 default value
HL7NO|HL7 notation
HL7OAN|HL7 other annotation
HL7OI|HL7 open issue
HL7PV|HL7 publisher version Id

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

Source: LOINC
VSAB: LNC269

1. New abbreviation | Class:
PANEL.SURVEY.BADS|Brief Anxiety and Depression Scale set
PANEL.SURVEY.BCAT|Brief Cognitive Assessment Tool set
PANEL.SURVEY.BRIEF|BRIEF Health Literacy Screening Tool set
PANEL.SURVEY.HITS|HITS Survey set
PANEL.SURVEY.NIDA|National Institute on Drug Abuse set
PANEL.SURVEY.NPASS|Neonatal Pain, Agitation and Sedation Scale set
PANEL.SURVEY.SDOH|Social determinants of health set
PANEL.SURVEY.SKINDEX|Skindex set
SURVEY.BADS|Brief Anxiety and Depression Scale (BADS)
SURVEY.BCAT|Brief Cognitive Assessment Tool (BCAT)
SURVEY.BRIEF|BRIEF Survey
SURVEY.HITS|HITS Survey
SURVEY.NIDA|National Institute on Drug Abuse
SURVEY.NPASS|Neonatal Pain, Agitation and Sedation Scale
SURVEY.SDOH|Social Determinants of Health
SURVEY.SKINDEX|Skindex
EYE.ERG|electroretinogram concepts

2. Dropped attribute name(s) (ATN):
TOP_2000_LAB_RESULTS_SI
TOP_2000_LAB_RESULTS_US

Discussion:

The file, Top 2000+ Lab Observations and Mapper's Guide, is no longer part of the release resulting in the deprecation of the ATNs.

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

Source: MedlinePlus Health Topics
VSAB: MEDLINEPLUS_20201125

The HT (hierarchical term) codes (e.g., 1,2,3, etc.) were prefixed with 'HT' (e.g., HT1, HT2, HT3, etc.).

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

Source: MedlinePlus Spanish Health Topics
VSAB: MEDLINEPLUS_SPA_20201125

1. New termtype(s) (TTY):
HT|Hierarchical term
PT|Designated preferred name

Discussion:

1. New source. This is the Spanish Edition of MedlinePlus Health Topics.

2. The HT (hierarchical term) codes (e.g., 1,2,3, etc.) were prefixed with 'HT' (e.g., HT1, HT2, HT3, etc.).

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

Source: NCI Thesaurus
VSAB: NCI2020_09D

This version includes:
NCI2020_ACC-AHA_2009D (American College of Cardiology/American Heart Association Clinical Data Terminology) NCI2020_BioC_2009D (BioCarta online maps of molecular pathways, adapted for NCI use)
NCI2020_BRIDG_2009D (Biomedical Research Integrated Domain Group Model Subset)
NCI2020_BRIDG_3_0_3_2009D (Biomedical Research Integrated Domain Group Model 3.0.3)
NCI2020_BRIDG_5_3_2009D (Biomedical Research Integrated Domain Group Model 5.3)
NCI2020_caDSR_2009D (Cancer Data Standards Registry and Repository)
NCI2020_CareLex_2009D (Content Archive Resource Exchange Lexicon)
NCI2020_CBDD_2009D (Chemical Biology and Drug Development Vocabulary)
NCI2020_CDC_2009D (U.S. Centers for Disease Control and Prevention)
NCI2020_CDISC_2009D (Clinical Data Interchange Standards Consortium)
NCI2020_CDISC-GLOSS_2009D (CDISC Glossary Terminology)
NCI2020_CELLOSAURUS_2009D (Cellosaurus)
NCI2020_CRCH_2009D (Cancer Research Center of Hawaii Nutrition Terminology)
NCI2020_CTCAE_2009D (Common Terminology Criteria for Adverse Events 4.3 Subset)
NCI2020_CTCAE_3_2009D (Common Terminology Criteria for Adverse Events 3.0)
NCI2020_CTCAE_5_2009D (Common Terminology Criteria for Adverse Events 5.0)
NCI2020_CTDC_2009D (Clinical Trial Data Commons)
NCI2020_CTEP-SDC_2009D (Cancer Therapy Evaluation Program - Simple Disease Classification)
NCI2020_CTRP_2009D (Clinical Trials Reporting Program)
NCI2020_DCP_2009D (NCI Division of Cancer Prevention Program)
NCI2020_DICOM_2009D (Digital Imaging Communications in Medicine)
NCI2020_DTP_2009D (NCI Developmental Therapeutics Program)
NCI2020_EDQM-HC_2009D (European Directorate for the Quality of Medicines and Healthcare)
NCI2020_FDA_2009D (U.S. Food and Drug Administration)
NCI2020_GAIA_2009D (Global Alignment of Immunization Safety Assessment in pregnancy)
NCI2020_GDC_2009D (NCI Genomic Data Commons Terms)
NCI2020_GENC_2009D (Geopolitical Entities, Names, and Codes (GENC) Standard Edition 1)
NCI2020_ICDC_2009D (NCI Integrated Canine Data Commons Terms)
NCI2020_ICH_2009D (International Conference on Harmonization)
NCI2020_INC_2009D (International Neonatal Consortium)
NCI2020_JAX_2009D (Jackson Laboratories Mouse Terminology, adapted for NCI use)
NCI2020_KEGG_2009D (KEGG Pathway Database)
NCI2020_NCI-GLOSS_2009D (NCI Dictionary of Cancer Terms)
NCI2020_NCI-HGNC_2009D (NCI HUGO Gene Nomenclature)
NCI2020_NCI-HL7_2009D (NCI Health Level 7)
NCI2020_NCPDP_2009D (National Council for Prescription Drug Programs)
NCI2020_NICHD_2009D (National Institute of Child Health and Human Development)
NCI2020_PCDC_2009D (Pediatric Cancer Data Commons)
NCI2020_PI-RADS_2009D (Prostate Imaging Reporting and Data System)
NCI2020_PID_2009D (National Cancer Institute Nature Pathway Interaction Database)
NCI2020_RENI_2009D (Registry Nomenclature Information System)
NCI2020_UCUM_2009D (Unified Code for Units of Measure)
NCI2020_ZFin_2009D (Zebrafish Model Organism Database)

1. New subsources:
CTDC|Clinical Trial Data Commons
PCDC|Pediatric Cancer Data Commons
caDSR|Cancer Data Standards Registry and Repository

2. New termgroup(s) | Description:
ACC-AHA/SY|Designated synonym
CTCAE/SY|Designated synonym
CTDC/DN|Display Name
CTDC/PT|Designated preferred name
CTDC/SY|Designated synonym
PCDC/PT|Designated preferred name
PCDC/SY|Designated synonym
caDSR/SY|Designated synonym

3. New attribute name (ATN) | Description:
NSC_NUMBER|NSC Number

4. Dropped attribute name (ATN) | Description:
NSC_CODE|NSC Code

4. New relationship | relationship attribute (RELA) | RELA inverse:
RO|has_ctdc_value|is_ctdc_value_of
RO|is_pcdc_aml_permissible_value_for_variable|has_pcdc_aml_permissable_value
RO|value_set_is_paired_with|is_paired_with_value_set

5. Dropped relationship | relationship attribute (RELA) | RELA inverse:
RO|has_cdrh_parent|cdrh_parent_of
RO|has_nichd_parent|nichd_parent_of

Discussion:

1. ATN = NSC_CODE was changed to ATN = NSC_NAME.

2. RELA = 'pcdc_aml_permissible_value_of' was changed to 'is_pcdc_aml_permissible_value_for_variable'. The inverse remains the same at 'has_pcdc_aml_permissible_value'.

3. All TTYs = AB were made suppressible.

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

Source: National Uniform Claim Committee - Health Care Provider Taxonomy
VSAB: NUCCHCPT_20.1

Dropped termtype(s) (TTY):
MP|Preferred names of modifiers

Discussion:

1. NUCCHCPT is a new source abbreviation and update for NUCCPT.

2. The characteristic file is no longer being processed resulting in the deprecation of TTY = MP.

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

Source: SNOMED Clinical Terms, Spanish Language Edition
VSAB: SCTSPA_2020_10_31

New relationship | relationship attribute (RELA) | RELA inverse:
RO|count_of_active_ingredient_of|has_count_of_active_ingredient
RO|has_compositional_material|compositional_material_of
RO|has_device_characteristic|device_characteristic_of
RO|has_device_intended_site|device_intended_site_of
RO|has_filling|filling_of
RO|has_ingredient_characteristic|ingredient_characteristic_of
RO|has_product_characteristic|product_characteristic_of
RO|has_surface_characteristic|surface_characteristic_of
RO|relative_to|inverse_relative_to

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

Source: Veterinary Extension to SNOMED CT
VSAB: SNOMEDCT_VET_2020_10_08

New relationship | relationship attribute (RELA) | RELA inverse:
RO|has_count_of_base_of_active_ingredient|count_of_base_of_act ive_ingredient_of

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

Last Reviewed: May 3, 2021