Unified Medical Language System® (UMLS®)
New and Updated Sources (Expanded Representation Information) - 2013AB Release
General Information:
What's New to the Metathesaurus
For 2013AB, there are 4 new sources (ATC, CDT, CVX, SNOMEDCT_US) and 47 updated sources (including subsources and translation sources).
ATC represents the Anatomical Therapeutic Chemical Classification System, maintained by the WHO Collaborating Centre for Drug Statistics Methodology (WHOCC). The ATC divides drugs into different groups according to the organ or system on which they act and their chemical, pharmacological and therapeutic properties. The purpose is to serve as a tool for drug utilization research in order to improve quality of drug use.
CDT represents the Code on Dental Procedures and Nomenclature as received from the American Dental Association (ADA). The purpose of the CDT is to achieve uniformity, consistency and specificity in accurately reporting dental treatment and to provide for the efficient processing of dental claims. CDT is the same as the HCPCS version of CDT (SAB = HCDT) except for the hierarchy and a few different attributes.
CVX represents the Vaccines Administered code set which is developed and maintained by the National Center of Immunization and Respiratory Diseases (NCIRD). It includes codes and notes for active and inactive vaccines available in the U.S.
SNOMEDCT_US represents The US Edition of SNOMED CT which is the official source of SNOMED CT for use in US healthcare systems. It is composed of 1) the International Release of SNOMED CT and 2) the US Extension to SNOMED CT. SNOMEDCT_US replaces the 2 individual sources of SNOMEDCT (International Release) and SNOMED_USX (US Extension) which have been deprecated.
Also, starting with this release, the NLM will no longer create "plain ASCII" versions of atoms when the original STR value includes non-ASCII characters. Existing terms and sources created for this purpose have been removed and the indexes have been restructured to maintain existing search and retrieval capabilities. The 2 sources that have been deprecated as a result of this new policy are: 1) MTHHL7V2.5 (HL7 Vocabulary Version 2.5, 7-bit Equivalents) and 2) MTHICPC2ICD107B (International Classification of Primary Care 2nd Edition, 7-bit Equivalents)/
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, CDT2013
Vaccines Administered, CVX2013_05_01
GO Ontology, GO2013_04_06
HUGO Gene Nomenclature Committee, HGNC2013_04
International Classification for Nursing Practice, ICNP_2013
Logical Observation Identifiers Names and Codes (LOINC), LNC244
Medical Dictionary for Regulatory Activities Terminology (MedDRA), MDR16_0
Medicomp Systems, MEDCIN [terminology files], MEDCIN3_2013_07_15
NCI Thesaurus, NCI2013_03D
NeuroNames Brain Hierarchy, NEU2013_06_09
RXNORM Vocabulary, RXNORM_13AA_130903F
SNOMED Clinical Terms, Spanish Language Edition, SCTSPA_2013_04_30
SNOMED CT US Edition, SNOMEDCT_US_2013_09_01
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What's New to the Metathesaurus:
Attribute name (ATN):
ATC_LEVEL
CHANGE_CLASS
HGNC_ID
IS_DRUG_CLASS
TRANSLATION
VACCINE_STATUS
Relationship attribute(RELA)| RELA inverse:
has_access_instrument|access_instrument_of
has_alternative|alternative_of
has_approach|approach_of
has_associated_etiologic_finding|associated_etiologic_finding_of
has_associated_function|associated_function_of
has_communication_with_wound|wound_has_communication_with
has_course|course_of
has_data_element|data_element_of
has_dependent|dependent_of
has_extent|extent_of
has_instrumentation|instrumentation_of
has_measured_component|measured_component_of
has_multipart|multipart_of
has_onset|onset_of
has_quotient|quotient_of
has_stage|stage_of
has_subject_of_information|subject_of_information_of
member_of|has_member
(RELA = member_of was changed from the RELA = member_of_cluster for purposes of clarity. The inverse remains the same 'has_member')
possibly_equivalent_to|possibly_equivalent_to
temporally_follows|temporally_followed_by
Term type (TTY):
CTEP-SDCPT
CTEP-SDCSY
MTH_OAF
MTH_OAP
MTH_OAS
MTH_OET
OAF
OAP
OAS
RXN_IN
RXN_PT
------------------------------------------
Source: Code on Dental Procedures and Nomenclature
VSAB: CDT2013
1. New term type (TTY) | Suppressible value:
HT|N
PT|N
2. New attribute name (ATN):
CHANGE_CLASS
Discussion:
1. New source.
2. CDT is extracted from a file provided by the American Dental Association (ADA). It is the same as the HCPCS version of CDT (SAB = HCDT) except for the hierarchy and a few different attributes. The CDT hierarchy is created from an ASCII data file while the HCDT hierarchy is created during Metathesaurus production.
HCDT remains as a UMLS source. It is not being removed.
3. ATN = CHANGE_CLASS identifies the type of change made to this version of the code. Valid values: 30 (no change), 31 (new code), 35 (revision).
------------------------------------------
Source: Vaccines Administered
VSAB: CVX2013_05_01
1. New term type (TTY) | Suppressible value:
AB|Y
OA|O
OP|O
PT|O
2. New relationship | relationship attribute(RELA) | RELA inverse:
SY|has_expanded_form|expanded_form_of
3. New attribute name (ATN):
DATE_LAST_MODIFIED
SOS
VACCINE_STATUS
Discussion:
1. New source.
2. TTY = AB or PT indicates an active or pending vaccine.
3. TTY = OA or OP indicates an inactive or never active vaccine.
4. RELA = has_expanded_form/expanded_form_of connects abbreviations (TTY = AB) with their long forms (TTY = PT or OP).
5. ATN = SOS represents information held in the notes field of the source.
6. ATN = VACCINE_STATUS has the valid values of: Active, Inactive, Never Active, Pending.
------------------------------------------
Source: Gene Ontology
VSAB: GO2013_04_06
New term type (TTY) | Suppressible value:
MTH_OET|O
Discussion:
For the GO Cellular Component Ontology, TTY = MTH_OET atoms are created for selected strings by including the word "location" in the string for additional clarification.
------------------------------------------
Source: HUGO Gene Nomenclature Committee
VSAB: HGNC2013_04
Dropped attribute name (ATN):
MAPPED_GDB_ID
MTH_LOCUS_SPECIFIC_DB_XR
Discussion:
1. Source deprecated field 33, the GDB_ID (mapped data) field.
2. Metathesaurus created attributes(e.g., MTH_LOCUS_SPECIFIC_DB_XR) that were created as a result of needing plain text versions of UTF-8 strings have been deprecated.
------------------------------------------
Source: International Classification for Nursing Practice
VSAB: ICNP_2013
1. New relationship | relationship attribute(RELA) | RELA inverse:
RB|mapped_from|mapped_to
RN|mapped_from|mapped_to
SY|mapped_from|mapped_to
2. Dropped relationship | relationship attribute (RELA):
RQ|mapped_from
3. New attribute name (ATN):
MAPSETXRTARGETID
4. Dropped attribute name (ATN):
MAPSETTYPE
Discussion:
1. All mappings are to SNOMEDCT_US_2013_03_01.
2. REL/RELA = SY|mapped_from|mapped_to represent one-to-one relationships with SNOMEDCT.
3. ATN = MAPSETXRTARGETID is added during Metathesaurus construction and represents the map set target identifier used for XR mappings.
------------------------------------------
Source: Logical Observation Identifiers Names and Codes (LOINC)
VSAB: LNC244
This version includes:
LNC244_ASQ_3_2009
LNC244_BRADEN_1988
LNC244_CAM_2003
LNC244_FACIT
LNC244_FLACC_1997
LNC244_MDS20
LNC244_MLHFQ_1986
LNC244_NEUROQOL_2010
LNC244_NPUAP_2012
LNC244_OASIS_2002
LNC244_OPTIMAL_2005
LNC244_PHQ_9_1999
LNC244_RHO_2008
LNC244_SPERTUS_2005
LNC244_VR_12_2004
LNC244_WHO_2006
1. New term type (TTY) | Suppressible value | Source(s):
LO|O|LNC244_FACIT, LNC244_NEUROQOL_2010
MTH_LO|O|LNC244_FACIT, LNC244_NEUROQOL_2010
OLC|O|LNC244_FACIT, LNC244_NEUROQOL_2010
2. Dropped term type (TTY):
MTH_LPN
3. New relationship | relationship attribute (RELA) | RELA inverse | Source(s):
RQ|mapped_from|mapped_to|LNC244
RO|has_multipart|multipart_of|LNC244
RO|has_quotient|quotient_of|LNC244
4. Dropped relationship | relationship attribute (RELA):
SY|mth_has_plain_text_form
5. New attribute name (ATN) | Source(s):
LMP|LNC244
6. Dropped attribute name (ATN):
MAPSETTYPE
MTH_COPYRIGHT
MTH_LEA
MTH_LFO
MTH_LQT
MTH_LRN2
MTH_LSU
MTH_SOS
Discussion:
1. Subsources within the LNC source data that are not included in the Metathesaurus:
Blessed Orientation-Memory-Concentration Test
Borderline Symptom List - 23 Item
Borderline Symptom List - Supplement
Edinburgh Postnatal Depression Scale
Edinburgh Postnatal Depression Scaletient Reported Outcomes Measurement (PROMIS)
Test of Infant Motor Performance (TIMP)
2. The process for identifying subsources has changed. Subsources are now created based on the external copyright field (field 33) only. Previously, they were created based on a combination of fields. Due to this new process, two subsources have been deprecated, MDS30 and AD8, however, the content from these subsources is still included in the Metathesaurus under the SAB = LNC.
3. ATN = LMP identifies the superceding code of that term.
4. Metathesaurus created attributes, relationships, and term types (e.g., MTH_LEA, mth_has_plain_text_form, MTH_LPN, etc.) that were created as a result of needing plain text versions of UTF-8 strings have been deprecated.
-----------------------------------------------
Source: Medical Dictionary for Regulatory Activities Terminology (MedDRA)
VSAB: MDR16_0
1. New relationship | relationship attribute(RELA) | RELA inverse:
RO|member_of|has_member
2. Dropped relationships | relationship attribute (RELA):
RO|member_of_cluster|has_member
Discussion:
RELA = member_of_cluster was changed to 'member_of' for purposes of clarity. The inverse remains the same, 'has_member'.
-----------------------------------------------
Source: Medicomp Systems, MEDCIN [terminology files]
VSAB: MEDCIN3_2013_07_15
1. Dropped term type (TTY):
MTH_FN
MTH_PT
MTH_SY
2. New relationship | relationship attribute(RELA) | RELA inverse:
RO|has_finding_context|finding_context_of
RO|has_procedure_context|procedure_context_of
RO|has_specimen_source_topography|specimen_source_topography_of
3. Dropped relationship | relationship attribute (RELA):
RO|has_specimen_procedure
SY|mth_plain_text_form_of
Discussion:
Metathesaurus created term types and relationships (e.g., MTH_FN, etc.) that were created as a result of needing plain text versions of UTF-8 strings have been deprecated.
------------------------------------------------
Source: NCI Thesaurus
VSAB: NCI2013_03D
1. New term type (TTY) | Suppressible value:
CTEP-SDCPT|N
CTEP-SDCSY|N
2. New relationship | relationship attribute(RELA) | RELA inverse:
RO|has_data_element|data_element_of
3. Dropped relationship | relationship attribute(RELA):
RO|allele_associated_with_disease
RO|allele_not_associated_with_disease
RO|gene_product_has_malfunction_type
4. New attribute name (ATN):
HGNC_ID
Discussion:
New subsource CTEP-SDC: Cancer Therapy Evaluation Program - Simple Disease Classification.
----------------------------------------------
Source: NeuroNames Brain Hierarchy
VSAB: NEU2013_06_09
1. New term type (TTY) | Suppressible value:
IS|N
OP|N
2. Dropped term type (TTY):
CHISY
FRESY
GERSY
INDSY
ITASY
KORSY
LATSY
RUSSY
SPASY
TURSY
3. New attribute name (ATN):
TRANSLATION
Discussion:
1. Non-English synonyms (except for Latin) are mapped to ATN = TRANSLATION. The ATV has the format "language: string" (e.g., TRANSLATION|Italian: encefalo).
In previous inversions the non-English synonyms were assigned specific TTYs such as CHISY, RUSSY, etc. All of these TTYs have been deprecated.
Latin synonyms are considered scientific names so they are treated as English strings and assigned the TTY=SY. The previous TTY=LATSY has been deprecated.
2. TTY = OP (obsolete preferred term) and TTY = IS (obsolete synonym). If the preferred term is obsolete, it is assumed that all associated synonyms are also obsolete regardless if they are marked obsolete or not.
----------------------------------------------
Source: RXNORM Vocabulary
VSAB: RXNORM_13AA_130903F
This version includes:
ATC_2013 (Anatomical Therapeutic Chemical Classification System)
GS_2013_08_05 (Gold Standard Drug Database)
MDDB_2013_08_07 (Master Drug Data Base. Medi-Span, a division of Wolters Kluwer Health)
MMSL_2013_08_01 (Multum MediSource Lexicon)
MMX_2013_08_05 (Micromedex RED BOOK)
MTHFDA_2011_06_01_13_05_06 (FDA National Drug Code Directory)
MTHSPL_2013_08_26 (FDA Structured Product Labels)
NDDF_2013_08_07 (FDB MedKnowledge)
NDFRT_2013_09_03 (National Drug File)
VANDF_2013_07_19 (Veterans Health Administration National Drug File)
1. New term type (TTY) | Suppressible value | Source(s):
IN|N|ATC_2013
PT|N|ATC_2013
RXN_IN|N|ATC_2013
RXN_PT|N|ATC_2013
2. New attribute name (ATN) | Source(s):
ATC_LEVEL|ATC_2013
IS_DRUG_CLASS|ATC_2013
3. Dropped attribute name (ATN) | Source(s):
NST (Normalized strength and units for drugs with one active ingredient)|MTHFDA_2011_06_01_13_05_06
RXO (Drug Description from NDF)|MTHFDA_2011_06_01_13_05_06
TRN (Trade name of product)|MTHFDA_2011_06_01_13_05_06
Discussion:
1. New subsource = ATC is included in this Metathesaurus release as part of RxNorm, however, it was not updated in this version. Per RxNorm, ATC is updated yearly in the July or August version.
2. TTY = IN (ingredient name) and TTY = RXN_IN (RxNorm preferred ingredient).
3. ATN = ATC_LEVEL indicates drug classification level. Valid levels: 1-5.
4. ATN = IS_DRUG_CLASS has valid value of Y.
5. MTHFDA is included in each Metathesaurus release as part of RxNorm, however, it was not updated in this version. MTHFDA was last updated in 2011.
6. 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.
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Source: SNOMED Clinical Terms, Spanish Language Edition
VSAB: SCTSPA_2013_04_30
1. Dropped term type (TTY):
SCTSPA_2013_04_30/MTH_FN
SCTSPA_2013_04_30/MTH_IS
SCTSPA_2013_04_30/MTH_OF
SCTSPA_2013_04_30/MTH_OP
SCTSPA_2013_04_30/MTH_PT
SCTSPA_2013_04_30/MTH_SY
2. New relationship | relationship attribute(RELA) | RELA inverse:
RO|has_access_instrument|access_instrument_of
RO|has_approach|approach_of
RO|has_associated_etiologic_finding|associated_etiologic_finding_of
RO|has_associated_function|associated_function_of
RO|has_communication_with_wound|wound_has_communication_with
RO|has_course|course_of
RO|has_dependent|dependent_of
RO|has_extent|extent_of
RO|has_instrumentation|instrumentation_of
RO|has_location|location_of
RO|has_measured_component|measured_component_of
RO|has_onset|onset_of
RO|has_stage|stage_of
RO|has_subject_of_information|subject_of_information_of
RO|has_time_aspect|time_aspect_of
RO|measures|measured_by
RO|temporally_follows|temporally_followed_by
RO|uses|used_by
3. Dropped relationship | relationship attribute (RELA):
RN|as_a
RO|may_be_a
RO|moved_to
RO|replaced_by
SY|same_as
4. New RF2 attribute name (ATN) | former RF1 attribute name (ATN), if applicable:
ACTIVE | CONCEPTSTATUS or DESCRIPTIONSTATUS
CASE_SIGNIFICANCE_ID | INITIALCAPITALSTATUS
CHARACTERISTIC_TYPE_ID | CHARACTERISTICTYPE
DEFAULT_MODULE_ID
DEFINITION_STATUS_ID | ISPRIMITIVE
INACTIVATION_INDICATOR | CONCEPTSTATUS or DESCRIPTIONSTATUS
MODIFIER_ID
MODULE_ID
SOURCE_EFFECTIVE_TIME
SUBSET_MEMBER
TARGET_EFFECTIVE_TIME
TYPE_ID | DESCRIPTIONTYPE
5. Dropped attribute name (ATN):
AQ
CHARACTERISTICTYPE
CONCEPTSTATUS
CTV3ID
DESCRIPTIONSTATUS
DESCRIPTIONTYPE
INITIALCAPITALSTATUS
ISPRIMITIVE
REFINABILITY
SNOMEDID
SUBSETCONTEXTID
SUBSETLANGUAGECODE
SUBSETMEMBER
SUBSETORIGINALID
SUBSETREALMID
SUBSETTYPE
SUBSETVERSION
Discussion:
1. This version of SCTSPA is in the new RF2 format so elements unique to RF2 are now included while elements unique to the RF1 format have been deprecated.
2. Metathesaurus created term types (e.g., MTH_FN, etc.) that were created as a result of needing plain text versions of UTF-8 strings have been deprecated.
------------------------------------------------------------
Source: SNOMED CT US Edition
VSAB: SNOMEDCT_US_2013_09_01
1. New term type (TTY) | Suppressible value:
MTH_OAF|O
MTH_OAP|O
MTH_OAS|O
OAF|O
OAP|O
OAS|O
2. Dropped term type (TTY):
MTH_OP
3. New relationship | relationship attribute(RELA) | RELA inverse:
RN|has_alternative|alternative_of
RN|refers_to|referred_to_by
RO|has_access_instrument|access_instrument_of
RO|has_approach|approach_of
RO|has_associated_etiologic_finding|associated_etiologic_finding_of
RO|has_associated_function|associated_function_of
RO|has_communication_with_wound|wound_has_communication_with
RO|has_course|course_of
RO|has_dependent|dependent_of
RO|has_extent|extent_of
RO|has_instrumentation|instrumentation_of
RO|has_location|location_of
RO|has_measured_component|measured_component_of
RO|has_onset|onset_of
RO|has_stage|stage_of
RO|has_subject_of_information|subject_of_information_of
RO|has_time_aspect|time_aspect_of
RO|measures|measured_by
RO|moved_from|moved_to
RO|possibly_equivalent_to|possibly_equivalent_to
RO|temporally_follows|temporally_followed_by
RO|uses|used_by
4. Dropped relationship | relationship attribute (RELA):
RO|is_alternative_use
RO|may_be_a
RO|refers_to
RO|replaces
5. New RF2 attribute name (ATN) | former RF1 attribute name (ATN), if applicable:
ACTIVE | CONCEPTSTATUS or DESCRIPTIONSTATUS
CASE_SIGNIFICANCE_ID | INITIALCAPITALSTATUS
CHARACTERISTIC_TYPE_ID | CHARACTERISTICTYPE
DEFAULT_MODULE_ID
DEFINITION_STATUS_ID | ISPRIMITIVE
DESCRIPTION_FORMAT
DESCRIPTION_LENGTH
ICD-O-3_CODE
INACTIVATION_INDICATOR | CONCEPTSTATUS or DESCRIPTIONSTATUS
MODIFIER_ID
MODULE_ID
REFSET_PATTERN
SOURCE_EFFECTIVE_TIME
SUBSET_MEMBER
TARGET_EFFECTIVE_TIME
TYPE_ID | DESCRIPTIONTYPE
6. Dropped attribute name (ATN):
AQ
CHARACTERISTICTYPE
COMPONENTHISTORY
CONCEPTSTATUS
DESCRIPTIONSTATUS
DESCRIPTIONTYPE
INITIALCAPITALSTATUS
ISPRIMITIVE
MAPSETREALMID
MAPSETRULETYPE
MAPSETSCHEMEID
MAPSETSCHEMENAME
MAPSETSCHEMEVERSION
MAPSETSEPARATORCODE
MAPSETTYPE
REFINABILITY
SUBSETCONTEXTID
SUBSETLANGUAGECODE
SUBSETMEMBER
SUBSETORIGINALID
SUBSETREALMID
SUBSETTYPE
SUBSETVERSION
TARGETSCHEMEID
Discussion:
A new set of SNOMEDCT-to-ICD10 mappings is included in this release.
