The Systematized Nomenclature of Medicine (SNOMED) is a multiaxial, hierarchical classification system [1]. As in any such system, a disease may be located in a body organ which results in a code in a topography axis and may lead to morphological alterations represented by a morphology code.
Purpose
SNOMED was designed as a comprehensive nomenclature of clinical medicine for the purpose of accurately storing and/or retrieving records of clinical care in human and veterinary medicine. The metaphor used by Roger A. Côté, the first editorial chair, was that SNOMED would become the periodical table of element of medicine because of its definitional organization beyond the hierarchical design. Indeed, diseases and procedures were ordered hierarchically and are further referenced back to more elementary terms (see Reference Ontology and Multi-Axial Design, below).
History
SNOMED was originally conceived by Dr. Roger A. Côté as an extension of the design of the Systematized Nomenclature of Pathology (SNOP) applicable for all medicine. SNOP was originally designed by Dr. Arnold Pratt to describe pathological specimen according to their morphology and anatomy (topography). The ambitious development of SNOMED required many more axes (see multi-axial design, below). SNOMED was jointly proposed for development to the College of American Pathologists by Drs. Côté and Dr. Arnold Pratt and the former was appointed as Editorial Chair of the Committee on Nomenclature and Classification of Diseases of the College of American Pathologists and developed the Systematized Nomenclature of Medicine (SNOMED) from 1973 to 1997. In 1998, Dr. Kent Spackman was appointed Chair of this Committee and spearheaded the transformation of the mutli-axis systems into a highly computable form (See SNOMED CT): a directed acyclic graph anchored in formal representation logic.
Brief timeline:
- 1965 SNOP
- 1974 SNOMED
- 1979 SNOMED II
- 1993 SNOMED International 3.0
- 1995 SNOMED Microglosasry of Signs and Symptoms
- 1993-98 SNOMED International versions 3.1-3.5
Reference Ontology
SNOMED was designed from its inception with complex conepts defined in term of simpler ones. For example, a disease can be defined in terms of its abnormal anatomy, abnormal functions and morphology. In some cases, the etiology of the disease is known and can be attributed to an infectious agent, a physican trauma or a chemical or pharmaceutical agent.
Multi-Axial Design
There are 11 axes that comprise terms organised in hierarchical trees. The axes and some examples are provided below:
T (Topography) -- Anatomic terms
M (Morphology) -- Changes found in cells, tissues and organs
- (M-40000) Inflammation
- (M-44000) Granuloma
- (M-54700) Infarcted
- (M-54701) Microscopic infarct
For the Morphology axis, SNOMED has agreed to use the same codes defined by International Classification of Diseases for Oncology. Additional examples on topology are provided on that page.
L (Living organisms) -- Bacteria and viruses
- (L-21801) Mycobacterium tuberculosis
- (L-25116) Streptococcus pneumoniae
C (Chemical) -- Drugs
F (Function) -- Signs and symptoms
- (F-03003) Fever
lll
J (Occupation) -- Terms that describe the occupation
BUSINESSMAN
SCHOOL TEACHER
COMPUTER PROGRAMMER
DOCTOR
NURSE
BEAUTICIAN
D (Diagnosis) -- Diagnostic terms
- (D-13510) Pneumococcal pneumonia
- (D-14800) Tuberculosis
- (D3-15000) Myocardial infarction
P (Procedure) -- Administrative, diagnostic and therapeutic procedures
A (Physical agents, forces, activities) -- Devices and activities associated with the disease
S (Social context) -- Social conditions and important relationships in medicine
- (S-10120) Mother
G (General) -- Syntactic linkages and qualifiers
See also
- Diagnosis codes
- Medical classification
- SNOMED CT
- Medical Dictionary for Regulatory Activities (MedDRA)
- DOCLE
References
External links
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