> For the complete documentation index, see [llms.txt](https://docs.snomed.org/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://docs.snomed.org/snomed-ct-practical-guides/snomed-ct-mapping-guide/evaluating-mapping-as-a-solution/4.1-clinical-risk.md).

# Clinical risk

Whenever the meaning of one code is being translated into another, there is always a potential change or loss of meaning due to the differences in the semantic structures of the source and target code systems.

If a map is used to map data collected for clinical purposes, a level of risk is introduced that can have clinical impacts.

## During development

When developing a map, consideration should be given to the implementation setting in which it is intended to be used. Where a map is intended for implementation in a clinical setting, further consideration is required; it may be that mapping is deemed unsuitable.

Clinical review during the mapping process may be required to support safe clinical practice. Testing against real patient data is also recommended to evaluate the impact of mapping on data outcomes, particularly if there are concerns around clinical safety.

## Prior to implementation

Before implementing a map in a clinical setting, it is important to do a risk assessment, including (but not limited to):

* Identification of all patient safety risks that arise from using the map in a clinical setting
* Perform and document a risk assessment
* Implement risk mitigation measures
* Undertake and document the risk management activities for both the mapping process and for ongoing maintenance of the map

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