# US vs. GB English

All fully specified names (FSN) should be represented in US English. When there is a difference between the US and GB spelling, there should be US and General British (GB) preferred terms (PT) and/or synonyms (SYN).

* For example:
  * FSN: Benign tumor of endocrine pancreas (disorder)
  * PT-US: Benign tumor of endocrine pancreas
  * PT-GB: Benign tumour of endocrine pancreas

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**Proper nouns**

Where an FSN represents the name of an organization or trademarked name, a synonym with variant GB or US spelling is not required.
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<table><thead><tr><th width="201.65625">References for Spelling</th><th>References</th><th>Notes</th></tr></thead><tbody><tr><td>US-GB differences</td><td><p>Wikipedia, the free encyclopedia*</p><p>*Note: Wikipedia may be used as a starting point, or source, for authoritative references, but not as an actual reference</p></td><td><ul><li>First point of reference</li><li>Provides a summary for authors, addresses many US-GB spelling differences, and provides references</li></ul></td></tr><tr><td>US Medical English</td><td><p>Stedman's Medical Dictionary</p><p>Merriam-Webster Online Dictionary</p><p>American Medical Association (AMA) Manual of Style</p></td><td>NA</td></tr><tr><td>GB English</td><td><p>Dorland's Medical Dictionary - medical terminology</p><p>Chambers 21st Century Dictionary - general</p></td><td>NA</td></tr></tbody></table>

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Oxford English Dictionary spelling is different from British English. A summary of the points of difference can be found at <http://en.wikipedia.org/wiki/Oxford_spelling_>. In those cases where British English and Oxford English Dictionary differ, SNOMED CT follows the British English spelling.

The addition of an Oxford English Dictionary term is allowed but not required. When added, it should be marked as acceptable in the British English dialect. In some cases, it is also accepted or preferred in US English.
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### Principles for selecting preferred spelling variants <a href="#principles-for-selecting-preferred-spelling-variants" id="principles-for-selecting-preferred-spelling-variants"></a>

SNOMED CT may include (or add) more than one description, each with a different spelling for a given concept. That is, if the above references provide evidence of acceptability in the dialects for which they are being added.

For spelling of preferred terms in a dialect, where the reference sources provide multiple options, a judgment about the most common spelling may be needed. This may be determined by reviewing journal articles containing the word in question.

* Articles should be from highly cited journals, e.g BMJ (for British English) or NEJM or JAMA (for US English).
* For concepts that are not clinical, appropriate scientific journals should be consulted, e.g. Science (US publisher) or Nature (UK publisher).

### Fetal vs. Foetal <a href="#fetal-vs.-foetal" id="fetal-vs.-foetal"></a>

*Fetal* is the preferred term in both the US and GB language reference sets. *Fetal* is acceptable in GB synonyms. Foetal is not acceptable for US language but acceptable for GB language.

### Sulfate vs. Sulphate

The terms *sulfate* and *sulphate* refer to salts or esters of sulfuric acid. *Sulfate* is the preferred international spelling in IUPAC and GSRS. However, *sulphate* is the traditional British English spelling. SNOMED CT uses *sulfate* in the FSN and the PT. A synonym with *sulphate* is added as acceptable to GB English but unacceptable to US English.

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