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Deprecation Notice
The Ordered Reference Set pattern is now deprecated as it has been replaced with two reference set types each of which is specific to one of the two distinct use cases supported by the Ordered Reference set pattern.
The recommended Reference sets to address the purposes identified below are now:
An 447258008 |Ordered type reference set| allows a collection of components to be defined with a specified given a priority ordering. This type of reference ret can also be used to specify ordered associations between different components. These can be used to specify several interrelated subsets of components and to define alternative hierarchies for navigation and selection of concepts or descriptions.
An Ordered Reference Set is an Integer Component Reference Set used to represent ordered lists and alternative hierarchies. Its structure is shown in the following table.
Ordered reference set - Data structure
The following metadata in the "Foundation metadata concept" hierarchy supports this reference set.
Ordered References Sets in the Metadata Hierarchy
The tables below show the descriptor that defines the structure of the pattern and an example of descriptor for a reference set that follows this pattern.
Refset Descriptor rows for Ordered Reference Set
Sample Content for an Ordered Reference Set
Boolean
The state of the identified reference set member as at the specified effectiveTime. If active = 1 (true) the reference set member is part of the current version of the set, if active = 0 (false) the reference set member is not part of the current version of the set.
YES
NO
moduleId
SCTID
Identifies the SNOMED CT module that contains this reference set member as at the specified effectiveTime .
The value must be a subtype of within the metadata hierarchy.
YES
NO
refsetId
SCTID
Identifies the reference set to which this reference set member belongs.
A subtype descendant of:
NO
NO
referencedComponentId
SCTID
A reference to the SNOMED CT component to be included in the reference set.
NO
NO
order
Integer
Specifies the sort order of the list. The list is ordered by applying an ascending sort of the order value.
The value of order =1 represents the highest priority. A value of '0' is not allowed. Duplicate values are permitted and the sort order between two members with the same order value is not defined.
If the linkedToId value is not 0, sorting occurs within subgroups that share the same linkedToId.
Note: The name "order" is a reserved word in some database environments. Please consider this when using this column.
YES
NO
linkedToId
SCTID
The identifier of a SNOMED CT component that acts as a grouper or hierarchy node, collecting together a subgroup from within the list.
This field either enables reference set member linked into a number of subgroups. These subgroups can be nested allowing representation of alternative hierarchies.
To link members into a subgroup, all components in the same subgroup should reference the same component. This can either be a component that represents the name of that subgroup or the first member of the subgroup. In the latter case, the first row of each subgroup will contain the same identifier in referencedComponentId and linkedToId and with order =1.
To link a number of children concepts to a single parent concept, one member record should exist per child, with the referencedComponentId field referencing the parent and this field referencing the child concept. The order field is then used to order the children concepts under the parent concept.
For ordered lists that do not require grouping or hierarchical arrangement the value of linkedToId should be the digit zero (0).
YES
NO
1
2
2
3
4
5
6
7
8
9
10
This allows an ordered or prioritized list of components to be represented.
It omits the linkedToId field in the pattern shown below as this is not required to address this use case.
Ordered Association Reference Set
This enables representation of alternative navigation hierarchies (in which child concepts are ordered) and also also supports representation of groups of ordered components.
The linkedToId field in the pattern shown below is replaced by the targetComponentId (this name is used to align with the Association Reference Set (used from unordered associations).
Deprecation does not prevent continued use of an existing reference set pattern. However it does indicate that a different solution is now specified and recommended to meet the requirements for this pattern
id
UUID
A 128 bit unsigned Integer, uniquely identifying this reference set member.Different versions of a reference set member share the same id but have different effectiveTime. This allows a reference set member to be modified or made inactive (i.e. removed from the active set) at a specified time.
NO
YES (Full/Snapshot)
effectiveTime
Time
The inclusive date or time at which this version of the identified reference set member became the current version.
Note : In distribution files the effectiveTime should follow the short ISO date format (YYYYMM DD) and should not include the hours, minutes, seconds or timezone indicator.The current version of this reference set member at time T is the version with the most recent effectiveTime prior to or equal to time T.
YES
YES (Full) Optional (Snapshot)
1
active
0
An |Ordered component type reference set (foundation metadata concept)| allows a collection of components to be defined with a specified order. This type of reference set is therefore useful for creating ordered lists and to specify groups where the components that belong to the same group share the same order.
An Ordered component reference set (an Integer Component reference set) is used to represent ordered lists and alternative hierarchies. Its structure is shown in the following table.
Ordered component reference set - Data structure
The following metadata in the "Foundation metadata concept" hierarchy supports this reference set:
Ordered Component Reference Sets in the Metadata Hierarchy
The tables below show the descriptor that defines the structure of the Ordered component type reference set pattern and an example of descriptor for a specific reference set that follows this pattern.
Refset Descriptor rows for an ordered reference set
Rational ordering of finger concepts using an ordered component reference set
Boolean
The state of the identified reference set member as at the specified effectiveTime .
If active = 1 (true) the reference set member is part of the current version of the set, if active = 0 (false) the reference set member is not part of the current version of the set.
YES
NO
moduleId
SCTID
Identifies the SNOMED CT module that contains this reference set member as at the specified effectiveTime.
The value must be a subtype of within the metadata hierarchy.
YES
NO
refsetId
SCTID
Identifies the reference set to which this reference set member belongs.
In this case, a subtype descendant of:
NO
NO
referencedComponentId
SCTID
A reference to the SNOMED CT component to be included in the reference set.
NO
NO
order
Integer
Specifies the sort order of the list. The list is ordered by applying an ascending sort of the order value.
The value of order =1 represents the highest priority. A value of '0' is not allowed. Duplicate values are permitted and the sort order between two members with the same order value is not defined.
Note: The name "order" is a reserved word in some database environments. Please consider this when using this column.
YES
NO
1
733619002
|Fingers ordered component reference set|
3
733619002
|Fingers ordered component reference set|
4
733619002
|Fingers ordered component reference set|
5
id
UUID
A 128 bit unsigned Integer, uniquely identifying this reference set member.
Different versions of a reference set member share the same id but have different effectiveTime. This allows a reference set member to be modified or made inactive (i.e. removed from the active set) at a specified time.
NO
YES (Full /Snapshot)
effectiveTime
Time
The inclusive date or time at which this version of the identified reference set member became the current version.
Note: In distribution files the effectiveTime should follow the short ISO date format (YYYYMMDD) and should not include the hours, minutes, seconds or timezone indicator.
The current version of this reference set member at time T is the version with the most recent effectiveTime prior to or equal to time T.
YES
YES (Full)
Optional (Snapshot)
733619002
|Fingers ordered component reference set|
1
733619002
|Fingers ordered component reference set|
active
0
2
An 733618005 | Ordered association type reference set (foundation metadata concept)| can be used to specify ordered associations between different components. These can be used to specify several interrelated subsets of components and to define alternative hierarchies for navigation while searching for an appropriate concept or description.
An Ordered association reference set is a component integer reference set that is used to represent ordered lists of associations and alternative hierarchies. Its structure is shown in the following table.
Ordered association reference set - Data structure
The following metadata in the "Foundation metadata concept" hierarchy supports this reference set:
Ordered Association References Set in the Metadata Hierarchy
The tables below show the descriptor that defines the structure of the pattern and an example of descriptor for a specific reference set that follows this pattern.
Refset Descriptor rows for an ordered association type reference set
can be used to specify and display a customized navigation hierarchy. Alternative hierarchical representations of SNOMED CT can support data entry by satisfying the requirements of a specific use case, and addressing some of the challenges of displaying an unordered polyhierarchy (as defined by SNOMED CT's subtype structure).
The figure below shows the way a navigation hierarchy is represented. The example reference set contains a set of description components used to describe finger structures.
The |All fingers| components is linked to the |Hand|, and the |Thumb| is linked to the |All fingers| component. The |Thumb| is placed first because it has the order value 1. Similarly, the components for |Second finger|, |Third finger|, |Fourth finger| and |Fifth finger| are also linked to the |All finger| component in the order specified by the order value. As shown in the figure the direction of the associations goes from the referenceComponentId to the targetComponentId so the components referenced by the targetComponentId are used to form the groups specified in the hierarchy
Navigation hierarchy example.
Boolean
The state of the identified reference set member as at the specified effectiveTime. If active = 1 (true) the reference set member is part of the current version of the set, if active = 0 (false) the reference set member is not part of the current version of the set.
YES
NO
moduleId
SCTID
Identifies the SNOMED CT module that contains this reference set member as at the specified effectiveTime .
The value must be a subtype of within the metadata hierarchy.
YES
NO
refsetId
SCTID
Identifies the reference set to which this reference set member belongs.
A subtype descendant of:
NO
NO
referencedComponentId
SCTID
A reference to the SNOMED CT component to be included in the reference set.
NO
NO
targetComponentId
SCTID
The identifier of the target component of the association that acts as a grouper or hierarchy node, collecting together a subgroup from within the list.
This field either enables reference set member linked into a number of subgroups. These subgroups can be nested allowing representation of alternative hierarchies.
To link members into a subgroup, all components in the same subgroup should reference the same component. This can either be a component that represents the name of that subgroup or the first member of the subgroup. In the latter case, the first row of each subgroup will contain the same identifier in referencedComponentId and targetComponentId and with order =1.
To link a number of children concepts to a single parent concept, one member record should exist per child, with the referencedComponentId field referencing the parent and this field referencing the child concept. The order field is then used to order the children concepts under the parent concept.
YES
NO
order
integer
Specifies the sort order of the list. The list is ordered by applying an ascending sort of the order value.
The value of order =1 represents the highest priority. A value of '0' is not allowed. Duplicate values are permitted and the sort order between two members with the same order value is not defined.
If the targetComponentId value is not 0, sorting occurs within subgroups that share the same targetComponentId.
Note: The name "order" is a reserved word in some database environments. Please consider this when using this column.
YES
NO
1
2
…
20160731
1
19999999103
159999999105
Associations as ordered reference set
70327001
All fingers
141819019
Hand
1
id
UUID
A 128 bit unsigned Integer, uniquely identifying this reference set member.Different versions of a reference set member share the same id but have different effectiveTime. This allows a reference set member to be modified or made inactive (i.e. removed from the active set) at a specified time.
NO
YES (Full/Snapshot)
effectiveTime
Time
The inclusive date or time at which this version of the identified reference set member became the current version.
Note : In distribution files the effectiveTime should follow the short ISO date format (YYYYMM DD) and should not include the hours, minutes, seconds or timezone indicator.The current version of this reference set member at time T is the version with the most recent effectiveTime prior to or equal to time T.
YES
YES (Full) Optional (Snapshot)
0
active
…
20160731
1
19999999103
159999999105
Associations as ordered reference set
127053016
Thumb
70327001
All fingers
1
…
20160731
1
19999999103
159999999105
Associations as ordered reference set
138873019
Second finger
70327001
All fingers
2
…
20160731
1
19999999103
159999999105
Associations as ordered reference set
108884010
Third finger
70327001
All fingers
3
…
20160731
1
19999999103
159999999105
Associations as ordered reference set
136021011
Fourth finger
70327001
All fingers
4
…
20160731
1
19999999103
159999999105
Associations as ordered reference set
21356012
Fifth finger
70327001
All fingers
5
​Simple Reference Set​
​
​
​
​
​
​
​
​
Historical Association Reference Sets are used to link concepts that have been inactivated to active concepts that represent an identical, similar or possible meaning of the inactivated concept.
Historical Association Reference Sets follow the release file specification documented in Association Reference Set with the inactive concept represented by the referencedComponentId, the type of association represented by the refsetId and the related active concept represented by the targetComponentId.
The following subsections identify the metadata used to represent different types of historical associations.
The following metadata supports this reference set:
Historical Association Reference Set names in the metadata hierarchy
Each member of a represents a reference from an inactive component to other equivalent or related components that were current in the Release Version in which that component was inactivated.
Each represents a different type of association between the components referred to by the referencedComponentId and the targetComponentId as shown in the Table below.
Association reference set types in the International Release of SNOMED CT
The component identified by the targetComponentId must be an instance of the same class of component as the component identified by the referencedComponentId for all Historical association reference sets apart from the |REFERS TO concept association reference set|.
The tables below show examples of the descriptors for specific reference sets that follow the pattern.
Refset Descriptor rows for the SAME AS association reference set
The following table holds example entries for the .
Sample content from
Practical Guide to Reference Sets
Applies to an erroneous, obsolete and other inactive component for which there is a single active replacement. The targetComponent identifies the active component that replaces this component.
Applies to a component that is a duplicate. The targetComponent identifies the active component that this component duplicates.
Links an inactive classification concept such as "not otherwise specified" or "otherwise specified" with the active concept that was formerly its most proximal supertype.
(not used currently)
Links an inactive classification concept derived from ICD-9 Chapter XVI "Symptoms signs and ill-defined conditions" with the most similar active concept.
Applies to an inactive description which is inappropriate to the concept it is directly linked to but instead should refer to the concept referenced by the targetComponent.
Applies to a component that is inactivated with reason outdated. The assigned targetComponent identifies two or more potential replacements that are active and represent the possible meanings of the inactive outdated component.
Applies to a component that is inactivated with reason classification derived. The assigned targetComponent identifies two or more replacements that are active and represent the possible meaning of the inactive component. This association signifies that all applied potential replacements must be implemented within the clinical record to ensure the original clinical idea is represented.
0
1
Applies to a concept that is ambiguous. The targetComponent is an active concept that represents one of the possible meanings of the inactive concept . Multiple rows are used to refer to each of the possible meanings of the ambiguous concept.
Applies to a component that has been moved to (or are pending a move to) another namespace. The targetComponent identifies the target namespace (not the new component).
Applies to a component that has been moved to this namespace from another namespace. The targetComponent identifies the original componentIdentifier in its previous namespace.
A |Simple type reference set| allows a set of components to be specified for inclusion or exclusion for a specified purpose. This type of reference set represents an extensional definition of a subset of SNOMED CT components. Thus it can be used to fully enumerate a subset of concepts, descriptions or relationships.
See also Query specification reference set, which can be used to represent an intensional definition of a subset of SNOMED CT components. In an intensional definition, the members of the subset are specified by rules rather than by enumerations (e.g. all subtypes of a specified concepts).
A Simple Reference Set does not have any additional fields.
Simple Reference Set - Data Structure
Simple References Sets are subtypes of in the metadata hierarchy.
Simple Reference Sets in the Metadata Hierarchy
The table below shows the descriptor for a specific reference set that follows the pattern.
Refset Descriptor rows for the Simple Reference Set Type
Example Data for a Simple Reference Set
Boolean
The state of the identified reference set member as at the specified effectiveTime. If active = 1 (true) the reference set member is part of the current version of the set, if active = 0 (false) the reference set member is not part of the current version of the set.
YES
NO
moduleId
SCTID
Identifies the SNOMED CT module that contains this reference set member as at the specified effectiveTime .
The value must be a subtype of within the metadata hierarchy.
YES
NO
refsetId
SCTID
Identifies the reference set to which this reference set member belongs.
A subtype descendant of:
NO
NO
referencedComponentId
SCTID
A reference to the SNOMED CT component to be included in the reference set.
NO
NO
0
id
UUID
A 128 bit unsigned Integer, uniquely identifying this reference set member.Different versions of a reference set member share the same id but have different effectiveTime. This allows a reference set member to be modified or made inactive (i.e. removed from the active set) at a specified time.
NO
YES (Full/Snapshot)
effectiveTime
Time
The inclusive date or time at which this version of the identified reference set member became the current version.
Note : In distribution files the effectiveTime should follow the short ISO date format (YYYYMM DD) and should not include the hours, minutes, seconds or timezone indicator.The current version of this reference set member at time T is the version with the most recent effectiveTime prior to or equal to time T.
YES
YES (Full) Optional (Snapshot)
active
An 900000000000521006 |Association type reference set| represents a set of unordered associations of a particular type between components.
An Association reference set is a reference set used to represent associations between components. Its structure is shown in the following table.
Association Reference Set - Data Structure
The following metadata supports this reference set:
Association Reference Sets in the Metadata Hierarchy
- this has many subtypes
See for an example of the reference set description and data representation in an association type reference set.
id
UUID
A 128 bit unsigned Integer, uniquely identifying this reference set member.Different versions of a reference set member share the same id but have different effectiveTime. This allows a reference set member to be modified or made inactive (i.e. removed from the active set) at a specified time.
NO
YES (Full/Snapshot)
effectiveTime
Time
The inclusive date or time at which this version of the identified reference set member became the current version.
Note : In distribution files the effectiveTime should follow the short ISO date format (YYYYMM DD) and should not include the hours, minutes, seconds or timezone indicator.The current version of this reference set member at time T is the version with the most recent effectiveTime prior to or equal to time T.
YES
YES (Full) Optional (Snapshot)
active
Boolean
The state of the identified reference set member as at the specified effectiveTime. If active = 1 (true) the reference set member is part of the current version of the set, if active = 0 (false) the reference set member is not part of the current version of the set.
YES
NO
moduleId
SCTID
Identifies the SNOMED CT module that contains this reference set member as at the specified effectiveTime .
The value must be a subtype of within the metadata hierarchy.
YES
NO
refsetId
SCTID
Identifies the reference set to which this reference set member belongs.
In this case, a subtype descendant of: .
NO
NO
referencedComponentId
SCTID
A reference to the SNOMED CT component to be included in the reference set. The source component of the association.
NO
NO
targetComponentId
SCTID
The identifier of the target component of the association. Note. An inconsistency in this specification was resolved by the Modeling Advisory Group 2018-10-15 decision that this field should be mutable.
YES
NO
The use of this reference set structure is now discouraged as it requires implementers to create a new refset concept for every new annotation type. New RF2 specifications have been created for annotations, please refer to these for future use:
An 900000000000516008 |Annotation type reference set| allows String to be associated with components for any specified purpose.
An annotation reference set is a String reference set used to apply text annotation to selected SNOMED CT components.
Annotation reference set - Data structure
The following metadata in supports this reference set :
Annotation References Sets in the Metadata Hierarchy
The tables below show the descriptors that define the structure of the pattern and examples of the descriptors for specific reference sets that follow this pattern.
Table: Descriptor Template for Annotation Reference Sets
The attributeType for the Annotation field can be any descendant of the " string " concept in the metadata hierarchy. This hierarchy is described in more detail under the section.
Descriptor for the Associated Image Annotation Reference set
Note that in the table above, the 900000000000469006 |URL| concept is a descendant of |string| concept in the metadata.
As no annotation reference sets are included in the International Release, these sample rows are for illustration only.
Example of Associated image Annotation Reference Set
In the above example, the two URLs have been used to annotate two SNOMED CT concepts with images on the web. It is not recommended that this mechanism be used to annotate concepts with text that may require translation to other languages. Instead, such text should be included under an appropriate description type within the Description.
The active field of each component version indicates whether a component is active or inactive. However, it does not provide any information about why a concept or description has been inactivated. The reason why a concept or description has been inactivated is indicated by a row in a component Inactivation reference set. The reason for inactivation may determine the appropriate way to deal with data in existing records, protocols or queries that use a concept or description after it has been inactivated.
The two component inactivation Reference Sets are shown in the table below.
Component Inactivation Reference Sets
The reason for inactivation is specified by a concept enumeration.
The permitted values for this enumeration for a concept are documented in the Editorial Guide pages on Concept Inactivation, and the type of historical association that should be applied is also provided.
Additionally, the inactivation reasons that may be stated for description inactivation are documented in this page: Description Inactivation
Related Links
See also the formal specification of .
A provides a standardized way to represent postcoordinated expressions. This representation is useful for the implementation of a postcoordinated expression repository.
A is a type of .
Postcoordinated expression type reference set reference set - Data structure
Indicates the reason that a concept has been made inactive.
Indicates the reason that a description has been made inactive.
effectiveTime
Time
The inclusive date or time at which this version of the identified reference set member became the current version.
Note : In distribution files the effectiveTime should follow the short ISO date format (YYYYMM DD) and should not include the hours, minutes, seconds or timezone indicator.The current version of this reference set member at time T is the version with the most recent effectiveTime prior to or equal to time T.
YES
YES (Full) Optional (Snapshot)
active
Boolean
The state of the identified reference set member as at the specified effectiveTime. If active = 1 (true) the reference set member is part of the current version of the set, if active = 0 (false) the reference set member is not part of the current version of the set.
YES
NO
moduleId
SCTID
Identifies the SNOMED CT module that contains this reference set member as at the specified effectiveTime .
The value must be a subtype of within the metadata hierarchy.
YES
NO
refsetId
SCTID
Identifies the reference set to which this reference set member belongs.
A subtype descendant of:
NO
NO
referencedComponentId
SCTID
A reference to the SNOMED CT component to be included in the reference set.
NO
NO
annotation
String
The text annotation to attach to the component identified by referencedComponentId.
YES
NO
1
1
id
UUID
A 128 bit unsigned Integer, uniquely identifying this reference set member.Different versions of a reference set member share the same id but have different effectiveTime. This allows a reference set member to be modified or made inactive (i.e. removed from the active set) at a specified time.
NO
YES (Full/Snapshot)
0
0
id
UUID
A 128 bit unsigned Integer, uniquely identifying this reference set member.
Different versions of a reference set member share the same id but have different effectiveTime. This allows a reference set member to be modified or made inactive (i.e. removed from the active set) at a specified time.
NO
YES (Full /Snapshot)
effectiveTime
Time
The inclusive date or time at which this version of the identified reference set member became the current version.
Note: In distribution files the effectiveTime should follow the short ISO date format (YYYYMMDD) and should not include the hours, minutes, seconds or timezone indicator.
The current version of this reference set member at time T is the version with the most recent effectiveTime prior to or equal to time T.
YES
YES (Full)
Optional (Snapshot)
The following metadata hierarchy supports this reference set:
Postcoordinated expression type reference set reference set in the Metadata Hierarchy
900000000000454005 |Foundation metadata concept| 900000000000455006 |Reference set| 1119417006 |Postcoordinated expression type reference set|
The tables below show the descriptor that defines the reference sets that follows the data structure of the |Postcoordinated expression type reference set (foundation metadata concept)| .
Refset Descriptor rows for the postcoordinated expression type reference set.
The International Edition of SNOMED CT includes two different types of the |Postcoordinated expression type reference set| . These are the |Canonical close to user form expression reference set (foundation metadata concept)| and |Classifiable form expression reference set (foundation metadata concept)| . Both of these reference sets provide a standardized way of representing different types of SNOMED CT expressions, and are useful for the implementation of a postcoordinated expression repository.
The |Canonical close to user form expression reference set (foundation metadata concept)| provides a standardized way to represent postcoordinated expressions as they were captured by the users, but in a canonical form. The 1119468009 | Classifiable form expression reference set (foundation metadata concept)| provides a standardized way to represent postcoordinated expressions in a classifiable form. The classifiable form is a syntactically valid and concept model compliant representation of the close-to-user form expression, and serves as the input to the classifier, enabling compositional expressions to be classified with SNOMED CT content.
active
Boolean
The state of the identified reference set member as at the specified effectiveTime .
If active = 1 (true) the reference set member is part of the current version of the set, if active = 0 (false) the reference set member is not part of the current version of the set.
YES
NO
moduleId
SCTID
Identifies the SNOMED CT module that contains this reference set member as at the specified effectiveTime.
The value must be a subtype of within the metadata hierarchy.
YES
NO
refsetId
SCTID
Identifies the reference set to which this reference set member belongs.
In this case, a subtype descendant of:
NO
NO
referencedComponentId
SCTID
A reference to the SNOMED CT component to be included in the reference set.
NO
NO
expression
String
A SNOMED CT expression that conforms to the compositional grammar.
YES
NO
substrate
Uniform Resource Identifier
The SNOMED CT content by which the expression is authored.
YES
NO
0
1
2
A 900000000000512005 | Query specification type reference set| allows a serialised query to represent the membership of a subset of SNOMED CT components. A query contained in the reference set is run against the content of SNOMED CT to produce a subset of concepts, descriptions or relationships. The query is referred to an intensional definition of the subset. It can be run against future releases of SNOMED CT to generate an updated set of subset members.
The members of the resulting subset may also be represented in an enumerated form as a Simple reference set. An enumerated representation of a subset is referred to as an extensional definition.
A Query Specification Reference Set is a String reference set containing query that represent intensional definitions of subsets of components. The result of running the query is an extensional representation of the subset of components which can be represented as a Simple Reference Set. Its structure is shown in the following table.
Query specification reference set - Data structure
The following metadata in the "Foundation metadata concept " hierarchy supports this reference set :
Hierarchy of Foundation metadata concept
The table below shows the descriptor that defines the structure of the pattern.
Descriptor Template for Query Specification Reference Sets
In the example below, "serialised query 1" is a text string that can be used to generate members for Reference set 1 , which is a simple member reference set (without any additional fields within its member records).
Example rows from Query Specification Reference Set
See for details of the language used to specify intensional definitions of concept subsets.
Boolean
The state of the identified reference set member as at the specified effectiveTime. If active = 1 (true) the reference set member is part of the current version of the set, if active = 0 (false) the reference set member is not part of the current version of the set.
YES
NO
moduleId
SCTID
Identifies the SNOMED CT module that contains this reference set member as at the specified effectiveTime .
The value must be a subtype of within the metadata hierarchy.
YES
NO
refsetId
SCTID
Identifies the reference set to which this reference set member belongs.
A subtype descendant of:
NO
NO
referencedComponentId
SCTID
A reference to the SNOMED CT component to be included in the reference set.
NO
NO
query
String
The serialised query that can be used to (re-)generate the reference set members.
The syntax for specifying the intensional definitions of concept subsets is specified in the
YES
NO
1
id
UUID
A 128 bit unsigned Integer, uniquely identifying this reference set member.Different versions of a reference set member share the same id but have different effectiveTime. This allows a reference set member to be modified or made inactive (i.e. removed from the active set) at a specified time.
NO
YES (Full/Snapshot)
effectiveTime
Time
The inclusive date or time at which this version of the identified reference set member became the current version.
Note : In distribution files the effectiveTime should follow the short ISO date format (YYYYMM DD) and should not include the hours, minutes, seconds or timezone indicator.The current version of this reference set member at time T is the version with the most recent effectiveTime prior to or equal to time T.
YES
YES (Full) Optional (Snapshot)
|Target reference set|
active
0
An 900000000000480006 | Attribute value type reference set| allows a value from a specified range to be associated with a component. This type of reference set can be used for a range of purposes where there is a requirement to provide additional information about particular concepts, descriptions or relationships. For example, an |Attribute value type reference set| is used to indicate the reason why a concept has been inactivated.
An Attribute value reference set is a component reference set used to apply a tagged value to a SNOMED CT component. Its structure is shown in the following table.
Attribute Value Reference Set - Data Structure
The metadata concepts shown below are examples of concepts that identify attribute value reference sets.
Attribute Value Reference Sets in the Metadata Hierarchy
< Not currently used
Concept Inactivation Values (with usage notes referring to the International Release)
< New introduced 2017-07-31 < NEVER used for descriptions in the International Release - may have been used in extensions
Description Inactivation Values (with usage notes referring to the International Release)
< New introduced 2017-07-31 < New introduced 2017-07-31 < NOT used for description inactivations after 2010-07-31 < NOT used for description inactivations before 2016-07-31 or after 2017-07-31 < NOT used for description inactivations before 2016-07-31 or after 2017-07-31 < NOT used for description inactivations before 2008-07-31 or after 2017-07-31 < NEVER used for descriptions in the International Release - may have been used in extensions
The tables below show the descriptors that define examples of reference sets that follow the pattern.
Refset Descriptor Rows for the Concept Inactivation Indicator Reference Set
Refset Descriptor Rows for the Description Inactivation Indicator Reference Set
Sample Rows from the Concept Inactivation Indicator Reference Set
Boolean
The state of the identified reference set member as at the specified effectiveTime. If active = 1 (true) the reference set member is part of the current version of the set, if active = 0 (false) the reference set member is not part of the current version of the set.
YES
NO
moduleId
SCTID
Identifies the SNOMED CT module that contains this reference set member as at the specified effectiveTime .
The value must be a subtype of within the metadata hierarchy.
YES
NO
refsetId
SCTID
Identifies the reference set to which this reference set member belongs.
In this case, a subtype descendant of:
NO
NO
referencedComponentId
SCTID
A reference to the SNOMED CT component to be included in the reference set.
NO
NO
valueId
SCTID
The tagged value applied to the referencedComponentId. A subtype of .
YES
NO
0
1
0
1
id
UUID
A 128 bit unsigned Integer, uniquely identifying this reference set member.Different versions of a reference set member share the same id but have different effectiveTime. This allows a reference set member to be modified or made inactive (i.e. removed from the active set) at a specified time.
NO
YES (Full/Snapshot)
effectiveTime
Time
The inclusive date or time at which this version of the identified reference set member became the current version.
Note : In distribution files the effectiveTime should follow the short ISO date format (YYYYMM DD) and should not include the hours, minutes, seconds or timezone indicator.The current version of this reference set member at time T is the version with the most recent effectiveTime prior to or equal to time T.
YES
YES (Full) Optional (Snapshot)
active
An 762676003 |OWL expression type reference set| associates description logic statements with SNOMED CT concept in the OWL functional syntax.
The SNOMED CT International Release contains content in two reference sets that follow the |OWL expression type reference set| pattern:
The 733073007 |OWL axiom reference set (foundation metadata concept)|, in which the OWL expressions represent axioms that form the logical definition of the concept identified by the referencedComponentId.
The 762103008 |OWL ontology reference set (foundation metadata concept)|, in which the OWL expressions represent essential information about an ontology. This information includes, namespaces, ontology URI, ontology version URI, and import statements. The |OWL ontology reference set (foundation metadata concept)| enables the use of prefixes in the ontology.
An is structured as shown in the following table.
The following metadata supports this reference set:
The reference set example tables on this page have been revised as follows to aid clarity and understanding:
The first four columns which are present in all release files are not shown. The omitted columns (id, effectiveTime, active) are used in the same way in all referenced sets to support identification, versioning and packaging. They do not directly affect the specific features of a particular reference set or reference set type.
Reference set columns that contain SNOMED CT identifiers are expanded to show details of the concept or description referenced by that identifier. In some cases, the term is shown in the same column using the expression syntax, in other cases an additional column with a name suffix '_term' has been added. In the standard reference set files only the identifier is present in the column and there is no added column for the term. When using reference sets, the term and other details of the component are looked up from the relevant component release files.
The table below shows the descriptors that define the structure of the pattern and examples of the descriptors for specific reference sets that follow this pattern.
Descriptor templates for OWL expression reference rets
OWL ontology reference set example
OWL axiom reference set example
id
UUID
A 128 bit unsigned Integer, uniquely identifying this reference set member.
Different versions of a reference set member share the same id but have different effectiveTime. This allows a reference set member to be modified or made inactive (i.e. removed from the active set) at a specified time.
NO
Prefix(:=<>)
SubClassOf(:404684003 :138875005)
YES (Full /Snapshot)
effectiveTime
Time
The inclusive date or time at which this version of the identified reference set member became the current version.
Note: In distribution files the effectiveTime should follow the short ISO date format (YYYYMMDD) and should not include the hours, minutes, seconds or timezone indicator.
The current version of this reference set member at time T is the version with the most recent effectiveTime prior to or equal to time T.
YES
YES (Full)
Optional (Snapshot)
active
Boolean
The state of the identified reference set member as at the specified effectiveTime .
If active = 1 (true) the reference set member is part of the current version of the set, if active = 0 (false) the reference set member is not part of the current version of the set.
YES
NO
moduleId
SCTID
Identifies the SNOMED CT module that contains this reference set member as at the specified effectiveTime.
The value must be a subtype of 900000000000443000 |Module (core metadata concept)| within the metadata hierarchy.
YES
NO
refsetId
SCTID
Identifies the reference set to which this reference set member belongs.
In this case, a subtype descendant of: 762676003 |OWL expression type reference set (foundation metadata concept)|
NO
NO
referencedComponentId
SCTID
A reference to the SNOMED CT component to be included in the reference set.
The concept to which the OWL expression applies. In the case of the 733073007 |OWL axiom reference set (foundation metadata concept)|, the axiom contributes to the definition of the identified concept.
NO
NO
owlExpression
String
The text of OWL expression to attach to the component identified by referencedComponentId.
YES
NO
0
1
0
1
0
1
Prefix(owl:=<http://www.w3.org/2002/07/owl#>)
Prefix(rdf:=<http://www.w3.org/1999/02/22-rdf-syntax-ns#>)
Prefix(xml:=<http://www.w3.org/XML/1998/namespace>)
Prefix(xsd:=<http://www.w3.org/2001/XMLSchema#>)
Prefix(rdfs:=<http://www.w3.org/2000/01/rdf-schema#>)
Ontology(<http://snomed.info/sct/900000000000207008>)
Example of SubClassOf, which is equivalent to an |Is a| relationship between most SNOMED CT concepts.
A different OWL expression is used to represent |Is a| relationships between attributes. This is shown in the row below.
SubObjectPropertyOf(:774081006 :733928003)
Example of SubObjectPropertyOf, which is equivalent to an |Is a| relationship between attributes.
EquivalentClasses(:90708001 ObjectIntersectionOf(:64572001 ObjectSomeValuesFrom(:609096000 ObjectSomeValuesFrom(:363698007 :64033007))))
Example of EquivalentClasses. which is equivalent to stating that a concept is sufficiently defined by a set of necessary relationships.
EquivalentClasses(:126516008 ObjectIntersectionOf(:64572001 ObjectSomeValuesFrom(:609096000 ObjectIntersectionOf(ObjectSomeValuesFrom(:116676008 :108369006) ObjectSomeValuesFrom(:363698007 :371311000)))))
Example of a role group with a conjunction of two relationships as its value.
TransitiveObjectProperty(:774081006)
Example of a transitive object property.
SubObjectPropertyOf(ObjectPropertyChain(:127489000 :738774007) :127489000))
Example of a property chain.
SubClassOf(ObjectIntersectionOf(:64859006 ObjectSomeValuesFrom(:609096000 ObjectSomeValuesFrom(:255234002 :387713003)) ObjectSomeValuesFrom(:609096000 ObjectSomeValuesFrom(:363698007 :272673000))) :703264005)
Example of a general concept inclusion (GCI).
