SNOMED International request for feedback: Inactivation of endoscopy procedures stating intent as diagnostic or therapeutic

Purpose
To obtain feedback from (MF/CMAG) on the suggested inactivation of concepts which refer to the intent of an endoscopy procedure as diagnostic or therapeutic.

Background
Following a customer request for a new concept, Diagnostic colonoscopy (procedure), an internal review examined the use case for this and similar existing concepts. Including the intent of a procedure in the description is currently a precoordination pattern that is generally not allowed in the international edition but legacy content exists in this format. Identifying the intent of a procedure can be problematic as a procedure may be ordered as diagnostic but during theprocedure a therapeutic process is undertaken e.g., polyp removal during a routine colonoscopy. Additionally the context of the procedure will be clear from other information in the clinical record.

Issues
Creating a new concept Diagnostic colonoscopy (procedure) as a subtype of 73761001|Colonoscopy (procedure)| could result in implementation issues where the existing concept has already been used for diagnostic purposes. This issue would apply to any requests for diagnostic or therapeutic endoscopy procedure concepts where the agnostic concept exists. It is not thought that this would impact procedure planning activities as endoscopy units are prepared for the procedure to change course if required.

Inactivation of endoscopy procedures stating intent as diagnostic or therapeutic: 77 concepts affected, 363071007 |Diagnostic endoscopy (procedure)| and its subtypes together with 7 therapeutic concepts.

Next Steps
We propose this format continues to be disallowed in favour of content that is agnostic to intentand inactivation of existing concepts would be the preferred approach. The inactivation reason would be non-conformance to editorial policy and our intention is to add a historical association of “REPLACED_BY” to an appropriate target replacement concept once the updated concept inactivation reasons have been implemented in the authoring tooling.

SNOMED International would appreciate any feedbackon the proposed inactivation of this content before September 13.
Thank you!