Request for feedback from SNOMED International: Inactivation of procedures stating intent as diagnostic or therapeutic

Good morning,

I would be interested to know what would be examples of exceptions to this approach. I agree that there are instances where the intent identification is unnecessary, but I am also hesitant as this can also give an indication as to the extent of a procedure, the time needed for a procedure, the equipment needed for a procedure, and so forth.

Off the top of my head, the following procedure is one that we utilize for sputum induction testing:

22144002 |Aerosol or vapor inhalation for sputum induction for diagnostic purposes (procedure)|

Thank you

Purpose
To obtain feedback from the Content Managers Advisory Group on the suggested inactivation of concepts with descriptions that refer to the intent of a procedure as diagnostic or therapeutic.

Background
A recent decision was made, in consultation with Member Forum and the Content Managers Advisory Group, to inactivate endoscopy procedures stating intent. The pre-coordination of new procedure content with intent is currently not allowed. Therefore the existence of any active content pre-coordinated in this way is inconsistent with current guidance and would be subject to the same issues as endoscopy content in that a diagnostic procedure can be converted to a therapeutic procedure. It is also at odds with the guidance on pre-coordinating the reason for a procedure. Unless there is a clinical reason and the procedure itself changes depending on whether it is diagnostic or therapeutic then the agnostic procedure would be sufficient.

Issues
Concepts with descriptions that include intent:
● Diagnostic = 473
● Therapeutic = 260

Next Steps
We propose that this description format continues to be disallowed for any procedure in favor of content that is agnostic to intent and 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 CT Editorial Guidance would be updated to reflect this. The exceptions to this approach would be those procedures that differ in what is actually done depending on whether the intent is diagnostic or therapeutic. Existing concepts will be reviewed on this basis.

SNOMED International would appreciate any feedback on the proposed inactivation of this content before January 7.
Thank you!