SI - Proposed update to content in the Radiographic imaging procedure hierarchy

Here is an update from SNOMED International on the subject:

A briefing note documenting the proposed changes for the hierarchy 363680008|Radiographic imaging procedure (procedure)| and descendants was shared in July 2023.

Feedback was received from a wide range of stakeholders. In response to this feedback the proposed changes to the hierarchy have been modified. These modifications will address issues raised in the feedback. This informational briefing note summarizes the changes that will be implemented.

Thank you,

Last week SNOMED International published a blog co-written by their Chief Terminologist Dr James Case and Senior Terminologist Maria Braithwaite which provides additional details and explains in more depth the challenges with the current hierarchy and the work that needs to be done to avoid inconsistencies and confusion in the future. The blog explains how the work will proceed and roll out, and, importantly, how it will avoid any negative impacts to existing implementations.

It also provides details of their goals, the scope of the work and the timeline, as well as how people can get involved and help shape this work.
You can read the blog here, also the period for providing feedback on this work has been extended to allow for wider community input. You now have until August 11 to share with us any comments and questions on the proposal.

Thank you,

Hello David,

Thank you very much for taking the time to answer our questions and thank you for all this information. We will take them into consideration in our response to SI and get back to you if more details are needed.

Thanks again!

Hello,

The following comments to the questions posted are from consultations with Radiography experts Bronwen Baylis and Donna Brown:

1. Is X-ray of x synonymous with Plain X-ray of x and/or Radiography of x?
No.
Support the recommendation from the Briefing note !HTSDO- 161 Radiography vs. Xray published July 7th, 2023, that definitions need to be applied.

X-ray ( radiation) is the energy source used to create images.

Plain x-ray is an old term describing original general x-ray procedures. This term does not refer to the specialties of CT, Mammography, bone density, interventional, fluoroscopy.

Radiography is the process (or occupation) of producing an imaging using x-rays. In Ontario as a regulated medical Radiation Technologist, you would be registered in one of the five specialties: Radiography, Radiation therapy, nuclear medicine, magnetic resonance, and diagnostic medical sonography.

2. Or are the terms X-ray of x, Plain X-ray of x and Radiography of x used in current practice to represent different diagnostic imaging procedures? If so, please define the distinction.

Radiography is used to describe the following :
• General x-ray
• CT
• Mammography
• Bone density
• Dental x-ray
• Dental Panorex
• Interventional
• Fluoroscopy procedures
• Tomography

Plain X-ray would in the past be used to differentiate from a more complex imaging such as CT, fluoroscopy or tomography.
Xray or Plain x-ray would be used to describe the following:
General x-ray – anatomically named – skull, Cervical Spine, Chest, Pelvis etc.
Dental x-ray
Plain X-ray would in the past be used to differentiate from a more complex imaging such as CT, fluoroscopy or tomography.
X-ray of x would be used in current practice i.e., X-ray of Chest
Radiography of x would be more inclusive to include imaging done with an X-ray source.

3. If not, and they can be used interchangeably, what term/terms are most commonly used?

They are not interchangeable.

Hello,

Content improvement changes have been proposed for <363680008|Radiographic imaging procedure (procedure)| namely concepts with descriptions ‘Radiography of X’ , ‘X-ray of X’ , ‘Plain X-ray of X’.

The aim of this content update will be to improve the quality of content in this hierarchy and specifically to:

1. Implement a consistent description pattern for FSN and preferred term.
2. Implement a consistent value for the method attribute that aligns with the concept FSN.
3. Improve hierarchical subsumption.
4. Inactivate duplicate concepts.

Please see the attached briefing note from SNOMED International for further information.

Also, we would like to get specific feedback on the following questions:

SNOMED International's proposal aims, among other things, to standardize the descriptions for all the concepts:
X-ray of x, Plain X-ray of x and Radiography of x (with the exception of the high-level grouper concepts).
The description "X-ray of x" will be retained as FSN and other descriptions (Plain X-ray of x, Plain film of x and Plain radiography of x) may be retained/added as acceptable synonyms. "Radiography of x" will be kept for concept for high-level grouper concepts that subsume different imaging procedures. We would like to validate that the result of this proposal would accurately represent curent diagnostic/medical imaging practices in the field:

1. Is X-ray of x synonymous with Plain X-ray of x and/or Radiography of x?
2. Or are the terms X-ray of x, Plain X-ray of x and Radiography of x used in current practice to represent different diagnostic imaging procedures? If so, please define the distinction.
3. If not, and they can be used interchangeably, what term/terms are most commonly used?

Please share any comments and questions on the proposal with us on this forum by July 28, 2023.

Thank you,