Expected vocabulary changes during Aug 2025 release

Vocabulary Users
1

Dear all,

Here I will share the vocabulary changes expected during the August 2025 release.
Traditionally, we’ll start from SNOMED. Below I attach deltas in concept and concept_relationship tables, respectively. You are welcome to explore them and share your thoughts.

Also, I would like to share some content changes performed by the SNOMED editors that are likely to affect phenotypes and ETL. They include revision of transplantation, angioplasty, and substance use/abuse hierarchies. A large number of these concepts have been deprecated by the source without replacement links. We have remapped these deprecated concepts to the active equivalents based on our clinical expertise to minimize negative impact on ETL and cohorts. Nevertheless, I encourage the Community members to pay additional attention to these concepts and their mapping changes, if these concept groups are relevant for your research.

Cheers,
Masha

SNOMED concept changes Aug 2025.xlsx (132.7 KB)
SNOMED mapping changes Aug 2025.xlsx (1.6 MB)

5 Likes
2

Hello,

I’m here to share a new portion of upcoming changes in vocabularies.

Below I attach the Excel files that contain changes in mapping of ICD vocabulary family.

During this release, no significant mapping revision has been performed. The majority of mapping changes are caused by the deprecation and propagation of the SNOMED concepts.

Please, feel free to explore them and report any concerns and questions you have :slight_smile:

Cheers,
Masha

ICD9CM_mapping_changes.xlsx (32.3 KB)
ICD10_mapping_changes.xlsx (22.8 KB)
ICD10CM_mapping_changes.xlsx (29.0 KB)
ICD10CN_mapping_changes.xlsx (36.6 KB)
ICD10GM_mapping_changes.xlsx (24.1 KB)
CIM10_mapping_changes.xlsx (21.7 KB)
KCD7_mapping_changes.xlsx (20.5 KB)

3

Greetings! Excellent job! Thank you for sharing the updated mapping files and for your continued work on vocabulary maintenance. I’ve reviewed the changes and have identified several concepts that may benefit from further clarification or discussion. I’m currently unable to upload files to the forum (apparently I’m still considered a new user), so I’m sharing the table with my findings directly in this post instead.

concept_id concept_code concept_name vocabulary_id concept_class_id old_standard_concept old_domain_id new_standard_concept new_domain_id comment_flag
4226938 421891006 Finding of pulse taking by auscultation SNOMED Clinical Finding S Observation S Condition OBS-RoutineAssessment
4028091 128255002 Finding on percussion of lung fields SNOMED Clinical Finding S Observation S Condition OBS-PhysicalExamFinding
4089049 185388001 Follow-up examination normal SNOMED Clinical Finding S Observation S Condition OBS-RoutineAssessment
44811638 914051000000102 Hearing examination - no abnormality detected SNOMED Clinical Finding S Observation S Condition OBS-RoutineAssessment
1244663 1290338002 Normal respiratory effort SNOMED Clinical Finding S Observation S Condition OBS-PhysicalExamFinding
4185225 5467003 Normal respiratory rhythm SNOMED Clinical Finding S Condition S Observation OBS-Inconsistency
4055295 167298001 Trace of non-hemolyzed blood detected in urine SNOMED Clinical Finding S Measurement S Condition MEAS-LabFindingNotDiagnosis
44811630 913861000000108 Vision examination - no abnormality detected SNOMED Clinical Finding S Observation S Condition OBS-RoutineAssessment
4090953 252135004 Balke protocol stage achieved SNOMED Observable Entity S Observation S Measurement OBS-EvaluationSummary
4120022 258088000 Bicycle test level achieved SNOMED Observable Entity S Observation S Measurement OBS-EvaluationSummary
4090952 252134000 Bruce protocol stage achieved SNOMED Observable Entity S Observation S Measurement OBS-EvaluationSummary
4123004 258140000 Level achieved SNOMED Observable Entity S Observation S Measurement OBS-EvaluationSummary
4092798 252136003 Master protocol stage achieved SNOMED Observable Entity S Observation S Measurement OBS-EvaluationSummary
4181005 428630002 Maximum heart rate achieved during course of procedure SNOMED Observable Entity S Observation S Measurement OBS-TestOutcomeStatus
4091287 252137007 Modified Bruce protocol stage achieved SNOMED Observable Entity S Observation S Measurement OBS-EvaluationSummary
4121039 258151000 Protocol stage achieved SNOMED Observable Entity S Observation S Measurement OBS-EvaluationSummary
4092799 252138002 Scandinavian protocol stage achieved SNOMED Observable Entity S Observation S Measurement OBS-EvaluationSummary
4120034 258153002 Target heart rate achieved SNOMED Observable Entity S Observation S Measurement OBS-TestOutcomeStatus
4091288 252140007 Treadmill gradient achieved SNOMED Observable Entity S Observation S Measurement OBS-TestOutcomeStatus
4106641 258152007 Treadmill level achieved SNOMED Observable Entity S Observation S Measurement OBS-EvaluationSummary
4090058 252141006 Treadmill speed achieved SNOMED Observable Entity S Observation S Measurement OBS-EvaluationSummary
4090954 252139005 Wingate protocol stage achieved SNOMED Observable Entity S Observation S Measurement OBS-EvaluationSummary

Comment Flag meaning:

  1. OBS-RoutineAssessment
    These concepts represent routine clinical assessments such as general patient evaluations or check-ups. They do not indicate the presence of disease or require medical intervention. Therefore, they belong in the Observation domain rather than Condition, as they capture clinical findings without implying a diagnosis.

  2. OBS-PhysicalExamFinding
    These concepts reflect findings from physical examinations that are not pathological in nature. As they do not constitute a diagnosis but rather describe normal or qualitative findings, they are best placed in the Observation domain.

  3. OBS-EvaluationSummary
    These concepts describe qualitative summaries or performance milestones (e.g., final stage reached during a protocol, max speed achieved). They are not structured numeric results but rather protocol-level descriptive outcomes, making Observation the appropriate domain.

  4. OBS-TestOutcomeStatus
    These concepts indicate binary or categorical outcomes of tests (e.g., goal met vs. not met), rather than direct quantitative measurements. As such, they do not fit into the Measurement domain and should be assigned to Observation.

  5. MEAS-LabFindingNotDiagnosis
    These concepts reflect quantified test results (e.g., urinalysis data) without implying a diagnosis. They should be mapped to the Measurement domain instead of Condition, as they report objective test data.

  6. OBS-Inconsistency
    This comment flags inconsistencies in domain assignment among similar concepts (e.g., “Normal respiratory rhythm” marked as Condition, while others with similar semantics are Observation). A uniform approach is recommended, with these concepts appropriately mapped to Observation for consistency.

Looking forward to your feedback!

4

Hello Tetiana,

Thank you for your feedback!

We try to avoid significant domain changes in SNOMED as our users need stable domains for their research.

However, SNOMED itself is not that stable, it changes its hierarchy from one release to another. In our development we use SNOMED hierarchy for domains, i.e., we assign domain to an ancestor and then our machinery propagates this assignment to its descendants. Thus, change of the ancestor may cause domain changes of the descendants, and this is the case for the Clinical Findings you’ve reported.

In this case, the branch of 4090947, Observation parameter was moved to the Measurement domain, as most of its descendants represent specific quantitative measurements, e.g., voltage, frequency, weight, pulse, temperature, etc. Among the descendants of 4123004, Level achieved I also see concepts, e.g. Treadmill speed achieved, Stairs climbed, which imply numerical results.

I agree, that some of the Observation parameters may belong to the Observation domain, rather than Measurement. However, from the perspective of the vocabulary development these are spot fixes that require manual work. Due to the large volume of SNOMED content, we do not routinely perform manual domain assignment, unless there’s a specific use case and request from the Community.

If you have a use case, you are always welcome to discuss it here or create a GitHub issue, and we will try to find a solution :slight_smile:

Best,
Masha

5

Dear all,

Just letting you know that the Upcoming changes have been already published at our GitHub Wiki.

Welcome to explore!

Masha.

6

Thank you for the clear explanation.
My review did not uncover a concrete use case requiring a reversal of these particular reassignments. My intent was to provide community feedback on edge cases that might otherwise be missed during large-scale automated domain updates. No pressure and no dissatisfaction, simply a genuine intention to collaborate :slight_smile:
Some high-level “domain-defining” branches in SNOMED have heterogeneous descendants. In such mixed branches, a wholesale reassignment to one domain can occasionally sweep in concepts that remain better suited for another one. It may be useful for the community to see a current list of SNOMED hierarchies that drive automated domain logic (please let me know if this information is available in a table format somewhere). Where full manual review is impractical, community could help run targeted QC queries and contribute “tickets” for any potential misclassifications.
I appreciate the openness to community input. If you believe a focused review of specific mixed branches would add value, please let me know.
Thank you for all the work that goes into each vocabulary release.