Unified Medical Language System® (UMLS®)
New and Updated Sources (Expanded Representation Information) - 2012AA Release
General Information:
What's New to the Metathesaurus
For 2012AA, there are 4 new sources (LNC_NEUROQOL, LNC_OPTIMAL, MSHNOR, SCTUSX) and 58 updated sources (including subsources and translation sources).
LNC_NEUROQOL is LNC's Quality of Life Outcomes in Neurological Disorders. It represents the impact of chronic neurological disorders and their treatments. It incorporates patient reported outcomes of functioning, such as social, psychological, and mental well-being.
LNC_OPTIMAL is LNC's Outpatient Physical Therapy Improvement in Movement Assessment Log. It describes the difficulty and self-confidence a patient/client faces in accomplishing 21 movements needed to do various functional activities.
MSHNOR is Medical Subject Headings (MeSH) Norwegian Translation.
SCTUSX is the US Extension to SNOMED CT.
For detailed information about sources that are new or have had changes made (e.g. new term types, new attribute names, etc.):
Clinical Care Classification, CCC2_5
Healthcare Common Procedure Coding System, HCPCS2012
HL7 Vocabulary Version 3.0, HL7V3.0_2011_03
International Classification of Diseases, 10th Revision, ICD10CM_2012
ICD-10-PCS, ICD10PCS_2012
Logical Observation Identifiers Names and Codes (LOINC), LNC238
Medicomp Systems, MEDCIN3_2011_12_15
MedlinePlus Health Topics, MEDLINEPLUS_20111228
Norwegian Translation of MeSH, MSHNOR2012
Spanish Translation of MeSH, MSHSPA2012
RXNORM Project, RXNORM_11AB_120305F
US Extension to SNOMED CT, SCTUSX_2012_03_01
SNOMED Clinical Terms, SNOMEDCT_2012_01_31
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What's New to the Metathesaurus:
Attribute name (ATN):
ADDED_MEANING
APPROVED_DRUG_PRODUCT_MANUFACTURED_EXCLUSIVELY_FOR_PRIVATE_LABEL_DISTRIBUTOR
COMMON_ORDER_RANK
COMPONENTHISTORY
CONCEPTSTATUS
EXEMPT_DEVICE
HL7AI
HL7AP
HL7AR
HL7AT
HL7AV
HL7BR
HL7CC
HL7CD
HL7CI
HL7CO
HL7CP
HL7CS
HL7CSC
HL7CST
HL7CY
HL7DC
HL7DH
HL7DI
HL7DK
HL7DV
HL7ED
HL7HA
HL7ID
HL7II
HL7IM
HL7IN
HL7IR
HL7IS
HL7LT
HL7MI
HL7MN
HL7NA
HL7NO
HL7OA
HL7OD
HL7OI
HL7PK
HL7PL
HL7PR
HL7PV
HL7RA
HL7RD
HL7RF
HL7RG
HL7RK
HL7RN
HL7RO
HL7RT
HL7SCS
HL7SL
HL7SQ
HL7SV
HL7SY
HL7TI
HL7TR
HL7TY
HL7VC
HL7VD
HL7VE
HL7VP
HL7XN
LEGALLY_MARKETED_UNAPPROVED_NEW_ANIMAL_DRUGS_FOR_MINOR_SPECIES
MTH_CODE_FIRST
MTH_COPYRIGHT
MTH_EXCLUDES1
MTH_EXCLUDES2
MTH_LEA
MTH_LFO
MTH_LQT
MTH_LRN2
MTH_LSU
ORDER_NO
RXN_AVAILABLE_STRENGTH
UNAPPROVED_HOMEOPATHIC
UNAPPROVED_MEDICAL_GAS
Relationship attribute(RELA)| RELA inverse:
classifies_class_code|class_code_classified_by
context_binding_of|has_context_binding
has_doseformgroup|doseformgroup_of
has_owning_affiliate|owning_affiliate_of
has_owning_section|owning_section_of
has_owning_subsection|owning_subsection_of
may_be_qualified_by|may_qualify
supported_concept_property_in|has_supported_concept_property
supported_concept_relationship_in|has_supported_concept_relationship
Term type (TTY):
BR
CDO
CPR
CR
CSY
DFG
MTH_HX
MTH_LPN
SBDG
SCDG
VS
------------------------------------------
Source: Clinical Care Classification
SAB: CCC2_5
1) New term type (TTY) | Suppressible value:
HT|N
MTH_HT|N
PT|N
Discussion:
1) This source is an update of HHC (Home Health Care Classification of Nursing Diagnoses and Interventions) which was last revised in 2003.
2) Previous TTYs were semantically-based while the new TTYs are structurally-based.
C0 (components) --> HT
DX (diagnoses) --> PT
IV (interventions)-->PT
3) Two Metathesaurus atoms, "Interventions" and "Diagnoses", assigned TTY = MTH_HT, were created so that the Interventions and Diagnoses atoms could be displayed in separate hierarchies. Previously, they were mixed together into a single hierarchy.
4) In the previous version, it was discovered that ".0" was getting cut off from some codes. The ".0" is now restored and is used as a parent concept in the hierarchy. For example:
Pressure Ulcer Care R51.0 ()
Pressure Ulcer Stage 1 Care R51.1 ()
Pressure Ulcer Stage 2 Care R51.2 ()
Pressure Ulcer Stage 3 Care R51.3 ()
Pressure Ulcer Stage 4 Care R51.4 ()
------------------------------------------
Source: Healthcare Common Procedure Coding System
SAB: HCPCS2012
This version includes:
HCDT2011-2012B
HCPT2012
MTHHH2012
1) Dropped term type (TTY) | Source:
MTH_PT|HCPT
2) Dropped relationship | relationship attribute (RELA) | Source:
SY|mth_plain_text_form_of|HCPT
Discussion:
TTY = MTH_PT and RELA = mth_plain_text_form_of were deprecated because non-ascii characters were removed from the source data file.
------------------------------------------
Source: HL7 Vocabulary Version 3.0
SAB: HL7V3.0_2011_03
1) New term type (TTY) | Suppressible value:
BR|N
CDO|N
CPR|N
CR|N
CSY|N
VS|N
2) New relationship | relationship attribute(RELA) | RELA inverse:
RO|classifies_class_code|class_code_classified_by
RO|component_of|has_component
RO|context_binding_of|has_context_binding
RO|has_owning_affiliate|owning_affiliate_of
RO|has_owning_section|owning_section_of
RO|has_owning_subsection|owning_subsection_of
RO|may_be_qualified_by|may_qualify
RO|supported_concept_property_in|has_supported_concept_property
RO|supported_concept_relationship_in|has_supported_concept_relationship
SY|expanded_form_of|has_expanded_form
3) Dropped relationship | relationship attribute (RELA):
SY|mth_plain_text_form_of
4) New attribute name (ATN):
HL7AI
HL7AP
HL7AR
HL7AT
HL7AV
HL7BR
HL7CC
HL7CD
HL7CI
HL7CO
HL7CP
HL7CS
HL7CSC
HL7CST
HL7CY
HL7DC
HL7DH
HL7DI
HL7DK
HL7DV
HL7ED
HL7HA
HL7ID
HL7II
HL7IM
HL7IN
HL7IR
HL7IS
HL7LT
HL7MI
HL7MN
HL7NA
HL7NO
HL7OA
HL7OD
HL7OI
HL7PK
HL7PL
HL7PR
HL7PV
HL7RA
HL7RD
HL7RF
HL7RG
HL7RK
HL7RN
HL7RO
HL7RT
HL7SCS
HL7SL
HL7SQ
HL7SV
HL7SY
HL7TI
HL7TR
HL7TY
HL7VC
HL7VD
HL7VE
HL7VP
HL7XN
5) Dropped attribute name (ATN):
HAT
HCDI
HCS
HDS
HHA
HID
HLIR
HOD
HOI
HPL
Discussion:
1) ATNs will now begin with the prefix 'HL7'. All previous ATNs were deprecated and replaced with "HL7'.
2) Atoms that were under 'CodeSystem' in the previous version have been moved out, so there are more than 170 top-level code system concepts. The hierarchy is now flatter.
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Source: International Classification of Diseases, 10th Revision, Clinical Modification
SAB: ICD10CM_2012
1) New term type (TTY) | Suppressible value:
AB|Y
MTH_ET|N
MTH_HT|N
MTH_PT|N
2) Dropped term type (TTY):
DET
3) New relationship | relationship attribute(RELA) | RELA inverse:
SY|expanded_form_of|has_expanded_form
SY|mth_has_plain_text_form|mth_plain_text_form_of
4) New attribute name (ATN):
MTH_CODE_FIRST
MTH_EXCLUDES1
MTH_EXCLUDES2
ORDER_NO
5) Dropped attribute name (ATN):
CHAPTER_NOTE
MAPSETTYPE
Discussion:
1) New MTH_* attributes and term types are due to the creation of plain ASCII text strings during Metathesaurus processing.
2) AB atoms are connected to the PT atom with the same code using the REL|RELA =SY|mth_expanded_form_of REL/RELA.
3) MTH_* atoms are connected to their non-MTH atom using the REL|RELA = SY|plain_text_form_of.
4) ATN = ORDER_NO indicates the line order in icd10cm_order_2012.txt.
5) ATN = MAPSETTYPE is no longer being created unless the source provides the value for the attribute.
-----------------------------------------
Source: ICD-10-PCS
SAB: ICD10PCS_2012
1) New term type (TTY) | Suppressible value:
AB|Y
HS|Y
HX|N
MTH_HX|N
2) Dropped term type (TTY):
MTH_HT
3) New attribute name (ATN):
ADDED_MEANING
ORDER_NO
Discussion:
1) TTY = HS is the abbreviated description for the 3-character (header) code.
2) TTY = HX is the expanded form of the 3-7 character codes. These were previously assigned the TTY = HT.
3) TTY = MTH_HX is the HX with the word "(Procedure)" or "(Therapy)" appended. These represent the top two levels of the hierarchy and were previously assigned the TTY = MTH_HT.
4) Some atoms that were previously assigned the TTY = HT are now TTY = HX. This was done to create an assignment structure parallel to the PT/PX assignments. TTY = HT is now only used to represent the "long description" of the 3-character (header) codes.
5) ATN = ADDED_MEANING is additional descriptive information about a header term.
6) ATN = ORDER_NO is the order number from the icd10pcs_*_order.txt file.
-----------------------------------------
Source: Logical Observation Identifiers Names and Codes (LOINC)
SAB: LNC238
This version includes:
LNC238_BRADEN_1988
LNC238_CAM_2003
LNC238_FLACC_1997
LNC238_MDS20
LNC238_MDS30
LNC238_NEUROQOL_2001 (new)
LNC238_OASIS_2002
LNC238_OPTIMAL_2005 (new)
LNC238_PHQ_9_1999
LNC238_RHO_2008
LNC238_WHO_2006
1) New term type (TTY) | Suppressible value | Source:
LC|N|NEUROQOL, OPTIMAL
LN|N|NEUROQOL, OPTIMAL
MTH_LN|N|NEUROQOL, OPTIMAL
MTH_LPN|N|LNC
2) Dropped term type (TTY) | Source:
MTH_SN|LNC
SN|LNC
3) New relationship | relationship attribute(RELA) | RELA inverse | Source:
RO|has_evaluation|NEUROQOL, OPTIMAL
SY|common_name_of|NEUROQOL, OPTIMAL
SY|mth_expanded_form_of|NEUROQOL, OPTIMAL
SY|mth_has_plain_text_form|mth_plain_text_form_of|LNC
4) New attribute name (ATN) | Source:
COMMON_ORDER_RANK|LNC, BRADEN, CAM, FLACC, MDS20, MDS30, NEUROQOL, OASIS, OPTIMAL, PHQ, RHO, WHO
COMMON_TEST_RANK|NEUROQOL, OPTIMAL
COPYRIGHT|NEUROQOL, OPTIMAL
LCL|NEUROQOL, OPTIMAL
LCN|NEUROQOL, OPTIMAL
LCS|NEUROQOL, OPTIMAL
LCT|NEUROQOL, OPTIMAL
LLR|NEUROQOL, OPTIMAL
LOINC_COMPONENT|NEUROQOL, OPTIMAL
LOINC_METHOD_TYP|NEUROQOL, OPTIMAL
LOINC_PROPERTY|NEUROQOL, OPTIMAL
LOINC_SCALE_TYP|NEUROQOL, OPTIMAL
LOINC_SYSTEM|NEUROQOL, OPTIMAL
LOINC_TIME_ASPECT|NEUROQOL, OPTIMAL
LQS|NEUROQOL, OPTIMAL
LQT|NEUROQOL
LRN2|NEUROQOL, OPTIMAL
LUR|NEUROQOL, OPTIMAL
MTH_COPYRIGHT|LNC
MTH_LEA|LNC
MTH_LFO|LNC
MTH_LQT|LNC
MTH_LRN2|LNC
MTH_LSU|LNC
MTH_SOS|LNC
SOS|NEUROQOL, OPTIMAL
STATUS_REASON|OASIS
5) Dropped attribute name (ATN) | Source:
DEFINITION|LNC
DEFINITION_DESCRIPTION_HELP|LNC, MDS20
INPC_PERCENTAGE|LNC, BRADEN, CAM, FLACC, MDS20, MDS30, OASIS, PHQ, RHO, WHO
LRF|LNC, FLACC, PHQ
LSR|LNC, BRADEN, CAM, FLACC, MDS20, MDS30, OASIS, PHQ, RHO, WHO
Discussion:
1) Two new subsources: NEUROQOL_2001 and OPTIMAL_2005. Note: NEUROQOL_2001 should actually be NEUROQOL_2010. This will be corrected in the next release.
2) ATN = COMMON_ORDER_RANK is the ranking of approximately 300 common orders performed by laboratories in the USA.
3) New MTH_* attributes and term types are due to the creation of plain ASCII text strings during Metathesaurus processing.
4) The dropped TTYs and ATNs are no longer being released in the source data.
5) Two subsources within the LNC source data -- Patient Reported Outcomes Measurement (PROMIS) and Test of Infant Motor Performance (TIMP) are not included in the Metathesaurus.
-----------------------------------------------
Source: Medicomp Systems, MEDCIN [terminology files]
SAB: MEDCIN3_2011_12_15
1) New term type (TTY) | Suppressible value:
MTH_FN|N
MTH_PT|N
MTH_SY|N
2) New relationship | relationship attribute(RELA) | RELA inverse:
RO|has_measurement_method|measurement_method_of
RO|has_time_aspect|time_aspect_of
RO|uses_energy|energy_used_by
SY|mth_plain_text_form_of|mth_has_plain_text_form
3) Dropped relationship | relationship attribute(RELA):
RO|has_specimen_procedure
RO|has_specimen_substance
4) Dropped attribute name (ATN):
MAPSETTYPE
Discussion:
1) New MTH_* term types and relationships are due to the creation of plain ASCII text strings during Metathesaurus processing.
2) ATN = MAPSETTYPE is no longer being created unless the source provides the value for the attribute.
------------------------------------------------
Source: MedlinePlus Health Topics
SAB: MEDLINEPLUS_20111228
1) New relationship | relationship attribute(RELA) | RELA inverse:
RO|mapping_qualifier_of|has_mapping_qualifier
Discussion:
1) In previous versions, the relationships between MSH qualifiers (TTY = TQ) and MEDLINEPLUS atoms were incorrectly being labeled as RQ|mapped_from. This has been corrected and the new relationship is R0|mapping_qualifier_of.
2) Changed TTY for "Groups" from PT to HT.
3) Atom "MedlinePlus Health Topics" (TTY = HT) was removed. This atom, which was created during Metathesaurus processing, is no longer necessary since Local Topics are not being released anymore.
------------------------------------------------
Source: Norwegian Translation of MeSH
SAB: MSHNOR2012
1) New term type (TTY) | Suppressible value:
DSV|Y
EN|N
EP|N
MH|N
PEN|N
PEP|N
2) New relationship | relationship attribute(RELA) | RELA inverse:
RB||
RB|inverse_isa|isa
RN||
RO||
SY|sort_version_of|has_sort_version
3) New attribute name (ATN):
TERMUI
Discussion:
This is a new source.
-----------------------------------------------
Source: Spanish Translation of MeSH
SAB: MSHSPA2012
1) Dropped term type (TTY):
MTH_EP
MTH_HT
MTH_MH
MTH_PEP
MTH_PXQ
MTH_SY
MTH_TQ
MTH_XQ
2) Dropped relationship | relationship attribute(RELA):
SY|mth_has_plain_text_form
Discussion:
TTY = MTH_* term types and RELA = mth_plain_text_form_of were deprecated because plain ASCII text is no longer being created.
----------------------------------------------
Source: RXNORM Project
SAB: RXNORM_11AB_120305F
This version includes:
GS_2012_02_06 (Gold Standard Alchemy)
MDDB_2012_02_08 (Master Drug Data Base. Medi-Span, a division of Wolters Kluwer Health)
MMSL_2012_02_01 (Multum MediSource Lexicon)
MMX_2012_02_06 (Micromedex DRUGDEX)
MSH2012_2011_09_09 (Medical Subject Headings)
MTHFDA_2011_06_01 (FDA National Drug Code Directory)
MTHSPL_2012_02_24 (FDA Structured Product Labels)
NDDF_2012_02_08 (First DataBank NDDF Plus Source Vocabulary)
NDFRT_2012_03_05 (National Drug File)
SNOMEDCT_2012_01_31 (SNOMED Clinical Terms (drug information). SNOMED International)
VANDF_2012_01_23 (Veterans Health Administration National Drug File)
1) New term type (TTY) | Suppressible value | Source:
DFG|N|RXNORM
SBDG|N|RXNORM
SBDG|O|RXNORM
SCDG|N|RXNORM
SCDG|O|RXNORM
2) New relationship | relationship attribute(RELA) | RELA inverse:
RO|has_doseformgroup|doseformgroup_of
3) Dropped relationship | relationship attribute(RELA):
RO|has_related_form
4) New attribute name (ATN) | Source:
APPROVED_DRUG_PRODUCT_MANUFACTURED_EXCLUSIVELY_FOR_PRIVATE_LABEL_DISTRIBUTOR|MTHSPL
EXEMPT_DEVICE|MTHSPL
LEGALLY_MARKETED_UNAPPROVED_NEW_ANIMAL_DRUGS_FOR_MINOR_SPECIES|MTHSPL
RXN_AVAILABLE_STRENGTH|RXNORM
UNAPPROVED_HOMEOPATHIC|MTHSPL
UNAPPROVED_MEDICAL_GAS|MTHSPL
Discussion:
Selected portions of MSH and SNOMEDCT are included in the RxNorm release files, however, they are not processed as part of RxNorm for the Metathesaurus except in assigning RXCUI and RXAUI attributes.
---------------------------------------------------------------------
Source: US Extension to SNOMED CT
SAB: SCTUSX_2012_03_01
1) New term type (TTY) | Suppressible value:
FN|E
FN|N
IS|O
OF|O
OP|O
PT|N
SY|N
2) New relationship | relationship attribute(RELA) | RELA inverse:
CHD|isa|inverse_isa
RO|due_to|cause_of
RO|has_associated_finding|associated_finding_of
RO|has_associated_morphology|associated_morphology_of
RO|has_associated_procedure|associated_procedure_of
RO|has_clinical_course|clinical_course_of
RO|has_finding_context|finding_context_of
RO|has_finding_site|finding_site_of
RO|has_focus|focus_of
RO|has_procedure_contet|procedure_context_of
RO|has_severity|severity_of
RO|has_specimen_substance|specimen_substance_of
RO|has_subject_relationship_context|subject_relationship_context_of
RO|has_temporal_context|temporal_context_of
RO|moved_to|moved_from
RO|replaced_by|replaces
RO|replaces|replaced_by
3) New attribute name (ATN):
COMPONENTHISTORY
CONCEPTSTATUS
DESCRIPTIONSTATUS
DESCRIPTIONTYPE
INITIALCAPITALSTATUS
ISPRIMITIVE
LANGUAGECODE
Discussion:
1) This is a new source.
2) The SCTUSX hierarchy is designed as an extension to the SNOMEDCT hierarchy. Due to complications in representing a mixed-source hierarchy, the SCTUSX hierarchy is not represented in MRHIER.RRF, however, it is represented in MRREL.RRF as follows:
REL/REL_INVERSE: PAR/CHD
RELA/RELA_INVERSE: inverse_isa/isa
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Source: SNOMED Clinical Terms
SAB: SNOMEDCT_2012_01_31
1) Dropped term type (TTY):
OB
Discussion:
TTY = OB has been deprecated because the combination of DESCRIPTIONTYPE=0 and DESCRIPTIONSTATUS other than 0 is no longer present in the data.
