1. Copyright © 2001 College of American Pathologists Sample Hierarchy for Nasal Septoplasty Hair bearing flap to eyebrow Repair of eyebrow Operation on eyebrow About SNOMED Relationships Linear repair of laceration of eyebrow Bicoronal browlift Simple browlift Suture of eyebrow

2. Copyright © 2001 College of American Pathologists Relationships Suture of Eyebrow (61723005) Closure of skin by suture (129359003) Closure by suturing (84238004) Eyebrow structure (66462004) Suture of eyebrow Descriptions (5721002) Repair of eyebrow Is a Has procedure site Has method (27065002) Surgical suture Using

3. Copyright © 2001 College of American Pathologists Concept Inter-relationships for Procedures SNOMED CT uses relationships between concepts to provide logical, computer readable definitions of medical concepts. These relationships, which can be hierarchical or non- hierarchical, enable health data to be re-used for decision support, outcomes analysis and clinical research. Follow this link to see the relationship types applicable to procedures.relationship types

4. Copyright © 2001 College of American Pathologists Relationship Types for Procedures Clinical Attributes Method Procedure Site Direct Morphology Laterality Direct Device Using

5. Copyright © 2001 College of American Pathologists The “Is a” Relationship The “Is a” relationship is used to create a hierarchical relationships between concepts, relating specific concepts to a more general category. For example: Needle biopsy “Is a” (kind of) “Biopsy”

6. Copyright © 2001 College of American Pathologists The “Procedure site” Relationship The “Procedure site” relationship identifies the part of the body acted on by the procedure. For example: “Lymph node biopsy” (has) “Procedure site” “Lymph node”

7. Copyright © 2001 College of American Pathologists The “Direct morphology” Relationship The “Direct morphology” relationship identifies the abnormal physical condition that is being directly addressed by the procedure. There is an implicit link between the “method” relationship and the direct morphology. The method acts on the direct morphology. For example:method “Biopsy of cyst” (has) “Method” “Biopsy” “Biopsy of cyst” (has) “Direct morphology” “Cyst”

8. Copyright © 2001 College of American Pathologists The “Method” Relationship The “Method” relationship identifies the kind of procedure that is being carried out. For example: “Excision of cyst” (has) “Method” “Excision” “Catheterization” (has) “Method” “Implantation” “Serum sodium measurement” (has) “Method” “Observation”

9. Copyright © 2001 College of American Pathologists The “Laterality” Relationship The laterality relationship specifies the side of the body that applies to an anatomy concept. Procedures, findings and disorders can have laterality by qualifying their site (procedure-site or finding-site). For example: “Left kidney” (has) “Laterality” “Left” “Cyst of left kidney” (has) “Finding site” “Left Kidney” “Biopsy of left kidney” (has) “Procedure site” “Left Kidney”

10. Copyright © 2001 College of American Pathologists The “Direct Device” Relationship The “Direct device” relationship identifies the device which involved in the core operation of the procedure. An example of the direct device relationship are as follows: “Catheterization of artery” (has) “Direct device” “Catheter”

11. Copyright © 2001 College of American Pathologists The “Using” Relationship The “Using” relationship refers to any instrument, equipment or energy that is used to perform the procedure. Examples of the direct device relationship are as follows: “Needle aspiration biopsy” “Using” “Fine biopsy needle” “Laser surgery” (has) “Using” “Laser light”

12. Copyright © 2001 College of American Pathologists Descriptions for suture of eyebrow