Clinical clarity versus terminological order: the readiness of SNOMED CT concept descriptors for primary care

As SNOMED usage becomes more ingrained within applications, its range of concept descriptors, and particularly its synonym adequacy, becomes more important. A simulated clinical scenario involving various term-based concept searches is used to assess whether SNOMED's concept descriptors provide sufficient differentiation to enable possible concept selection between similar terms. Four random samples from different SNOMED concept populations are utilized. Of particular interest are concepts mapped duplicately into UMLS concepts due to shared term patterns. While overall synonym problems are rare (1%), some concept populations exhibited a high rate of potential problems for clinical use (17-62%). The vast majority of issues are due to SNOMED's inherent structure and fine granularity. Many findings hint at a lack of clear delineation between reference and interface terminological qualities. Closer attention should be given to practical clinical use-case scenarios. Reducing SNOMED's structural complexity may alleviate many of the described findings and encourage clinical adoption.