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Concept Term

A concept term defines a medical coding term or OpenMRS concept dictionary term that could be mapped to a concept.   A medical coding term is used to represent a name from a standard medical code (ie.  SNOMED, ICD10, LOINC, etc).  OpenMRS concept dictionary terms are used to refer to concepts by concept_id or name of a concept in the concept dictionary (ie. CIEL, PIH, AMPATH, etc.).  

Here are some examples of concept terms (with concept source / term):

SNOMED CT /  38341003
WHO ICD 10 /  D64.9
PIH / Sickle-Cell Anemia
PIH /  7814
CIEL / 117703
LOINC / 36296-2
ICPC2 / B82

A concept term for PIH or CIEL mappings would only be used on one and only one concept.  These terms are only used on one concept.  You would never have 2 (or more) concepts in a concept dictionary with the same concept term when using the concept source of CIEL, PIH, or AMPATH.  For example, the concept term of "PIH: 7814" would only be associated with one concept.  On the PIH metadata server, the term "PIH: 7814" would be associated with concept id = 7814.   

SNOMED, LOINC, ICD10 codes could be assigned to multiple concepts.  The next section explains these examples.

Concept Mappings

A concept map connects a concept term to a concept.  

Concepts could use the same concept term.  For example, the ICD10 code "D64.9" is a concept term and is "mapped" to 19 concepts in the CIEL dictionary – "anemia", "severe anemia", "chronic anemia", "anemia due to infection", etc.  In ICD10, the definition is "Anemia, unspecified".  For the concept of anemia, the concept mapping would use the same mapping of "D64.9", but with the mapping type of "SAME-AS".  For "severe anemia", the same term would be mapped with the type of "NARROWER-THAN". 

SAME-AS / ICD 10 /  D64.9 / "Anemia"
NARROWER-THAN / ICD 10 /  D64.9 / "Severe Anemia"


A concept map with the concept type (SAME-AS) is used when there is one and only one use of a mapping in the concept dictionary.  This is used for PIH and CIEL mappings which should always be assigned a type of "SAME-AS".  A single concept could have many SAME-AS mappings ("CIEL: 117703", "PIH: Sickle-Cell Anemia", and "PIH: 7814").


SAME-AS / PIH / Sickle-Cell Anemia
SAME-AS / PIH /  7814
SAME-AS / CIEL / 117703
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  1. Ellen, it took me a bit to follow this. 

    I think what you are describing are source/code pairs which might include base concepts or external code systems. These source/code pairs as those listed at the top include the code SOURCE/SYSTEM (SNOMED, ICD, etc.) plus a CODE (38341003) and usually a source-derived DESCRIPTION (such as Anemia).

    The relationship between these source/code pairs and the OpenMRS concepts are deterministic. There should only be ONE and ONLY ONE map between an OpenMRS concept and a source/code with a mapping type of SAME_AS. It is possible that multiple OpenMRS concepts could map to the same source/code pair if the mapping type is not SAME_AS. There are certain sources which would suspicious if duplicated regardless of mapping type. Examples are the AMPATH, CIEL and PIH sources. However, there are examples where multiple maps are acceptable. In the case where prior retired concepts or where there were duplicate or redundant concepts in PIH or AMPATH, CIEL created multiple links in the mapping to the same CIEL concept.