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Synonyms and near synonyms in the Controlled Vocabularies
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Where synonyms or near-synonyms appear in the controlled vocabularies that we will use the following processes to standardize annotations (as much as possible). |
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A term in one vocabulary has a synonymous term in the same vocabulary
MedDRA
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A term in one vocabulary has a synonymous term in the same vocabulary
MedDRA
For some reason, MedDRA has been structured so that every term at the second-lowest level of its hierarchy (PT - Preferred Term) has a synonymous term at it's lowest level (LLT - Lowest Level Term). The LLT member of each of these pairs has been removed from our Cochrane Vocabulary, so there should be no exactly identical terms within MedDRA. If you uncover any examples in the course of annotation or QA, please flag them up for us to resolve. However, there will be many close matches within MedDRA - for example UK and US spellings of a term (oedema, edema etc) are separate terms in MedDRA. We are in the process of resolving this in a way that will merge these MedDRA synonyms.
Interim work-around
- If one of the MedDRA synonyms is linked to a SNOMED term, pick that one
- If a UK spelling exists, please use it.
- If neither of the above exists, just pick any one of a group of MedDRA terms that seem to be synonyms and we will be able to merge your annotation with annotations using one of the other terms.
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ATC Category | CODE Starts with |
ALIMENTARY TRACT AND METABOLISM | A |
BLOOD AND BLOOD FORMING ORGANS | B |
CARDIOVASCULAR SYSTEM | C |
DERMATOLOGICALS | D |
GENITO URINARY SYSTEM AND SEX HORMONES | G |
ANTIINFECTIVES FOR SYSTEMIC USE | J |
ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS | L |
MUSCULO-SKELETAL SYSTEM | M |
NERVOUS SYSTEM | N |
RESPIRATORY SYSTEM | R |
SENSORY ORGANS | S |
VARIOUS | V |
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If you encounter synonymous drug categories, please pick the one that seems best using the above table, and also let us know so that we can change the term labels. |
Duplication due to multiple uses of the same (or similar) terms at different levels in the WHO-ATC hierarchy
ATC has 3 closely related terms - Tetracyclines J01A, Tetracyclines J01AA, and Tetracycline J01AA07. These are actually 3 different levels in the hierarchy:
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The duplication of the Tetracyclines label for J01A and J01AA, with J01AA being the only child happens elsewhere within ATC as well. (e.g. Antimycotics for systemic use J02/Antimycotics for systemic use J02A). If you find other examples in the course of annotation or QA, please flag them up for us to resolve.
The Tetracyclines/Tetracycline duplication is somewhat different. Tetracycline is a specific drug and one of several members of the class Tetracyclines, so the 2 terms are not equivalent or interchangeable. This situation should be fairly rare (Tetracycline(s) may be the only example).
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In addition to these exact synonyms, there are many cases in which a term in MedDRA looks as if it is probably identical to a term in SNOMED CT but has a slightly different label. An example is the MedDRA term Premature Baby & the SNOMED CT term Premature Infant. These have now been combined into a single Cochrane term with the label Preterm Infant (Less than 37 weeks). If you find examples of near synonyms in these 2 vocabularies in the course of annotation or QA, please flag them up for us to resolve. Our plan is to either combine them into a single Cochrane term (as above) or to designate one of the pair as a "Cochrane Preferred Term" to be used in all relevant annotations. Be the first to like this
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