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1. If one of the MedDRA synonyms is linked to a SNOMED term, pick that one
2. If a UK spelling exists, please use it.  
3. 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.   
   
   

ATC/WHO

Duplication arising from different formulations of the same drug

 WHO-ATC is organized by organ system, so a drug that is used in different formulation for different body systems will have multiple entries in the original WHO vocabulary (e.g. tetracycline formulations for application to the skin have a term that starts with D (dermatologic), those for use in eyes or ears have an S (sensory), in the mouth it's A (alimentary) etc.)  We have merged all of these terms into a single Cochrane tetracycline term and merged it with related terms from RxNorm and SNOMED CT - so tetracylcline is now mapped to

SNOMED: 66261008
RxNorm: 10395
ATC: S02AA08,S03AA02,S01AA09,J01AA07,D06AA04,A01AB13
MeSH: D013752If you come across multiple identical terms for an individual drug, please let us know so that we can resolve the issue.

Duplication in Drug Category arising from different formulations of the same drug

Unfortunately the WHO drug categories are also organized by organ system, and WHO has chosen to give identical labels or labels that appear synonymous to to drug categories in different (organ system) parts of their vocabulary.   So the parent terms for Tetracycline include Tetracyclines, Antiinfectives, Antibiotics, and a second Antiinfectives and these categories are based on organ systems.  The two Antiinfective terms, for example, apply to tetracycline eye or ear drops, so would not be an appropriate choice for an annotation of systemic anti-infectives.   We are working to relabel the WHO drug categories to make these distinctions clearer, but if there are apparent synonyms, the correct term can be chosen by looking at the initial letter in the WHO identifier.  

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A term in one vocabulary has a synonymous term in a different vocabulary

MedDRA and SNOMED CT

We have attempted to identify all cases in which a term in MedDRA has a label that is identical to the label from a term in SNOMED CT and these have been merged into a single Cochrane term - with both parent terms listed in the our various tools whenever the term is used.  If you find examples of synonymous terms in these 2 vocabularies in the course of annotation or QA, please flag them up for us to resolve. 

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. 

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