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Terms for the "Condition" portion of P are drawn from 2 standard vocabularies - MedDRA and SNOMED CT. All of the terms from MedDRA are available for P annotation, but only selected subsets of SNOMED have been included. If you find term in SNOMED that you feel would be applicable for annotation of a Condition, but you cannot access the term in the P part of the PICO-annotator, please flag it as a vocabulary issue so that we can investigate the possibility of adding it (along with related terms from SNOMED CT).
Vocabularies for I and C
Drug Interventions
Terms The terms for drug interventions are drawn from 3 standard vocabularies - RxNorm, WHO ATC and SNOMED CT.come from the following vocabularies:
- RxNorm,
- WHO ATC
- SNOMED CT
Drug categories
We are only using WHO ATC and SNOMED CT for categories.
Many interventions (especially at the review level) involve are drug categories of drugs rather than a single agents agent - antibiotics, vitamins, analgesics, etc. RxNorm only lists individual drugs or drug combinations and has no codes for drug categories. We are therefore only using WHO ATC and SNOMED CT for categories.
Individual drugs
Since both RxNorm and WHO ATC have terms for individual drugs, either one can be used to annotate a drug intervention. However, the terms in WHO ATC are linked to drug categories while the terms in RxNorm are not. Because of this, a drug with multiple uses may appear more than once in different parts of the WHO ATC vocabulary tree.
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In cases where there are several options to choose from, for instance one or more WHO ATC codes and an RXNorm code, then it is best to use the most appropriate WHO ATC codes rather than the RxNorm code. |
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If you are not sure which one to choose, use the RxNorm code. |
Drug combinations
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Terms for all non-drug interventions are drawn from SNOMED CT. As with P, we have included only selected subsets of this vocabulary. If
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If you find term in SNOMED that you feel would be applicable for annotation of a non-drug intervention, but you cannot access the term in the I or C part of the PICO annotator, please flag it as a vocabulary issue so that we can investigate the possibility of adding it (along with related terms). |
Vocabularies for O
Originally there was not a controlled vocabulary that fit well for all outcomes. However, during the annotation process, it became clear that many Many of the terms used in the Conditions section of P were are also applicable to outcomes. Therefore, the same controlled vocabulary terms that are available in P P (MedDRA and portions of SNOMED CT) are now available in used for Outcomes.
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Duplication in Drug Category arising from different formulations of the same drug
Unfortunately the The WHO drug categories are also organized organised 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. The
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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. |
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