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MedDRA has been structured so that every term at the second-lowest level of its hierarchy (PT - Preferred Term) has a synonymous term at its lowest level (LLT - Lowest Level Term). The LLT member of each of these pairs has been removed from the Cochrane vocabulary, so there should be no exactly identical terms from MedDRA. If you uncover any examples in the course of annotation or QA, please send a Merge request via the Vocabulary Request form on your Review Group page. However, there may be other close matches within MedDRA; for example, UK and US spellings of a term (oedema, edema etc.) are separate terms in MedDRA. This will be resolved in a way that will merge these MedDRA synonyms.
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How to guide
- If one of the MedDRA synonyms is linked to a SNOMED term, pick that one.
- Annotate using the more frequently used term. If needed, send a Preferred Term Selection request via the Vocabulary Request form on your Review Group page.
- If a UK spelling exists, please use it. If you do find US spellings, request a Merge of these terms via the Vocabulary Request form on your Review Group page.
WHO ATC
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.) The Linked Data team has 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: D013752
Duplication in Drug Category arising from different formulations of the same drug
The WHO drug categories are organised by organ system, and WHO has chosen to give identical labels or labels that appear synonymous to drug categories in different (organ system) parts of their vocabulary.
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. The LInked Data team is 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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| title | Click here for the full list of top level terms and corresponding first levels for the terms |
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ATC Category
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CODE Starts with
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ALIMENTARY TRACT AND METABOLISM
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A
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BLOOD AND BLOOD FORMING ORGANS
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B
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CARDIOVASCULAR SYSTEM
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C
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DERMATOLOGICALS
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D
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GENITO URINARY SYSTEM AND SEX HORMONES
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G
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ANTIINFECTIVES FOR SYSTEMIC USE
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J
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ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS
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L
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MUSCULO-SKELETAL SYSTEM
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M
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NERVOUS SYSTEM
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N
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RESPIRATORY SYSTEM
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R
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SENSORY ORGANS
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S
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VARIOUS
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V
| Info |
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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:
Tetracyclines J01A
Tetracyclines J01AA (and this is the only child term under Tetracyclines J01A
Tetracycline J01AA07.
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).
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A term in one vocabulary has a synonymous term in a different vocabulary
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