Background: In the context of synonymous concepts, errors and term duplications in SNOMED CT are likely. This aects in particular clinical ideas with multiple types of display, like the example of the Von Willebrand disease. Objectives: It is required to ensure a common and correct interpretation of medical terms. Thus, it is necessary to distinguish between the clinical ideas of disease, disorder and syndrome in the Von Willebrand context. To perform a critical examination of the associated hierarchical order in SNOMED CT and above that, to follow the given rules of correct terminology binding.
Methods: The synonymous concepts problem is ana- lyzed in reference to the Von Willebrand context in the SNOMED CT International Version 31012015. Improve- ments of handling are formulated based on the valid SNOMED CT compositional grammar and the SNOMED CT Editorial Guidelines. Terminology binding is examined regarding the prerequisites given in the "Using SNOMED CT in HL7 Version 3 Implementation Guide, Release 1.5
Results: Many Von Willebrand concepts in SNOMED CT are not fully de ned but primitive, which means that their de ning characteristics are not sucient to distigu- ish synonymous meanings. Improved handling of synony- mous concepts is proposed by the installation of a broader grouper concept and an adaption of the SNOMED CT hi- erarchical structure to avoid misinterpretations and dupli- cations.
Conclusions: The terminology binding between the SNOMED CT semantics in the Von Willebrand context and HL7 V3 seems technically well described. It has been shown, that the problematic handling of synonymous terms is assigned to hierarchical structure problems out of SNOMED CT.