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Hyphen

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( - )

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Hyphens should follow rules of style for the dialect and language in which the descriptions are used as found in such publications as the Chicago Manual of Style, the American Medical Association’s Manual of Style, a current medical dictionary, etc.  Punctuation is to be used sparingly unless used to prevent ambiguity. 

Unless used to prevent ambiguity, punctuation is to be used sparinglyWhen a hyphen is used to join words or to separate syllables, there is no space either before or after the hyphen.  

For example,

• • Anti-infective agent (product)
  • Zollinger-Ellison syndrome (disorder)
  • Zellweger's-like syndrome (disorder)
  • Tick-borne hemorrhagic fever (navigational concept)
  • Phospho-2-dehydro-3-deoxygluconate aldolase (substance)
  • Multidrug-resistant bacteria (organism)
  • Pandrug-resistant bacteria (organism)
  • Extended spectrum beta-lactamase-producing bacteria (organism)

A dash may hyphen may be used to separate two phrases, to contrast values, or to show a relationship between two things.  A dash hyphen should not rarely be used in an FSN, with rare exception, because it may obscure the exact meaning of the description. The dash ; the hyphen should be replaced with words that clarify the meaning. 

A dash hyphen is also used to separate an acronym from its expanded form when no other terms are included in a description. 

For example,

• • Concept
    t 273420000 |Disability assessment schedule (assessment scale)|

     has 30549001 |Removal of suture (procedure)| has a synonym of DAS - Disability assessment scheduleROS - removal of suture
    

    Concept
    t 719977005 |Communication Activities of Daily Living (assessment scale)|

     has a synonym of CADL - Communication Activities of Daily Living

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• • 
    

Tip

When there is a need to distinguish categories from more specific subtypes with the same name, a dash followed by the word category, may be used.

For example,

Concept
t 416500007 |Malignant glioma - category (morphologic abnormality)|

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Concept
t 74532006 |Glioma, malignant (morphologic abnormality)|

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Concept
t 416500007 |Malignant glioma - category (morphologic abnormality)|

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The hyphen is represented by UTF-8 and can be entered directly by a standard keyboard.  Although the hyphen may sometimes be referred to as a dash, the EN dash and EM dash are not used in SNOMED CT.

Colon ( : )

In general, colons should not be used in fully specified names.

Exceptions

Colons are allowed in the FSNs of organisms, substances, or products where the colon is part of the name. They are also allowed in ratios and in tumor stages.

For example,

• • • Salmonella II 43:g,t:[1,5] (organism)
    • Lidocaine hydrochloride 1.5%/epinephrine 1:200,000 injection solution vial (product)
    • pT3: tumor invades adventitia (esophagus) (finding)

Colons may be allowed in non-FSN descriptions. 

For example, to separate an abbreviation from the rest of a name or a specimen from the finding

• • • Urine: turbid (finding)

Double Colon (::)

A double colon ( :: ) notation is allowed in the neoplastic morphologic abnormalities (400177003 |Neoplasm and/or hamartoma (morphologic abnormality)| subhierarchy).  The notation can be used to represent gene fusions; for example, BCR::ABL1 fusion.

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• • FSN: Per cubic millimeter (qualifier value)
  • SYN:  /mm³

Exceptions

A forward slash may be used to represent units of measure, official enzyme names, and laboratory test results. They may also be used in and/or when part of FSNs. There should be no space either before or after the slash.

For example,

• • • Nitroglycerin 0.3mg/hr disc (product)
    • Ibuprofen 5%/Levomenthol 3% gel (product)
    • Milligram/deciliter haptoglobin (qualifier value)
    • Bone structure of head and/or neck (body structure)

A forward slash may be allowed in non-FSN descriptions in a variety of contexts. Some common examples of use are in acronyms with findings, and as an abbreviation meaning and/or concepts.

Protein names may contain the forward slash ‘/’ for separating multiple domains or functions:

For example, 1222712000 |Serine/threonine-protein kinase B-raf (substance)| 

Certain neoplastic variants incorporate a slash in their terming (note this slash does not mean 'and' or 'and/or'). Based on pathology input, a dash can be utilized in the FSN and a slash retained in the Preferred Term for clinical usage.

For example,

• • • FSN: Myelodysplastic-myeloproliferative neoplasm with neutrophilia (disorder)
    • PT:  Myelodysplastic/myeloproliferative neoplasm with neutrophilia

Plus sign ( + )

The plus sign is generally discouraged for use in descriptions, and legacy content still contains this symbol.  However, some uses are allowed. Plus signs may be found in the product, disposition, and substance hierarchies. 

For example,

• • |H+/K+-exchanging ATPase inhibitor| is an acceptable synonym for 

    Concept
    t 734582004 |Hydrogen/potassium adenosine triphosphatase enzyme system inhibitor (disposition)|

    .  

Caret symbol ( ^ )

A pair of caret symbols is used to enclose character strings that should display as superscript.

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An umlaut should only be accepted for terms that do not have equivalences in English. Synonyms without umlauts should be added to facilitate searching in English.

For example,

• • Conceptt83901003 |Sjögren's syndrome (disorder)|  and and one of its synonyms, Sjogrens syndrome

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