Objective Our study evaluates an existing SNOMED CT model for structured recording of heart murmur findings and compares it to a concept-dependent attributes model using content from SNOMED CT.

Methods We developed a model for recording heart murmur findings as an alternative to SNOMED CT's use of Interprets and Has interpretation. A micro-nomenclature was then created to support each model using subset and extension mechanisms described for SNOMED-CTr. Each micro-nomenclature included a partonomy of cardiac cycle timing values. A mechanism for handling ranges of values was also devised. One hundred clinical heart murmurs were recorded using purpose built recording software based on both models.

Results Each micro-nomenclature was extended through the addition of the same list of concepts. SNOMED role grouping was required in both models. All one hundred clinical murmurs were described using each model. The only major differences between the two models were the number of relationship rows required for storage and the hierarchical assignments of concepts within the micro-nomenclatures.

Conclusion We were able to capture one hundred clinical heart murmurs with both models. Requirements for implementing the two models were virtually identical. In fact, data stored using these models could be easily inter-converted. There is no apparent penalty for implementing either approach.