Usage

Use these terms with the following definitions in mind:

• Curative is defined as any treatment meant to reduce or control a disease process, even if a ‘cure’ is not anticipated.
• Palliative treatments are intended to improve the quality of life, typically without concurrent curative treatments. Examples are pain medications or surgery to reduce the size (but not fully remove) a tumor close to the spine that could impact mobility. Palliative care most often refers specifically to end-of-life care.
• Supportive treatments do not treat or improve the underlying condition, but could extend life or be used in conjunction with curative treatments to improve patient comfort. They could be preventive drugs administered to preemptively manage side effects or toxicities from an anti-neoplastic (e.g.: G-CSFs to manage neutropenia, epoetins for anemia, dexamethasone for delayed nausea and vomiting, etc.). Supportive drugs could also be chemoprotective, or chemo-enhancing, and in some cases even included as part of the regimen even though the drug in itself is not an antineoplastic (e.g.: leucovorin is not an antineoplastic but an chemoprotectant oftentimes combined with the antineoplastics 5-FU and methotrexate).
• Diagnostic refers to procedures carried out to identify the nature of an illness
• Preventive refers to treatments designed to keep an illness or harm from occurring.
• Screening relates to procedures carried out to detect disease in individuals who do not have any symptoms of disease.
• Guidance relates to education and counselling, such as smoking cessation programs.
• Forensic in the medical context refers to procedures carried out to determine the cause of death.

These values appear in SNOMED-CT under “Intents (nature of procedure values)” (code 363675004). There are certain terms under the same heading that were not included in this value set:

• Prophylaxis is essentially synonymous with preventive. See https://en.wikipedia.org/wiki/Preventive_healthcare for the distinction between these terms.
• Neo-adjuvant deals with the timing of a treatment relative to other treatments, not the intent. SNOMED’s classification of this term is questionable.
• Adjuvant also relates to the relative timing of a treatment. Again, SNOMED’s classification of this term is questionable.
• Adjunct refers to a treatment accompanying or in support of another therapy. This is a situation or circumstance, not an intent.

• Include these codes as defined in http://snomed.info/sct

  Code	Display
  373808002	Curative - procedure intent
  363676003	Palliative - procedure intent
  399707004	Supportive - procedure intent
  261004008	Diagnostic intent
  129428001	Preventive - intent
  429892002	Guidance intent
  360156006	Screening - procedure intent
  447295008	Forensic intent

This value set contains 8 concepts

Expansion based on SNOMED CT United States edition 01-Mar 2021

All codes from system http://snomed.info/sct