733127007: Acute occlusion of artery of upper limb caused by thrombus (disorder)

SNOMED CT Concept\Clinical finding\...

\Finding of limb structure\Disorder of extremity\Vascular disorder of extremity\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Finding of limb structure\Disorder of extremity\Vascular disorder of extremity\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Finding of limb structure\Disorder of extremity\Disorder of upper extremity\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Finding of limb structure\Disorder of extremity\Disorder of upper extremity\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Finding of limb structure\Finding of upper limb\Disorder of upper extremity\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Finding of limb structure\Finding of upper limb\Disorder of upper extremity\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus

\General finding of soft tissue\Blood vessel finding\Arterial finding\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Blood vessel finding\Arterial finding\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Blood vessel finding\Arterial finding\Disorder of artery\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Blood vessel finding\Arterial finding\Disorder of artery\Occlusion of artery\Acute occlusion of artery\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Blood vessel finding\Arterial finding\Disorder of artery\Occlusion of artery\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Blood vessel finding\Arterial finding\Systemic arterial finding\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Blood vessel finding\Arterial finding\Systemic arterial finding\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Blood vessel finding\Disorder of blood vessel\Thrombosis of blood vessel\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Blood vessel finding\Disorder of blood vessel\Vascular disorder of extremity\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Blood vessel finding\Disorder of blood vessel\Vascular disorder of extremity\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Blood vessel finding\Disorder of blood vessel\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Blood vessel finding\Disorder of blood vessel\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Blood vessel finding\Disorder of blood vessel\Disorder of artery\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Blood vessel finding\Disorder of blood vessel\Disorder of artery\Occlusion of artery\Acute occlusion of artery\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Blood vessel finding\Disorder of blood vessel\Disorder of artery\Occlusion of artery\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Disorder of soft tissue\Soft tissue lesion\Thrombosis of blood vessel\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Disorder of soft tissue\Soft tissue lesion\Occlusion of artery\Acute occlusion of artery\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Disorder of soft tissue\Soft tissue lesion\Occlusion of artery\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Disorder of soft tissue\Disorder of blood vessel\Thrombosis of blood vessel\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Disorder of soft tissue\Disorder of blood vessel\Vascular disorder of extremity\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Disorder of soft tissue\Disorder of blood vessel\Vascular disorder of extremity\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Disorder of soft tissue\Disorder of blood vessel\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Disorder of soft tissue\Disorder of blood vessel\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Disorder of soft tissue\Disorder of blood vessel\Disorder of artery\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Disorder of soft tissue\Disorder of blood vessel\Disorder of artery\Occlusion of artery\Acute occlusion of artery\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\General finding of soft tissue\Disorder of soft tissue\Disorder of blood vessel\Disorder of artery\Occlusion of artery\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus

\Cardiovascular finding\Disorder of cardiovascular system\Thrombosis\Thrombosis of blood vessel\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Disorder of cardiovascular system\Peripheral vascular disease\Peripheral arterial disease\Peripheral arterial occlusive disease\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Disorder of cardiovascular system\Peripheral vascular disease\Peripheral arterial disease\Peripheral arterial occlusive disease\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Disorder of cardiovascular system\Acute disease of cardiovascular system\Acute occlusion of artery\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Disorder of cardiovascular system\Disorder of blood vessel\Thrombosis of blood vessel\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Disorder of cardiovascular system\Disorder of blood vessel\Vascular disorder of extremity\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Disorder of cardiovascular system\Disorder of blood vessel\Vascular disorder of extremity\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Disorder of cardiovascular system\Disorder of blood vessel\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Disorder of cardiovascular system\Disorder of blood vessel\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Disorder of cardiovascular system\Disorder of blood vessel\Disorder of artery\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Disorder of cardiovascular system\Disorder of blood vessel\Disorder of artery\Occlusion of artery\Acute occlusion of artery\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Disorder of cardiovascular system\Disorder of blood vessel\Disorder of artery\Occlusion of artery\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Blood vessel finding\Arterial finding\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Blood vessel finding\Arterial finding\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Blood vessel finding\Arterial finding\Disorder of artery\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Blood vessel finding\Arterial finding\Disorder of artery\Occlusion of artery\Acute occlusion of artery\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Blood vessel finding\Arterial finding\Disorder of artery\Occlusion of artery\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Blood vessel finding\Arterial finding\Systemic arterial finding\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Blood vessel finding\Arterial finding\Systemic arterial finding\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Blood vessel finding\Disorder of blood vessel\Thrombosis of blood vessel\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Blood vessel finding\Disorder of blood vessel\Vascular disorder of extremity\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Blood vessel finding\Disorder of blood vessel\Vascular disorder of extremity\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Blood vessel finding\Disorder of blood vessel\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Blood vessel finding\Disorder of blood vessel\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Blood vessel finding\Disorder of blood vessel\Disorder of artery\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Blood vessel finding\Disorder of blood vessel\Disorder of artery\Occlusion of artery\Acute occlusion of artery\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Cardiovascular finding\Blood vessel finding\Disorder of blood vessel\Disorder of artery\Occlusion of artery\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus

\Disease\Disorder of body system\Disorder of cardiovascular system\Thrombosis\Thrombosis of blood vessel\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of body system\Disorder of cardiovascular system\Peripheral vascular disease\Peripheral arterial disease\Peripheral arterial occlusive disease\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of body system\Disorder of cardiovascular system\Peripheral vascular disease\Peripheral arterial disease\Peripheral arterial occlusive disease\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of body system\Disorder of cardiovascular system\Acute disease of cardiovascular system\Acute occlusion of artery\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of body system\Disorder of cardiovascular system\Disorder of blood vessel\Thrombosis of blood vessel\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of body system\Disorder of cardiovascular system\Disorder of blood vessel\Vascular disorder of extremity\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of body system\Disorder of cardiovascular system\Disorder of blood vessel\Vascular disorder of extremity\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of body system\Disorder of cardiovascular system\Disorder of blood vessel\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of body system\Disorder of cardiovascular system\Disorder of blood vessel\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of body system\Disorder of cardiovascular system\Disorder of blood vessel\Disorder of artery\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of body system\Disorder of cardiovascular system\Disorder of blood vessel\Disorder of artery\Occlusion of artery\Acute occlusion of artery\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of body system\Disorder of cardiovascular system\Disorder of blood vessel\Disorder of artery\Occlusion of artery\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of extremity\Vascular disorder of extremity\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of extremity\Vascular disorder of extremity\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of extremity\Disorder of upper extremity\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of extremity\Disorder of upper extremity\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of soft tissue\Soft tissue lesion\Thrombosis of blood vessel\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of soft tissue\Soft tissue lesion\Occlusion of artery\Acute occlusion of artery\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of soft tissue\Soft tissue lesion\Occlusion of artery\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of soft tissue\Disorder of blood vessel\Thrombosis of blood vessel\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of soft tissue\Disorder of blood vessel\Vascular disorder of extremity\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of soft tissue\Disorder of blood vessel\Vascular disorder of extremity\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of soft tissue\Disorder of blood vessel\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of soft tissue\Disorder of blood vessel\Disorder of artery\Disease of non-coronary systemic artery\Peripheral arterial disease\Peripheral arterial occlusive disease\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of soft tissue\Disorder of blood vessel\Disorder of artery\Arterial thrombosis\Thrombosis of arteries of the extremities\Thrombosis of arteries of upper extremity\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of soft tissue\Disorder of blood vessel\Disorder of artery\Occlusion of artery\Acute occlusion of artery\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Disorder of soft tissue\Disorder of blood vessel\Disorder of artery\Occlusion of artery\Occlusion of artery of upper extremity\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus
\Disease\Acute disease\Acute disease of cardiovascular system\Acute occlusion of artery\Acute occlusion of artery of upper limb\Acute occlusion of artery of upper limb caused by thrombus

Status: current, Sufficiently defined by necessary conditions definition status. Date: 31-Jul 2017. Module: SNOMED CT core module

Descriptions:

Id Description Lang Type Status Case? Module

3498817017 Acute occlusion of artery of upper limb caused by thrombus (disorder) en Fully specified name Active Entire term case insensitive SNOMED CT core module

3498818010 Acute occlusion of artery of upper limb caused by thrombus en Synonym Active Entire term case insensitive SNOMED CT core module

3498819019 Acute thrombotic occlusion of artery of upper limb en Synonym Active Entire term case insensitive SNOMED CT core module

Expanded Value Set

Outbound Relationships	Type	Target	Active	Characteristic	Refinability	Group	Values
Acute occlusion of artery of upper limb caused by thrombus	Is a	Thrombosis of arteries of upper extremity	true	Inferred relationship	Existential restriction modifier
Acute occlusion of artery of upper limb caused by thrombus	Is a	Acute occlusion of artery	false	Inferred relationship	Existential restriction modifier
Acute occlusion of artery of upper limb caused by thrombus	Clinical course	Sudden onset AND/OR short duration	true	Inferred relationship	Existential restriction modifier	1
Acute occlusion of artery of upper limb caused by thrombus	Associated morphology	Occlusive thrombus	true	Inferred relationship	Existential restriction modifier	2
Acute occlusion of artery of upper limb caused by thrombus	Finding site	Structure of artery of upper extremity	true	Inferred relationship	Existential restriction modifier	2
Acute occlusion of artery of upper limb caused by thrombus	Is a	Acute disease of cardiovascular system	false	Inferred relationship	Existential restriction modifier
Acute occlusion of artery of upper limb caused by thrombus	Is a	Acute occlusion of artery of upper limb	true	Inferred relationship	Existential restriction modifier

Inbound Relationships	Type	Active	Source	Characteristic	Refinability	Group
Acute occlusion of axillary artery due to thrombosis	Is a	True	Acute occlusion of artery of upper limb caused by thrombus	Inferred relationship	Existential restriction modifier
Acute occlusion of brachial artery due to thrombosis	Is a	True	Acute occlusion of artery of upper limb caused by thrombus	Inferred relationship	Existential restriction modifier

This concept is not in any reference sets