Content updates

Our clinical team are continuously broadening, updating, and refining the Concentric ontology (i.e. the treatment templates), and updates are released every few weeks.

Most healthcare organisations use the main (‘master’) version of the Concentric ontology – those using this version will see updates as per the below release notes. Deployments using a locally modified version of the Concentric ontology sometimes receive updates on different dates to the main version, and the content of the updates can be different – including further local modifications requested.

Release notes for the last 6 content updates are presented in reverse chronology (most recent first). Earlier release notes are available on request. The list of all the treatment templates available within Concentric, presented by specialty, is maintained in our treatment template list.

Each release goes through a thorough release process, as outlined within our release process page. These release notes highlight the recent areas of focus, listing new treatment templates made available and reviews undertaken, but do not detail every change within a release. Our reviews involve a review of the existing template alongside clinician feedback received, a review of the published evidence-base, and insights gathered from real-world use of the template – for example patterns in terms of risks modified or added.

If you don’t currently have access to Concentric but would like to see the Concentric ontology in context within the application please contact us to request demo access.

Release 58 - 2 Dec 2024

New templates released:

• ENT: Robot-assisted hemi/total/completion thyroidectomy, Thyroid isthmusectomy, Excision of external ear lesion, Nasal cautery, Reduction of inferior turbinates, Nasal turbinate cauterisation, Radiofrequency nasal turbinate reduction, Revision septoplasty, Examination of nose/nostril under anaesthesia, Navigational endoscopic sinus surgery, Endoscopic excision of sinonasal tumour, Endoscopic repair of CSF leak, Trans-oral laser microsurgery base of tongue, Open pharyngeal pouch repair, Endoscopic dilatation of airway stenosis
• Generic: Drug challenge, Oral food challenge
• Medicine: Allergen immunotherapy injections, Omalizumab, pH-study, pH-impedance study
• Paediatric medicine: Paediatric flexible bronchoscopy
• Urology: Open/laparoscopic simple cystectomy and ileal conduit formation/orthotopic neobladder reconstruction, Removal of a female urethral diverticulum with Martius graft interposition, Abdominal/vaginal vesicovaginal fistula repair, Laser treatment to penis

Review conducted: Hormone replacement therapy (oral/transdermal/implant), Tonsillectomy, Septorhinoplasty, Partial/total laryngectomy, Parotidectomy, Endoscopic sinus surgery, Frontal sinus trephination, Dacryocystorhinostomy

Release 57 - 8 Nov 2024

New templates released:

• Cardiac surgery: Pleural effusion surgery, VATS/open bullectomy (+pleurectomy, +talc pleurodesis)
• Dermatology: Patch testing
• ENT: Steroid injection into larynx/trachea, Injection laryngoplasty, Botox toxin injection into salivary gland/palate/larynx/facial intradermal
• Nutrition: Endoscopic insertion and change of various feeding tubes, Radiological insertion and change of various feeding tubes, Cut and push removal of PEG, Endoscopic removal of PEG
• Obstetrics & Gynaecology: Induction of labour, Wide local excision of the vulva + inguinal sentinel lymph node biopsy with or without inguinofemoral lymphadenectomy
• Oncology: Palliative radiotherapy
• Ophthalmology: EUA eye, Lacrimal gland biopsy, Nasalacrimal stent insertion/removal, Punctoplasty
• Orthopaedics: Closed reduction of joint dislocations and fractures, Examination under anaesthesia of various joints
• Respiratory: Rigid/robotic with EBUS/navigational bronchoscopy
• Urology: Male urethrectomy, Incision/excision biopsy of a penile skin lesion, Removal of a female urethral diverticulum, Open/laparoscopic partial cystectomy, Total/partial penectomy, Dynamic sentinel inguinal lymph node biopsy, Glansectomy with primary closure/skin graft
• Vascular: Transmetatarsal amputation, Supraclavicular/transaxillary first and/or cervical rib resection with/without scalenectomy, Scalenectomy

Review conducted: Planned caesarean birth with bilateral tubal ligation, Assisted vaginal birth with or without caesarean birth, Tarsorrhaphy, Syringing and probing of lacrimal ducts, Ectropion repair

Release 56 - 11 Oct 2024

New templates released:

• Cardiac surgery: Thoracoabdominal aorta repair, Descending thoracic aorta repair, Aorta arch replacement, Ascending aorta replacement, Frozen elephant trunk, Septal myectomy, Left atrial appendage occlusion, Convergent ablation procedure
• Thoracic surgery: Ravitch procedure, Nuss procedure, Lung volume reduction surgery, Endobronchial valve insertion, Pulmonary segmentectomy
• Breast surgery: Lateral scar/J scar/V scar/Omega (batwing)/Short Scar Periareolar Inferior Pedicle Reduction (SPAIR) therapeutic mammoplasty
• Dentistry: Professional mechanical plaque removal (PMPR), Subgingival professional mechanical plaque removal (PMPR), Dentures, Direct dental restoration, Teeth Whitening, Dental implant insertion, Root canal treatment

Review conducted: Temporary transvenous pacing, Coronary artery bypass graft, Valve replacements, Incision oral biopsies, Excision oral biopsies, Cytoreductive surgery for ovarian cancer (previously ovarian debulking surgery), Catheter ablation, Anterior mediastinal mass surgery, Pulmonary lobectomy, Pneumonectomy, Pulmonary wedge resection.

Release 55 - 1 Oct 2024

New templates released:

• Gynaecology: Egg collection
• Medicine: Immunoglobulin replacement therapy

Review conducted: Caesarean section, Assisted vaginal delivery, Intrauterine devices, Anti-VEGF intravitreal injections.

Release 54 - 9 Sep 2024

New templates released:

• Paediatric: Childhood immunisations (under one year)

• Cardiology: Cardiopulmonary exercise test (CPET)

• Ophthalmology: Shave biopsy of an eyelid lesion, Paediatric cataract surgeries

• Nuclear medicine: Pharmacological nuclear stress test

Review conducted: Eyelid reconstruction, Excision biopsy of an eyelid lesion, Forehead lift, Cataract surgery, Fixed appliances orthodontic treatment

Release 53 - 27 Aug 2024

New templates released

• Obstetrics & Gynaecology: Excision of vulval lesion

• General surgery: Spigelian hernia repair

• Haematology: Ponatinib

• Orthopaedic: Mako robot-assisted total/uni-compartmental knee replacement

Reviews conducted: Total/Uni-compartmental knee replacement, Red cell transfusion, Platelet transfusion, Cyclophosphamide.

Release 52 - 22 Jul 2024

New templates released

• Radiology: Diagnostic angiography of arteriovenous fistula, Angioplasty of arteriovenous fistula, Superior mesenteric artery angioplasty, Gastroduodenal artery embolisation, Venoplasty, Coeliac artery embolisation, Percutaneous liver cyst drainage, Ultrasound guided drainage, Diagnostic angiography of the external/common iliac artery, Tunnelled ascitic drain insertion, Percutaneous drainage of perihepatic fluid

• Gender-affirming surgery: Vaginoplasty, Vulvoplasty, Mastectomy, Nipple reconstruction, Chest liposuction

• Medicine: Fresh Frozen Plasma transfusion, Platelet transfusion, Oral/IV methotrexate

• Cardiothoracics: Minimally invasive mitral valve surgery

• Ophthalmology: Excision biopsy of an upper/lower eyelid lesion

• Oncology: Sacituzumab govitecan

• Orthopaedics: Revision total shoulder replacement

Release 51 - 30 May 2024

New templates released

• Radiology: Nephrostomy tube removal, Biliary drain removal, Percutaneous cholecystostomy, Inferior/Superior vena cava stent insertion, Thrombin injection into femoral artery pseudoaneurysm, Parotid/Sublingual/Submandibular sialogram, Parotid/Sublingual/Submandibular sialoplasty, External/Common iliac artery angioplasty

Release 50 - 10 May 2024

New templates released

• Radiology: Ultrasound guided intra-articular injections (multiple sites), Large joint arthrocentesis (multiple sites), Seroma aspiration, Tubogram, Diagnostic venogram

• Orthopaedics: Wrist denervation, Open reduction and internal fixation of a periprosthetic fracture, Arthrosamid injection into the knee, Excision of Morton’s neuroma, Medial patellofemoral ligament autograft reconstruction, Proximal medial gastrocnemius release, Terminalisation/replantation of a finger, Distal femoral osteotomy, Open plantar fasciotomy, Medial/Lateral collateral ligament repair, Posterior cruciate ligament reconstruction, Tibial tubercle transfer osteotomy

• Maxillofacial: Anterior craniofacial resection

• Plastics: Facelift, Brow lift

• Ophthalmology: Subtenon’s steroid injection

• General Surgery: Insertion/Change of a vacuum assisted closure (VAC) dressing

• Gynaecology: Cervical/Vaginal wall polyp/cyst removal

• Medicine: Adalimumab