Understanding MedDRA

The Medical Dictionary for Regulatory Activities

What is ICH?
The International Conference on Harmonisation of Technical Requirements for Registration of
Pharmaceuticals for Human Use (ICH) (www.ich.org) is an initiative by regulators and
research-based pharmaceutical industry organisations to standardise and streamline scientific and
technical aspects of the drug regulatory process. Its purpose is to achieve greater harmonisation of
technical guidelines and requirements for pharmaceutical product registration.

Founding members are:

In Europe, European Union (EU) and In USA, Food and Drug Administration (FDA)
European Federation of Pharmaceutical and Pharmaceutical Research and
Industries and Associations (EFPIA); Manufacturers of America (PhRMA);

In Japan, Ministry of Health, Labour and Additional members include Observers from
Welfare (MHLW) and the Japan the European Free Trade Association (EFTA),
Pharmaceutical Manufacturers Association Health Canada, and the World Health
(JPMA); Organization (WHO).

ICH activities now also include participation from other countries and regions (Drug Regulatory Authorities/Departments
of Health from Australia, Brazil, China, Chinese Taipei, India, Republic of Korea, Russia and Singapore, and Regional
Harmonisation Initiatives from APEC – Asia-Pacific Economic Cooperation, ASEAN – Association of Southeast Asian
Nations, EAC – East African Community, GCC – Gulf Cooperation Council, PANDRH – Pan American Network for Drug
Regulatory Harmonization, and SADC – Southern African Development Community).

ICH Products:
The ICH has produced numerous guidelines in the areas of quality, safety and efficacy. Several
multidisciplinary guidelines and standards have also been developed. MedDRA is a leading example of an
ICH multidisciplinary standard. In developing MedDRA, a medical dictionary for regulatory activities, the ICH
endeavoured to provide a single standardised international medical terminology.

MedDRA® trademark is owned by IFPMA on behalf of ICH

Contents
MedDRA: An Overview 2
............................................................................................................................................................
MedDRA: An Investment for Regulatory Activities 4
............................................................................................................................................................
Organised for analysis 4
............................................................................................................................................................
Tried and tested 4
............................................................................................................................................................
Multilingual to maximise data sharing 5
............................................................................................................................................................
Electronic communication connecting regulators & the regulated 5
............................................................................................................................................................
Free for regulators, affordable for all 6
............................................................................................................................................................
MedDRA: Network and Infrastructure 8
............................................................................................................................................................
Structure of MedDRA 8
............................................................................................................................................................
SMQs assist with signal detection 10
............................................................................................................................................................
A collaborative standardisation project 10
............................................................................................................................................................
Language neutral to maximise data sharing 11
............................................................................................................................................................
Compatible with other terminologies 11
............................................................................................................................................................
Governance ensures the integrity of updates 12
............................................................................................................................................................
Maintenance and support 13
............................................................................................................................................................

Key Acronyms

CIOMS Council for International MSSO Maintenance and Support

Organizations of Medical Sciences Services Organization

ICH International Conference on MVAT MedDRA Version Analysis Tool

Harmonisation of Technical Requirements
for Registration of Pharmaceuticals for PtC WG Points to Consider Working Group
Human Use
SMQ Standardised MedDRA Query
ICSR Individual Case Safety Report
WHO-ART WHO Adverse Reaction
JMO Japanese Maintenance Organization Terminology

MedDRA Medical Dictionary for Regulatory

Activities
MedDRA:
An Overview
Collaboration is a fundamental pillar of medical research. From the inception of a drug to its placement on the market
and beyond, teams from across the medical community come together to develop and test the best possible medical
products for patient use. These products are extensively reviewed by regulatory authorities before general release
and closely monitored thereafter.

ICH recognised that the use of different terminologies at different stages in the course of developing medicines made
it difficult to cross-reference and analyse data. Converting data from one terminology to another cost time, resources
and resulted in the inevitable loss or distortion of data. In view of these challenges, ICH created the Medical
Dictionary for Regulatory Activities (MedDRA) to facilitate the exchange of information through standardisation.

Used by regulators and industry for more than a decade, MedDRA is an important tool for product evaluation,
monitoring, communication, electronic records exchange and oversight. MedDRA was created to manage clinical
information about pharmaceuticals, biologics, vaccines and drug-device combinations for the entire lifespan of
products. It is a rich, highly specific, hierarchical, medically oriented, and rigorously maintained terminology designed
to meet the needs of drug regulators and the pharmaceutical industry as a shared international standard.

APPROVAL

Marketed
Preclinical Clinical Clinical Clinical Product
Testing Phase I Phase II Phase III
Phase IV

"MedDRA has its origins in regulatory pharmacovigilance and has developed into the complete
terminology for all medicines regulation in Europe and beyond. The granularity and usability of
MedDRA, coupled with new technologies, has enabled pharmacovigilance signal detection to
now look across large volumes of data and identify the most important public health issues. Knowing that
MedDRA continues to be maintained and developed to the highest standards means that we can be assured
it will continue to be the terminology that underpins our pharmacovigilance activities."

Mick Foy, Vigilance and Risk Management of Medicines, UK MHRA

UK MHRA MedDRA Management Board Representative

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For example, clinical trials are increasingly conducted internationally. Much of the clinical information gathered in
trials – such as disease and disorders present; medical, social and family history; signs and symptoms observed; as
well as adverse events and adverse drug reactions – can be accurately and efficiently communicated using
MedDRA. This allows such data to be pooled, compared and analysed across trials, regardless of linguistic barriers.

ICH’s powerful tool, MedDRA, is available worldwide

for monitoring medical products. Because MedDRA is
"Targeted monitoring strategies
already widely used, integration of information among
using MedDRA coded data are
regulators and business partners, both domestic and
effective methods for identification
international, is facilitated.
of potential signals."
Tried and trusted by experts around the world,
MedDRA is an investment for drug regulators and Heather Sutcliffe
pharmaceutical companies to protect patients, and an Canada Vigilance Programme, Health Canada

important tool for researchers and health Health Canada MedDRA

professionals. Management Board Representative

MedDRA at a Glance

MedDRA is an extensive medical terminology

with a unique architecture and features that
support public health monitoring, data
analysis, communication (both electronic and
traditional) and data management. This
terminology is hierarchical, multiaxial,
multilingual, regularly-updated, and strictly
maintained. Since it has been in widespread
use for more than a decade, it is stable and
mature with extensive supporting materials.

www.meddra.org 3
MedDRA: An Investment
for Regulatory Activities
This section provides an overview of MedDRA features, benefits and uses. A more in-depth view
can be found in the section entitled “MedDRA: Network and Infrastructure”.

MedDRA was developed by ICH in the late 1990s after decades of using other or no terminologies. ICH envisioned
that the adoption of MedDRA as a single standardised terminology would offer a number of clear advantages for
regulators and industry:

Improvements in the ease, quality and timeliness of data available for analysis, exchange and decision making;
Facilitation of the electronic exchange of data relating to medical products;
Long-term savings in resources, due to substantial time saved converting data from one terminology to another.

Organised for analysis

“Coding” data into a standardised terminology facilitates its
Drug Drug Industry
analysis. A critical benefit of MedDRA is in its support of Regulator Employee
straightforward as well as sophisticated analyses. Whether
one is a drug regulator, or works within a pharmaceutical
company, or is a medical researcher or a public health
official, information is critical to making decisions that affect
the well-being of people covered by your area of
responsibility. With MedDRA, the information is organised
to be of greatest value so that data can be examined from
multiple points of view whilst ensuring that the method of
organisation is valid, thereby allowing detailed as well as
high level analyses. It must also be robust enough to stand
up to new challenges and changing needs whilst allowing
others to reproduce the results using the same tools. Public Medical
Health Official Researcher
Tried and tested
The organisational structure of MedDRA has been proven through a decade of usage in ICH regions to fulfil these
needs. MedDRA is constantly maintained by experts allowing it to remain valid and current, even as new medical
concepts arise. Its structure means it is robust and flexible. MedDRA has a hierarchical structure and can be used to
analyse a particular medical event (e.g., Migraine) or an issue involving a whole system or organ (e.g., Nervous
system). Thanks to its multiaxiality and a special feature known as Standardised MedDRA Queries (SMQs),
MedDRA can be used to examine medical conditions which affect more than one organ or system.

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SMQs also support signal detection and the retrieval
“MedDRA has made a great
of data for safety analyses. As over 90 SMQs have
contribution to safety measures in
already been created to date, covering the major
Japan. This is especially due to its
events of interest (e.g., Cardiac failure and
high quality and the fact that it is standardised
Anaphylactic reaction), this is a very powerful feature.
across its translations, which include
Because these queries are standardised, the
Japanese – MedDRA/J. This standardisation
confirmation of a finding is facilitated, potentially
and ease of interoperability through the
saving valuable time. Additional SMQs are created as
eight-digit numeric code enables us to take
the need arises.
advantage of safety information from all over
the world without any language barriers.”

Makoto Hirose, Safety Division, MHLW

MHLW MedDRA Management Board Representative

Multilingual to maximise data sharing

The users of MedDRA have found it to be such an Cefaleia
Portuguese
important tool that in addition to the English Master, it Hoofdpijn Kopfschmerz
has been translated into Chinese, Czech, Dutch, Dutch German
French, German, Hungarian, Italian, Japanese,
Headache Fejfájás
Portuguese and Spanish. Each MedDRA term has an
English Hungarian
associated numerical code which remains the same
irrespective of the language. Thus, for example, a Céphalée Cefalea
French
10019211 Italian
user of the French version can understand the results
from the user of the Japanese version through their
Bolest hlavy
identical numerical codes.
Czech
This multilingual approach allows most users to
Cefalea
operate in their native language which promotes
Spanish
accuracy and precision of assigning codes.
Interoperability is very powerful and allows easy
multinational sharing of data. Essential supporting
documentation is available in all the languages. Electronic Submission

Electronic communication connecting regulators

& the regulated
One of the important visions of ICH is the exchange of electronic documents and records. To achieve this vision,
MedDRA was created along with specifications for the content needed to exchange electronic Individual Case Safety
Reports (ICSRs). MedDRA is used within the ICSR for medical history (diagnoses, surgical procedures), reported
cause of death, reactions/events, laboratory terms and indication for drug use. MedDRA and the ICSR accelerate
exchange of information and increase the efficiency with which important regulatory information is shared.
MedDRA is an essential tool for those engaged in regulating, monitoring, marketing, or researching the use of
pharmaceutical products.

www.meddra.org 5
In the ICH regions, Europe and Japan require the use of MedDRA by pharmaceutical companies, while in the United
States, although not required, it is the de facto standard. Other regulators also either recommend the use of
MedDRA (including Australia, Canada and Singapore) or require it (Saudi Arabia). MedDRA and the ICSR can also
be used for regulator-to-regulator and company-to-company (licence agreements or co-development)
communication.
MedDRA is already in wide usage with more than 3,700 subscribing organisations around the world including
numerous regulators. Many subscribing organisations are outside of the ICH regions.

Free for regulators, affordable for all

A MedDRA subscription is available without charge to each governmental regulator, while non-profit organisations
conducting non-commercial work, direct patient care providers, educational institutions and non-profit medical
libraries can have access to MedDRA at either a nominal cost or no cost at all. The cost for commercial users
increases as the subscriber’s revenue increases.
Special Licences are also available allowing MedDRA’s use by smaller commercial users without charge in
non-downloadable format within electronic systems designed to allow companies to meet their regulatory reporting
requirements. One such system for which a Special Licence has been granted is the European Medicines Agency’s
EudraVigilance system. This allows certain small and micro-sized enterprises to enter data using MedDRA without
the need for a MedDRA subscription.

MedDRA remains very The MSSO is tasked with maintenance of the

Robust much an ICH initiative. terminology, including the addition of new terms,
Oversight Each of the six ICH updating the hierarchy, distributing the new

by Experts members name

representatives to the
versions of MedDRA (including SMQs), training of
users and managing subscriptions. Each year,
MedDRA Management Board, as do Health there are two updates to MedDRA.
Canada and the Medicines and Healthcare A Japanese Maintenance Organization (JMO) has
products Regulatory Agency of the UK (MHRA). also been established to support users in Japan
The Board works under the ICH Steering and works closely with the MSSO to provide
Committee. It is responsible for ensuring that Japanese user input into MedDRA and to
subscriber needs are met, through continuous translate MedDRA into Japanese. The JMO
development and maintenance that meets the reports to a Japanese Management Board (JMB)
highest standards. The Board is also responsible which includes representation from the Japanese
for overseeing the activities of the organisation drug regulatory authority and pharmaceutical
that acts as the Maintenance and Support industry. The JMB in turn reports to the ICH
Services Organization (MSSO). Oversight MedDRA Management Board.
consists of frequent meetings with MSSO
personnel, clinical audits and financial audits.

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 “As a powerful and truly international terminology, MedDRA is core to protect public health. By
providing a multilingual and routinely maintained extensive medical coding standard, safety data
can be analysed faster and consistently throughout the life cycle of a medicinal product. This allows for
improved decision making, timely information of healthcare professionals and to better safeguard patients.”

Sabine Brosch, Pharmacovigilance and Risk Management Sector, EMA

EU MedDRA Management Board Representative

WHO EU

IFPMA UK MHRA

PhRMA EFPIA

Health Canada MHLW

FDA JPMA

MedDRA is an important ICH product for the communication of clinical

information. It is mature, current and available in many languages. Use of
MedDRA allows information exchange and analysis among many partners over
the entire lifespan of products in an efficient manner with accuracy and
reproducibility.

www.meddra.org 7
MedDRA: Network and
Infrastructure
This section is intended for those who need an in-depth understanding of MedDRA and provides
a detailed description about how MedDRA is structured, maintained, and supported, as well as
highlighting the materials available to MedDRA subscribers.

Structure of MedDRA
The most important reason to “code” data into a
Glossary of
standardised terminology is to analyse it. A benefit of MedDRA Terms
MedDRA is in its support of straightforward as well as
sophisticated analyses. MedDRA can be used to SOC System Organ Class
analyse individual medical events (e.g., Influenza) or
HLGT High Level Group Term
issues involving a system, organ or etiology (e.g.,
Infections) using its hierarchical structure. MedDRA HLT High Level Term
can be used for signal detection and monitoring of PT Preferred Term
clinical syndromes whose symptoms encompass LLT Lowest Level Term
numerous systems or organs using its multiaxial
SMQ Standardised MedDRA Query
hierarchy or though the special feature of
Standardised MedDRA Queries (SMQs).

Hierarchical system

At first, the structure of MedDRA sounds complicated. However, the structure is very logical. There are five levels to
the MedDRA hierarchy, arranged from very specific to very general.

System Organ 26
Classes

High Level Group Terms > 330

High Level Terms > 1,700

Preferred Terms > 20,000

Lowest Level
> 70,000
Terms
Over 70,000 “Lowest Level Terms” (LLTs) parallel how information is communicated, reflecting how an observation
is reported in practice. This level directly supports assigning MedDRA codes within a user database.

Over 20,000 “Preferred Terms” (PTs) are single concepts for symptoms, signs, disease diagnoses, therapeutic
indications, investigations, surgical or medical procedures, and medical, social or family history characteristics.

Related PTs are grouped together into over 1,700 “High Level Terms” (HLTs) based upon anatomy, pathology,
physiology, etiology or function. HLTs are in turn linked to over 330 “High Level Group Terms” (HLGTs).

Finally, HLGTs are grouped into 26 “System Organ Classes” (SOCs) which are grouped by etiology (e.g., Infections
and infestations), manifestation site (e.g., Gastrointestinal disorders) or purpose (e.g., Surgical and medical
procedures). There is also a SOC accounting for social circumstances.

Multiaxial structure
SOC = Respiratory,
Even a single medical concept can be examined from SOC = Infections thoracic and
several points of view. For example, the PT Influenza and infestations mediastinal
disorders
represents an important respiratory tract problem as
well as an infection. For this reason, each PT is
assigned to a primary SOC, but may also be assigned
to one or more secondary SOCs. The multiaxial HLGT = HLGT =
Viral infectious Respiratory
structure of MedDRA supports signal detection and
disorders tract infections
signal monitoring. The PT Influenza is primary to the
SOC Infections and infestations, but this PT is also
secondary to the SOC Respiratory, thoracic and
mediastinal disorders. HLT = Viral upper
HLT = Influenza respiratory tract
viral infections infections

PT = Influenza

“In co-licensing, MedDRA enables faster and more accurate review of the safety profile of
another company’s product. I have experienced due diligence efforts pre and post MedDRA and
can attest to the vast difference that this common terminology has made when there are tight timelines.”

Christina Winter, Global Clinical Safety & Pharmacovigilance, GlaxoSmithKline R&D

EFPIA MedDRA Management Board Representative

www.meddra.org 9
SMQs assist with signal detection
SMQs may also be used to further support signal detection and monitoring. SMQs are validated, pre-determined sets
of MedDRA terms grouped together after extensive review, testing, analysis and expert discussion. A SMQ can be
wide in reach, such as Taste and smell disorders, or specific, such as the SMQ on Agranulocytosis. Currently, more
than 90 SMQs have been created. Additional SMQs are created as the need arises.

SMQs are complex and varied in concept. Some SMQs are a simple set of PTs while other SMQs are hierarchical
containing subordinate SMQs. SMQs can include “narrow” and “broad” terms. Narrow terms are those that are highly
likely to represent the condition of interest. For example, the PTs Pancreatitis acute and Pancreatitis haemorrhagic
are narrow terms for the Acute pancreatitis (SMQ) whereas the PT Blood bilirubin increased is a broad term. Not all
instances of increased blood bilirubin are indicative of acute pancreatitis. SMQ retrievals may be limited to narrow
terms if desired.

All SMQs have been validated for sensitivity and specificity and are actively maintained to reflect changes in
MedDRA. The Council for International Organizations of Medical Sciences (CIOMS) Working Group, in collaboration
with ICH, has been instrumental in the development and maintenance of SMQs. The CIOMS Working Group on
SMQs is composed of senior scientists from several drug regulatory authorities, international pharmaceutical
companies, the MSSO, the JMO, the WHO, and other institutions.

“MedDRA is an excellent and unique medical terminology. It enables us to communicate safety

data of medicines easily and globally, not only with healthcare companies, but also with
regulators. We can also contribute to the continual enhancement of MedDRA through the change
request process, since MedDRA is a “live” terminology. Working in the MedDRA world is really wonderful!”

Yo Tanaka, Chugai Clinical Research Center, Chugai Pharmaceutical Co., Ltd.

JPMA MedDRA Management Board Representative

A collaborative standardisation project

MedDRA was based on a terminology belonging to the Medicines and Healthcare products Regulatory Agency
(MHRA) of the UK and was developed by the ICH partners, including the WHO. The intention was to establish a
standardised terminology which would eliminate the use of different terminologies through the different stages of the
development of medicines, such that separate terminologies for subjects like patient diagnoses and adverse reactions
are not needed. This required the development of a terminology that was clinically correct, highly structured, rich in
available terms, and could be standardised across regulatory bodies and the pharmaceutical industry. Further
important aims were to have a terminology to transmit electronic data files and that could support multiple languages.
MedDRA meets these goals.

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Language neutral to
maximise data sharing MedDRA Facilitates
All MedDRA data are stored using numerical codes for
Electronic
each term. While these codes have no inherent Communication
meaning, they allow efficient database management.
MedDRA is an important component of the
These codes also allow easy use of multiple
CTD whereby pharmaceutical companies
languages. Each code is unique to a single MedDRA
assemble all quality, safety and efficacy
term and can be displayed (decoded) in the desired
information into one format for all ICH
language in an efficient manner. Thus, an Individual
regulatory authorities. In addition, MedDRA is
Case Safety Report (ICSR) from one country can be
a necessary part of the electronic submission
easily understood in all the other countries, and is
of ICSRs using the ICH E2B standard. This is
another important public health benefit of MedDRA.
beneficial to everyone as information can be
quickly and efficiently exchanged, allowing
more resources to be expended on the
content of the ICSR and less on data
management.

Preferred Term Code English Spanish Japanese

10022000 = Influenza = Influenza =

10047470 = Viral myocarditis = Miocarditis vírica =

10027599 = Migraine = Migraña =

Compatible with other terminologies

The MedDRA Management Board recognises that there is a need for interoperability with other terminologies. For
example, a collaborative effort has been undertaken between the ICH and the Uppsala Monitoring Centre (UMC) of
the WHO to develop a mapping between WHO Adverse Reaction Terminology (WHO-ART) and MedDRA to make
the WHO Vigibase™ database compatible with both MedDRA and WHO-ART. This allows access to over 7 million
ICSRs in either terminology, making it a powerful tool for public health and signal detection. This mapping, available
from UMC, can be used to convert legacy data from WHO-ART to MedDRA. Another example involves compatibility
across cancer research. Since CTCAE version 4.0, all the terms in the Common Terminology Criteria for Adverse
Events (CTCAE), used and maintained by the US National Cancer Institute (NCI) of the National Institutes of Health
(NIH), are themselves LLTs of MedDRA.

www.meddra.org 11
Governance ensures the integrity of updates
MedDRA is an extensive and highly organised terminology. Experience with previously used terminologies
demonstrated that terminologies must change as new medical knowledge develops. Thus, one of the ICH
requirements was that MedDRA be maintained. That is, terms must be added or updated as knowledge grows, with
careful review so that changes are medically correct and the logical structure and consistency are retained. To meet
this requirement, ICH created a governance structure, the MedDRA Management Board, to nurture and protect the
integrity of MedDRA.

Management Board

Japanese
Management Board

Secretariat

MSSO JMO
Maintenance and Support Japanese Maintenance
Services Organization Organization

User Community

Blue Ribbon SMQ Advisory

Expert Panel
Panel Panel

User Groups

The professionals who are members of the Board use An ICH Expert Working Group, the MedDRA Points to
MedDRA in their daily work. Therefore, there is strong Consider Working Group (PtC WG), has also been
interest in ensuring that subscriber needs are met. established to create and maintain guiding principles
The Board has created initiatives to improve on the use of MedDRA (how to select MedDRA terms
MedDRA, such as expanding the original scope to and retrieve and present MedDRA coded data).
include the creation of SMQs and clinical events When appropriate, the Board works with independent
associated with vaccines and drug-device organisations, such as CIOMS which has established
combinations. a Working Group that helps manage SMQ creation,
The MedDRA Management Board has supported the updating and documentation.
convening of expert groups, called Blue Ribbon
Panels to examine such scope changes.

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Maintenance and support
Maintenance of the terminology and support for users are key components of MedDRA’s success.

Maintenance and continuous development

Part of the responsibility of the MedDRA Management Board is oversight of the MSSO. The MSSO’s responsibilities
include: addition of new terms and changes to existing terms; placement of terms in the hierarchy; review of the
hierarchy as medical concepts change; coordination of translations; coordination of changes in documentation;
updating SMQs as terms are added or updated; creation of tools to help users (browsers, MedDRA Version Analysis
Tool (MVAT), change request system); and release and distribution of new versions of MedDRA. Since all of this
must also protect the clinical integrity of MedDRA, personnel at MSSO include a number of international medical
doctors as well as computer experts. Subscription fees cover these extensive services.

“MedDRA has been designed for long term use – since no Lowest Level Terms are ever
deleted, it ensures no events are “lost” even when searching for information originally coded
in a much earlier version.”

Hilary Vass, Medical Coding, Biogen Idec Ltd.

EFPIA MedDRA Management Board Representative

Support from experts

The MedDRA Management Board is continuously working to ensure that subscribers have the support they need.
Every subscriber has access to the MedDRA website (www.MedDRA.org) that offers extensive information, help and
resources. All support materials are available on this website and the MSSO/JMO can be directly contacted for
further support.

The MedDRA Management Board is continuously working

to ensure that subscribers have the support they need

Since MedDRA has been in wide use for more than a decade, considerable expertise is available to support those
who wish to use it. This support includes documentation, help from the MSSO/JMO, training, electronic tools and
knowledgeable peers.

www.meddra.org 13
Written support

MedDRA is always current with two releases

annually. The first annual release in the spring
includes changes to all levels in MedDRA (if any
occur). The second release in the autumn is
minor and only includes changes to terms at the
PT and LLT levels (e.g., new terms, spelling
changes, non-current LLTs). With both releases,
there are easily understood documents detailing
the changes (listings, explanations, version
reports, SMQ spreadsheets).

With both releases,

there are easily understood
documents detailing the changes
(listings, explanations, version reports, SMQ spreadsheets)

Each new version of MedDRA has updated guides for MedDRA itself and the SMQs. These guides are available as
PDF files in all 11 MedDRA languages and can be easily shared:

• The “MedDRA Introductory Guide” includes the rules and conventions used for spelling, abbreviations, word order,
punctuation, naming conventions for terms at all levels, anatomical considerations and an explanation and
rationale of what is included in each SOC;

• The “SMQ Introductory Guide” details such information as design concepts, the definition of “narrow” and “broad”
terms, and how to take full advantage of each SMQ. Each SMQ is given a definition of its intent as well as
inclusion and exclusion criteria;

Guidance for use of the electronic files with explanations of the file structure is described in the document entitled
“MedDRA Distribution File Format Document”.

Two “Points to Consider” (PtC) documents – “MedDRA Term Selection” and “MedDRA Data Retrieval and
Presentation” are available in English and Japanese and provide invaluable advice on the use of MedDRA. Both
documents are updated, as needed, with the release of each new version of MedDRA, by members of the ICH
MedDRA PtC WG who are expert users.

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Direct support and helpdesk

Direct support can be obtained from the MSSO/JMO and a helpdesk is available. Subscribers may submit change
requests to MedDRA using the WebCR tool, by e-mail or via the helpdesk. Change requests are a way for
subscribers to contribute to keeping MedDRA current. As new medical knowledge evolves, subscribers are likely to
encounter the new medical concept first. By making a request for a change to MedDRA, subscribers bring this new
knowledge into the terminology in a timely manner.

MedDRA User Group meetings are also organised and provide an opportunity to discuss MedDRA-related topics
and network with other MedDRA users.

Training

Online Support
Guides

Electronic Tools

www.meddra.org 15
Training and electronic tools

Extensive training on MedDRA is available in a MedDRA Browsers

variety of languages in addition to a range of
powerful computer tools which help users to get Two types of MedDRA “browsers” are
the most out of the terminology. available to subscribers. One is intended
for your personal computer and one is
Free face-to-face training sessions are conducted accessible via the internet. The browsers
at locations around the globe. include the entire hierarchy of MedDRA
terms and allow examination in detail from
Virtual training sessions (webinars) and recorded various points of view. They can be used
videocasts/webinars are available on the as aides to assigning MedDRA codes to
MedDRA website. data or to create search strategies. All
levels of MedDRA can be searched for
Browsers are available to help navigate MedDRA. specific words or combinations of words
or searches can be limited to specific
MVAT is another available tool which allows levels of MedDRA terms. Synonyms are
subscribers to assess the impact of any changes available. For example, using the
in their data due to version changes in MedDRA. synonym function, a search for the word
The user can see changes in MedDRA terms “skin” also retrieves the word “derm”.
between any two versions, find how these Using the browsers, one can view all
changes may impact their data and search terms within a hierarchy. You can also
specific terms for changes. view the available SMQs, their content,
and a term’s scope (narrow versus broad).

MedDRA has become the standard medical terminology for drug regulators and
pharmaceutical companies in the ICH region. MedDRA allows easy
communications with others and is a powerful tool for public health monitoring.
Availability in multiple languages makes it accessible to the widest numbers of
users. After more than a decade of use, MedDRA has a wealth of experience
around it with a strong maintenance programme to keep it current and numerous
tools to support subscribers.

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 www.meddra.org

Contact MSSO at [email protected]

International Conference on Harmonisation of Technical Requirements
for Registration of Pharmaceuticals for Human Use

2013
ICH Secretariat
e-mail: [email protected]
www.ich.org

MedDRA® trademark is owned by IFPMA on behalf of ICH