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  1. FHIR Specification Feedback
  2. FHIR-24518

Use BodyStructure rather than extensions - MCODE #101

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    Details

    • Type: Change Request
    • Status: Resolved - No Change (View Workflow)
    • Priority: Medium
    • Resolution: Not Persuasive
    • Specification:
      US Minimal Common Oncology Data Elements (mCODE) (FHIR)
    • Raised in Version:
      STU3
    • Work Group:
      Clinical Interoperability Council
    • Related Page(s):
      (NA)
    • Related Section(s):
      Extensions
    • Resolution Description:
      Hide

      This comment deserves serious consideration because of the source (Lloyd McKenzie). Lloyd's proposal is to use the BodyStructure resource instead of bodySite when a single code doesn't adequately describe a body location.

      The Condition resource provides body location code only.

      BodyStructure provides body location code, locationQualifier, morphology, description, and image.

      The mCODE body location provides: body location code, laterality, orientation, and relation to landmark. The relation to landmark includes landmark type, landmark location, distance from landmark to body location, and direction from landmark to body location. The use of landmarks is typical in determining the location of a tumor, for example, a breast tumor at 3 o'clock radially and 4 cm from the nipple of the right breast.

      Using BodyStructure "off the rack" would not be sufficient because it does not include relation to landmark. That extension would have to be added to BodyStructure. It is simpler and more direct to add the necessary extensions to bodySite instead of requiring a separate resource with yet another profile.

      Proposed resolution: Not persuasive.

      Show
      This comment deserves serious consideration because of the source (Lloyd McKenzie). Lloyd's proposal is to use the BodyStructure resource instead of bodySite when a single code doesn't adequately describe a body location. The Condition resource provides body location code only. BodyStructure provides body location code, locationQualifier, morphology, description, and image. The mCODE body location provides: body location code, laterality, orientation, and relation to landmark. The relation to landmark includes landmark type, landmark location, distance from landmark to body location, and direction from landmark to body location. The use of landmarks is typical in determining the location of a tumor, for example, a breast tumor at 3 o'clock radially and 4 cm from the nipple of the right breast. Using BodyStructure "off the rack" would not be sufficient because it does not include relation to landmark. That extension would have to be added to BodyStructure. It is simpler and more direct to add the necessary extensions to bodySite instead of requiring a separate resource with yet another profile. Proposed resolution: Not persuasive.
    • Resolution Vote:
      MayTerry/Richard Esmond: 14-0-0
    • Change Category:
      Correction

      Description

      Comment:

      [AnatomicalOrientation, Laterality, etc.] We don't have 'standard' extensions for laterality, orientation and similar information in FHIR because the expectation is that if you need those things, you'll use BodyStructure. Please do that - it can be contained if you'd like it to be.

      Specifically:

      AnatomicalOrientation

      Laterality

      RelationToLandmark (need to understand how this would be handled using BodyStructure - but that should be discussed/addressed)

      Summary:

      Use BodyStructure rather than extensions

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              Assignee:
              may_terry May Terry
              Reporter:
              lloyd Lloyd McKenzie
              Watchers:
              3 Start watching this issue

                Dates

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                Updated:
                Resolved:
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