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  1. FHIR Specification Feedback
  2. FHIR-31298

Make BIRADS Assessment Cateogry Code Definitions Extensible.

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    • Type: Change Request
    • Status: Triaged (View Workflow)
    • Priority: Highest
    • Resolution: Persuasive
    • Specification:
      US Breast Cancer Radiology Reporting (FHIR)
    • Raised in Version:
      current
    • Work Group:
      Clinical Interoperability Council
    • Related Artifact(s):
      BiRads(r) Assessment Category Codes CodeSystem
    • Related Section(s):
      13.44.2
    • Grouping:
    • Resolution Description:
      Hide

      The BiRads values are required in two places.

      a) In discrete Observations as components.
      Another component can be added to the Observation.Component field with any coded values desired, allowing both BiRads value and any other desired code set value to allow future values.

      b) In Observation grouping classes where the Observation.value[x] is the birads value.
      I moved the birads value from Observation.value[x] to Observation.Component so that the solution detailed in a will also work here.

      c)  DiagnosticReport.ConclusionCode.
      Currently this is bound to the birads value and forced cardinality of 1. 

      This will be modified to slice the conclusionCode and set cardinality at 1..* so new codes can also be appended here.

       

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      The BiRads values are required in two places. a) In discrete Observations as components. Another component can be added to the Observation.Component field with any coded values desired, allowing both BiRads value and any other desired code set value to allow future values. b) In Observation grouping classes where the Observation.value [x] is the birads value. I moved the birads value from Observation.value [x] to Observation.Component so that the solution detailed in a will also work here. c)  DiagnosticReport.ConclusionCode. Currently this is bound to the birads value and forced cardinality of 1.  This will be modified to slice the conclusionCode and set cardinality at 1..* so new codes can also be appended here.  
    • Change Category:
      Correction
    • Change Impact:
      Non-compatible
    • Pre Applied:
      Yes
    • Applied for Version:
      current

      Description

      The codes defined are not fully inclusive of codes used or that may be defined in the future by the U.S. FDA's MQSA program. Radiologists may use other assessment codes to indicate interim statuses or more granual assessments, some of which are endorsed by the FDA's MQSA program. The FDA's MQSA program may also include additional codes in the future. Suggest adding an "other" code or adding codes for commonly used assessments that are not currently included.

      (Comment 5 - imported by: Jean Duteau)

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              Assignee:
              Unassigned Unassigned
              Reporter:
              bzeug@epic.com Ben Zeug
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                Created:
                Updated:
                Resolved: