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  1. FHIR Specification Feedback
  2. FHIR-32340

LocationQualifier replacing Laterality

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • US Minimal Common Oncology Data Elements (mCODE) (FHIR)
    • current
    • Clinical Interoperability Council
    • Primary Cancer Condition Profile
      Secondary Cancer Condition Profile
      Tumor Specimen Profile [deprecated]
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      The LocationQualifer will be replaced by a  laterality (as in STU1) and body location qualifier components, as proposed.

      This change would be made to every place the Location Qualifier (now BodyLocationQualifier) extension is used:
         - Primary Cancer Condition, Secondary Cancer Condition
         - Tumor Specimen, Genetic Specimen
         - Cancer Related Surgical Procedure

      LateralityVS would include: (as per STU1)
         - left
         - right
         - right and left
         - midline

      The BodyLocationQualifier would include:

      • Include codes from http://snomed.info/sct where concept is-a 106233006 (Topographical modifier)
      • Include codes from http://snomed.info/sct where concept is-a 272424004 (Relative sites)
        excluding the codes in the LateralityVS that are under topgraphical modifier.

       

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      The LocationQualifer will be replaced by a  laterality (as in STU1) and body location qualifier components, as proposed. This change would be made to every place the Location Qualifier (now BodyLocationQualifier) extension is used:    - Primary Cancer Condition, Secondary Cancer Condition    - Tumor Specimen, Genetic Specimen    - Cancer Related Surgical Procedure LateralityVS would include: (as per STU1)    - left    - right    - right and left    - midline The BodyLocationQualifier would include: Include codes from  http://snomed.info/sct  where concept is-a 106233006 (Topographical modifier) Include codes from  http://snomed.info/sct  where concept is-a 272424004 (Relative sites) excluding the codes in the LateralityVS that are under topgraphical modifier.  
    • Saul Kravitz/Sherita Alai:4-0-0
    • Correction
    • Non-compatible
    • Yes

    Description

      With the replacement of Laterality  http://hl7.org/fhir/us/mcode/StructureDefinition-mcode-laterality.html  and related value set, http://hl7.org/fhir/us/mcode/ValueSet-mcode-laterality-vs.html to a more broad Location Qualifier, http://build.fhir.org/ig/HL7/fhir-mCODE-ig/StructureDefinition-mcode-location-qualifier.html  with associated value set http://build.fhir.org/ig/HL7/fhir-mCODE-ig/ValueSet-mcode-location-qualifier-vs.html    

      laterality is no longer distinguished as a separate data element. Laterality is a critical qualifier that  informs patient care, and without a clear understanding of laterality, miscommunication could occur. 

      Laterality concepts are part of the Location Qualifier value set and are not distinguished from other, more general body location qualifiers. 

      Suggest keeping laterality, and adding a more generic Body Location Qualifier extension with value set that does not include laterality concepts. 

      In person resolution requested by CDC, Radiation Therapy and Registry Reporting terminology teams. 

      FYI ssebastian

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            Unassigned Unassigned
            carmela_couderc Carmela A. Couderc
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              Updated:
              Resolved: