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  1. FHIR Specification Feedback
  2. FHIR-32893

Evidence Type value set is too constrained

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    Details

    • Type: Change Request
    • Status: Resolved - change required (View Workflow)
    • Priority: Medium
    • Resolution: Persuasive
    • Specification:
      US Minimal Common Oncology Data Elements (mCODE) (FHIR)
    • Raised in Version:
      1.16.0
    • Work Group:
      Clinical Interoperability Council
    • Related Artifact(s):
      Evidence Type
    • Grouping:
    • Resolution Description:
      Hide

      After consultation with Wendy Scharber, the value set will be built intentionally from the descendents of the following codes, with narrative explanation that systems offering a selection for this field should include at least the top level codes.

      • include codes from system SCT where concept is-a #714797009 "Histologic test (procedure)" // Rolls up to NAACR 1 - Positive Histology
      • include codes from system SCT where concept is-a #116147009 "Cytologic test (procedure)" // Rolls up to NAACR 2 - Positive Cytology
        // Rolls up to NAACR 3 - Combo of Tumor Maker + Histological Test
      • include codes from system SCT where concept is-a #108257001 "Anatomic pathology procedure (procedure)" // Rolls up to NAACR 4 - Positive microscopic confirmation, method not specified
      • include codes from system SCT where concept is-a #386344002 "Laboratory data interpretation (procedure)" // Rolls up to NAACR 5 - Positive laboratory test/marker study
      • include codes from system SCT where concept is-a #5880005 "Clinical examination (procedure)" // Rolls up to NAACR 6 Direct visualization without microscopic confirmation
      • include codes from system SCT where concept is-a #363679005 "Imaging (procedure)" // Rolls up to NAACR 7 Radiography and/or other imaging techniques without microscopic confirmation
        // NAACR 8 intentionally NOT supported - Clinical Diagnosis
        // NAACR 9 represented by no value provided – Unknown
      • include codes from system SCT where concept is-a #250724005 "Tumor marker measurement procedure (procedure)"
      Show
      After consultation with Wendy Scharber, the value set will be built intentionally from the descendents of the following codes, with narrative explanation that systems offering a selection for this field should include at least the top level codes. include codes from system SCT where concept is-a #714797009 "Histologic test (procedure)" // Rolls up to NAACR 1 - Positive Histology include codes from system SCT where concept is-a #116147009 "Cytologic test (procedure)" // Rolls up to NAACR 2 - Positive Cytology // Rolls up to NAACR 3 - Combo of Tumor Maker + Histological Test include codes from system SCT where concept is-a #108257001 "Anatomic pathology procedure (procedure)" // Rolls up to NAACR 4 - Positive microscopic confirmation, method not specified include codes from system SCT where concept is-a #386344002 "Laboratory data interpretation (procedure)" // Rolls up to NAACR 5 - Positive laboratory test/marker study include codes from system SCT where concept is-a #5880005 "Clinical examination (procedure)" // Rolls up to NAACR 6 Direct visualization without microscopic confirmation include codes from system SCT where concept is-a #363679005 "Imaging (procedure)" // Rolls up to NAACR 7 Radiography and/or other imaging techniques without microscopic confirmation // NAACR 8 intentionally NOT supported - Clinical Diagnosis // NAACR 9 represented by no value provided – Unknown include codes from system SCT where concept is-a #250724005 "Tumor marker measurement procedure (procedure)"
    • Resolution Vote:
      Saul Kravitz/Sherita Alai:4-0-0
    • Change Category:
      Correction
    • Change Impact:
      Non-compatible
    • Pre Applied:
      Yes

      Description

      CodeX state registry reporting use case stakeholders are concerned about the limited number of concepts available in the STU2 Cancer Disease Status Evidence Type Value Set. 

      EHRs usually capture the "evidence type" at a much more granular level and will be forced to "map up" to the available higher-level concepts in the value set. On the registry reporting side, research requires more granular details about the evidence type, which cannot be derived from the available higher-level concepts. 

      We request that you consider including descendants of each current concept in the value set definition. Of note, CDC stakeholders are in the midst of creating a proposed value set that is based off descendants of each concept, but then removes concepts that are not relevant.

      Of additional note, this value set has a "required" binding strength, which complicates matters.

      Please contact Wendy Scharber (ewy1@cdc.gov), Wendy Blumenthal (wfb6@cdc.gov), and Sharon Sebastian (ssebastian@mitre.org) for additional details. I have attached a draft version of the proposed updated value set, however additional review and edits are required.

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            Assignee:
            Unassigned Unassigned
            Reporter:
            ssebastian Sharon Sebastian
            Watchers:
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              Dates

              Created:
              Updated:
              Resolved:
              Vote Date: