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  1. FHIR Specification Feedback
  2. FHIR-34144

Variant valueCodeableConcept too constrained. Conflicts with USCoreLabResultObservation.

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    • Icon: Change Request Change Request
    • Resolution: Not Persuasive
    • Icon: Medium Medium
    • Genomics Reporting (FHIR)
    • Clinical Genomics
    • Variant
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      FHIR subgroup proposed to not make this change (Feb 14, 2022), so marking as Not Persuasive.

      could include both codings:
      Loinc to fulfiil the CG binding and SCT for US-Core

      Show
      FHIR subgroup proposed to not make this change (Feb 14, 2022), so marking as Not Persuasive. could include both codings: Loinc to fulfiil the CG binding and SCT for US-Core
    • Kevin P / Bob F : 9 - 0 - 2

    Description

      Recent changes in US Core USCoreLabResultObservation (http://hl7.org/fhir/us/core/STU4/StructureDefinition-us-core-observation-lab.html) has added an invariant on value[x] such that for codeableConcepts, us-core-4: SHOULD use SNOMED CT for coded Results.
      This broke validation of mCODE examples for CancerGenomicVariant profile which tried to align with the CGWG Genomics Reporting IG whereby the Variant valueCodeableConcept is tightly bound to LOINC Answer List LL1971-2 (required) but also derives from US Core Lab Result Observation.

      Suggestions:

      • would it be possible for CGWG to relax the binding for Variant:Observation.valueCodeableConcept to (preferred) instead?
      • Should Variant create a SNOMED value set with terms equivalent to what is found in LOINC Answer List LL1971-2?

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            may_terry May Terry
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