Section 10.122.1.1 Mandatory and Must Support Data Elements. US Core Screening Response Observation Profile should include a MUST SUPPORT element for recording multiple answer for a screening question in a single observation. These components do not necessarily stand on their own, they are generally validated as useful only in context of the full set of components of an evaluation tool. LOINC may include a stand-alone observation that seems similar to a component of an existing evaluation tool but that is because the item is separately collected and validated. The suggestion that using multiple observations seems to contradict that concept and flatten out a purposely integrated set of questions. The result may lead to inaccurate decision making by clinicians and patients alike. Implementations should not be encouraged to break apart terminology to enable inaccurate conclusions.