Details
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Change Request
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Resolution: Persuasive with Modification
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Medium
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US Minimal Common Oncology Data Elements (mCODE) (FHIR)
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2.0.0 [deprecated]
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Clinical Interoperability Council
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Cancer Stage Group Profile [deprecated]
Cancer-Related Medication Administration Profile
Cancer-Related Medication Request Profile
Cancer-Related Surgical Procedure Profile -
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Jim McClay/Saul Kravitz :8-0-0
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Correction
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Non-compatible
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Yes
Description
Use case:
- If a patient has e.g., multiple separate melanomas, this would be represented with multiple Conditions conforming to PrimaryCancerCondition to represent these lesions
- The resource instances representing stage, medication, and surgical procedure should all be linked back to the correct Condition resource. There could be multiple PrimaryCancerConditions in a given patient bundle, so not having this linkage could lead to garbage data.
This linkage is done via various References
- Stage *
- PrimaryCancerCondition.stage.assessment
- CancerStageGroup.focus
- Medication
- CancerRelatedMedicationAdministration.reasonReference
- CancerRelatedMedicationRequest.reasonReference
- Procedure
- CancerRelatedSurgicalProcedure.reasonReference
These elements are currently MS in mCODE but are not required. This issue proposes making these elements min cardinality 1. Note that it's not clear if the benefits of this additional constraint would outweigh the downsides.
- Note there is a bi-directional reference for Stage. For this use case, only CancerStageGroup.focus would be 1.. as it’s realistic to have a PrimaryCancerCondition without staging, but not vice versa.