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 Core (FHIR)
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5.0.1
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Cross-Group Projects
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US Core Diagnostic Report Category Codes
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Eric Haas/Floyd Eisenberg: 14-0-0
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Clarification
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Non-substantive
Description
DiagnosticReport.category is MS and bound required to three LOINC LP codes that likely do not represent "a categorization" of any and all document codes from LOINC that can be sent using this profile. Users are struggling to understand how the linkages in LOINC for these LP codes helps computably indicate which is the best code to choose for the category. Of note, as chair of the LOINC document Ontology committee, our group has not been able to give guidance for this because we do not understand how this choice in the value set CLD was picked and what justifies its use. Our analysis of this is:
The three LP in the value set CLD def are Cardiology, Radiology, Pathology. It is unclear if anyone knows all the actual document LOINC codes that are sent using this resource and if those three categories cover all uses? The code binding is loose and there is NO linkage from those three LP codes to a LOINC subset. We believe that one of the following should be done:
- Decide by fiat that the three codes cover all documents sent. In doing this the IG must clarify that the LOINC meaning of those three codes should be ignored and any LOINC defined linkages based upon the codes being LP-type codes is not important when determining categorization. It is up to the sender to decide how to chose a category code for whatever document code they send in code,
- change the set of LOINC codes to something different that can computably be linked to actual LOINC document codes sent in the code element - we at the DO committee are struggling to figure this out and decide what the "category" idea should be therefore if this approach is chosen we must have active involvement and guidance from CGP to complete this solution,
- Admit category is useless as is and remove the MS plus make the binding extensible.