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  1. FHIR Specification Feedback
  2. FHIR-39359

Primary Cancer Condition.AssertedDate

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    • Icon: Change Request Change Request
    • Resolution: Not Persuasive
    • Icon: Medium Medium
    • US Minimal Common Oncology Data Elements (mCODE) (FHIR)
    • 2.0.0 [deprecated]
    • Clinical Interoperability Council
    • Primary Cancer Condition Profile
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      Specific use cases can change optional to required. If the element is required in mCODE, use cases in which the asserted date is unknown (for example, if the code for "history of breast cancer" is present) would be hampered. 

      We encourage users who want to change optional elements to be required to suit specific use cases to create a profile based on the current profile to accomplish this. 

       

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      Specific use cases can change optional to required. If the element is required in mCODE, use cases in which the asserted date is unknown (for example, if the code for "history of breast cancer" is present) would be hampered.  We encourage users who want to change optional elements to be required to suit specific use cases to create a profile based on the current profile to accomplish this.   
    • Jim McClay/Saul Kravitz :8-0-0

    Description

      This feedback is from the CDC on behalf of their Central Cancer Registry Reporting IG effort to support transmission of EHR data to cancer registries to meet reporting requirements.

      1. Primary Cancer Condition.AssertedDate
        1. Clinicians require some kind of date the cancer was first recognized and we could find no date in mCODE that was required in the Primary Cancer Condition Profile.
        2. Currently, mCODE has the cardinality of AssertedDate as 0..1.  I believe this data element, which is the date the cancer was first observed/identified/diagnosed (which is what registries require) is vital for all cancer care. 
        3. When we discussed the rationale for having cardinality = 0..1 with the mCODE team, they indicated that not all use cases would require a date the cancer was first identified.  As subject matter expert, I believe this is unlikely and would like the mCODE to actively reconsider its decision.
        4. In the event the date is not available, FHIR has a companion data element DataAeasonAbsent that is completed when DateAssertedDate is not populated.  For the very few use cases that truly do not need a date, their IG can have instructions to  use the appropriate null value and set DateReasonAbsent to “unknown” or “not asked” (subject matter expert recommendation).

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            ssebastian Sharon Sebastian
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