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Specification:

US Minimal Common Oncology Data Elements (mCODE) (FHIR)
Raised in Version:

2.0.0 [deprecated]
Work Group:

Clinical Interoperability Council
Related Artifact(s):

Primary Cancer Condition Profile
Secondary Cancer Condition Profile
Grouping:
- Block-STU3-B
Resolution Description:

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Added a value set binding to evidence.type on Primary and Secondary Cancer Condition. Also defined the order of evidence to be meaningful in the priority discussed in the comment.

(The reference to Cancer Disease Status in the original issue is a red herring - the issue is with the cancer diagnosis).

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Added a value set binding to evidence.type on Primary and Secondary Cancer Condition. Also defined the order of evidence to be meaningful in the priority discussed in the comment. (The reference to Cancer Disease Status in the original issue is a red herring - the issue is with the cancer diagnosis).
Resolution Vote:
Jim McClay/Saul Kravitz :8-0-0
Change Category:
Enhancement
Change Impact:
Compatible, substantive
Pre Applied:
Yes

This feedback is from the CDC on behalf of their team working on the Central Cancer Registry Reporting IG team.

Disease Status. Evidence.Type
1. I don’t remember the exact details of this one, but this data element exists in a different profile. Because it didn’t exist in the Primary Cancer Condition Profile (or Secondary Cancer Condition Profile) and it was the only data element our IG needed from the mCODE profile it is in, we had to make our own Primary Cancer Condition profile to include it.
2. We settled on Disease Status.EvidenceType as a proxy. I don’t believe it matches the cancer registry’s definition and intent. We need the physician’s declaration of how the cancer was diagnosed as a hierarchy of activities with the most invasive (autopsy/histopathology first, cytology, radiology, physicial exam, etc.)

It appears that Disease Status is based from a clinical test of some type and would not get us a value of physical exam.

We feel Evidence.Type should be a single hierarchically physician determined value and be place in Primary Cancer Condition and in Secondary Cancer Condition
It may be that I (subject matter expert) am not understanding the Disease Status Profile’s intended use well enough. An explanation/education may lead us to a different decision.