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  1. FHIR Specification Feedback
  2. FHIR-40811

Cancer Disease Status

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US Minimal Common Oncology Data Elements (mCODE) (FHIR)
    • 3.0.0-ballot [deprecated]
    • Clinical Interoperability Council
    • Cancer Disease Status Profile
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      The purpose of this profile is to track the disease status.  
      A qualifier code for metastasis has been added and the disorder codes for remission have been replaced with qualifier codes based on SNOMED guidance that FHIR Observations should be answered with code from the qualifier hierarchy or finding hierarchy (see https://confluence.ihtsdotools.org/display/FHIR/Observation+binding). To assure backward compatibility with this change, the two disorder codes will be moved into a maximum value set, while the following becomes the preferred binding:

      Code System Display
        268910001 http://snomed.info/sct Patient's condition improved (finding)
        359746009 http://snomed.info/sct Patient's condition stable (finding)
        271299001 http://snomed.info/sct Patient's condition worsened (finding)
        709137006 http://snomed.info/sct Patient condition undetermined (finding)
        550991000124107 http://snomed.info/sct Malignant neoplasm in full remission (disorder)
        551001000124108 http://snomed.info/sct Malignant neoplasm in partial remission (disorder)
      103338009 http://snomed.info/sct "In full remission (qualifier value)"
      103337004 http://snomed.info/sct "In partial remission (qualifier value)"
      399409002 http://snomed.info/sct "Distant metastasis present (finding)"

      This strategy allows implementers time to transition to the qualifier values, while legacy applications can still use the two disorder codes.

       

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      The purpose of this profile is to track the disease status.   A qualifier code for metastasis has been added and the disorder codes for remission have been replaced with qualifier codes based on SNOMED guidance that FHIR Observations should be answered with code from the qualifier hierarchy or finding hierarchy (see https://confluence.ihtsdotools.org/display/FHIR/Observation+binding). To assure backward compatibility with this change, the two disorder codes will be moved into a maximum value set, while the following becomes the preferred binding: Code System Display    268910001 http://snomed.info/sct Patient's condition improved (finding)    359746009 http://snomed.info/sct Patient's condition stable (finding)    271299001 http://snomed.info/sct Patient's condition worsened (finding)    709137006 http://snomed.info/sct Patient condition undetermined (finding)    550991000124107 http://snomed.info/sct Malignant neoplasm in full remission (disorder)    551001000124108 http://snomed.info/sct Malignant neoplasm in partial remission (disorder) 103338009 http://snomed.info/sct "In full remission (qualifier value)" 103337004 http://snomed.info/sct "In partial remission (qualifier value)" 399409002 http://snomed.info/sct "Distant metastasis present (finding)" This strategy allows implementers time to transition to the qualifier values, while legacy applications can still use the two disorder codes.  
    • D Pyke / M Kramer : 11-0-0
    • Enhancement
    • Compatible, substantive

    Description

      In review of the Cancer Disease Status Profile, it appears that a link can be made to the Secondary Cancer Condition Profile to support the provided status value. Though this modelling allows for a more detailed rationale for the status, it would be good to allow for a summary of the patient's condition without being required to proliferate a secondary resource in a FHIR message that may be unwarranted or unneeded for particular use cases. Is it possible to add the following code to the Condition Status Trend Value Set:  SNOMED CT 128462008. If this is not possible, what would be the alternative for reliably retrieving this information?

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            stan_rankins Stan Rankins
            Gail Winters
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              Updated:
              Resolved: