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  1. FHIR Specification Feedback
  2. FHIR-43539

Observation.value Omission

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US Core (FHIR)
    • 7.0.0-ballot
    • Cross-Group Projects
    • US Core Average Blood Pressure Profile
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      Background

      Changing the guidance to 

      • the Observation.value[x] element SHALL be omitted  

      is equivalent to constraining out Observation.value by setting its maximum cardinality to 0.  However, the US Core design adheres to the FHIR best practice of avoiding constraining elements because it can limit interoperability and reuse of the profile even if no scenarios can be currently identified.

      Further, US Core profiles provide the floor for standards development for specific use cases, allowing for further profiling.  Authors of these and other implementation-specific profiles can choose to constrain Observation.value if they choose.

       

      Decision:

      Change 

      Observation.value max = 0 ( constraint out element) 

      Guidance will be 

      • the Observation.value[x] element SHALL be omitted  

      Note that this does not change the US Core design adheres to the FHIR best practice of avoiding constraining elements, but in this case a single LOINC and panel codes is an exception.

       

       

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      Background Changing the guidance to  the  Observation.value [x]  element  SHALL be omitted   is equivalent to constraining out Observation.value by setting its maximum cardinality to 0.  However, the US Core design adheres to the FHIR best practice of avoiding constraining elements because it can limit interoperability and reuse of the profile even if no scenarios  can be currently identified. Further, US Core profiles provide the floor for standards development for specific use cases, allowing for further profiling.  Authors of these and other implementation-specific profiles can choose to constrain Observation.value if they choose.   Decision: Change  Observation.value max = 0 ( constraint out element)  Guidance will be  the  Observation.value [x]  element  SHALL be omitted   Note that this does not change the US Core design adheres to the FHIR best practice of avoiding constraining elements, but in this case a single LOINC and panel codes is an exception.    
    • Hans Buitendijk/Brett Marquard: 46-0-4
    • Clarification
    • Compatible, substantive

    Description

      The Profile Specific Implementation Guidance indicates:

      Because the blood pressure values are communicated in the mandatory systolic and diastolic components:

      • the Observation.value[x] element SHOULD be omitted

      It seems that the Observation.component.value and .dataAbsentReason would always be used to either have a value or a reason why it is not valued when 96607-7 is used.  Therefore it is unclear that Observation.value SHOULD be omitted rather than stating it SHALL be omitted.  Suggest to change the "SHOULD" to a "SHALL" to avoid that Observation.value includes something that has no meaning or would be hard to understand.  If there is a scenario where it is reasonable to have a value in Observation.value that should be clarified, but we are not aware of any.

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            Unassigned Unassigned
            hbuitendijk Hans Buitendijk
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              Created:
              Updated:
              Resolved: