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  1. FHIR Specification Feedback
  2. FHIR-43937

Race extension cardinality / documentation does not match value set

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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 Race Extension
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      1)  Update the cardinality to 0..6 to accommodate the additional category of "Other Race"

      2) Add invariant to the race extension:  If ASKU or UNK are present, then no other race categories can be present.  

      extension.where(url = 'ombCategory').value.where(code in 'ASKU'|'UNK').exists() implies extension.where(url = 'ombCategory').count() = 1

      3)  Regarding the question  "I thought the reason "Other Race" was originally excluded was because regulations required reporting one of the 5 categories. Has this changed or does this extension no longer align with regulations?"

      From USCDI:

      Both standards are required

      • The Office of Management and Budget Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997
      • CDC Race and Ethnicity Code Set Version 1.0 (March 2000)

      Adopted at 45 CFR 170.207(f)

       

      CDC Race and Ethnicity Code Set Version 1.0 (March 2000) includes the concept: 2131-1 Other Race

      The concepts ‘Unknown’ and  ‘Asked but Unknown’ were added because of common usage patterns.

       

       

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      1)  Update the cardinality to 0..6 to accommodate the additional category of "Other Race" 2) Add invariant to the race extension:  If ASKU or UNK are present, then no other race categories can be present.   extension.where(url = 'ombCategory').value.where(code in 'ASKU'|'UNK').exists() implies extension.where(url = 'ombCategory').count() = 1 3)  Regarding the question  "I thought the reason "Other Race" was originally excluded was because regulations required reporting one of the 5 categories. Has this changed or does this extension no longer align with regulations?" From USCDI: Both standards are required The Office of Management and Budget Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997 CDC Race and Ethnicity Code Set Version 1.0 (March 2000) Adopted at 45 CFR 170.207(f)   CDC Race and Ethnicity Code Set Version 1.0 (March 2000) includes the concept: 2131-1 Other Race The concepts ‘Unknown’ and  ‘Asked but Unknown’ were added because of common usage patterns.    
    • Eric Haas/Jason Vogt: 25-0-0
    • Clarification
    • Compatible, substantive

    Description

      The ombCategory sub-extension still has cardinality of 0..5 and a comment about "5 race category codes" - but the value set now contains the 6th category code of "Other Race". While it seems highly unlikely someone would actually have all 6 of these categories, it seems wrong to limit this to 5.

      It may also be wise to include an invariant that, if a NullFlavor value is included as an ombCategory, then there shall be only a single ombCategory extension.

      Aside - I thought the reason "Other Race" was originally excluded was because regulations required reporting one of the 5 categories. Has this changed or does this extension no longer align with regulations?

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            benjamin Benjamin Flessner
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              Updated:
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