FHIR Chat · ECOG / Karnofsky / Performance Status - Obs or ClinImpress? · implementers

Stream: implementers

Topic: ECOG / Karnofsky / Performance Status - Obs or ClinImpress?

view this post on Zulip Thomas Wicker (Oct 12 2016 at 13:39):

Anyone know off top of head whether performance status info would go in:
1. Observation ( http://hl7.org/fhir/2016Sep/observation.html ), or
2. Clinical Impression ( http://hl7.org/fhir/2016Sep/clinicalimpression.html )?
I've looked @ examples and descriptions, and they don't seem to indicate either a "shall" or "should" re: this info. I'd think performance status would be a clinical impression (performance status = clinician's impression/assessment of pts ability to carry on normal tasks/etc.), but the Apgar note suggests intent of ClinicalImpression may be capturing items outside tools/specific scales, even with inclusion of codeable concepts.

Or maybe it can be in either, and there's no set determination yet?
More re: performance status measures (ECOG, Karnofsky, Lansky, Zubrod; see "Relationships" tab for info re: individual scales):
URL: https://ncit.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&version=16.09d&ns=NCI_Thesaurus&code=C20641

view this post on Zulip Grahame Grieve (Oct 12 2016 at 19:41):

if it's a measure, it belongs in an Observation. You could use that NCI concept directly in an observation:

view this post on Zulip Grahame Grieve (Oct 12 2016 at 19:43):

{
  "resourceType" : "Observation",
  "code" { 
    "coding" : {
      "system" : "http://ncimeta.nci.nih.gov",
      "code" : "C20641",
      "dsplay" : "Performance Status"
    }
  }, 
  ...

view this post on Zulip May Terry (Oct 13 2016 at 00:15):

Agreed that it's an observation as a measurement. Assuming that Grahame's reply was just an example, I would suggest being more explicit on the performance status type. So, for NCIt codes, Karnofsky Performance Status is C28013 and ECOG Performance Status is C102408.

view this post on Zulip Grahame Grieve (Oct 13 2016 at 00:26):

yes just an example

view this post on Zulip Thomas Wicker (Oct 20 2016 at 13:13):

Thanks! Very helpful. Seems to suggest that any scale, regardless of subjectivity, is an "observation." What matters is that the scale/tool has distinct codeable categories, not whether the scale is based on relatively-specific numbers v. based on underlying clinical impressions/assessments.

Last updated: Apr 12 2022 at 19:14 UTC


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