Stream: implementers
Topic: Negation of comorbidity
Shlomy Reinstein (Nov 21 2016 at 07:58):
I work in the Oncology domain, and currently with DSTU2. I model patient's comorbidities, such as diabetes, heart conditions, using Condition resource. For each comorbidity, there are 3 options I need to model:
(1) The patient has (suffers from) this comorbidity.
(2) The patient does *not* have this comorbidity.
(3) We do not know whether or not the patient has this comorbidity.
The difference between (2) and (3) is important for the clinicians. Option (1) is the default; just having a Condition resource that specifies the comorbidity. Option (3) can be modeled as inexistence of such resource; if there is no diabetes resource for the patient, it means I don't know if the patient has diabetes or not. However, how do I model option (2) - negation?
The initial thought was to extend the value-set of the "Condition.clinicalStatus" field. Is this possible in FHIR? It does not seem possible with the HAPI FHIR client library that we're using.
Should I use an extension of Condition resource to indicate that the patient does not suffer from the comorbidity? If so, then should it be an extension of a specific field, or an extension of the resource itself?
Stefan Lang (Nov 21 2016 at 08:59):
What about Condition.verificationStatus="refuted" for (2)?
Stefan Lang (Nov 21 2016 at 09:02):
You may even consider verificationStatus="unknown" for (3) to differentiate between "I don't know" (status unknown) and "I have no data" (absence of resource)
Shlomy Reinstein (Nov 21 2016 at 10:36):
Thanks @Stefan Lang !
Michelle (Moseman) Miller (Nov 28 2016 at 23:36):
Refer to http://build.fhir.org/condition.html#9.2.3.5
Last updated: Apr 12 2022 at 19:14 UTC
