Stream: implementers
Topic: Searching for a negated result
Shamil Nizamov (Apr 06 2021 at 23:08):
In a number of clinical resources (e.g., AllergyIntolerance, Condition), to store the negated result, e.g., "no known allergy/condition", the spec recommends to use the List resource with List.emptyReason.code="notasked".
Why to use the List resource instead of the NullFlavor value set for the .code element?
And, there is nothing in the search parameters for a resource to inform that the List resource needs to be included into the search as well.
Eric Haas (Apr 07 2021 at 00:42):
I would like to know the rationale as well. It makes no sense to me to "jump ship" and represent the no known allergy/condition concept in a List resource when you would expect to fetch the patient's Allergies resource to find out what and whether they are allergic to. I think there must be some rather big undocumented assumptions to make these assertions. Anyhow we will be discussing these issues and more on this week's CGP call in the context of US Core
Lloyd McKenzie (Apr 07 2021 at 01:09):
Assertion of "none known" is something that can only reasonably be done at the "collection" level. If you create an AllergyIntolerance that says "none known" and another that says "allergic to peanuts", what does that mean?
That said, the implementer community hasn't really gotten on board with the notion of using List - in part because they've taken the approach that the only AllergyIntolerances that will be exposed from an endpoint are those that are "in the List", rather than exposing all information they have available, including duplicates, information received from documents, etc. which was sort of the expectation for initial design. The intention had been that the authoritative lists of allergies would be a curated subset of the complete set of instances available. As such, there might be a historical record or two of allergies or intolerances available for query from the endpoint that had since been refuted/subsided but you would have an empty List resource that declared "no known allergies".
Last updated: Apr 12 2022 at 19:14 UTC
