Stream: terminology
Topic: SNOMED qualifiers in Extensions
Simone Heckmann (Oct 01 2021 at 09:28):
On a similar note:
We have an extension "agegroup" in the german base profiles with a binding to a list of SNOMED qualifier values. It is intended as an extension on Date or Age where exact values are not known (e.g. "I recieved this diagnosis in my youth", "I had this procedure in my infancy" etc.).
We have now received a comment that SNOMED qualifier values cannot be used by themselves and that we should instead use the postcoordinated form, e.g.:
<concept>
<code value="105726004:246454002=41847000"/>
<display value="Age AND/OR growth finding (finding) : Occurrence (attribute) = Adulthood (qualifier value)"/>
</concept>
<concept>
<code value="105726004:246454002=263659003"/>
<display value="Age AND/OR growth finding (finding) : Occurrence (attribute) = Adolescence (qualifier value)"/>
</concept>
<concept>
<code value="105726004:246454002=255398004"/>
<display value="Age AND/OR growth finding (finding) : Occurrence (attribute) = Childhood (qualifier value)"/>
</concept>
<concept>
<code value="105726004:246454002=713153009"/>
<display value="Age AND/OR growth finding (finding) : Occurrence (attribute) = Toddler (qualifier value)"/>
</concept>
We intend to refuse this change request on the grounds that the values, in fact, do not stand alone (the Extension estabishes context, in our opinion much better so than the post-coordination). Our reference is the guidance section on Observation that allows the usage of qualifiers for Observation.value. We argue that an Extension establishes context in a similar way the Observation does.
Is our take on this correct?
Robert McClure (Oct 02 2021 at 12:09):
In short, I agree that for this specific situation: the use of concepts that describe age periods, use of them as an extension is very clear and SCT expressions are never widely understood.
I will say that the initial text in section 10.1.4.5 Refining the interpretation of an Observation using additional codes or Observations is pretty clear:
The following list provides guidance on using codes or other observations to provide additional context that may alter how an observation is interpreted.
But the examples are not clear (I have no idea what #2 is really saying) so my agreement is based on assuming the initial text is consistent with your addition of an extension.
Last updated: Apr 12 2022 at 19:14 UTC
