Stream: terminology
Topic: Searching for postcoordinated code(fragements)
Patrick Werner (Nov 29 2021 at 15:07):
As the fhir search api doesn't allow for searching parts of a code - dealing with postcoordinated codes is hard. As a result we forbid post-coordination in ICD10-GM in the latest german base IG version.
Implementers complaint, that the couldn't search for one of the concepts in the postcoordinated codes.
Patrick Werner (Nov 29 2021 at 15:08):
But there are some implementers who want to use/need to use postcoordinated codes (e.g.SnomedCT ones). Is there a best practice or experience on how you still could enable searchability, or search for parts of a postkoordinated code?
Grahame Grieve (Nov 29 2021 at 18:50):
the fhir search api doesn't allow for searching parts of a code
Doesn't it? where does it say that?
Daniel Venton (Nov 29 2021 at 19:24):
I suspect @Patrick Werner is referring to the idea that most codes are represented via a Token search. Token searches by default are "exact match" style. There is no modifier on a token search that is a "contains". So when the code value is "A21.1 B32.2 C21.5" how do you search for all items with "B32.2"?
Patrick Werner (Nov 29 2021 at 19:25):
correct @Daniel Venton Thats exactly what i meant
Grahame Grieve (Nov 29 2021 at 19:27):
well, there is a mechanism for it. It's indirect, but it has to be to deal with the complexity required here.
- define a value set "all codes qualified by B32.2"
- search for all concepts in the value set
Sure, that requires work to set up - but any server is going to have to work on something like that
Grahame Grieve (Nov 29 2021 at 19:31):
on a more ad-hoc level, there's :below.
- search for :below "anything B32.2"
This is... obscure... and depends on code system semantics.
Grahame Grieve (Nov 29 2021 at 19:32):
I think that my server doesn't support either of these anyway, and I very much doubt others do. (well, my server supports value set searches, but I don't think that it supports the ICD-10 logic implied by the question)
Grahame Grieve (Nov 29 2021 at 19:32):
I did think we had some partial search arrangement on tokens, but it doesn't look like we do
Patrick Werner (Nov 30 2021 at 08:21):
and now it is too late to add i'm afraid? It would be very helpful to have :contains on token searches.
Grahame Grieve (Nov 30 2021 at 10:18):
no it's not too late to add.
Grahame Grieve (Nov 30 2021 at 10:26):
at least, not procedurally. It might be a hard to get up though
Michael Lawley (Nov 30 2021 at 10:30):
:text as a search modifier could allow this to work without changes?
Grahame Grieve (Nov 30 2021 at 12:08):
no because that searches the text, not the code
Carl Leitner (Dec 09 2021 at 17:26):
Grahame Grieve said:
well, there is a mechanism for it. It's indirect, but it has to be to deal with the complexity required here.
- define a value set "all codes qualified by B32.2"
- search for all concepts in the value set
Sure, that requires work to set up - but any server is going to have to work on something like that
For reference, ICD-11 puts post-coordinated codes in a valueset (and working on getting this exposed as FHIR now). Flagging for @Jonathan Payne and @Joe Amlung
Last updated: Apr 12 2022 at 19:14 UTC
