Stream: terminology
Topic: VSAC introduces Intensional definitions
Robert McClure (Dec 21 2018 at 14:09):
Reposting an exciting announcement from the NLM:
VSAC Intensional Definition Functionality
The National Library of Medicine (NLM) Value Set Authority Center (VSAC), with support from the Centers for Medicare and Medicaid Services (CMS), is pleased to announce the launch of Intensional Value Set Definition Functionality in the VSAC Authoring Tool.
Through the VSAC Authoring user interface, value set authors can algorithmically define value sets with logical rule-based Boolean clauses and hierarchy operators, leveraging the structure and hierarchies of terminologies. Logically-defined value sets, combined with the value set author’s guidance, can incorporate future changes as terminologies evolve to add or remove concepts, increasing efficiency and accuracy of value set creation and maintenance.
An example of a rule-based value set could be: include all codes that are descendantsOf the SNOMED CT® code for ‘Clinical finding’, exclude all codes that are descendantOrSelfOf of ‘Wound finding’.
This first deployment of VSAC Intensional Functionality provides support for hierarchy functions for several terminologies. Later in 2019 we will add intensional functionality for more terminologies, including RxNorm and LOINC®.
You can learn more in our VSAC Support Center: Create an Intensional Value Set
You can contribute to the improvement of this application by sending feedback and ideas to the NLM Support Center. We especially would love to hear from you about specific intensional value sets you want to be able to create in VSAC in the future using RxNorm or LOINC.
Peter Jordan (Dec 22 2018 at 01:31):
Interesting. Are the value set definitions produced by this tool persisted as FHIR ValueSet resources?
Grahame Grieve (Dec 22 2018 at 05:46):
do you mean 'availabe as', or 'stored as'?
Peter Jordan (Dec 22 2018 at 20:52):
My question was whether the definitions are stored as a FHIR ValueSet resources - if so, one would hope that they might be available as such on request. However, it would also be of interest to know if the output generated by the Expand/Publish button is a FHIR ValueSet resource... https://www.nlm.nih.gov/vsac/support/authorguidelines/createvs.html#expand -noting that there is no mention of FHIR in the page as a whole and the Value Set identifiers are OIDs.
Grahame Grieve (Dec 23 2018 at 20:02):
there is a FHIR API for vsac, so I expect that these new value sets are available on that API
Robert McClure (Dec 31 2018 at 19:27):
I'm embarrassed to say that I don't know how the FHIR API works with expression-based definitions. The VSAC FHIR API currently only works against published value sets, and as of today (2018-12-31) there are no expression-based ("intensional") value sets published. While in testing mode the FHIR API did not run against the sandbox and I forgot to ask about this. But tomorrow, we'll have one published (I assume) since I just published one. So we can all test it on value set 2.16.840.1.113762.1.4.1021.40 (MDP Test Intensional) - a SCT value set with an INCLUDE of
concept Equal ("390802008:Goal achieved (finding)...")
OR
concept descendantOrSelfOf ("390801001:Goal not achieved (finding)...")
that should generate 4 codes:
390801001 Goal not achieved (finding) SNOMEDCT 2018-03 Active
390802008 Goal achieved (finding) SNOMEDCT 2018-03 Active
706905005 Goal not attainable (finding) SNOMEDCT 2018-03 Active
706906006 No progress toward goal (finding) SNOMEDCT 2018-03 Active
Robert McClure (Jan 02 2019 at 02:43):
Tested today and the new Intensional value sets are now published but are "not found" by the FHIR API.
Peter Jordan (Jan 07 2019 at 23:25):
@Robert McClure the compose section of the FHIR intensional value set would look like this (on my Server)
<compose>
<include>
<system value="http://snomed.info/sct" />
<version value="http://snomed.info/sct/21000210109/version/20181101" />
<filter>
<property value="constraint" />
<op value="=" />
<value value="390802008 OR DESCENDANTORSELFOF 390801001" />
</filter>
</include>
</compose>
When an expansion is requested, the Server executes the (SCT ECL) constraint and returns the relevant concepts.
Michael Lawley (Jan 14 2019 at 06:32):
I would have expected a non-ECL definition like:
"compose": { "include": [ { "system": "http://snomed.info/sct", "concept": [ { "code": "390802008", "display": "Goal achieved" } ] }, { "filter": [ { "property": "concept", "op": "is-a", "value": "390801001" } ], "system": "http://snomed.info/sct" } ] }
Last updated: Apr 12 2022 at 19:14 UTC
