Stream: terminology
Topic: using the 2nd level of a code system
Diane (Dec 07 2021 at 23:20):
A. Is it possible to use only the 2nd level of the codeystem for the answer options in a questionnaire? (A previous question has already established the data for the 1st level).
B. If yes, would this be the correct syntax? I don't need to include some direction that this is level 2?
"answerOption" : [
{
"valueCoding" : {
"system" : "https://www.hl7.org/fhir/codesystem-adverse-event-seriousness",
"code" : "SeriousResultsInDeath",
"display" : "Results in death"
}
},
{
"valueCoding" : {
"system" : "https://www.hl7.org/fhir/codesystem-adverse-event-seriousness",
"code" : "SeriousIsLifeThreatening",
"display" : "Is Life-threatening"
}
},
etc.
C. Is https://www.hl7.org/fhir/codesystem-adverse-event-seriousness a valid code system? I found it at https://www.hl7.org/fhir/codesystem-adverse-event-seriousness.html but the url https://www.hl7.org/fhir/codesystem-adverse-event-seriousness gives a 404 error. Also, the directory at https://terminology.hl7.org/codesystems.html lists a code system https://terminology.hl7.org/CodeSystem-adverse-event-seriousness.html which is only the level 1 values.
etc.
Grahame Grieve (Dec 08 2021 at 00:37):
A. yes
B. yes.
c. it was only partially moved and is in editorial error. You'll have to ask the patient care committee what their intent is (@Rob Hausam)
Rob Hausam (Dec 08 2021 at 11:45):
@Diane I don't recall any particular details on this, including why only the top-level codes are in the THO copy. I'm not sure if PCWG made a decision to do this, or if it was done (by BRRR) prior to PCWG becoming the owner or somehow in the process of the incorporating into THO. @Michelle (Moseman) Miller?
Diane (Dec 13 2021 at 22:59):
@Michelle (Moseman) Miller I am trying to use the 2nd level of https://www.hl7.org/fhir/codesystem-adverse-event-seriousness in our IG.
Grahame says that this is only partially moved and is in editorial error. What is the status of this codesystem?
The directory at https://terminology.hl7.org/codesystems.html lists a code system https://terminology.hl7.org/CodeSystem-adverse-event-seriousness.html which is only the level 1 values. I need the 2nd level values. Will this be fixed soon?
Michelle (Moseman) Miller (Dec 13 2021 at 23:08):
In build (emerging R5), Patient Care voted to remove the second level codes, per J#22994
In R4, the code system had second level codes, per http://hl7.org/fhir/codesystem-adverse-event-seriousness.html
I can't explain why the R4 terminology page seems to have pulled in the R5 changes
CC: @Rob Hausam @Grahame Grieve
Grahame Grieve (Dec 22 2021 at 07:07):
I can't explain why the R4 terminology page seems to have pulled in the R5 changes
umm. which page @Michelle (Moseman) Miller ?
Michelle (Moseman) Miller (Dec 22 2021 at 14:43):
https://terminology.hl7.org/CodeSystem-adverse-event-seriousness.html
Grahame Grieve (Dec 22 2021 at 19:44):
that is the R5 content
Diane (Dec 22 2021 at 19:57):
In our use case of reporting adverse events resulting from clinical research studies to the IRB (Institutional Review Board), the IRB needs to see the granularity of the 2nd level values. Since the 2nd level values are not published as a HL7 terminology, then is our best option to create a custom code system for use within our IG?
Grahame Grieve (Dec 22 2021 at 21:36):
possibly, if no one else defines it. I would've thought that SCT would cover that kind of concept (I assumed that's why it was dropped)
Michelle (Moseman) Miller (Dec 23 2021 at 15:02):
Why does the yellow banner at the top say it is based on FHIR R4?
That confusion aside, J#22994 has the justification for the change, which is essentially a separation of seriousness vs outcome. While seriousness is an example binding that can support being profiled with other value sets, many of the former 2nd level codes seem more like outcomes ("results in... "), so I question whether we need a change request logged to either loosen the binding strength of outcome or expand the outcome value set.
Grahame Grieve (Dec 23 2021 at 19:35):
Why does the yellow banner at the top say it is based on FHIR R4?
good question. It shouldn't say that for terminology.hl7.org
Lloyd McKenzie (Dec 23 2021 at 21:57):
I suspect because the IG does say that and the template spits out what the IG says. ImplementationGuides can't not depend on a particular FHIR version. We'll have to tweak the UTG template to hide it.
Grahame Grieve (Dec 23 2021 at 21:58):
it's not the UTG template. That's the release management code
Lloyd McKenzie (Dec 23 2021 at 21:59):
I suspect either the header or footer has something from the template...
Grahame Grieve (Dec 23 2021 at 22:01):
yes the 'based on FHIR 4.0.1' in the footer does come from the template
Diane (Jan 20 2022 at 13:13):
My IG needs the values in the ICSR which are different than SCT values. Since http://hl7.org/fhir/codesystem-adverse-event-seriousness.html is apparently cancelled, but I still need to reference a codesystem for our questionnaires, I am still trying to decide what to do for both the Level 1 and Level 2 values.
A. Level 1 values (Serious; non-serious)
I noticed that this IG: http://hl7.org/fhir/us/icsr-ae-reporting/ uses valueset http://hl7.org/fhir/us/icsr-ae-reporting/ValueSet-ICSRAESeriousness.html which references https://terminology.hl7.org/3.0.0/CodeSystem-adverse-event-seriousness.html.
Can my FHIR R4 IG reference https://terminology.hl7.org/3.0.0/CodeSystem-adverse-event-seriousness.html for the top-level values? Or is https://terminology.hl7.org/3.0.0/CodeSystem-adverse-event-seriousness.html only for FHIR R5 IGs?
B. Level 2 values (eg. Results in death; Is Life-threatening; etc.)
Should we reference https://ich.org/page/e2br3-individual-case-safety-report-icsr-specification-and-related-files for the codesystem? The download https://admin.ich.org/sites/default/files/inline-files/E2B%28R3%29_IG_Complete_Package_v1_08.zip from that page contains the IG with the Level 2 values.
Should we create our own custom codesystem in our IG?
Should we open a jira ticket to have Level 2 of http://hl7.org/fhir/codesystem-adverse-event-seriousness.html reactivated?
It seems like sooner or later someone else is going to need ICSR code system for seriousness, so I want to do what is best for the community and not just me.
Jean Duteau (Jan 20 2022 at 14:17):
If you look further at the ICSR AE Reporting guide, we have a 2nd value set that includes the ICSR codes: http://hl7.org/fhir/us/icsr-ae-reporting/ValueSet-ICSRSeriousness.html. This is using the ICSR codes and some FDA codes. The ICSR codes are found in the code system that has the following OID: 'urn:oid:2.16.840.1.113883.3.989.2.1.1.19' .
Diane (Jan 20 2022 at 23:28):
@Jean Duteau has helped with the 2nd level.
As for the 1st level, I still need a code system that works with R4. @Grahame Grieve @Lloyd McKenzie What did you decide about http://terminology.hl7.org/CodeSystem/adverse-event-seriousness? Is that a R5 code system (with a malfunctioning yellow banner from the wrong template?) If yes, where is the valid R4 code system?
Jean Duteau (Jan 21 2022 at 04:12):
I'm not sure why you think this is a "R5" code system. It's a code system that is available on terminology.hl7.org, so it's available for use by any IG. I'm using that code system in my IG as you noted.
Last updated: Apr 12 2022 at 19:14 UTC
