Stream: terminology
Topic: valueset.designation.use` for `.text`
Eric Haas (May 28 2018 at 22:07):
I would like to use the valueset.designation.use for prescribing the codeableConcept.text element. I kind of thought that would be a relatively common use case if the input is from a pick list or machine generated. LIke a common name for an organization but I don't see it in http://build.fhir.org/valueset-designation-use.html ? Am I off base?
Michael Lawley (May 28 2018 at 22:13):
I believe ValueSets concept.display is the intended mechanism for indicating the test that should be displayed in the UI for selection and thus propagated to the codeableConcept.coding and thus also the appropriate value for codeableConcept.text.
Eric Haas (May 28 2018 at 22:17):
the concept name is the name that is associated with the code:
e.g.,
<code value="55423-8"/>
<display value="Number of steps in unspecified time Pedometer"/>
Nobody other than a terminologist can be loving that name or want to see it on a pick list.... ( sorry Dan :-))
Rather the .text is for non-terminologist human consumption and they would rather see something a lot more friendly like "Step Count"
Richard Townley-O'Neill (May 28 2018 at 22:47):
As I read the ValueSet docco , you can have "Number of steps in unspecified time Pedometer" in the CodeSystem's concept.display and "Step Count" in the ValueSet's concept.display.
Rob Hausam (May 28 2018 at 23:10):
Yes, I agree with @Michael Lawley and @Richard Townley-O'Neill. There is some additional detail in 4.8.5:
Any display name for a concept provided in the value set is only used in the UI. The display in a Coding must be taken from the underlying code system definition, even if a value set is referenced explicitly in the Coding (e.g. by an extension). The alternative display specified in the value set would go in CodeableConcept.text, perhaps appended to the UI label for the matching data element.
There is also the note above it that care must be taken in order to avoid "changing the meaning" of the concept when using the alternative display. If, instead you want to use concept.designation for this, as Eric is requesting, it seems to me that you could do this (with or without a code for concept.designation.use). If you want to be explicit about the use with CodeableConcept.text then the extensible binding should allow you to create and use an additional code for that.
Eric Haas (May 29 2018 at 00:27):
@Rob Hausam thanks, I always thought the same rules applied for both CodeSystem and ValueSet. Learned something new !!!
Eric Haas (May 29 2018 at 00:27):
though I suspect that the Text will be used for display as often as not too.
Eric Haas (May 29 2018 at 17:54):
@Rob Hausam after reviewing the discussion on display in ValuseSet this seems to contradict the above...
"Any display name for a concept provided in the value set is only used in the UI. The display in a Coding must be taken from the underlying code system definition, even if a value set is referenced explicitly in the Coding (e.g. by an extension). The alternative display specified in the value set would go in CodeableConcept.text, perhaps appended to the UI label for the matching data element."
I thought what you all said above is that
ValueSet...concept.display X-X-> Observation.code.coding.display = NOT My pretty human friendly term but the ugly LOINC term
but in fact
ValueSet...concept.display ---> Observation.code.text = My pretty human friendly term
...or is it not exposed at all in the Resource?
I think an example in the resource narrative would be instructive?
Grahame Grieve (May 29 2018 at 19:58):
make a task to add an example - that would be good
Eric Haas (May 29 2018 at 20:50):
Robert McClure (May 29 2018 at 23:49):
@Eric Haas You have it right so far as I understand and Rob pointed out: You need to create a value set with "Step Count" specifically enumerated as one of the members using ValueSet.compose.include.concept.code with 55423-8 as the code and "Step Count" as ValueSet.compose.include.concept.display. I for one am very wary of the freedom to screw up this gives everyone. But hopefully users will understand that the coding this generates conveys the meaning, not the display.
You and Rob found this at the end of 4.8.5
Any display name for a concept provided in the value set is only used in the UI. The display in a Coding must be taken from the underlying code system definition, even if a value set is referenced explicitly in the Coding (e.g. by an extension). The alternative display specified in the value set would go in CodeableConcept.text, perhaps appended to the UI label for the matching data element.
To me this means that when the user picks "Step Count" from the value set we are discussing creating, the the expectation is that you will use a codableConcept to do that. This means LOINC 55423-8 goes into codingand "Step Count" into CodableConcept.text.
I do want to point out something important here: You are all talking about concept.display, which happens to be in the ValueSet.compose section (the "CLD") part of the value set resource. You should not be getting the concepts to be displayed in a pick list from the compose elements, you need to be using the expansion of the value set as the members of a picklist. If you enumerate the set of concepts you want, and populate concept.display with your favorite string, then I suppose it will show up in the expansion (@Grahame Grieve - right?) as is noted in 4.8.5. Given the requirement to list each member of the value set with a specific display, I'd encourage us to consider using a ... code system supplement... as another approach to this. I know Lloyd will say that any UI display string will always be value set specific, but to that I say, nope, and here is a good example.
Eric Haas (May 30 2018 at 01:54):
As I discussed with Rob H. CodeableConcept.text definition implies more about user input than UI display and I wonder if we should provide clearer guidance there as well?
Grahame Grieve (May 30 2018 at 08:10):
yes it will be in the expansion
Grahame Grieve (May 30 2018 at 08:11):
Eric, we don't want to get into the extremely thorny question of CodeableConcept.text guidance again...
Grahame Grieve (Oct 15 2018 at 01:10):
ok. just added an example. will be published shortly
Last updated: Apr 12 2022 at 19:14 UTC
