FHIR Chat · Race Code System · IG creation

Stream: IG creation

Topic: Race Code System

view this post on Zulip Sarah Gaunt (May 06 2021 at 21:56):

So I'm trying to use the us-core-race extension. The example in the US Core IG has:

<extension url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
    <extension url="ombCategory">
      <valueCoding>
        <system value="urn:oid:2.16.840.1.113883.6.238"/>
        <code value="2106-3"/>
        <display value="White"/>
      </valueCoding>
    </extension>

If I try to use urn:oid:2.16.840.1.113883.6.238 I get Code System URI 'urn:oid:2.16.840.1.113883.6.238' is unknown so the code cannot be validated

So I looked in the VSAC package and saw: "http://terminology.hl7.org/CodeSystem/v2-0005". So I replaced urn:oid:2.16.840.1.113883.6.238 with that.

Now I am getting: "The Coding provided (http://terminology.hl7.org/CodeSystem/v2-0005#2054-5) is not in the value set http://hl7.org/fhir/us/core/ValueSet/omb-race-category, and a code is required from this value set. (error message = Not in value set http://hl7.org/fhir/us/core/ValueSet/omb-race-category)"

When I look up the OID there are two pages: https://terminology.hl7.org/2.1.0/CodeSystem-PHRaceAndEthnicityCDC.html and https://terminology.hl7.org/2.1.0/CodeSystem-v2-0005.html

How does this work? Why can't I get what is working in the US Core example to work in my IG?

The code 2054-5 is clearly in the value set: http://hl7.org/fhir/us/core/ValueSet/omb-race-category. But with the urn:oid:2.16.840.1.113883.6.238 code system, which I can't get to work...

view this post on Zulip Sarah Gaunt (May 06 2021 at 22:03):

My dependency is to the US Core January ballot version (because ballot comments wanted us to use the new Vital Records profiles). Obviously we will have to point to the published US Core once it's published. Could this have anything to do with it?

view this post on Zulip Sarah Gaunt (May 06 2021 at 22:14):

I'm thinking that this might have something to do with the fact that in the new version of US Core - one of the value sets is defined in VSAC and the other isn't... Might have to use different values for the same code system... (http://hl7.org/fhir/us/core/2021Jan/ValueSet-omb-race-category.html and https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.1.11.14914/expansion).

Coincidentally I'm just talking to @Eric Haas and @Brett Marquard about moving that one that isn't in VSAC into VSAC...

view this post on Zulip Eric Haas (May 06 2021 at 22:24):

Now I remember that there is a problem with this race and vsac thing;

  • CDCREC codes and code system value ( OID vs ? defined in package or by VSAC ????) see this Zulip for details per 12/2 FMG won't be able to sort out by ballot.

view this post on Zulip Sarah Gaunt (May 06 2021 at 22:27):

Thanks @Eric Haas !

view this post on Zulip Sarah Gaunt (May 06 2021 at 22:40):

So based on that thread - right now there is nothing that I can do to get the examples to validate? We have to wait until a VSAC alignment is done?

view this post on Zulip Eric Haas (Jun 09 2021 at 02:21):

OK I investigated this further and downloaded the VSAC expansion for race valueset 2.16.840.1.114222.4.11.8 336 (https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836/$expand) and it appears they are using the OID for the code system. But @Grahame Grieve when I open up the valueset 2.16.840.1.114222.4.11.836 in the us.nlm.vsac#0.3.0 package file it is using the url:http://cts.nlm.nih.gov/fhir/cs/cdcrec:

resourceType: ValueSet
id: 2.16.840.1.114222.4.11.836
meta:
  versionId: '1'
  lastUpdated: '2012-10-25T12:28:31.000-04:00'
text:
  status: generated
url: 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.836'
version: '20121025'
name: Race
status: active
date: '2012-10-25T12:28:31-04:00'
publisher: CDC NCHS
compose:
  include:
    - system: 'http://cts.nlm.nih.gov/fhir/cs/cdcrec' #<<<<<not 2.16.840.1.114222.4.11.836!
      concept:
        - code: 1002-5
          display: American Indian or Alaska Native
        - code: 2028-9
          display: Asian
        - code: 2054-5
          display: Black or African American
        - code: 2076-8
          display: Native Hawaiian or Other Pacific Islander
        - code: 2106-3
          display: White
        - code: 2131-1
          display: Other Race

view this post on Zulip Eric Haas (Jun 09 2021 at 02:26):

I am pretty sure this is causing validation errors for patient race values like those that can be seen here: http://build.fhir.org/ig/HL7/US-Core/qa.html and described by Sarah

When do you think you can look into this?

view this post on Zulip Grahame Grieve (Jun 14 2021 at 06:48):

well, first of all, where is this code system actually meant to be defined?

view this post on Zulip Eric Haas (Jun 14 2021 at 15:48):

I am not sure what you mean. All I want is the code system to be consistently the OID throughout and the errors to go away.

view this post on Zulip Grahame Grieve (Jun 14 2021 at 16:42):

the code system actually has to be defined somewhere for the errors to go away

view this post on Zulip Eric Haas (Jun 14 2021 at 18:32):

Following the breadcrumbs here:

image.png

view this post on Zulip Eric Haas (Jun 14 2021 at 18:45):

http://build.fhir.org/ig/HL7/UTG/CodeSystem-v3-Race.html

view this post on Zulip Eric Haas (Jun 14 2021 at 18:54):

except they don't use the same OID that is used in CCDA and FHIR (2.16.840.1.113883.6.238):

there are two other codessytems called: CodeSystem: PH_RaceAndEthnicity_CDC which do use the OID, but don't enumerate any codes so this seems to be a muddled mess

I guess the next step is to harangue HTA... https://chat.fhir.org/#narrow/stream/179202-terminology/topic/US.20CDCREC.20codessystems.20in.20HTA/near/242645695

view this post on Zulip Grahame Grieve (Jun 14 2021 at 19:59):

right. raise it on #terminology, because I can't solve that

view this post on Zulip Eric Haas (Jun 17 2021 at 06:20):

So now we have determined the issue with CDCREC codesystem, we put the CDCREC code system back into US Core until HTA can get that sorted out. This resolves many but not all of the errors with race and ethnicity

view this post on Zulip Eric Haas (Jun 17 2021 at 06:21):

These errors remain:

image.png

view this post on Zulip Eric Haas (Jun 17 2021 at 06:22):

And I believe there are related to the nlm vsac package version 0.3.0.

view this post on Zulip Eric Haas (Jun 17 2021 at 06:25):

the code systems in the package for the following value sets are not in alignment with the latest VSAC expansions I downloaded.

view this post on Zulip Eric Haas (Jun 17 2021 at 06:29):

for example for valueset 877:

package file:

{
  "resourceType": "ValueSet",
  "id": "2.16.840.1.114222.4.11.877"
  ...
  "compose": {
    "include": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v2-0005",  #<<<< SHOULD BE OID
        "version": "1.2",
        "concept": [
        ....

view this post on Zulip Eric Haas (Jun 17 2021 at 06:32):

vs direct expansion from VSAC:

<?xml version="1.0" encoding="UTF-8"?>

<ValueSet xmlns="http://hl7.org/fhir">
  <id value="2.16.840.1.114222.4.11.877"/>
 ...
    <contains>
      <system value="urn:oid:2.16.840.1.113883.6.238"/>  <!-- Correct OID in expansion -->
      <version value="1.2"/>
      <code value="2137-8"/>
      <display value="Spaniard"/>

view this post on Zulip Eric Haas (Jun 17 2021 at 06:37):

So we are going work around this by using the US Core valuesets from the prior version and use vsac whenever the package is fixed.

view this post on Zulip Eric Haas (Jun 17 2021 at 16:32):

cc @Brett Marquard and @Gay Dolin

Last updated: Apr 12 2022 at 19:14 UTC


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