Stream: Orders and Observation WG
Topic: Follow-up on #17518
Christine D (Jul 27 2018 at 15:13):
Just wanted to check in on #17518. There was discussion about category. In looking at the existing list, it matches our requirements for category (LBCAT in CDISC), but not the subcategory (LBSCAT), which is a level lower. We would want to capture both 'Chemistry' (category) and 'Electrolytes' (subcategory). We don't see a way to do that with the current DIAGNOSTIC REPORT resource.
Suggestions for filling that gap? Our proposal was to add subcategory as a codeable concept 0..1, just like category (which is already on DR), but with a different value set.
Other options?
Christine D (Jul 27 2018 at 15:16):
Link is https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=17518
Lloyd McKenzie (Jul 27 2018 at 16:02):
It's not clear why the proposed solution - send both in category.coding won't work.
Christine D (Jul 27 2018 at 16:07):
@Lloyd McKenzie then would the codes for category be extended to include both category and subcategory values?
Christine D (Jul 27 2018 at 16:09):
Or do we need a new code list for the subcategory values?
Christine D (Jul 27 2018 at 16:11):
it feels like we need to somehow differentiate the two. have system point to existing category list for category and system point to new subcategory list for subcategory?
Lloyd McKenzie (Jul 27 2018 at 16:16):
If you want to have systems send both, you'd create a profile that sliced Observation.category.coding by value set and specify two slices, one with the value set for category and one with the value set for subcategory. You could use different code systems for each and if you did so, differentiation would be easier, but that's not technically necessary to enforce the expectation.
Eric Haas (Jul 27 2018 at 16:24):
For me Going from category to code is a continuum of specificity and you want a point in the middle, but I don't think adding a subcategory element is any better than using code translation like LLoyd suggests.
Lloyd McKenzie (Jul 27 2018 at 16:28):
The primary challenge is that your category might be someone else's sub-category. And someone else might have need for a sub-sub-category.
Christine D (Jul 27 2018 at 16:31):
How would we go about adding terms to the existing category vocabulary? Is that a tracker?
Lloyd McKenzie (Jul 27 2018 at 16:52):
Yes, that would be a change request, though there's no guarantee that all of your preferred categories will make it into HL7's preferred category set. It's totally possible to send an HL7 category, an SDTM LBCAT and an STDM LBSBCAT as alternative codings within Observation.category
Christine D (Jul 27 2018 at 17:50):
Ah, ok. So we just need to be able to point to the coding system? It doesn't need to reside within HL7?
Lloyd McKenzie (Jul 27 2018 at 18:51):
No. The preferred code system is defined by HL7, but you're allowed to send codes from whatever code systems you prefer.
Lloyd McKenzie (Jul 27 2018 at 18:52):
If the binding had been 'required' (or 'extensible' and the observation fell within the valueset), then you'd be expected to send the HL7 code, but would still have been free to include additional codes from other code systems.
Christine D (Jul 27 2018 at 19:08):
Thanks for the clarification. I think we can close that tracker. I don't have edit privs to be able to withdraw it.
Lloyd McKenzie (Jul 27 2018 at 19:18):
Add a comment indicating that you wish to withdraw and we can change the status for you. (Unfortunately gForge isn't terribly flexible in terms of edit privileges - it's all or nothing.
Last updated: Apr 12 2022 at 19:14 UTC
