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Difference between revisions of "Specializing reason relationship for flavors of indications"

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''(This is a template. Do not edit. Copy and paste its source to a new page)''
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NOTE: Harmonization proposal on public display here for the purpose of commenting and collaborative editing. All your edits are tracked and nothing gets lost. FEEL FREE to improve the proposal and to add any question you want to raise in the discussion. Thanks!
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Editing of harmonization proposals prior to a harmonization meeting is restricted to the proposal submitter and the co-chairs of the steward comittee. Other changes will be undone. Please add comments to the "discussion" page associated with this proposal.
 
  
 
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|bgcolor="#bbbbff"| '''RECOMMENDATION ID:'''
 
|bgcolor="#bbbbff"| '''RECOMMENDATION ID:'''
 
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|| Submitted by: Gunther Schadow
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|| Revision (# and date):
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|| Revision (# and date): 2
 
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|| Date submitted: 20050212
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|| Committee status:
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|| Committee status: open
 
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|| Submitted by:
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|| Submitted by: Gunther Schadow
 
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|| NAME: ActRelationship.typeCode for reason
 
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|bgcolor="#aaaaff" align=center| '''AFFECTED ENTITIES OF INTEREST TO TC''' <br/> (responsibility level: S=Steward; I=Interested)
 
|bgcolor="#aaaaff" align=center| '''AFFECTED ENTITIES OF INTEREST TO TC''' <br/> (responsibility level: S=Steward; I=Interested)
 
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== Issue ==
 
== Issue ==
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''One paragraph summary of the issue and the solution as detailed in this proposal.''
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Need to be more specific about the nature of an indication (reason).
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== Current State ==
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Has reason (RSON) has one specialization already: mitigates (MTGT). No other place to qualify reasons to say how specifically something is a reason.
  
 
== Recommendation(s) ==
 
== Recommendation(s) ==
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Add additional ActRelationship subtypes of “has reason” (RSON), thius expanding the hierarchy
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for types of reasons (indications). Currently HL7 has:
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  - RSON - has reason (indication)
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  - - MTGT - mitigates
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and we can propose to add:
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  - - MTGT.ADJ - adjuct mitigation
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  - - CURE - curative indication
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  - - CURE.ADJ - adjunct curative indication
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  - - DIAG - diagnosis of, (i.e., used in the diagnosis of the indicated disease.)
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  - - SYMP - symptomatic relief
  
  
 
== Rationale ==
 
== Rationale ==
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The change is a logical extension of the finer nuances that are already been made with the difference between has-reason and mitigates, it's necessary to describe indications better.
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The change is motivated to complete the U.S. national SPL project with FDA and all of Pharma Industry to provide improved drug labeling in HL7 v3 format. It is implementing a requirement from the Physician’s Labeling Rule that became effective in January 2006.
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== Workaround Considered ==
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Attaching some arbitrary observation, but that would be an abuse of observations.
  
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For the use case at hand -- indication for treatment -- we could use a has-generalization to a SubstanceAdministration code which would classify the administration act as to its intent to mitigate, cure, diagnose, etc. This seems the wrong place to do it, as we are truly qualifying the reason or rationale of administering a substance.
  
 
== Recommended Action Items ==
 
== Recommended Action Items ==

Revision as of 03:46, 17 February 2006

NOTE: Harmonization proposal on public display here for the purpose of commenting and collaborative editing. All your edits are tracked and nothing gets lost. FEEL FREE to improve the proposal and to add any question you want to raise in the discussion. Thanks!

Recommendation for HL7 RIM Change RECOMMENDATION ID:
Submitted by: Gunther Schadow Revision (# and date): 2
Date submitted: 20050212 Committee status: open
Submitted by: Gunther Schadow  
NAME: ActRelationship.typeCode for reason  

Stewards Position

REQUIRED - This table should contain one row for each Steward Committee affected by the recommendation.

TC RECOMMENDATION APPROVAL STATUS AFFECTED ENTITIES OF INTEREST TO TC
(responsibility level: S=Steward; I=Interested)
O&O Unknown I
RCRIM Unknown I
PC Unknown I

Issue

Need to be more specific about the nature of an indication (reason).

Current State

Has reason (RSON) has one specialization already: mitigates (MTGT). No other place to qualify reasons to say how specifically something is a reason.

Recommendation(s)

Add additional ActRelationship subtypes of “has reason” (RSON), thius expanding the hierarchy for types of reasons (indications). Currently HL7 has: 

 - RSON - has reason (indication)
 - - MTGT - mitigates

and we can propose to add: 

 - - MTGT.ADJ - adjuct mitigation
 - - CURE - curative indication
 - - CURE.ADJ - adjunct curative indication
 - - DIAG - diagnosis of, (i.e., used in the diagnosis of the indicated disease.)
 - - SYMP - symptomatic relief


Rationale

The change is a logical extension of the finer nuances that are already been made with the difference between has-reason and mitigates, it's necessary to describe indications better.

The change is motivated to complete the U.S. national SPL project with FDA and all of Pharma Industry to provide improved drug labeling in HL7 v3 format. It is implementing a requirement from the Physician’s Labeling Rule that became effective in January 2006.

Workaround Considered

Attaching some arbitrary observation, but that would be an abuse of observations.

For the use case at hand -- indication for treatment -- we could use a has-generalization to a SubstanceAdministration code which would classify the administration act as to its intent to mitigate, cure, diagnose, etc. This seems the wrong place to do it, as we are truly qualifying the reason or rationale of administering a substance.

Recommended Action Items

  • Implement the proposed solution


Resolution

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