Comment:

Mayo Clinic recommends creating a parent concept for equal, equivalent, narrower, wider, and inexact called "related to." Mayo Clinic is requesting the parent concept "related to" be added to the value set: https://hl7-fhir.github.io/valueset-concept-map-equivalence.html (gForge Tracker # 10437). Mayo has not asserted map equivalence for the many mappings we have developed and maintain in our terminology server. We suspect this may be the case for other organizations as well, either that the map equivalence has not been asserted or the terminology servers do not support this richness.

Summary:

Required value set is problematic in asserting map equivalence.