TreatmentIntent should be handled as a category - MCODE #106

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    • Type: Change Request
    • Resolution: Not Persuasive
    • Priority: Medium
    • US Minimal Common Oncology Data Elements (mCODE) (FHIR)
    • STU3
    • Clinical Interoperability Council
    • (NA)
    • TreatmentIntent-exte
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      Arguments FOR using category to represent TreatmentIntent:

      1) Whether a treatment is curative or palliative could be considered a categorization of the treatment.

      2) Profiles should avoid introducing unnecessary extensions.

      Arguments AGAINST using category to represent TreatmentIntent:

      1) Category is a less obvious place to look for this information, as opposed to an extension explicitly designed for the purpose.

      2) MedicationStatement.category is defined as "Indicates where the medication is expected to be consumed or administered." According to this definition, putting treatement intent into the category attribute would be inappropriate.

      3) Both MedicationStatement.category and Procedure.category are 0..1. If there the category is used for the intended purpose and already has a value, like "outpatient" or "surgical procedure", then there is no room to put TreatmentIntent.

      4) "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core simplicity for everyone."

      Based on the weight of the arguments against this change, we feel this tracker is not persuasive.

      Suggested resolution: Not persuasive.

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      Arguments FOR using category to represent TreatmentIntent: 1) Whether a treatment is curative or palliative could be considered a categorization of the treatment. 2) Profiles should avoid introducing unnecessary extensions. Arguments AGAINST using category to represent TreatmentIntent: 1) Category is a less obvious place to look for this information, as opposed to an extension explicitly designed for the purpose. 2) MedicationStatement.category is defined as "Indicates  where  the medication is expected to be consumed or administered." According to this definition, putting treatement intent into the category attribute would be inappropriate. 3) Both MedicationStatement.category and Procedure.category are 0..1. If there the category is used for the intended purpose and already has a value, like "outpatient" or "surgical procedure", then there is no room to put TreatmentIntent. 4) "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core simplicity for everyone." Based on the weight of the arguments against this change, we feel this tracker is not persuasive. Suggested resolution: Not persuasive.
    • Richard Esmond/Kurt Allen: 10-0-1

      Comment:

      TreatmentIntent should be handled as a category as it's essentially a categorization of the procedure or intervention. No need to use an extension.

      Summary:

      TreatmentIntent should be handled as a category

            Assignee:
            May Terry
            Reporter:
            Lloyd McKenzie
            Watchers:
            5 Start watching this issue

              Created:
              Updated:
              Resolved: