“No Known Problems” validation error with code 55607006

[Chien Dinh]

Hello,

 

We are receiving the following error when we are trying to validate the test data in the ETT.

 

Error - 

The scenario contains problem observation for Problem Code: 55607006 , however there is no matching observation in the submitted CCDA.

Line number: 0

 

We are following the IG when it comes to indicating No Known Problems in the CCDA:

 

 

Note "observation/value" in the text above. That is explicitly referring to the <value> node of the observation, not the <code> node. In the herokuapp link  (http://hl7-c-cda-examples.herokuapp.com/examples/view/7353a215efda8dfe3fbacb19abbb90756ce14bab) that has been used as the correct example of indicating No Known Problems, we have noticed that the example is placing the SNOMED 64572001 in the <code> node instead of the <value> node, and then placing the 55607006 in the <value> node instead.  Additionally, according to our testing into this, the ETT is validating the xml along those lines as well.

 

However this seems to go against what the IG is saying and we’d like for this contradiction to be clarified as soon as possible.

 

Thanks,

Chien

[Brett Marquard]

Hi, Chien,

 

What are you placing in your observation/code?

 

The HL7 example task force agreed ‘No known problems’  is best represented by observation/code=64572001 (condition) and observation/value=55607006 (problem) with negationInd=true.

 

The guidance in the IG is about no known conditions – which you could argue is the same thing…If easy to change to best practice please do so.

 

Best,

Brett

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[Chien Dinh]

Hi Brett,

Currently we are using <code> = 282291009 and <value>=64572001 which according to the IG should be valid.  We tested a few other scenarios on the ETT and it looks like the ETT is only looking for the observation/value=55607006 along with the negationInd=true.  The combinations we tested are below:

1. <code> = 64572001  <value> = 55607006

No Error

2. <code> = 64572001  <value> = 282291009

Error found (Same error as found in my original post)

3. <code> = 55607006  <value> = 64572001

Error found (Same error as found in my original post)

4. <code> = 55607006  <value> = 282291009

Error found (Same error as found in my original post_

5. <code> = 282291009 <value> = 55607006

No Error

6. <code> = 282291009 <value> = 64572001

Error found (Same error as found in my original post)

Based on the results from ETT,we can deduce that 55607006 is expected in value tag. But as per IG, the value 55607006 is valid for a <code> and not <value>, because the code sets from which the 55607006 is selected is different for <code> and
<value>. (Screenshots of IG below, highlighting different value sets):

[Brett Marquard]

Than you Chien.

 

If you search VSAC (https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.88.12.3221.7.4/expansion) you will see the 55607006 value present in both value sets. If you wish to discuss why, or have suggestions to improve, please come to a HL7 Structured Documents call (Thursdays 10-11 PM EDT).

 

 

 

 

From: edge-te...@googlegroups.com [mailto:edge-te...@googlegroups.com] On Behalf Of Chien Dinh
Sent: Thursday, July 27, 2017 10:22 AM
To: Edge Test Tool (ETT) <edge-te...@googlegroups.com>

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