Consol Assessment Scale Supporting Observation code

[Kevin Walsh]

On line 3316 (and a number of other places) of the attached document we are getting a validation error. Should this be an error when a nullFlavor="UNK" is present?

Error - 

Consol Assessment Scale Supporting Observation V2 SHALL contain exactly one [1..1] value with @xsi:type="CD" (4515-16754)

/ClinicalDocument/component/structuredBody/component[5]/section/entry[23]/observation/entryRelationship/observation

Line Number: 3326

<!-- Assessment Scale Observation (v2) USCDI V3 IGpg66 -->
          <entry>
            <observation classCode="OBS" moodCode="EVN">
              <templateId root="2.16.840.1.113883.10.20.22.4.69" extension="2022-06-01"/>
              <id root="5d1d895c-2dc0-50dc-9b38-6160269735c4"/>
              <code nullFlavor="UNK">
                <originalText>
                  <reference value="#social_hist_assess-3"/>
                </originalText>
              </code>
              <statusCode code="completed"/>

[Kim Poletti]

Hi - Thanks for reaching out. This has been logged for review and a member of the team will reach out in the near future.

[kylem...@gmail.com]

Looking at this CCDA and the validation error report, I think the issue is not in the Assessment Scale Observation (2.16.840.1.113883.10.20.22.4.69) section quoted above, but rather it is with the Assessment Scale Supporting Observation (2.16.840.1.113883.10.20.22.4.86).

                            <entryRelationship typeCode = "COMP">
                                <observation classCode = "OBS" moodCode = "EVN">
                                    <templateId root = "2.16.840.1.113883.10.20.22.4.86" extension = "2022-06-01"/>
                                    <id root = "ad804f53-b761-5b1a-8f9d-7d1958c55e16"/>
                                    <code nullFlavor = "UNK">
                                        <originalText>
                                            <reference value = "#social_hist_obs-3.1"/>
                                        </originalText>
                                    </code>
                                    <statusCode code = "completed"/>
                                    <value xsi:type = "ED">
                                        <reference value = "#social_hist_obs_rsp-3.1"/>
                                    </value>
                                </observation>
                            </entryRelationship>

I think it is throwing an error because of the xsi:type NOT being CD data type. Like if you replace any of those <value> elements in the Scale Observation as follows the errors would go away

                                    <value
                                        xsi:type = "CD"
                                        code = "LA28397-0"
                                        displayName = "Often true"
                                        codeSystem = "2.16.840.1.113883.6.1"/>

But I think this is a bug in the validator.

In the spec (https://www.hl7.org/ccdasearch/templates/2.16.840.1.113883.10.20.22.4.86.html), it says that we must have a value, but it does not require a specific value type. However, it has a note in there that says If xsi:type="CD", MAY have a translation code to further specify the source if the instrument has an applicable code system and value set for the integer (CONF:14639) (CONF:4515-16755).

It appears the tool has made this note into a MUST that the data type must be the coded (CD) value. I believe it needs to be relaxed to allow different value types. 

[nagesh bashyam]

It is the value element that it is complaining about, not the code element.

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[Kyle Meadors]

I agree - it is the <value> element of the Assessment Scale Supporting Observation. My question is should it be throwing an error? It seems like it wants the <value> data type to be CD when I don't think the spec requires only that data type.

BTW, this is not my CCDA - just following up on this thread. 

--

Kyle Meadors
@kylemeadors

[Kevin Walsh]

Thank you for the correction, Kyle.

As shared above Nagesh, the  <value> element of the Assessment Scale Supporting Observation still appears to be valid according to the spec. Nothing is binding the value xsi:type to "CD". There is just a note saying "  If xsi:type="CD", MAY have a translation code to further specify the source if the instrument has an applicable code system and value set for the integer (CONF:14639) (CONF:4515-16755)"

[Ann Marie Dunn]

Is there an update for this issue? Should this be giving an error?  

[Kim Poletti]

Hello,

The team is working on this issue, and it will be included in a future release.

Thank you,

Kim

[James Spillman]

A change was deployed to production last night allowing values other than "CD". Please retest.