ICAREdata® Structured Phrases to mCODE™ Mapping Guidance

There are currently two structured phrases, including:

• Cancer Disease Status, which maps to the mCODE CancerDiseaseStatus profile; and
• Cancer Treatment Plan Change, which maps to the CarePlanWithReview profile defined in this implementation guide.

The mapping details for each structured phrase are provided below, and are aligned with mCODE v1.0 FHIR R4.

Cancer Disease Status

The Cancer Disease Status structured phrase maps to the mCODE CancerDiseaseStatus profile. Mapping details are provided in Table 1 below.

For more information on the CancerDiseaseStatus profile, please consult the mCODE specification.

Table 1. Mapping of ICAREdata Cancer Disease Status structured phrase to the mCODE CancerDiseaseStatus profile

ICAREdata Cancer Disease Status Phrase		mCODE v1.0 FHIR R4 CancerDiseaseStatus Profile Mapping
Phrase Component	Phrase Component Value	FHIR Profile Element	Terminology Binding			Notes
			Value Set	Code	Description
Lesion evaluated	Primary tumor	modifierExtension.relatedCancerCondition.ValueReference	n/a			This element should reference a resource compliant with the the PrimaryCancerCondition mCODE profile.
	Metastatic tumor		n/a			This element should reference a resource compliant with the the SecondaryCancerCondition mCODE profile.
	Not evaluated	dataAbsentReason.valueCodeableconcept	Observation Value Absent Reason	not-asked	Not Asked
Status	No evidence of disease	valueCodeableConcept	ConditionStatusTrendVS	260415000	Not detected (qualifier)
	Responding			268910001	Patient condition improved (finding)
	Stable			359746009	Patient's condition stable (finding)
	Progressing			271299001	Patient's condition worsened (finding)
	Undetermined			709137006	Patient condition undetermined (finding)
Reason	Imaging	extension.obf-evidenceType-extension.valueCodeableConcept	CancerDiseaseStatusEvidenceTypeVS	363679005	Imaging (procedure)
	Pathology			252416005	Histopathology test (procedure)
	Symptoms			711015009	Assessment of symptom control (procedure)
	Physical exam			5880005	Physical examination procedure (procedure)
	Lab results			386344002	Laboratory data interpretation (procedure)

Cancer Treatment Plan Change

The ICAREdata Cancer Treatment Plan Change structured phrase maps to the CodeX ICAREdata FHIR profile CarePlanWithReview defined in this implementation guide.

The allowable values for the structured phrase include information about whether a treatment change was made, as well as a reason, when a change did take place. In the CarePlanWithReview profile, this translates into two separate elements: one that captures whether a change took place, and another that holds the reason for the change. Mapping details for this structured phrase are provided in Table 2 below.

Table 2. Mapping of ICAREdata Cancer Treatment Plan Change structured phrase to the CodeX ICAREdata CarePlanWithReview profile

ICAREdata Cancer Treatment Plan Change Phrase	ICAREdata CarePlanWithReview Profile Mapping
Phrase Value	FHIR Profile Element	Terminology Binding
		Value Set	Code	Description
No change in treatment plan	extension.obf-Review-extension.extension.obf-Changed-extension.valueBoolean = false	n/a
yes-disease not responding	extension.obf-Review-extension.extension.obf-Changed-extension.valueBoolean = true	n/a
	extension.obf-Review-extension.extension.obf-ReasonCode-extension.valueCodeableConcept	CarePlanChangeReasonVS	266721009	Absent response to treatment (situation)
yes-due to AE/toxicity	extension.obf-Review-extension.extension.obf-Changed-extension.valueBoolean = true	n/a
	extension.obf-Review-extension.extension.obf-ReasonCode-extension.valueCodeableConcept	CarePlanChangeReasonVS	281647001	Adverse reaction (disorder)
yes-planned change	extension.obf-Review-extension.extension.obf-Changed-extension.valueBoolean = true	n/a
	extension.obf-Review-extension.extension.obf-ReasonCode-extension.valueCodeableConcept	CarePlanChangeReasonVS	405613005	Planned Procedure (situation)
yes-due to patient request	extension.obf-Review-extension.extension.obf-Changed-extension.valueBoolean = true	n/a
	extension.obf-Review-extension.extension.obf-ReasonCode-extension.valueCodeableConcept	CarePlanChangeReasonVS	182890002	Patient requests alternative treatment (finding)
yes-due to other	extension.obf-Review-extension.extension.obf-Changed-extension.valueBoolean = true	n/a
	extension.obf-Review-extension.extension.obf-ReasonCode-extension.valueCodeableConcept	CarePlanChangeReasonVS	74964007	Other (qualifier value)