Data mapping

Source Data item Cardinality Target FHIR Element Notes
Reporting Organisation 1..1 Organization.id
Organization.name		 ODS should be used for identifier & name, using the system "https://fhir.nhs.uk/Id/ods-organization-code"
Requested Test 1..1 ServiceRequest.code A fixed value of
system "http://snomed.info/sct"
code "1148754001"
display "Screening for neoplasm"
Repost Date 1..1 DiagnosticReport.issued Using the appropriate dateTime format
Report Type 1..1 DiagnosticReport.code A fixed value of
system "http://snomed.info/sct"
code "721981007"
display "Diagnostic studies report"
Report Standard Text 1..1 DiagnosticReport.conclusion A fixed disclaimer string
Participant Identifier 1..1 Patient.identifier The patient identifier used by the screening organisation
Sample Identifier 1..1 Specimen.identifier The speciment identifier used by the screening organisation
Sample Type 1..1 Specimen.type A fixed value of
system "http://snomed.info/sct"
code "119297000"
display "Blood specimen"
Sample Collection Date 1..1 Specimen.collection.collectedDateTime Using the appropriate dateTime format
Requesting Organisation Name 1..1 Organization.name ODS organization name NHS England. Name fixed to "NHS ENGLAND - X26"
Requesting Organisation Identifier 1..1 Organization.identifier A fixed value of
system "https://fhir.nhs.uk/Id/ods-organization-code"
value "X26"
Requesting Organisation Address 1..1 Organization.address ODS organization address for NHS England. Address fixed to line "THE LEEDS GOVERNMENT HUB"
line "7-8 WELLINGTON PLACE"
city "LEEDS"
postalCode "LS1 4AP"
country "ENGLAND"
Requesting Practitioner Name 0..1 Practitioner.name Name of the requesting practitioner
Requesting Practitioner Identifier 0..1 Practitioner.Identifier Identifier of the requesting practitioner
Test Result (overall) 0..1 Observation.valueCodeableConcept.coding The cancer signal result
system "http://snomed.info/sct"
See below for SNOMED CT cancer signal result codes
Test Result Primary Site 0..* Observation.component.valueCodeableConcept As part of the Observation for the primary site, that has an Observation.code.coding.code "1873921000000106" and Observation.code.coding.display "Multi-cancer early detection highest scored cancer signal origin by machine learning-based classifier"
See below for SNOMED CT body site mapping
Test Result Secondary Site 0..* Observation.component.valueCodeableConcept As part of the Observation for the primary site, that has an Observation.code.coding.code "1873931000000108" and Observation.code.coding.display "Multi-cancer early detection second highest scored cancer signal origin by machine learning-based classifier"
See below for SNOMED CT body site mapping
Lab Comments 0..1 DiagnosticReport.[extension-DiagnosticReport.note].valueAnnotation.text An extension to hold lab comments
Performing Lab Name 1..1 Organization.name Name of Laboratory where the sample was processed
Performing Lab Director Name 1..1 Organization.contact.name.text Full name of the Laboratory director of the sample processing lab
Lab Identifiers 1..1 Organization.identifier Identifiers that the Lab has been assigned. These may be regulatory body identifiers that regulates labs testing human specimens
Lab Address 1..1 Organization.address Address of the lab that performed the sample processing
Lab Contact Details 1..1 Organization.telecom Using system "phone" for phone numbers, using system "fax" for fax numbers, using system "email" for email addressed
Attachment 1..1 DiagnosticReport.presentedForm.data Attached pdf document in Base64 that the Lab may provide

Body site mapping to SNOMED CT

Body sites should be drawn from the Body Structure hierarchy within SNOMED ( < 123037004 | Body structure (body structure) ). The body structure suspected as part of a multi-cancer early detection test is recorded in the component Backbone element of the Observation resource that is either the primary or secondary recorded site. Sometimes there may be multiple body sites detected for a primary or secondary cancer signals. In these cases, multiple component Backbone elements should be recorded within the Observation.

For example, for a single body site for a cencer signal detected in the prostate, a single Observation.component should be recorded. In the following snippets not all the Observation elements are shown.

Example of a single body structure recorded

{
  "resourceType": "Observation",
  "id": "dacb177a-9501-4dcc-8b22-b941791ae0db",
  "status": "final",
  "code": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "1873921000000106",
        "display": "Multi-cancer early detection highest scored cancer signal origin by machine learning-based classifier"
      }
    ]
  },
  "component": [
    {
      "code": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "123037004",
            "display": "Body structure"
          }
        ]
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "41216001",
            "display": "Prostatic structure"
          }
        ]
      }
    }
  ]
}

Example of two body structures recorded

{
  "resourceType": "Observation",
  "id": "dacb177a-9501-4dcc-8b22-b941791ae0db",
  "status": "final",
  "code": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "1873921000000106",
        "display": "Multi-cancer early detection highest scored cancer signal origin by machine learning-based classifier"
      }
    ]
  },
  "component": [
    {
      "code": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "123037004",
            "display": "Body structure"
          }
        ]
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "89837001",
            "display": "Urinary bladder structure"
          }
        ]
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "123037004",
            "display": "Body structure"
          }
        ]
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "57789003",
            "display": "Structure of urothelium"
          }
        ]
      }
    }
  ]
}

Cancer Signal Result

SNOMED CT Code Display
1854981000000108 Multi-cancer early detection signal detected
1854991000000105 Multi-cancer early detection signal not detected