To avoid any confusion and misinterpretation Before a template can be processed, it is important that the input data is represented in a clear and unambiguous way that ease the interpretation of the input data and ensure correct processing of the expression template. Poorly represented input data may result in expressions that express a different meaning than intended, which can be critical if the resulting expressions are used for safety critical purposes (storage, communication, trigger decision support rules etc.)

Templates with Repeatability of Groups and Attributes

. This is required to ensure that the template is processed in the expected manner, and the intended results are produced. In this section, we explain some of the considerations in representing and preparing the input data for processing.

Input Data Representation

Template input data may be represented in a variety of forms, ranging from flat tabular structures to nested serializations. Irrespective of the format, however, it is important that there is no ambiguity as to how each piece of input data should be used to create the resulting expressions. This can be particularly challenging where repetition of relationship groups or attribute name-value pairs is required.

The UML diagram below illustrates the logical structure of expression template input data. Each set of Expression Template Input Data includes the data intended to be used to create one or more expressions. The data used to populate a single expression is referred to in this model as Expression Data. Each Expression Data (identified by an expression id), may include at most one Definition Status Slot (with a slot name and a definitionStatus value), zero or more Focus Concept Slots (each with a slotName and zero or more values), zero or more Relationship Group Slots (each with a group name), and zero or more ungrouped Attribute Name-Value Pair Slots (each with a name). Each Relationship Group Slot has zero or more Relationship Group Data instances in the input data (each identified by a group id). Each of these Relationship Group Data instances has input data for one to many Attribute Name-Value Pair Slots. And for each Attribute Name-Value Pair Slot within a Relationship Group Data instance, there are zero to many Attribute Name-Value Pair Data instances (identified by an anvPair id), each with at most one Attribute Name Slot (with name and value), and at most one Attribute Value Slot (with name and either a simple data value, or an Expression Data instance of its own).

Image Added

Input Data Examples

In this section, we provide some examples of unambiguous expression template input data, and discuss how this input data can be used to populate each expression.

Example 1

The expression template below is used to create expressions that represent a

Concept

ShowParts	term
t	363698007 \|Disease\|

with one or more

Concept

ShowParts	term
t	363698007 \|Finding site\|

and

Concept

ShowParts	term
t	116676008 \|Associated morphology\|

. When using expression templates, such as this one, in which attribute name-value pairs and relationship groups may In situations where the template allow for attribute-value pairs or relationships groups to be repeated, the input data should be explicit about which data values are used to populate each slot, and how these values are grouped into relationship groups.

Scg expression

Border	solidridge

	[[@Expression +tok (=== <<<) @DefStatus]] [[+id (<< 64572001 |Disease (disorder)||) @Disease]] : 
		[[@Group]] { 363698007 |Finding site (attribute)|  =  [[+ (<< 272673000 |Bone structure (body structure)| ) @Site]],
					   116676008 |Associated morphology (attribute)|  =  [[+ (<< 72704001 |Fracture (morphologic abnormality)| ) @Morphology]] }

To support the creation of input data for this expression template, the logical model in above can be specialized by replacing the 'Slot' classes (e.g. 'Relationship Group Slot' and 'Attribute Value Slot') with the name of the respective slots in the template, and simplifying where possible. The resulting logical model of input data for the above expression template is shown below in . Please note that this model has been simplified by removing unnamed logical classes, which have a cardinality of 1..1 and no data attribute. For example, attribute name-value slots are not required in this example. In general, attribute name-value slots are only required where both the attribute name and the attribute value are represented using a slot.

Image Added

By populating this logical model with input data, as shown below in , the expression template can be processed to generate completed expressions. Please note that the first column in the table below is used to group together the input data intended to populate each expression. Subsequent columns are named according to the associated slot in the expression template. Relationship group slots are used to group the data that is intended to populate

...

a single relationship group. Attribute name-value slots are not required in this example. They are are only required where both the attribute name and attribute value use a slot.

PDF: Landscape

Expression Data

DefStatus

Disease

Group

Site

Morphology

1

===

Scg expression
46866001 \|Fracture of lower limb\|

1

Scg expression
12611008 \|Bone structure of tibia\|

Scg expression
72704001 \|Fracture\|

2

<<<

Scg expression
92196005 \|Benign neoplasm of lung\|

1

Scg expression
39607008 \|Lung structure\|

Scg expression
3898006 \|Neoplasm, benign\|

Scg expression
92038006 \|Benign neoplasm of bronchus\|

2

Scg expression
955009 \|Bronchial structure\|

Scg expression
3898006 \|Neoplasm, benign\|

3

<<<

Scg expression
60667009 \|Closed fracture of rib\|

1

Scg expression
113197003 \|Bone structure of rib\|

Scg expression
34305007 \|Fracture, multiple, closed\|

Scg expression
36991002 \|Closed fracture of upper limb\|

Scg expression
371195002 \|Bone structure of upper limb\|

4

===

Scg expression
16119006 \|Abscess of jaw\|

1

Scg expression
70925003 \|Bone structure of maxilla\|

Scg expression
44132006 \|Abscess\|

Scg expression
109327001 \|Abscess of facial bone\|

Scg expression
128234004 \|Disorder of maxilla\|

Using input data shown in to populate the given expression template will result in following four expressions.

...

@Expression

@Group

@Site

@Morphology

1

Concept

t	312763008 \|Bone structure of trunk\|

Concept

t	72704001 \|Fracture\|

2

Concept

t	84667006 \|Bone structure of cervical vertebra\|

Concept

t	72704001 \|Fracture\|

2

1

Concept

t	62413002 \|Bone structure of radius\|

Concept

t	72704001 \|Fracture\|

Concept

t	23416004 \|Bone structure of ulna\|

Concept

t	72704001 \|Fracture\|

3

1

Concept

t	71341001 \|Bone structure of femur\|

Concept

t	72704001 \|Fracture\|

4

1

Concept

t	12611008 \| Bone structure of tibia\|

Concept

t	72704001 \|Fracture\|

The above input data would result in following four expressions to be generated when processing the template:

64572001 |Disease| : { 12611008 tibia 72704001Fracture

Expression

1

Scg expression
64572001 === 46866001 \|Disease\|Fracture :of {lower limb\|: { 363698007 \|Finding site\| = 31276300812611008 \|Bone structure of trunktibia\|, 116676008 \|Associated morphology \|= 72704001 \|Fracture\| }

2

Scg expression

	<<< 92196005 |Benign neoplasm of lung| + 92038006 |Benign neoplasm of bronchus|:
		,
{ 363698007 |Finding site| = 8466700639607008 |BoneLung structure of cervical vertebra|,
		  116676008 |Associated morphology|  = 727040013898006 |FractureNeoplasm, benign| }

2

Scg expression

64572001 |Disease| : { 
  ,
		{ 363698007 |Finding site|  = (62413002955009 |BoneBronchial structure of radius| + 23416004 |Bone structure of ulna|),
		  116676008 |Associated morphology|  = 727040013898006 |FractureNeoplasm, benign| }

3

Scg expression

64572001 |Disease	<<< 60667009 |Closed fracture of rib| + 
	36991002 |Closed fracture of upper limb| : { 

		{ 363698007 |Finding site| = 113197003 |Bone structure of rib|,
		  363698007 |Finding site| = 71341001371195002 |Bone structure of upper femurlimb|,
		  116676008 |Associated morphology|  = 7270400134305007 |Fracture, multiple, closed| }

4

Scg expression

	=== 16119006 |Abscess of jaw| + 
		109327001 |Abscess of facial bone| +
		128234004 |Disorder of maxilla|:
			{ 363698007 |Finding site|

70925003 |

Bone structure of

maxilla|, 
			  116676008 |Associated morphology|

44132006 |

Abscess|

Templates with Cardinality Constraints

Specifying the expression and group when representing input data is particularly important when the template includes cardinality constraints, to be able to determine the repeatability of groups and attributes. Expression templates which specifies a [1..1] cardinality of slots or expression parts can omit the group column, as shown in the following example.

Cardinality Constraints on Groups

...

Example 2

The expression template below is used as a pattern for family history expressions. It contains a nested relationship group (i.e. SSgroup) inside the outer relationship group (i.e. AFgroup). To populate this expression template, the input data must be clear as to where each value should be used, and how these values should be grouped into relationship groups and expressions.

Scg expression

Border

...

ridge

[[

...

+id (<< 413350009 |Finding with explicit context| ) @Condition]]:
		[[ 1..2 @AFgroup ]] { [[1..

...

1]]  246090004 |Associated finding|  = ([[+id (<<  404684003 |Clinical finding| ) @Finding]]:
			[[0..1 @SSgroup]] { [[0..1]]  246112005 |Severity|  = [[+id (<  272141005 |Severities| ) @Severity]],
								[[0..1]]  363698007 |Finding site|  =

...

 [[+id (

...

91723000 |

...

Anatomical structure| ) @Site]] }),
						[[1..1]]

...

408732007 |Subject relationship context|  = [[+id (<  444148008 |Person in family of subject| ) @Relationship]],
						[[1..1]]  408731000 |Temporal context|   = [[+id (<  410510008 |Temporal context value| ) @Time]],
						[[1..1]]  408729009 |Finding context|   = [[+id (<  410514004 |Finding context value| ) @Context]] }

To support the creation of input data for this expression template, the logical model in above can be specialized as shown below in . Please note that this model has been simplified by removing unnamed logical classes, which have a cardinality of 1..1 and no data attribute.

Image Added

This logical model can be populated with input data, as shown below in .

PDF: Landscape

Expression Data

Condition

AFgroup

Finding

SSgroup

Severity

Site

Relationship

Time

Context

1

Scg expression
266898002 \|Family history: Respiratory disease\|

1

Scg expression
195967001 \|Asthma\|

1

Scg expression
24484000 \|Severe\|

Scg expression
444301002 \|Mother of subject\|

Scg expression
410589000\|All times past\|

Scg expression
410515003 \|Known present\|

2

Scg expression
161077003 \|Father smokes\|

1

Scg expression
77176002 \|Smoker\|

1

Scg expression
255604002 \| Mild\|

Scg expression
444295003 \|Father of subject\|

Scg expression
15240007 \|Current\|

Scg expression
410515003 \|Known present\|

Scg expression
161078008 \|Mother smokes\|

2

Scg expression
77176002 \|Smoker\|

1

Scg expression
24484000 \|Severe\|

Scg expression
444301002 \|Mother of subject\|

Scg expression
15240007 \|Current\|

Scg expression
410515003 \|Known present\|

3

Scg expression
160288009 \|Family history: neoplasm of skin\|

1

Scg expression
372130007 \|Malignant neoplasm of skin\|

1

Scg expression
6736007 \|Moderate\|

Scg expression
113179006 \|Skin structure of nose\|

Scg expression
444304005 \|Sister of subject\|

Scg expression
410511007 \|Current or past (actual)\|

Scg expression
410515003 \|Known present\|

Scg expression
275937001 \|Family history of cancer\|

2

Scg expression
255604002 \|Mild\|

Scg expression
88089004 \|Skin structure of lip\|

Using the input data shown above to process the given expression template will result in following three expressions.

Expression

1

Scg expression

	266898002 |Family history: Respiratory disease|:
		{ 246090004 |Associated finding| = (195967001 |Asthma|: { 246112005 |Severity| = 24484000 |Severe| }),
		   408732007 |Subject relationship context| = 444301002 |Mother of subject|,
		   408731000 |Temporal context| = 410511007 |Current or past (actual)|,
		   408729009 |Finding context| = 410515003 |Known present| }

2

Scg expression

	161077003 |Father smokes| + 161078008 |Mother smokes|:
		{ 246090004 |Associated finding| = (77176002 |Smoker|: { 246112005 |Severity| = 24484000 |Severe| }),
		   408732007 |Subject relationship context| = 444295003 |Father of subject|,
		   408731000 |Temporal context| = 15240007 |Current|,
		   408729009 |Finding context| = 410515003 |Known present|},
		{ 246090004 |Associated finding| = (77176002 |Smoker|: { 246112005 |Severity| = 255604002 |Mild| }),
		   408732007 |Subject relationship context| = 444301002 |Mother of subject|,
		   408731000 |Temporal context| = 15240007 |Current|,
		   408729009 |Finding context| = 410515003 |Known present| }

3

Scg expression

	160288009 |Family history: neoplasm of skin| + 275937001 |Family history of cancer|:
		{ 246090004 |Associated finding| = (372130007 |Malignant neoplasm of skin|:
				{ 246112005 |Severity| = 6736007 |Moderate|, 363698007 |Finding site| = 113179006 |Skin structure of nose| },
				{ 246112005 |Severity| = 255604002 |Mild|, 363698007 |Finding site| = 88089004 |Skin structure of lip| }), 
		408732007 |Subject relationship context| = 444304005 | Sister of subject|,
		408731000 |Temporal context| = 410511007 |Current or past (actual)|,
		408729009 |Finding context| = 410515003 |Known present| }

Example 3

The expression template below represents a procedure with a single method and one or more procedure devices. Please note that in the first attribute name-value pair, both the attribute name and the attribute value use a slot. Because this name-value pair is repeatable, the input data needs to include an attribute name-value pair slot to ensure that the corresponding attribute name and attribute value stays connected.

Scg expression

Border	ridge
ShowFormat	block

	[[+id (<< 71388002 |Procedure|) @Procedure]]:

In this situation, processing the template against the input data would result in a processing error, because the first expression would not be valid. the expression template allow for only one @Group within each expression, whereas the input data specify an expression with more that one @Group.

@Expression

@Group

@Site

@Morphology

Processing Result1

1

Concept

t	312763008 \|Bone structure of trunk\|

Concept

t	72704001 \|Fracture\|

INVALID

Only one group is allowed due to cardinality constraints

2

Concept

t	84667006 \|Bone structure of cervical vertebra\|

Concept

t	72704001 \|Fracture\|

2

1

Concept

t	62413002 \|Bone structure of radius\|

Concept

t	72704001 \|Fracture\|

VALID

1

Concept

t	23416004 \|Bone structure of ulna \|

Concept

t	72704001 \|Fracture\|

3

1

Concept

t	71341001 \|Bone structure of femur\|

Concept

t	72704001 \|Fracture)\|

VALID4

1

Concept

t	12611008 \| Bone structure of tibia\|

Concept

t	72704001 \|Fracture\|

VALID

So in this case, there would be no need to include the second column in the input data to differentiate between different groups in the same expression. Hence, the input data could be simplified as:

@Expression

@Site

@Morphology

2

Concept

t	62413002 \|Bone structure of radius\|

Concept

t	72704001 \|Fracture\|

Concept

t	23416004 \|Bone structure of ulna \|

Concept

t	72704001 \|Fracture\|

3

Concept

t	71341001 \|Bone structure of femur\|

Concept

t	72704001 \|Fracture)\|

4

Concept

t	12611008 \| Bone structure of tibia\|

Concept

t	72704001 \|Fracture\|

Cardinality Constraints on Attributes

Consider the following template, where the template includes a cardinality constraint on each attribute like this:

Scg expression

Border	solid

[[@Expression ]] 64572001 |Disease| : [[1..*]] 
[[1..1 @Group]]
			{ [[1..1] 363698007 |Finding site| * @PD_ANVpair]] [[+id (< 405815000 |Procedure device|) @DeviceType]] =  [[+ (<< 272673000<260787004 |BonePhysical structureobject| ) @Site@Device]],
			  [[1..1]] 116676008260686004 |Associated morphologyMethod|  =  [[+ (<< 72704001 |Fracture| ) @Morphology<129264002 |Action (qualifier value)|) @Method]] }

In this case, the second expression would not be valid … so there would be no need to include the expression column, as each row would signify a separate expression. That is, we could just define the data as:

...

@Site

...

@Morphology

...

Concept

t	62413002 \|Bone structure of radius\|

...

Concept

t	72704001 \|Fracture\|

...

INVALID

Only one @Site is allowed due to cardinality constraints

...

Concept

t	23416004 \|Bone structure of ulna \|

...

Concept

t	72704001 \|Fracture\|

...

Concept

t	71341001 \|Bone structure of femur\|

...

Concept

t	72704001 \|Fracture)\|

...

Concept

t	12611008 \| Bone structure of tibia\|

...

Concept

t	72704001 \|Fracture\|

...

Similarly, if only precoordinated concepts were allowed in the slots, like this:

...

Border	solid

...

To support the creation of input data for this expression template, the logical model in above can be specialized as shown below in . Please note that this model has been simplified by removing unnamed logical classes, which have a cardinality of 1..1 and no data attribute.

Image Added

This logical model can be populated with input data, as shown below in . Please note that because the first attribute name-value pair is repeatable and uses a replacement slot for both the attribute name and attribute value, the input data needs to include the attribute name-value pair slot to ensure that the corresponding attribute name and attribute value stays connected.

PDF: Landscape

Expression Data

Procedure

Group

PD_ANVpair

DeviceType

Device

Method

1

Scg expression
387713003 \|Surgical procedure\|

1

Scg expression
363699004 \|Direct device\|

Scg expression
2282003 \|Breast prosthesis, device\|

Scg expression
257867005 \|Insertion - action\|

2

Scg expression
71388002 \|Procedure\|

1

Scg expression
363699004 \|Direct device\|

Scg expression
313025003 \|Hearing aid battery\|

Scg expression
282089006 \|Replacement - action\|

2

Scg expression
363710007 \|Indirect device\|

Scg expression
6012004 \|Hearing aid, device\|

Using the input data shown in to process the given expression template will result in the following two expressions.

Expression

1

Scg expression
387713003 \|Surgical procedure\|: { 363699004 \|Direct device\| = 2282003 \|Breast prosthesis, device\|, 260686004 \|Method\| = 257867005 \|Insertion - action\|}

2

Scg expression

	384728007 |Replacement of device|:
            { 363699004 |Direct device| = 313025003 |Hearing aid battery|,
              363710007 |Indirect device| = 6012004 |Hearing aid, device|,
              260686004 |Method| = 282089006 |Replacement - action|}

Example 4

The expression template below represents a

Concept

ShowParts	term
t	64572001 \|Disease\|

with one or more values for

Concept

ShowParts	term
t	363698007 \|Finding site\|

and

Concept

ShowParts	term
t	116676008 \|Associated morphology\|

, grouped into one or more relationship groups.

Scg expression

Border	ridge
ShowFormat	block

	64572001 |Disease|: 
		[[@Group]] { 363698007 |Finding site|  =  [[+

...

(<< 272673000 |Bone structure|

...

) @Site]],

...

					 116676008 |Associated morphology|  =  [[+

...

 (<< 72704001 |Fracture|

...

) @Morphology]] }

To support the creation of input data for this expression template, the logical model in above can be specialized as shown below in . Please note that this model has been simplified by removing unnamed logical classes, which have a cardinality of 1..1 and no data attribute.

...

then only the following data value would be valid:

Image Added

below shows some example input data for the above template represented using the tabular format used in the previous examples.

Expression Data

Group

Site

Morphology

1

Concept

t	312763008 \|Bone structure of trunk\|

Concept

t	72704001 \|Fracture\|

2

Concept

t	84667006 \|Bone structure of cervical vertebra\|

Concept

t	72704001 \|Fracture\|

2

1

...

@Site

...

Concept

t	71341001 \|Bone structure of femur\|

Concept

t	72704001 \| Fracture

...

|

3

1

Concept

t	12611008 \| Bone structure of tibia\|

Concept

t	72704001 \|Fracture\|

...

In

...

addition to this tabular representation, there are a wide variety of other possible formats for representing template input data, including json, xml, tsv, csv etc. The exact format used will depend on the format required by the template processor. For example, the above input data can be represented in JSON as shown below.

Panel

title	Example JSON Representation of Input Data

{"Expression Data": [
        { "Group": [
                {  "Site":"312763008 |Bone structure of trunk|",
                    "Morphology":"72704001 |Fracture|" },
                {  "Site": "84667006 |Bone structure of cervical vertebra|",
                    "Morphology": "72704001 |Fracture|" } ] },
        { "Group": [
                {  "Site":"71341001 |Bone structure of femur|",
                    "Morphology": "72704001 |Fracture|" } ] },
        { "Group":[  
                {  "Site":"12611008 | Bone structure of tibia|",
                    "Morphology": "72704001 |Fracture|" } ] } ] }

Simplification of Data Representation

While it is important that there is no ambiguity as to how each piece of input data should be used in processing the associated expression template, there are often opportunities to make the input data much simpler than is represented in the full logical model above. In particular:

When the maximum cardinality of a relationship group is 1, there is no need to include the relationship group slot in the input data to group the attributes it contains;
When the maximum cardinality of an attribute name-value pair is 1, there is no need to include the attribute name-value pair slot in the input data to group the corresponding name and value pairs;
When there is either an attribute name slot with a fixed attribute value, or a fixed attribute name with an attribute value slot, there is no need to include the attribute name-value pair slot in the input data to group the corresponding name and value pairs.

With this in mind, the examples in 8. Expression Template Examples simplify the input data, where appropriate, using these assumptions and an implicit association with the logical model described above.

if the expression column is omitted then it is assumed that each row should be processed into separate expressions (i.e. no repeating of rows into the same expression)
if the grouping is omitted, then it can be assumed that each column should be processed into separate expression parts (i.e. no grouping of rows into the same expression)

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Templates with Repeatability of Groups and Attributes

Input Data Representation

Input Data Examples

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Example 2

Example 3

Cardinality Constraints on Attributes

Example 4

Simplification of Data Representation

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Versions Compared

Old Version 1

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Templates with Repeatability of Groups and Attributes

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Input Data Examples

Example 1

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Example 2

Example 3

Cardinality Constraints on Attributes

Example 4

Simplification of Data Representation