How do I enter free text in a TID 1501?

In row 12 of TID 1501 it appears that text entries can be added to the object; the Content Item Description for this line states Allows encoding a flat list of name-value pairs that are coded questions with coded or text answers, for example, to record categorical observations related to the subject of the measurement group. A single level of coded modifiers may be present.. What is the recommended way to add these values?

If I create a MeasurementsAndQualitativeEvaluations object containing QualitativeEvaluations of the sort

    text_item = QualitativeEvaluation(
        name=CodedConcept(
            value='121071',
            meaning='Finding',
            scheme_designator='DCM',
        ),
        value=CodedConcept(
            value=text,
            meaning='Finding',
            scheme_designator='DCM',
        )
    )

this will work (and pass SR validation) until the size of the text exceeds 16 characters (after that there is an exception in coding.py). This may also be considered an abuse of CodedConcept? Or perhaps there is a way to include aTextContentItem but I don’t see the way to do this.

The use case is to permit free text additions to an SR by a radiologist for findings not present in the original SR generated by the model output. These text findings are at coded anatomic finding sites.

[fedorov]

This feature will be helpful for us in the future as well, thanks for bringing this up @seandoyle! When we worked on the PI-RADS family of templates, we deliberately made the decision not to codify everything that the guidelines mention or allow to capture - that would be an enormous effort, and the guidelines are under-defined, requiring interviews and iterations with the domain experts to identify and finalize the codes. Codifying makes sense when the concepts are well-established and there is broad consensus for the specific use case. Otherwise, this is (at least for some use cases) a huge and potentially counterproductive effort.

I understand that allowing free text opens the door for not using the codes at all, but I think this is a better evil than significantly increasing the complexity of the template and introducing coded concepts that have not reached consensus, and also completely removing the possibility of describing something that cannot be anticipated and is not covered by the codes.

[hackermd]

Implementing this in a backwards compatible way could get a bit messy. We’d probably need to create a new, alternative TextQualitativeEvaluation, or similar, and then accept Sequence[Union[QualitativeEvaluation, TextQualitativeEvaluation]] for the qualitative_evaluations parameter of the measurement group constructors. It’s also true that currently the parsing API won’t return content items of value type TEXT for the get_qualitative_evaluations method

We could call those TEXT content items “descriptions” rather than “evaluations” and add a descriptions parameter to the constructor as well as a corresponding get_descriptions method to the class.