HRSA 2024 Uniform Data System (UDS) Patient Level Submission (PLS) (UDS+) FHIR IG
2.0.0 - STU2 Release 1 - Standard for Trial-Use

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## Extension: UDS Plus Age Extension

Official URL: http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension | Version: 2.0.0
Standards status: Trial-use | Maturity Level: 2 | Computable Name: UDSPlusAgeExtension

Indicates the age of the patient at a specific time

Context of Use

This extension may be used on the following element(s):

- Element ID: `Patient`
- Element ID: `Encounter`

### Introduction

This extension is used to convey the age of the patient at a specific point in time. The HHS De-identification Guidance is to be followed to ensure appropriate level of de-identification is performed on the age extension.

According to the HHS guidance, for patients whose age is computed to be greater than 89 the de-identification rule requires it be reported as greater > 90 and not report the specific age.

**Representing Age > 89 **

Since Age is represented as a valueQuantity data type the following method should be used to represent Age > 89.

    * Age > 89 : use valueQuantity.value to represent 90, units of a and comparator of ">="

Usage info

Usage:

- Use this Extension: De-Identified UDS Plus Patient, De-Identified UDS Plus Diagnosis and De-Identified UDS Plus Encounter
- Examples for this Extension: Encounter/de-identified-example, Patient/de-identified-age89-example, Patient/de-identified-example and Patient/de-identified-smallpop-example

### Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

- Differential Table
- Snapshot Table
- Statistics/References
- All

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Extension |  | 1..1 | Extension | Indicates the age of the Patient.
url |  | 1..1 | uri | "http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension"
value[x] | C | 1..1 | Quantity | Value of extension uds-plus-age-1: All Patients aged more than 89 years, should be grouped together as 90+ years to meet de-identification requirements. uds-plus-age-2: All Patients should be aged 0 or more years.
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Extension |  | 1..1 | Extension | Indicates the age of the Patient.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension"
value[x] | C | 1..1 | Quantity | Value of extension uds-plus-age-1: All Patients aged more than 89 years, should be grouped together as 90+ years to meet de-identification requirements. uds-plus-age-2: All Patients should be aged 0 or more years.
Documentation for this format

This structure is derived from Extension

Summary

Simple Extension of type Quantity: Indicates the age of the patient at a specific time

Maturity: 2

Differential View

This structure is derived from Extension

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Extension |  | 1..1 | Extension | Indicates the age of the Patient.
url |  | 1..1 | uri | "http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension"
value[x] | C | 1..1 | Quantity | Value of extension uds-plus-age-1: All Patients aged more than 89 years, should be grouped together as 90+ years to meet de-identification requirements. uds-plus-age-2: All Patients should be aged 0 or more years.
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Extension |  | 1..1 | Extension | Indicates the age of the Patient.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://fhir.org/guides/hrsa/uds-plus/StructureDefinition/uds-plus-age-extension"
value[x] | C | 1..1 | Quantity | Value of extension uds-plus-age-1: All Patients aged more than 89 years, should be grouped together as 90+ years to meet de-identification requirements. uds-plus-age-2: All Patients should be aged 0 or more years.
Documentation for this format

This structure is derived from Extension

Summary

Simple Extension of type Quantity: Indicates the age of the patient at a specific time

Maturity: 2

Other representations of profile: CSV, Excel, Schematron

#### Constraints

Id | Grade | Path(s) | Details | Requirements
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) |
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |
uds-plus-age-1 | error | Extension.value[x] | All Patients aged more than 89 years, should be grouped together as 90+ years to meet de-identification requirements. : (($this.where(code = 'a').value <= 89) or ($this.where(code = 'a' and comparator = '>=').value = 90)) or (($this.where(code = 'mo').value <= 1068) or ($this.where(code = 'mo' and value > 1068 and value <= 1080).comparator = '>=')) or (($this.where(code = 'd').value <= 32485) or ($this.where(code = 'd' and value > 32485 and value <= 32850).comparator = '>=')) or (($this.where(code = 'wk').value < 4628) or ($this.where(code = 'wk' and value > 4628 and value <= 4680).comparator = '>=')) |
uds-plus-age-2 | error | Extension.value[x] | All Patients should be aged 0 or more years. : ($this.value >= 0) |