Content items for de-identification with Clean Structured Content Option Status Letter Ballot Date of Last Update 2019/01/23 Person Assigned David Clunie Submitter Name David Clunie Submission Date 2018/09/29 Correction Number CP-1860 Log Summary: Content items for de-identification with Clean Structured Content Option Name of Standard PS3.15 Rationale for Correction: The Clean Structured Content option in PS3.15 Annex E is not specific about which content items to process and in what manner. Add specific content item concept names using the templates in PS3.16 and apply related options for patient, device, institution characteristics. Also add clinical trial time point related attributes to PS3.15 Annex E Table E.1-1. [Ed.Note. When CP 1850 is final text, the SRT codes listed in this CP will be replaced with SCT codes. Text describes that a de-identifier is expected to handle both.] Correction Wording:

Application Level Confidentiality Profile Attributes

Attribute Name	Tag	Retd. (from )	In Std. Comp. IOD (from )	Basic Prof.	Rtn. Safe Priv. Opt.	Rtn. UIDs Opt.	Rtn. Dev. Id. Opt.	Rtn. Inst. Id. Opt.	Rtn. Pat. Chars. Opt.	Rtn. Long. Full Dates Opt.	Rtn. Long. Modif. Dates Opt.	Clean Desc. Opt.	Clean Struct. Cont. Opt.	Clean Graph. Opt.
Clinical Trial Time Point ID	(0012,0050)	N	Y	Z								C
Clinical Trial Time Point Description	(0012,0051)	N	Y	X								C
Clinical Trial Sponsor Name	(0012,0010)	N	Y	D
Clinical Trial Protocol ID	(0012,0020)	N	Y	D
Clinical Trial Protocol Name	(0012,0021)	N	Y	Z
Clinical Trial Site ID	(0012,0030)	N	Y	Z				K
Clinical Trial Site Name	(0012,0031)	N	Y	Z				K
Clinical Trial Subject ID	(0012,0040)	N	Y	D
Clinical Trial Subject Reading ID	(0012,0042)	N	Y	D
Clinical Trial Protocol Ethics Committee Name	(0012,0081)	N	Y	D				K
Clinical Trial Protocol Ethics Committee Approval Number	(0012,0082)	N	Y	X
Clinical Trial Coordinating Center Name	(0012,0060)	N	Y	Z				K
Clinical Trial Series ID	(0012,0071)	N	Y	X								C
Clinical Trial Series Description	(0012,0072)	N	Y	X								C

Instances of Structured Report SOP Classes may contain identifiable information in a Content Sequence (0040,A730) encoded in Content Items. Instances of other SOP Classes may contain structured content encoded in a similar manner in the Acquisition Context Sequence (0040,0555) or Specimen Preparation Sequence (0040,0610). When this Option is specified in addition to an Application Level Confidentiality Profile, any information encoded in SR Content Items or Acquisition Context or Specimen Preparation Sequence Items corresponding to the Attribute information specified to be removed by the Profile and any other Options specified shall also be removed. For example, the "observer" responsible for a diagnostic imaging report may be explicitly identified in Observation Content related Content Items in an SR. A de-identifier that does not implement this option creates significant risk when attempting to de-identity a Structured Report unless it is only used to de-identify instances that are known to have no identifying information in the Content Sequence. As this Standard and external coding schemes are maintained, the codes specified as Concept Name Codes may change. The previous codes are considered Retired but implementations may continue to send them and de-identifiers will be expected to be able to continue to recognize and de-identify Content Items with the Retired codes, including the Code Value and Coding Scheme Designator, even if the current Standard does not publish them. A notable example is the change throughout the Standard from using "SNOMED-RT style" code values with a Coding Scheme Designator of "SRT", "SNM3" or "99SDM", to the use of SNOMED CT numeric code values with a Coding Scheme Designator of "SCT". Those retired codes may be found in PS3.15. 2019x. A mapping of retired to new SNOMED codes is found in PS3.16 Annex XXX. Add new table to DICOM PS3.15 Section E.3.4 as follows :

Application Level Confidentiality Profile Clean Structured Content Option Content Item Concept Name Codes

Code Meaning	Code Value	Coding Scheme Designator	Value Type	Retd. (from )	In Std. Tpl. (from )	Basic Prof.	Rtn. UIDs Opt.	Rtn. Dev. Id. Opt.	Rtn. Inst. Id. Opt.	Rtn. Pat. Chars. Opt.	Rtn. Long. Full Dates Opt.	Rtn. Long. Modif. Dates Opt.	Clean Desc. Opt.
Accession Number	121022	DCM	TEXT	N	Y	X
Acquired Image	113795	DCM	IMAGE	N	Y	D	K
Acquisition Date	126201	DCM	DATE	N	Y	X					K	C
Acquisition Protocol	125203	DCM	TEXT	N	Y	X							C
Acquisition Time	126202	DCM	TIME	N	Y	X					K	C
Activity Session	C67447	NCIt	TEXT	N	Y	X							C
Administration of radiopharmaceutical	440252007	SCT	TEXT	N	Y	D							C
Admission DateTime	15	NCDR [2.0b]	DATETIME	N	Y	X					K	C
Anatomic Identifier	112050	DCM	TEXT	N	Y	X							C
Anesthesia Finish Time	DF-0070B	SRT	DATETIME	N	Y	X					K	C
Anesthesia Start Time	DF-0068E	SRT	DATETIME	N	Y	X					K	C
Best illustration of finding	121080	DCM	IMAGE	N	Y	X	K
Best illustration of finding	121080	DCM	WAVEFORM	N	Y	X	K
Calibration DateTime	113723	DCM	DATETIME	N	Y	D					K	C
Calibration Protocol	113720	DCM	TEXT	N	Y	X							C
Calibration Responsible Party	113724	DCM	TEXT	N	Y	D							C
Catheterization Operator	76	NCDR [2.0b]	PNAME	N	Y	D
Cath Lab Procedure Log	121120	DCM	COMPOSITE	N	Y	X	K
Clinical Report	R-42B89	SRT	COMPOSITE	N	Y	X	K
Clinical Report	R-42B89	SRT	TEXT	N	Y	X							C
Comment	121106	DCM	TEXT	N	Y	X							C
Complication of Procedure	DD-60002	SRT	TEXT	N	Y	X							C
Component ID	112347	DCM	TEXT	N	Y	D
Conclusion	121077	DCM	TEXT	N	Y	X							C
Content Date	111018	DCM	DATE	N	Y	X/D					K	C
Content Time	111019	DCM	TIME	N	Y	X/D					K	C
Current procedure evidence	122073	DCM	COMPOSITE	N	Y	X	K
Date of last menstrual period	11955-2	LN	DATE	N	Y	X					K	C
DateTime Concern Noted	121431	DCM	DATETIME	N	Y	X					K	C
DateTime Concern Resolved	121432	DCM	DATETIME	N	Y	X					K	C
DateTime Ended	111527	DCM	DATETIME	N	Y	X					K	C
DateTime of Death	122165	DCM	DATETIME	N	Y	X					K	C
DateTime of Intervention	122105	DCM	DATETIME	N	Y	X					K	C
DateTime of last evaluation	111536	DCM	DATETIME	N	Y	X					K	C
DateTime of processing	111702	DCM	DATETIME	N	Y	X					K	C
DateTime of Recording of Log Entry	121125	DCM	DATETIME	N	Y	X					K	C
DateTime problem observed	111535	DCM	DATETIME	N	Y	X					K	C
DateTime Problem Resolved	121433	DCM	DATETIME	N	Y	X					K	C
DateTime Started	111526	DCM	DATETIME	N	Y	X/D					K	C
Degree of Freedom ID	112363	DCM	TEXT	N	Y	D
Derived Fiducial	112357	DCM	UIDREF	N	Y	D	K
Derived Planning Data	112373	DCM	COMPOSITE	N	Y	X	K
Derived Planning Images	112372	DCM	COMPOSITE	N	Y	X	K
Description of Change	111021	DCM	TEXT	N	Y	X							C
Description of Material	121145	DCM	TEXT	N	Y	X							C
Device Name	113877	DCM	TEXT	N	Y	X		K
Device Observer Name	121013	DCM	TEXT	N	Y	X		K
Device Observer Physical Location During Observation	121017	DCM	TEXT	N	Y	X			K
Device Observer Serial Number	121016	DCM	TEXT	N	Y	X		K
Device Observer UID	121012	DCM	UIDREF	N	Y	X/D	K	K
Device Serial Number	113880	DCM	TEXT	N	Y	X/D		K
Device Subject Name	121193	DCM	TEXT	N	Y	D		K
Device Subject Physical Location during observation	121197	DCM	TEXT	N	Y	X			K
Device Subject Serial Number	121196	DCM	TEXT	N	Y	X		K
Device Subject UID	121198	DCM	UIDREF	N	Y	X	K	K
Discharge DateTime	122163	DCM	DATETIME	N	Y	X					K	C
Dose Image	121342	DCM	IMAGE	N	Y	X	K
Drug administered	122083	DCM	TEXT	N	Y	X/D							C
Drug end	122082	DCM	DATETIME	N	Y	X					K	C
Drug start	122081	DCM	DATETIME	N	Y	X					K	C
ECG Finding	F-00033	SRT	TEXT	N	Y	X/D							C
EDD	11778-8	LN	DATE	N	Y	X					K	C
End of X-Ray Irradiation	113810	DCM	DATETIME	N	Y	D					K	C
Equipment Identification	121122	DCM	TEXT	N	Y	X		K					C
Event UID Used	128429	DCM	UIDREF	N	Y	D	K
Fellow	121088	DCM	PNAME	N	Y	X
Fetus ID	11951-1	LN	TEXT	N	Y	D
Filler Number	121021	DCM	TEXT	N	Y	X
Finding	121071	DCM	TEXT	N	Y	X/D							C
Finding Site	G-C0E3	SRT	TEXT	N	Y	D							C
Frame of Reference UID	112227	DCM	UIDREF	N	Y	X/D	K
Glucose Measurement Date	127857	DCM	DATE	N	Y	D					K	C
Glucose Measurement Time	127858	DCM	TIME	N	Y	D					K	C
History	11329-0	LN	TEXT	N	Y	X							C
Identification of the X-Ray Source	113832	DCM	TEXT	N	Y	D		K
Identifier	125010	DCM	TEXT	N	Y	X
Identifier within Person Observer's Role	128775	DCM	TEXT	N	Y	X
Identifying Segment	112229	DCM	IMAGE	N	Y	D	K
Illustration of Finding	125201	DCM	IMAGE	N	Y	X	K
Illustration of ROI	121200	DCM	IMAGE	N	Y	X	K
Image Acquired	121138	DCM	IMAGE	N	Y	D	K
Imaging Start DateTime	122712	DCM	DATETIME	N	Y	D					K	C
Implant Assembly Template	112366	DCM	COMPOSITE	N	Y	X	K
Impression Description	111033	DCM	TEXT	N	Y	D							C
Indications for Procedure	18785-6	LN	TEXT	N	Y	D							C
Intervention attempt identifier	121154	DCM	TEXT	N	Y	D
Irradiation Authorizing	113850	DCM	PNAME	N	Y	D
Irradiation Event Label	113605	DCM	TEXT	N	Y	X
Irradiation Event UID	113769	DCM	UIDREF	N	Y	D	K
Issuer of Identifier	110190	DCM	TEXT	N	Y	X
Issuer of Parent Specimen Identifier	111706	DCM	TEXT	N	Y	X
Issuer of Specimen Identifier	111724	DCM	TEXT	N	Y	X
Key Object Description	113012	DCM	TEXT	N	Y	X							C
LV Wall Motion Segmental Findings	18118-0	LN	TEXT	N	Y	X							C
Manufacturer Implant Template	112371	DCM	COMPOSITE	N	Y	D	K
Mating Feature ID	112352	DCM	TEXT	N	Y	D
Mating Feature Set ID	112351	DCM	TEXT	N	Y	D
Medication Type	111516	DCM	TEXT	N	Y	X							C
Mother of fetus	121036	DCM	PNAME	N	Y	X
Organization Name	113873	DCM	TEXT	N	Y	X			K
Original Source	111040	DCM	COMPOSITE	N	Y	D	K
Parent Specimen Identifier	111705	DCM	TEXT	N	Y	D
Patient Data Used During Planning	112361	DCM	COMPOSITE	N	Y	X	K
Patient Image	112354	DCM	IMAGE	N	Y	X	K
Patient Model	113815	DCM	TEXT	N	Y	D							C
Patient Presentation	121110	DCM	TEXT	N	Y	X							C
Patient Radiation Dose Model Data	128425	DCM	COMPOSITE	N	Y	X	K
Patient Radiation Dose Model Data	128425	DCM	IMAGE	N	Y	X	K
Patient Radiation Dose Model Data	128425	DCM	UIDREF	N	Y	X	K
Patient Radiation Dose Model Reference	128426	DCM	TEXT	N	Y	X							C
Patient State	109054	DCM	TEXT	N	Y	X							C
Patient Transferred From	122128	DCM	TEXT	N	Y	X			K
Performed Procedure Step SOP Instance UID	121126	DCM	UIDREF	N	Y	D	K
Performing Physician	121114	DCM	PNAME	N	Y	D
Person administering drug/contrast	121152	DCM	PNAME	N	Y	X
Person ID	113871	DCM	TEXT	N	Y	X
Person ID Issuer	113872	DCM	TEXT	N	Y	X
Person Name	113870	DCM	PNAME	N	Y	D
Person Observer's Login Name	128774	DCM	TEXT	N	Y	X
Person Observer's Organization Name	121009	DCM	TEXT	N	Y	X			K
Person Observer Name	121008	DCM	PNAME	N	Y	D
Physician Note	121173	DCM	TEXT	N	Y	X							C
Placer Number	121020	DCM	TEXT	N	Y	X
Prescription Identifier	113516	DCM	TEXT	N	Y	X
Prior report for current patient	122075	DCM	COMPOSITE	N	Y	X	K
Procedure Action ID	121124	DCM	TEXT	N	Y	X/D
Procedure DateTime	122146	DCM	DATETIME	N	Y	X/D					K	C
Procedure DateTime	52	NCDR [2.0b]	DATETIME	N	Y	D					K	C
Procedure Description	121065	DCM	TEXT	N	Y	X/D							C
Procedure Number in this admission	53	NCDR [2.0b]	TEXT	N	Y	X
Procedure Result	122177	DCM	TEXT	N	Y	X							C
Procedure Study Component UID	121019	DCM	UIDREF	N	Y	X	K
Procedure Study Instance UID	121018	DCM	UIDREF	N	Y	X	K
Procedure Time Base	122701	DCM	DATETIME	N	Y	X					K	C
Processing step description	111703	DCM	TEXT	N	Y	X							C
Protocol Time Point Identifier	126071	DCM	TEXT	N	Y	X							C
Pulse Sequence Name	128230	DCM	TEXT	N	Y	X							C
Quoted Source	121002	DCM	COMPOSITE	N	Y	D	K
Radiation Dose Composite Parameters	128436	DCM	COMPOSITE	N	Y	D	K
Radiation Dose Estimate Name	128403	DCM	TEXT	N	Y	D							C
Radiation Dose Representation Data	128414	DCM	COMPOSITE	N	Y	D	K
Radiation Dose Representation Data	128414	DCM	IMAGE	N	Y	D	K
Radionuclide Identifier	113514	DCM	TEXT	N	Y	X
Radiopharmaceutical Administration Event UID	113503	DCM	UIDREF	N	Y	D	K
Radiopharmaceutical Dispense Unit Identifier	113511	DCM	TEXT	N	Y	X
Radiopharmaceutical Lot Identifier	113512	DCM	TEXT	N	Y	X
Radiopharmaceutical Start DateTime	123003	DCM	DATETIME	N	Y	X/D					K	C
Radiopharmaceutical Stop DateTime	123004	DCM	DATETIME	N	Y	X					K	C
Reagent Vial Identifier	113513	DCM	TEXT	N	Y	X
Real World Value Map used for measurement	126100	DCM	COMPOSITE	N	Y	X	K
Reason for Proceeding	113907	DCM	TEXT	N	Y	X							C
Recent Physical Activity	113552	DCM	TEXT	N	Y	X							C
Recommendation	121075	DCM	TEXT	N	Y	X							C
Recommended Follow-up Date	111054	DCM	DATE	N	Y	X/D					K	C
Referenced Segment	121191	DCM	IMAGE	N	Y	X/D	K
Referenced Segmentation Frame	121214	DCM	IMAGE	N	Y	D	K
Related Patient Data Not Used During Planning	112364	DCM	COMPOSITE	N	Y	X	K
Room Identification	121121	DCM	TEXT	N	Y	X
Sampling DateTime	111469	DCM	DATETIME	N	Y	D					K	C
Selected Region Description	111058	DCM	TEXT	N	Y	D							C
Series Instance UID	112002	DCM	UIDREF	N	Y	D	K
Series or Instance used for Water Equivalent Diameter estimation	113985	DCM	UIDREF	N	Y	D	K
Service Delivery Location	121434	DCM	TEXT	N	Y	X			K
Service Performer	121435	DCM	PNAME	N	Y	X
Service Performer	121435	DCM	TEXT	N	Y	X
Social History	F-02455	SRT	TEXT	N	Y	X							C
Source image for segmentation	121233	DCM	IMAGE	N	Y	D	K
Source of Measurement	121112	DCM	IMAGE	N	Y	D	K
Source of Measurement	121112	DCM	WAVEFORM	N	Y	X	K
Source series for segmentation	121232	DCM	UIDREF	N	Y	D	K
Spatial Fiducials	128447	DCM	COMPOSITE	N	Y	X	K
Spatial Registration	112353	DCM	COMPOSITE	N	Y	X	K
Spatial Registration Reference	128444	DCM	COMPOSITE	N	Y	D	K
Specimen Container Identifier	111700	DCM	TEXT	N	Y	X
Specimen Identifier	121041	DCM	TEXT	N	Y	X
Specimen UID	121039	DCM	UIDREF	N	Y	X	K
SR Instance Used	128416	DCM	COMPOSITE	N	Y	D	K
Start DateTime	G-D321	SRT	DATETIME	N	Y	D					K	C
Start of X-Ray Irradiation	113809	DCM	DATETIME	N	Y	D					K	C
Station AE Title	110119	DCM	TEXT	N	Y	X		K
ST Elevation Onset DateTime	122173	DCM	DATETIME	N	Y	X					K	C
Stop DateTime	G-D320	SRT	DATETIME	N	Y	D					K	C
Stress Protocol	109056	DCM	TEXT	N	Y	X							C
Study Date	111060	DCM	DATE	N	Y	X/D					K	C
Study Instance UID	110180	DCM	UIDREF	N	Y	D	K
Study Time	111061	DCM	TIME	N	Y	X/D					K	C
Subject Age	121033	DCM	NUM	N	Y	X				K
Subject Birth Date	121031	DCM	DATE	N	Y	X
Subject ID	121030	DCM	TEXT	N	Y	X/D
Subject Name	121029	DCM	PNAME	N	Y	D
Subject Sex	121032	DCM	CODE	N	Y	X				K
Subject Time Point Identifier	126070	DCM	TEXT	N	Y	X							C
Subject UID	121028	DCM	UIDREF	N	Y	X	K
Summary	121111	DCM	TEXT	N	Y	X							C
Supporting Information	112359	DCM	COMPOSITE	N	Y	X	K
Time Point	C2348792	UMLS	TEXT	N	Y	X/D							C
Tracking Unique Identifier	112040	DCM	UIDREF	N	Y	D	K
User Selected Fiducial	112356	DCM	UIDREF	N	Y	D	K
Waveform Acquired	121143	DCM	WAVEFORM	N	Y	D	K
X-Ray Attenuator Model Data	128470	DCM	COMPOSITE	N	Y	X	K
X-Ray Attenuator Model Data	128470	DCM	IMAGE	N	Y	X	K
X-Ray Attenuator Model Data	128470	DCM	UIDREF	N	Y	X	K
X-Ray Radiation Dose Report	113701	DCM	COMPOSITE	N	Y	X	K