FFFFF.2 Patient Level Attributes that Change Over Time

FFFFF.2 Patient Level Attributes that Change Over Time (Current)
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In the DICOM Information Model, attributes in the Patient Module and the Clinical Trial Subject Module, exist at the Patient Level. These are not supposed to be different at patient level for all the studies for the patient. This has implications when:

One of these attributes changes in the real world, e.g., a patient’s name changes.
SOP Instances are imported from a different environment.
Hospitals merge and consolidate their archives.

Most organizations will have policies regarding what should be done when one of these changes takes place. DICOM does not specify or recommend such policies but rather supports the usage of local policies.

The Original Attributes Sequence (0400,0561) and Instance Coercion DateTime (0008,0015) can be used to record prior values when changes are made to any attributes.

There are also attributes at the Study Level that might differ between studies when Patient Root queries are performed. These include:

Gender Identity Sequence (0010,0041)
Sex Parameters for Clinical Use Category Sequence (0010,0043)
Person Names to Use Sequence (0010,0011)
Third Person Pronouns Sequence (0010,0014)

As Study level Attributes, the Values of these are required by DICOM to be the same for all the SOP Instances in a single Study. They are allowed to be different in different Studies for the same patient.