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The National Cancer Institute has long been a leader in terminology related services and has provided the cancer community with structured terminology through the NCI enterprise vocabulary services Enterprise Vocabulary Services for several years. There are now a much wider range of terminology use cases to meet for the needs from bedside to bench and back and the Semantic Semantic Infrastructure 2.0 is being designed to meet address all of these use cases. The use cases require thinking beyond the capabilities of the existing metadata repository as demonstrated in caDSR and to support supporting semantic representations of concepts as they are used in clinical information exchange using the HL7 structure document's. It is also recognized that there are needs to bind structured documents. Requirements are also recognized for binding concepts to information models in the abstract as domain values, for use in models such as the BRIDG domain analysis model or the life sciences DAM.

As we support NCI supports these new information models it is recognized that there is , a fundamental requirement is recognized to continue to support those customers who have invested in the common data element vision promoted by capabilities of NCI over the last several years and to provide ways for this group customers to continue to use those elements while gracefully moving to making the transition to Semantic Infrastructure 2.0. The result will be a more robust representation that captures semantics consistent with their use usage in clinical care , and clinical research, and extending closer to a The semantics will provide more nearly full coverage for the life sciences research community.

Below are several high-level use cases that highlight some of these demanding requirements.

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- Translate local codes to standard code systems

A user has a local proprietary code system that they the user would like translated to standard code systems adopted by the vocabulary and common data elements workspace. She The user would like to be able to capture these local concepts in an Excel spreadsheet and submit them in a simple electronic way (such as an attachment to an e-mailemail). She The user would like to have the concepts returned to her with the original concepts, the new standard coded concepts with the quality of the mapping, and with the definitions associated with the coded concepts. Furthermore she the user would like the concepts returned back to her as a CSV file.

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- Create nested value sets

The user is building the specifications for a new application to manage follow-up of chemotherapy patients to track the signs and symptoms associated with a clinical trial of these certain chemotherapy agents. She The user has been given a set of CTCAE terms to capture the signs and symptoms but the set of symptom list is symptoms listed is so large that it does not fit well into a single drop-down menu. She The user would like to subset create subsets of these concepts into according related organ systems affected. She The user would like to have a unique identifier for each of these sets so that she can reuse them they can be reused in future studies. She The user has already investigated the available resources and did not find a collection of codes that met her these requirements.

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- Retrieve semantic code system cross-links

A user is constructing a case report form and as part of the form, will have some data entry fields that correspond to laboratory tests that were ordered as part of the study. She The user would like to constrain the inputs on the results of these tests to valid possibilities that can be provided via a menu selection. She The user would like to submit a list of these laboratory tests to an application that can return an identified value set of possible ranges of answers and associated units of measure for each test. She The user realizes that some of the tests will have results that are not available for some reason and would like the appropriate null representations returned as part of the value sets presented by the application.

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- Transform CTS 2 value set export to an HL7V3 coded data type

A user is building a form that will correspond to a clinical document recording for a pathology report. The user would like the vocabulary drop-down lists to be derived from a CTS 2 value set but would like this value set to be delivered to the document in the syntactical structure required for validation against the CDA schema. In other words, the user would like to submit a list of concepts and have  the the concepts structured with metadata in a HL7V3 CD data type. The structure that they anticipate the user anticipates would be delivered as an XML blob with the following structure:

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                <displayName value="Headache" />

           </code>

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- Transform an ISO-11179 common data element to an HL7 V3 class object

A user has a group of caDSR common data elements which they have been used in form construction in the past but . Now the user would now like to move their these forms to the HL7 CDA structure. They find that they can The user finds it possible to represent a portion but not all of the contextual meaning of the data element elements in 11179 but not all and . The user would like to transform their CDE's the CDEs to HL7 V3 class structures in order to get the full contextual meaning as used in the CDA document. They The user would like to submit their the list of CDE's CDEs to the ECCF registry transformer and get have a return set of V3 object classes returned.