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Any number of terms in additional languages and dialects can be specified for a given code in the "Designation" field (eg ValueSet.compose.include.concept.designation ) where the particular language refset to be referred to can be mapped from the language code field  "Language"(eg ValueSet.compose.include.concept.designation.language)  and the type of the term (ie FSN, Synonym, Definition) is held in the "Use" field ValueSet.compose.include.concept.designation.use.

The ExpansionProfile resource can be used to augment information supplied in ValueSet elements on request.   Michael Lawley Reuben Daniels - can you help out here?   Also suggestion that the ValueSet is not the correct place to making language reference set available.   Rather it should be augmented locally in the specific implementation.   Suggestion that the display element should specify the language code, but perhaps this is better done in an extension rather than forcing everyone to deal with it (ie core).   Also since ValueSets can be defined using filters (ie intesionally) that display terms would not be relevant in this case.

Note that all resources include an inherited "language" field which states the default language for all strings where a language code is not otherwise specified.

TODO: CodeSystem Supplement.  Peter Jordan?

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  1. Peter G. Williams please see my comments at the bottom of the page. I raised doubts as to whether CodeSystem supplements are relevant for SNOMED CT at all.

    1. I did see that, thanks for bringing it up Peter.   I'll add that into the agenda for our next discussion, or perhaps there will be further comments made before then.

  2. The challenge I have with Language Refsets (LRs) is that if the request asks for, for example, "fr", then there may be many LRs that contain French display text.  How does my server choose which one?

  3. When invoking the Value Set Expansion operation provided by a FHIR Terminology Server which supports the operation's profile parameter, a FHIR Expansion Profile resource may be used to constrain the behaviour of the terminology server when generating the expansion.

    Regarding display values, the referenced Expansion Profile may:

    • contain a ExpansionProfile.displayLanguage value (a code) to assert the language for use by ValueSet.expansion.contains.display values in the expansion; and/or
    • contain a number of ExpansionProfile.designation.include.designation elements which assert additional designations to be included in the value set expansion (i.e. in ValueSet.expansion.contains.designation elements which correspond to the ExpansionProfile.designation.include.designation elements).


    1. Currently the FHIR specification does not specify how a terminology server should behave when referenced Expansion Profile resources contain ExpansionProfile.displayLanguage or ExpansionProfile.designation.include.designation elements for languages or uses not supported by the terminology server. This may thus be assumed to be left up to the terminology server implementation e.g. return an error, revert to defaults, or silently leave out the additional designations in the value set expansion. In practice, I think few terminology servers would support processing Expansion Profile resources which are not provided by the implementation or configured for use.
    2. The displayLanguage parameter of the Value Set Expansion operation overrides a referenced Expansion Profile’s ExpansionProfile.displayLanguage value.
    3. The includeDesignations boolean parameter of the Value Set Expansion operation overrides a referenced Expansion Profile’s ExpansionProfile.designation.include.designation values.