03/04/14
NTE content, how to structure multiple
lines, cardinality, line breaks and length
proposal
Issue 1: What constitutes a single complete comment (“thought”)

Proposal 1: One NTE segment shall contain a single complete comment. If several distinct
comments are to be conveyed in the message, one NTE segment shall be used for each
comment. The use of formatting commands in the base standard V2.7.1, section 2.7.6
allows for appropriate formatting of the comment within the NTE-3 (Comment) field if
desired.
Note: this is a non-testable requirement in context free validation.
Question for discussion: Is the richness of the of formatting commands in V2 sufficient for
display requirements? (see figure below)
Example: (these are taken from result messages and not order messages)
Instead of this
…
NTE|1||result should be interpreted in conjunction with other
laboratory and
NTE|2||clinical data available to the clinician.
NTE|3||Identification performed by DLS Laboratories, Aiea, HI.
Susceptibility
NTE|4||performed by Focus Diagnostics, Inc., Cypress, CA
…
Would be this (Option 1)
…
NTE|1||result should be interpreted in conjunction with other
laboratory and clinical data available to the clinician.
NTE|2||Identification performed by DLS Laboratories, Aiea, HI.
NTE|3||Susceptibility performed by Focus Diagnostics, Inc.,
Cypress, CA
…
Or this: (Option 2)
…
NTE|1||result should be interpreted in conjunction with other
laboratory and \.br\ clinical data available to the clinician.
NTE|2||Identification performed by DLS Laboratories, Aiea, HI.
NTE|3||Susceptibility performed by Focus Diagnostics, Inc.,
Cypress, CA
…
Or this: (Option 3)
…
NTE|1||result should be interpreted in conjunction with other
laboratory and \.br\ clinical data available to the clinician. \.br\
Identification performed by DLS Laboratories, Aiea, HI.
\.br\ Susceptibility performed by Focus Diagnostics, Inc.,
Cypress, CA
…
3/4/14 – Motion to accept Proposal 1 as written with all three options as acceptable – David
Burgess, Mark Jones
Against: 0 Abstain: 4 For: 7
Issue 2: Cardinality of NTE-3 – Does the “~” imply line breaks?

Proposal 2: In order to remove ambiguity and reduce the number of option for
representation of line breaks change the cardinality of NTE-3 from [1..*] to [1..1]. The use of
formatting commands in the base standard V2.7.1, section 2.7.6 allows for appropriate
formatting including line breaks of the comment within the NTE-3 (Comment) field if
desired.
3/4/14 – Motion to accept change in cardinality and to add note to IG that disallows use of ‘~’
as a line break indicator. Hans Buitendijk, Eric Haas
Against: 0 Abstain: 2 For: 10
Example: (these are taken from result messages and not order messages)
Instead of this….
…
NTE|1||result should be interpreted in conjunction with other
laboratory and ~ clinical data available to the clinician. ~
Identification performed by DLS Laboratories, Aiea, HI.
Susceptibility ~ performed by Focus Diagnostics, Inc., Cypress,
CA
…
Would be like examples above.
Issue 3 and 4: Empty NTE-3 and Does the end of the comment in NTE-3
imply a line break or should there be an explicit line break “/.br/” ?

Proposal 3: In order to remove ambiguity and reduce the number of option for
representation of line breaks use the formatting command “/.br/” as defined in the base
standard V2.7.1, section 2.7.6. shall be used at the end of the comment in NTE-3 in order to
indicate a line break.

Proposal 4: An empty NTE-3 or an NTE-3 composed of only white space characters is not
allowed. The minimum entry in an NTE-3 shall be the /.br/ character.
3/4/14 – Motion that an empty NTE-3 or an NTE-3 with only formatting characters is not a valid
thought that stands on its own. Add an example to show how to do multiple line breaks
(\.br\\.br\\.br\) within an NTE-3 that contains a valid concept. Riki Merrick, Freida Hall
Against: 0 Abstain: 2 For: 11
3/4/14 – Motion that the receiver must treat each NTE as a separate concept and process
and/or present accordingly and cannot be considered a continuation of a prior NTE/concept,
e.g., prior paragraph. David Burgess, Mark Jones.
NOTE: Mark Jones to provide an example of NTE with a table in it
Against: 0 Abstain: 2 For: 12
Question: Is this superfluous if adopt proposal 1 and 2 above since a NTE-3 composed of
only a “/.br/” constitute a complete comment or thought?

Example: (these are taken from result messages and not order messages)
Instead of this NOT VALID
…
NTE|1||result should be interpreted in conjunction with other
laboratory and /.br/ clinical data available to the clinician.
NTE|2||Identification performed by DLS Laboratories, Aiea, HI.
NTE|3||Susceptibility performed by Focus Diagnostics, Inc.,
Cypress, CA
…
Would be this:
…
NTE|1||result should be interpreted in conjunction with other
laboratory and /.br/ clinical data available to the clinician. /.br/
NTE|2||Identification performed by DLS Laboratories, Aiea, HI.
/.br/
NTE|3||Susceptibility performed by Focus Diagnostics, Inc.,
Cypress, CA/.br/
…
Issue 5: Technical correction in base standard to V2.7.1, section 2.7.6 for
representation of the formatting characters.
Proposal for v 2.9 – “SHALL use escape” (not MAY)
Proposal 5: In this guide, the formatting comments in v 2.7.1 Section 2.7.6 SHALL be
surrounded by the escape character.
Example:
instead of “.br” shall use “/.br/”
3/4/14 – Motion to include this constraint in the IG (shall use escape characters) and also to
make proposal for V2.9. Mark Jones, Eric Haas (will submit for V2.9)
Against: 0 Abstain: 2 For: 11
Note: will decide how to present entire topic in the IG (include FT and notes, or new section)
Issue 6: NTE-3 – FT (Comment) has no practical size limit, what is
reasonable?
Proposal 6: Select 64K as initial test limit for a single repeat of a single NTE-3.
For Orders – exceeding the limit is a soft error (progress but notify)
For Results – exceeding the limit is a hard error (due to current practice and to be
consistent with exceeding cardinality)
3/4/14 – Motion that the test limit for NTE-3 be 64K characters. Bob Dieterle, Eric Haas
Against: 0 Abstain: 2 For: 12