QDM defines Symptom as an indication that a person has a condition or disease. Some examples are headache, fever, fatigue, nausea, vomiting, and pain. Also, symptoms are subjective manifestations of the disease perceived by the patient. As an example to differentiate symptom from finding, the patient’s subjective symptom of fever is distinguished from the temperature (a finding). For a finding, there is either a source of either a temperature-measuring device together with a recorder of the device (electronically) or an individual (healthcare provider, patient, etc.).

Reviewing the mapping from QDM datatypes and attributes to HL7 FHIR and QI Core, the Clinical Quality Information Work Group questioned the validity of the QDM datatype symptom.
Note: Definitions regarding symptom on the HL7 FHIR condition resource (http://hl7.org/fhir/condition.html) include:
1. Use the Observation resource when a symptom is resolved without long term management, tracking, or when a symptom contributes to the establishment of a condition.
2. Use Condition when a symptom requires long term management, tracking, or is used as a proxy for a diagnosis or problem that is not yet determined.

To the QDM User Group: Should the QDM datatype Symptom be retired with guidance consistent with the HL7 FHIR considerations listed above?