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The concept map below describes the modeling discrepancies between tumor and non-tumor lesions. Note the dotted lines and boxes indicate a step that didn't happen and data not modeled.

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•  If all I need to do is to identify an objectlesion, it’s location, and then evaluate its severity, no disease response to treatment data, in other words I have TU, maybe TR and CC data, but no TR and RS, can I use TU? Show this example: https://wiki.cdisc.org/x/zxMiBw
•  How do we modeling model Result Location, when the result itself is the location? Should this be modeled in variables (RESLOC), or should we create tests for result location findings?
•  "Location" identification should be modeled separately from "Role" Identification.
  •  To get around this issue: for the "where is it?" question for non-tumor lesions, suggesting a different TUTEST = XXX Location Identification, where TUORRES = Located.

CT Questions - The Non-Tumor Lesion Side

•  On the tumor side, because you are only dealing with one type of lesion, you can get away with TUTEST = Tumor Identification. Use "tumor" as the beginning for all the identification tests. For non-tumor lesions, this convention is a bit odd. In the published CT I found: TUTEST = Cardiovascular Lesion Indicator, so is the expectation then to put the "type" of CV lesion in TULNKID? For example, TULNKID = Thoracic Aortic Aneurysm 1, where TUTEST = Cardiovascular Lesion Indicator? Alternative approach would be to pre-coordinate the suspected object into TUTEST, i.e. TUTEST = Aneurysm Lesion Indicator; TUTEST = Calcified Cardiac Annuls Indicator, etc.

Recommendations

1. Combining domains cause modeling inconsistencies. Oftentimes domains are created by different groups under different circumstances. The premises based on which a domain is built varies greatly for essentially, the same type of data (Tumor vs Non-tumor lesions). Because domains are governed by different teams (i.e. oncology and QRS SDS/CT teams), there are also different CT business rules developed for different domains.
   
2. May consider adding an assumption to better define "lesion" for TU: A localized pathological or traumatic structural change, damage, deformity, or discontinuity of tissue, organ, or body part (C3824). Anything that causes fundamental architectural changes to the structure is considered as a lesion. Jordan Li : ask Al and Nick to draft a better definition for lesion.
3. Consider updating the TUTEST = Tumor Identification to: Tumor "Role" Identification

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