CDA Implementation Guidance Narrative Block Tags

CDA Narrative Block

Tag Name Allowable Attribute Description
<text>

This tag encompassing a text section

ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Styles text, such as presenting text in bold, italics underline
mediaType mediaType is akin to mimeType. This is a fixed value in the CDA narrative block, and so can be omitted.

Tags allowed within <text>

<content>
<linkHTML>
<sub>
<sup>
<br>
<footnote>
<footnoteRef>
<renderMultiMedia>
<paragraph>
<list>
<table>

Example

<text>

    <paragraph>Some document text</paragraph>

</text>




Tag Name Allowable Attribute Description
<content>

Use this tag to wrap some text so that it can be referenced (using the ID attribute), or styled (using the styleCode attribute). This element can be used recursively.

ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics
revised An indication that text has been revised from the original, as an insert or delete

Tags allowed within <content>

<content>
<linkHTML>
<sup>
<sub>
<br>
<footnote>
<footnoteRef>
<renderMultiMedia>

Example

<text>

     <content styleCode="bold">Some document text appears in bold</content>

 </text>

 

<text>

     Sally has a history of <content ID="a1">Exercise Related Asthma</content> latest attack 2 weeks ago.

 </text>




Tag Name Allowable Attribute Description
<linkHTML>

Acts similar to the HTML anchor tag. Can be used to reference identifiers that are both internal and external to the document.

name DO NOT USE THIS
href The reference location
rel  
rev  
title  
ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics

Tags allowed within <linkHTML>

<footnote>
<footnoteRef>

Example

<section ID="SECT001">

   <code code="10164-2" codeSystem="2.16.840.1.113883.6.1"

      codeSystemName="LOINC"/>

   <title>History of Present Illness</title>

   <text>Mr. Smith is a 57 year old male presenting with chest

      pain. He sustained a myocardial infarction 3 years ago,

      ...</text>

</section>

...

<section ID="SECT003">

   <code code="10153-2" codeSystem="2.16.840.1.113883.6.1"

      codeSystemName="LOINC"/>

   <title>Past Medical History</title>

   <text>History of coronary artery disease, as noted

      <linkHtml href="#SECT001">above</linkHtml>.

   </text>

</section>




Tag Name Allowable Attribute Description
<sub>

Puts text into subscrip.

   

Tags allowed within <sub>

<<NONE>>

Example

<text>

    This is <sub>subscript</sub>

</text>




Tag Name Allowable Attribute Description
<sup>

Puts text into superscript

   

Tags allowed within <sup>

<<NONE>> 

Example

<text>

    This is <sup>superscript</sup>

</text>

 



Tag Name Allowable Attribute Description
<br>

Used to indicate a hard line break.

   

Tags allowed within <br>

<<NONE>>

Example

<text>This text appears on line one<br/>and this on line two</text>




Tag Name Allowable Attribute Description
<footnote>

Indicates a footnote, inline with the flow of text to which it is applied.

ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics

Tags allowed within <footnote>

<content>
<linkHTML>
<sub>
<sup>
<br>
<renderMultiMedia>
<paragraph>
<list>
<table>

Example

<text>This is the text for the section <footnote>this is a footnote for the section</footnote></text>

 



Tag Name Allowable Attribute Description
<footnoteRef>

The <footnoteRef> element can reference an existing footnote in the same or different CDA Narrative Block of the same document. It can be used when the same footnote is being used multiple times. The value of the footnoteRef.IDREF must be an footnote.ID
value in the same document.

 

ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics
IDREF Used to reference a previous footnote

Tags allowed within <footnoteRef>

<<NONE>>

Example

<text>This is the text for the section <footnote ID="F1">this is a footnote for the section</footnote></text>

....

<text>This another text section that references a footnote <footnoteRef IDREF="#F1"</footnoteRef></text>




Tag Name Allowable Attribute Description
<renderMultiMedia>

renderMultiMedia element references external multimedia that is integral to a document, and part of the attestable content of the document, and serves to show where the referenced multimedia is to be rendered.

Multimedia that is simply referenced by the document and not an integral part of the document must use <linkHtml>.

referencedObject  
ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics

Tags allowed within <renerMultiMedia>

<caption>
Example

<section>

   <code code="ABCD" codeSystem="2..6.7.8.3.4445"

      codeSystemName="MyCODESYSTEM"/>

   <title>Skin exam</title>

   <text>Erythematous rash, palmar surface, left index finger.

      <renderMultiMedia referencedObject="MM1"/>

   </text>

   <entry>

      <observationMedia classCode="OBS" moodCode="EVN" ID="MM1">

         <id root="10.23.4567.345"/>

         <value xsi:type="ED" mediaType="image/jpeg">

            <reference value="left_hand_image.jpeg"/>

         </value>

      </observationMedia>

   </entry>

</section>




Tag Name Allowable Attribute Description
<paragraph>

Works the same as a HTML <p> tag

ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics

Tags allowed within <paragraph>

<caption>
<content>
<linkHTML>
<sub>
<sup>
<br>
<footnote>
<footnoteRef>
<renderMultiMedia>

Example

<text>The text section starts with some text.<p>The has a second paragraph</p><p styleCode="bold">And a third in bold</p></text>




Tag Name Allowable Attribute Description
<caption>

The CDA <caption> is a label for a paragraph, list, list item, table, or table cell. It can also be used within the <renderMultiMedia> element to indicate a label for referenced ObservationMedia and RegionOfInterest entries. A <caption> contains plain text and may contain links and footnotes.

ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics

Tags allowed within <list>

<linkHTML>
<sub>
<sup>
<footnote>
<footnoteRef>

Example

<section>

   <code code="ABCD" codeSystem="2..6.7.8.3.4445"

      codeSystemName="MyCODESYSTEM"/>

   <title>Skin exam</title>

   <text>Erythematous rash, palmar surface, left index finger.

      <renderMultiMedia referencedObject="MM1"><caption styleCode="italics">Left index finger image</caption></renderMultiMedia>

   </text>

   <entry>

      <observationMedia classCode="OBS" moodCode="EVN" ID="MM1">

         <id root="10.23.4567.345"/>

         <value xsi:type="ED" mediaType="image/jpeg">

            <reference value="left_hand_image.jpeg"/>

         </value>

      </observationMedia>

   </entry>

</section>

 



Tag Name Allowable Attribute Description
<list>

produces an ordered (numbered) or unordered (bulleted) list. Unordered is the default.

ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics
listType List cane be "ordered" or "unordered"

Tags allowed within <list>

<caption>
<item>

Example

<text>The following is a list of options<list><item>Option1</item><item>Option2</item></list></text>

<text>The following is an ordered list of options<list listType="ordered"><item>Option1</item><item>Option2</item></list></text>




Tag Name Allowable Attribute Description
<item>

An item within a list

ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics

Tags allowed within <item>

<caption>
<content>
<linkHTML>
<sub>
<sup>
<br>
<footnote>
<footnoteRef>
<renderMultiMedia>
<paragraph>
<list>
<table>

Example

see above



Tag Name Allowable Attribute Description
<table>

A table - this acts in the same way as a HTML table

ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics
summary  
width Table width
border Deprecated in favour of styleCode
frame  
rules  
cellspacing Deprecated in favour of styleCode
cellpadding Deprecated in favour of styleCode

Tags allowed within <table>

<caption>
<col>
<colgroup>
<thead>
<tfoot>
<tbody>
 

Tag Name Allowable Attribute Description
<col> ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics, and for cell borders using "Lrule", "Rrule", "Toprule" and "Botrule"
span Number of columns this cell spans
width  
align  
char  
charoff  
valign Vertical alignment

Tags allowed within <col>

<<NONE>> 

Tag Name Allowable Attribute Description
<colgroup> ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics
span  
width  
align  
char  
charoff  
valign  

Tags allowed within <col>

<col>
  

Tag Name Allowable Attribute Description
<thead>

Table header

ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics
align  
char  
charoff  
valign  

Tags allowed within <thead>

<tr>
  

Tag Name Allowable Attribute Description
<tfoot>

table footer

ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics
align  
char  
charoff  
valign  

Tags allowed within <tfoot>

<tr>
  

Tag Name Allowable Attribute Description
<tbody>

Table body

ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics
align  
char  
charoff  
valign  

Tags allowed within <tbody>

<tr>
  

Tag Name Allowable Attribute Description
<tr>

Table row

ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics
abbr  
axis  
headers  
scope  
rowspan  
colspan  
align  
char  
charoff  
valign  

Tags allowed within <tr>

<th>
<td>
 

Tag Name Allowable Attribute Description
<th>

Table head

ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics
abbr  
axis  
headers  
scope  
rowspan  
colspan  
align  
char  
charoff  
valign  

Tags allowed within <th>

<content>
<linkHTML>
<sub>
<sup>
<br>
<footnote>
<footnoteRef>
<renderMultiMedia>
 

Tag Name Allowable Attribute Description
<td>

Table data

ID Allows a reference to a coded entry (sometimes called a clinical statement). If no coded entries are referenced, ID is omitted.
language The language used for the text between these tags. In the NHS England, this is assumed to be English. If any language other then English is used, the language should be specified.
styleCode Used to style text in the document, such as bold, underline and italics
abbr  
axis  
headers  
scope  
rowspan  
colspan  
align  
char  
charoff  
valign  

Tags allowed within <td>

<content>
<linkHTML>
<sub>
<sup>
<br>
<footnote>
<footnoteRef>
<renderMultiMedia>
<paragraph>
<list>