If identical copies of an SR Document are to be included in multiple Studies then the entire SR Document shall be duplicated with appropriate changes for inclusion into the different Studies (i.e. Study Instance UID, Series Instance UID, SOP Instance UID, Identical Documents Sequence etc.). The Identical Documents Sequence Attribute in each SOP Instance shall contain references to all other duplicate SOP Instances.
Note: If an SR Document contains an Identical Documents Sequence then it will not be further duplicated without producing a new complete set of duplicate SOP Instances with re-generated Identical Documents Sequences. This is a consequence of the rules for modification of SR Document content in PS3.4. For example, if there are two identical reports and an application is creating a third identical report, then the first two reports must be re-generated in order that their Identical Documents Sequence will reference the new duplicate document and all other identical documents.
If a new SR Document is created using content from an SR Document that contains an Identical Documents Sequence and is part of the same Requested Procedure, then the new SR Document shall only contain a new Identical Documents Sequence if the new SR Document is duplicated. The Predecessor Documents Sequence in all the new SR Documents shall contain references to the original SR Document and all its duplicates as well as any other documents from which content is included.
Note: It is up to an implementation to decide whether a new SR Document is duplicated across multiple Studies. This may require user input to make the decision.