R4 Draft for Comment

This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Clinical Decision Support Work GroupMaturity Level: 1 Trial Use Compartments: Device, Patient, Practitioner

Detailed Descriptions for the elements in the RiskAssessment resource.

RiskAssessment
Definition

An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood of each outcome.

Control1..1
Alternate NamesPrognosis
RiskAssessment.identifier
Definition

Business identifier assigned to the risk assessment.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
Summarytrue
RiskAssessment.basedOn
Definition

A reference to the request that is fulfilled by this risk assessment.

Control0..1
TypeReference(Any)
RiskAssessment.parent
Definition

A reference to a resource that this risk assessment is part of, such as a Procedure.

Control0..1
TypeReference(Any)
RiskAssessment.status
Definition

The status of the RiskAssessment, using the same statuses as an Observation.

Control1..1
Terminology BindingObservationStatus (Required)
Typecode
Summarytrue
RiskAssessment.method
Definition

The algorithm, process or mechanism used to evaluate the risk.

Control0..1
Terminology BindingRiskAssessmentMethod:
TypeCodeableConcept
Requirements

The method can influence the results of the assessment.

Summarytrue
RiskAssessment.code
Definition

The type of the risk assessment performed.

Control0..1
TypeCodeableConcept
Summarytrue
RiskAssessment.subject
Definition

The patient or group the risk assessment applies to.

Control0..1
TypeReference(Patient | Group)
Summarytrue
RiskAssessment.context
Definition

The encounter where the assessment was performed.

Control0..1
TypeReference(Encounter | EpisodeOfCare)
Summarytrue
RiskAssessment.occurrence[x]
Definition

The date (and possibly time) the risk assessment was performed.

Control0..1
TypedateTime|Period
[x] NoteSee Choice of Data Types for further information about how to use [x]
Requirements

The assessment results lose validity the more time elapses from when they are first made.

Summarytrue
RiskAssessment.condition
Definition

For assessments or prognosis specific to a particular condition, indicates the condition being assessed.

Control0..1
TypeReference(Condition)
Summarytrue
RiskAssessment.performer
Definition

The provider or software application that performed the assessment.

Control0..1
TypeReference(Practitioner | Device)
Summarytrue
RiskAssessment.reason[x]
Definition

The reason the risk assessment was performed.

Control0..1
TypeCodeableConcept|Reference(Any)
[x] NoteSee Choice of Data Types for further information about how to use [x]
RiskAssessment.basis
Definition

Indicates the source data considered as part of the assessment (FamilyHistory, Observations, Procedures, Conditions, etc.).

Control0..*
TypeReference(Any)
RiskAssessment.prediction
Definition

Describes the expected outcome for the subject.

Control0..*
Comments

Multiple repetitions can be used to identify the same type of outcome in different timeframes as well as different types of outcomes.

InvariantsDefined on this element
ras-2: Must be <= 100 (expression : probability is decimal implies probability.as(decimal) <= 100, xpath: not(f:probabilityDecimal) or f:probabilityDecimal/@value <= 100)
RiskAssessment.prediction.outcome
Definition

One of the potential outcomes for the patient (e.g. remission, death, a particular condition).

Control1..1
Terminology BindingRiskAssessmentOutcome:
TypeCodeableConcept
RiskAssessment.prediction.probability[x]
Definition

How likely is the outcome (in the specified timeframe).

Control0..1
Typedecimal|Range
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

If range is used, it represents the lower and upper bounds of certainty; e.g. 40-60% Decimal values are expressed as percentages as well (max = 100).

InvariantsDefined on this element
ras-1: low and high must be percentages, if present (expression : (low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum))), xpath: (not(f:low) or f:low[f:code/@value='%' and f:system/@value='http://unitsofmeasure.org']) and (not(f:high) or f:high[f:code/@value='%' and f:system/@value='http://unitsofmeasure.org']))
RiskAssessment.prediction.qualitativeRisk
Definition

How likely is the outcome (in the specified timeframe), expressed as a qualitative value (e.g. low, medium, high).

Control0..1
Terminology BindingRisk Probability (Example)
TypeCodeableConcept
RiskAssessment.prediction.relativeRisk
Definition

Indicates the risk for this particular subject (with their specific characteristics) divided by the risk of the population in general. (Numbers greater than 1 = higher risk than the population, numbers less than 1 = lower risk.).

Control0..1
Typedecimal
Requirements

Absolute risk is less meaningful than relative risk.

RiskAssessment.prediction.when[x]
Definition

Indicates the period of time or age range of the subject to which the specified probability applies.

Control0..1
TypePeriod|Range
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

If not specified, the risk applies "over the subject's lifespan".

RiskAssessment.prediction.rationale
Definition

Additional information explaining the basis for the prediction.

Control0..1
Typestring
RiskAssessment.mitigation
Definition

A description of the steps that might be taken to reduce the identified risk(s).

Control0..1
Typestring
Requirements

One of the main reasons for assessing risks is to identify whether interventional steps are needed to reduce risk.

RiskAssessment.comment
Definition

Additional comments about the risk assessment.

Control0..1
Typestring