Release 5 Ballot
Clinical ReasoningThis page is part of the FHIR Specification (v5.0.0-ballot: FHIR R5 Ballot Preview). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions 
| Clinical Decision Support Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Not linked to any defined compartments |
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RecommendationEligibilityCriteria: Eligibility Criteria for Bariatric Surgery (ADA Recommendation 8.16)
@prefix fhir: <http://hl7.org/fhir/> .
@prefix loinc: <http://loinc.org/rdf#> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
[a fhir:EvidenceVariable;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "example-eligibility-criteria-ada-rec-bariatric"];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: EvidenceVariable</b><a name=\"example-eligibility-criteria-ada-rec-bariatric\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource EvidenceVariable "example-eligibility-criteria-ada-rec-bariatric" </p></div><p><b>identifier</b>: FEvIR Object Identifier: 32140</p><p><b>title</b>: RecommendationEligibilityCriteria: Eligibility Criteria for Bariatric Surgery (ADA Recommendation 8.16)</p><p><b>shortTitle</b>: Recommend bariatric surgery if BMI 35 or higher</p><p><b>status</b>: active</p><p><b>publisher</b>: Computable Publishing LLC</p><p><b>contact</b>: <a href=\"mailto:support@computablepublishing.com\">support@computablepublishing.com</a></p><p><b>description</b>: Inclusion Criteria: [[1]] Adults. [[2]] Diagnosed with type 2 diabetes. [[3]] Body Mass Index (BMI) ≥ 40.0 kg/m2 (BMI ≥ 37.5 kg/m2 in Asian Americans), or BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 (BMI 32.5-37.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods. [[4]] Screened surgical candidates.</p><p><b>copyright</b>: https://creativecommons.org/licenses/by-nc-sa/4.0/</p><p><b>effectivePeriod</b>: 2021-01 --> (ongoing)</p><p><b>author</b>: Brian S. Alper: </p><p><b>actual</b>: false</p><blockquote><p><b>characteristic</b></p><p><b>description</b>: Adult.</p><p><b>exclude</b>: false</p><h3>DefinitionByTypeAndValues</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Age <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#397669002)</span></td><td>>=18 years<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code a = 'a')</span></td></tr></table></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: Diagnosed with type 2 diabetes.</p><p><b>exclude</b>: false</p><h3>DefinitionByTypeAndValues</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001; resource-types#Condition "Condition")</span></td><td>Diabetes mellitus type 2 (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#44054006)</span></td></tr></table></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: Body Mass Index (BMI) ≥ 40.0 kg/m2 (BMI ≥ 37.5 kg/m2 in Asian Americans), or BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 (BMI 32.5-37.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods.</p><blockquote><p><b>definitionByCombination</b></p><p><b>code</b>: any-of</p><blockquote><p><b>characteristic</b></p><p><b>description</b>: Body Mass Index (BMI) ≥ 40.0 kg/m2</p><p><b>exclude</b>: false</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: BMI ≥ 37.5 kg/m2 in Asian Americans</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods.</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: BMI ≥ 32.5 kg/m2 and ≤ 37.4 kg/m2 in Asian Americans who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods.</p></blockquote></blockquote></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: Cardiovascular event (myocardial infarction, acute coronary syndrome, coronary artery angioplasty or bypass, stroke) in the past six months.</p><p><b>note</b>: placeholder for now to represent 'screened surgical candidate'</p><p><b>exclude</b>: true</p><blockquote><p><b>definitionByCombination</b></p><p><b>code</b>: any-of</p><blockquote><p><b>characteristic</b></p><p><b>description</b>: acute coronary heart disease (a value set covering many forms)</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: coronary artery angioplasty or bypass</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: stroke</p></blockquote></blockquote><h3>TimeFromEvents</h3><table class=\"grid\"><tr><td>-</td><td><b>Description</b></td><td><b>Note</b></td><td><b>Range</b></td></tr><tr><td>*</td><td>in the past six months</td><td>occurrence within the range is equivalent to 'in the past six months'</td><td>-6-0 months</td></tr></table></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: Current evidence of congestive heart failure, angina pectoris, or symptomatic peripheral vascular disease.</p><p><b>note</b>: This may be possible to encode as presence of Disease(disorder) without 'in remission', placeholder for now to represent 'screened surgical candidate'</p><p><b>exclude</b>: true</p><p><b>definitionCodeableConcept</b>: Current evidence of congestive heart failure, angina pectoris, or symptomatic peripheral vascular disease. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: Cardiac stress test indicating that surgery or IMM would not be safe.</p><p><b>note</b>: placeholder for now to represent 'screened surgical candidate'</p><p><b>exclude</b>: true</p><p><b>definitionCodeableConcept</b>: Cardiac stress test indicating that surgery or IMM would not be safe. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: Pulmonary embolus in the past six months.</p><p><b>note</b>: placeholder for now to represent 'screened surgical candidate'</p><p><b>exclude</b>: true</p><h3>DefinitionByTypeAndValues</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001; resource-types#Condition "Condition")</span></td><td>Pulmonary embolism (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#59282003)</span></td></tr></table><h3>TimeFromEvents</h3><table class=\"grid\"><tr><td>-</td><td><b>Description</b></td><td><b>Note</b></td><td><b>Range</b></td></tr><tr><td>*</td><td>in the past six months</td><td>occurrence within the range is equivalent to 'in the past six months'</td><td>-6-0 months</td></tr></table></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: Thrombophlebitis in the past six months.</p><p><b>note</b>: placeholder for now to represent 'screened surgical candidate'</p><p><b>exclude</b>: true</p><h3>DefinitionByTypeAndValues</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001; resource-types#Condition "Condition")</span></td><td>Thrombophlebitis (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64156001)</span></td></tr></table><h3>TimeFromEvents</h3><table class=\"grid\"><tr><td>-</td><td><b>Description</b></td><td><b>Note</b></td><td><b>Range</b></td></tr><tr><td>*</td><td>in the past six months</td><td>occurrence within the range is equivalent to 'in the past six months'</td><td>-6-0 months</td></tr></table></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented to be disease-free for five years.</p><p><b>note</b>: This combination logic fails if the patient has both a basal cell skin cancer or cancer in situ and a cancer of another kind., placeholder for now to represent 'screened surgical candidate'</p><p><b>exclude</b>: true</p><blockquote><p><b>definitionByCombination</b></p><p><b>code</b>: all-of</p><blockquote><p><b>characteristic</b></p><p><b>description</b>: Cancer of any kind</p><p><b>exclude</b>: false</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: (except basal cell skin cancer)</p><p><b>exclude</b>: true</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: (except cancer in situ)</p><p><b>exclude</b>: true</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: unless documented to be disease-free for five years</p><p><b>exclude</b>: true</p><p><b>definitionCodeableConcept</b>: No evidence of cancer found (situation) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#395100000)</span></p></blockquote></blockquote></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: History of coagulopathy</p><p><b>note</b>: placeholder for now to represent 'screened surgical candidate'</p><p><b>exclude</b>: true</p><p><b>definitionCodeableConcept</b>: history of coagulopathy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: Significant anemia (hemoglobin 1.0 g or more below normal range)</p><p><b>note</b>: placeholder for now to represent 'screened surgical candidate'</p><p><b>exclude</b>: true</p><h3>DefinitionByTypeAndValues</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value[x]</b></td><td><b>Offset</b></td></tr><tr><td>*</td><td>Hemoglobin [Mass/volume] in Blood <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#718-7)</span></td><td><=-1 g/dL<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code g/dL = 'g/dL')</span></td><td>Lower Normal Limit <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"codesystem-characteristic-offset.html\">CharacteristicOffset</a>#LNL)</span></td></tr></table></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: Serum creatinine ≥ 1.5 mg/dl</p><p><b>note</b>: placeholder for now to represent 'screened surgical candidate'</p><p><b>exclude</b>: true</p><h3>DefinitionByTypeAndValues</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Creatinine [Mass/volume] in Serum or Plasma <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#2160-0)</span></td><td>>=1.5 mg/dl<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code mg/dL = 'mg/dL')</span></td></tr></table></blockquote></div>"
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fhir:Range.high [
fhir:Quantity.value [ fhir:value "37.4"^^xsd:decimal ];
fhir:Quantity.unit [ fhir:value "kg/m2" ];
fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
fhir:Quantity.code [ fhir:value "kg/m2" ]
]
]
]
], [
fhir:index 1;
fhir:EvidenceVariable.characteristic.description [ fhir:value "Asian American" ];
fhir:EvidenceVariable.characteristic.definitionId [ fhir:value "AsianAmerican" ]
], [
fhir:index 2;
fhir:EvidenceVariable.characteristic.description [ fhir:value "who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods." ];
fhir:EvidenceVariable.characteristic.exclude [ fhir:value "true"^^xsd:boolean ];
fhir:EvidenceVariable.characteristic.definitionCodeableConcept [
fhir:CodeableConcept.text [ fhir:value "achieving durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods" ]
]
]
]
]
]
], [
fhir:index 3;
fhir:EvidenceVariable.characteristic.description [ fhir:value "Cardiovascular event (myocardial infarction, acute coronary syndrome, coronary artery angioplasty or bypass, stroke) in the past six months." ];
fhir:EvidenceVariable.characteristic.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "placeholder for now to represent 'screened surgical candidate'" ]
];
fhir:EvidenceVariable.characteristic.exclude [ fhir:value "true"^^xsd:boolean ];
fhir:EvidenceVariable.characteristic.definitionByCombination [
fhir:EvidenceVariable.characteristic.definitionByCombination.code [ fhir:value "any-of" ];
fhir:EvidenceVariable.characteristic.definitionByCombination.characteristic [
fhir:index 0;
fhir:EvidenceVariable.characteristic.description [ fhir:value "acute coronary heart disease (a value set covering many forms)" ];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue [
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.type [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:64572001;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "64572001" ];
fhir:Coding.display [ fhir:value "Disease (disorder)" ]
], [
fhir:index 1;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
fhir:Coding.code [ fhir:value "Condition" ];
fhir:Coding.display [ fhir:value "Condition" ]
]
];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.valueReference [
fhir:Reference.reference [ fhir:value "ValueSet/32152" ];
fhir:Reference.type [ fhir:value "ValueSet" ];
fhir:Reference.display [ fhir:value "Acute Coronary Heart Disease Value Set" ]
]
]
], [
fhir:index 1;
fhir:EvidenceVariable.characteristic.description [ fhir:value "coronary artery angioplasty or bypass" ];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue [
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.type [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:71388002;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "71388002" ];
fhir:Coding.display [ fhir:value "Procedure (procedure)" ]
], [
fhir:index 1;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
fhir:Coding.code [ fhir:value "Procedure" ];
fhir:Coding.display [ fhir:value "Procedure" ]
]
];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:81266008;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "81266008" ];
fhir:Coding.display [ fhir:value "Heart revascularization (procedure)" ]
]
]
]
], [
fhir:index 2;
fhir:EvidenceVariable.characteristic.description [ fhir:value "stroke" ];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue [
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.type [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:64572001;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "64572001" ];
fhir:Coding.display [ fhir:value "Disease (disorder)" ]
], [
fhir:index 1;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
fhir:Coding.code [ fhir:value "Condition" ];
fhir:Coding.display [ fhir:value "Condition" ]
]
];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:230690007;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "230690007" ];
fhir:Coding.display [ fhir:value "Cerebrovascular accident (disorder)" ]
]
]
]
]
];
fhir:EvidenceVariable.characteristic.timeFromEvent [
fhir:index 0;
fhir:EvidenceVariable.characteristic.timeFromEvent.description [ fhir:value "in the past six months" ];
fhir:EvidenceVariable.characteristic.timeFromEvent.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "occurrence within the range is equivalent to 'in the past six months'" ]
];
fhir:EvidenceVariable.characteristic.timeFromEvent.range [
fhir:Range.low [
fhir:Quantity.value [ fhir:value "-6"^^xsd:decimal ];
fhir:Quantity.unit [ fhir:value "months" ];
fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
fhir:Quantity.code [ fhir:value "mo" ]
];
fhir:Range.high [
fhir:Quantity.value [ fhir:value "0"^^xsd:decimal ];
fhir:Quantity.unit [ fhir:value "months" ];
fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
fhir:Quantity.code [ fhir:value "mo" ]
]
]
]
], [
fhir:index 4;
fhir:EvidenceVariable.characteristic.description [ fhir:value "Current evidence of congestive heart failure, angina pectoris, or symptomatic peripheral vascular disease." ];
fhir:EvidenceVariable.characteristic.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "This may be possible to encode as presence of Disease(disorder) without 'in remission'" ]
], [
fhir:index 1;
fhir:Annotation.text [ fhir:value "placeholder for now to represent 'screened surgical candidate'" ]
];
fhir:EvidenceVariable.characteristic.exclude [ fhir:value "true"^^xsd:boolean ];
fhir:EvidenceVariable.characteristic.definitionCodeableConcept [
fhir:CodeableConcept.text [ fhir:value "Current evidence of congestive heart failure, angina pectoris, or symptomatic peripheral vascular disease." ]
]
], [
fhir:index 5;
fhir:EvidenceVariable.characteristic.description [ fhir:value "Cardiac stress test indicating that surgery or IMM would not be safe." ];
fhir:EvidenceVariable.characteristic.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "placeholder for now to represent 'screened surgical candidate'" ]
];
fhir:EvidenceVariable.characteristic.exclude [ fhir:value "true"^^xsd:boolean ];
fhir:EvidenceVariable.characteristic.definitionCodeableConcept [
fhir:CodeableConcept.text [ fhir:value "Cardiac stress test indicating that surgery or IMM would not be safe." ]
]
], [
fhir:index 6;
fhir:EvidenceVariable.characteristic.description [ fhir:value "Pulmonary embolus in the past six months." ];
fhir:EvidenceVariable.characteristic.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "placeholder for now to represent 'screened surgical candidate'" ]
];
fhir:EvidenceVariable.characteristic.exclude [ fhir:value "true"^^xsd:boolean ];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue [
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.type [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:64572001;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "64572001" ];
fhir:Coding.display [ fhir:value "Disease (disorder)" ]
], [
fhir:index 1;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
fhir:Coding.code [ fhir:value "Condition" ];
fhir:Coding.display [ fhir:value "Condition" ]
]
];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:59282003;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "59282003" ];
fhir:Coding.display [ fhir:value "Pulmonary embolism (disorder)" ]
]
]
];
fhir:EvidenceVariable.characteristic.timeFromEvent [
fhir:index 0;
fhir:EvidenceVariable.characteristic.timeFromEvent.description [ fhir:value "in the past six months" ];
fhir:EvidenceVariable.characteristic.timeFromEvent.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "occurrence within the range is equivalent to 'in the past six months'" ]
];
fhir:EvidenceVariable.characteristic.timeFromEvent.range [
fhir:Range.low [
fhir:Quantity.value [ fhir:value "-6"^^xsd:decimal ];
fhir:Quantity.unit [ fhir:value "months" ];
fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
fhir:Quantity.code [ fhir:value "mo" ]
];
fhir:Range.high [
fhir:Quantity.value [ fhir:value "0"^^xsd:decimal ];
fhir:Quantity.unit [ fhir:value "months" ];
fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
fhir:Quantity.code [ fhir:value "mo" ]
]
]
]
], [
fhir:index 7;
fhir:EvidenceVariable.characteristic.description [ fhir:value "Thrombophlebitis in the past six months." ];
fhir:EvidenceVariable.characteristic.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "placeholder for now to represent 'screened surgical candidate'" ]
];
fhir:EvidenceVariable.characteristic.exclude [ fhir:value "true"^^xsd:boolean ];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue [
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.type [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:64572001;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "64572001" ];
fhir:Coding.display [ fhir:value "Disease (disorder)" ]
], [
fhir:index 1;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
fhir:Coding.code [ fhir:value "Condition" ];
fhir:Coding.display [ fhir:value "Condition" ]
]
];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:64156001;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "64156001" ];
fhir:Coding.display [ fhir:value "Thrombophlebitis (disorder)" ]
]
]
];
fhir:EvidenceVariable.characteristic.timeFromEvent [
fhir:index 0;
fhir:EvidenceVariable.characteristic.timeFromEvent.description [ fhir:value "in the past six months" ];
fhir:EvidenceVariable.characteristic.timeFromEvent.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "occurrence within the range is equivalent to 'in the past six months'" ]
];
fhir:EvidenceVariable.characteristic.timeFromEvent.range [
fhir:Range.low [
fhir:Quantity.value [ fhir:value "-6"^^xsd:decimal ];
fhir:Quantity.unit [ fhir:value "months" ];
fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
fhir:Quantity.code [ fhir:value "mo" ]
];
fhir:Range.high [
fhir:Quantity.value [ fhir:value "0"^^xsd:decimal ];
fhir:Quantity.unit [ fhir:value "months" ];
fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
fhir:Quantity.code [ fhir:value "mo" ]
]
]
]
], [
fhir:index 8;
fhir:EvidenceVariable.characteristic.description [ fhir:value "Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented to be disease-free for five years." ];
fhir:EvidenceVariable.characteristic.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "This combination logic fails if the patient has both a basal cell skin cancer or cancer in situ and a cancer of another kind." ]
], [
fhir:index 1;
fhir:Annotation.text [ fhir:value "placeholder for now to represent 'screened surgical candidate'" ]
];
fhir:EvidenceVariable.characteristic.exclude [ fhir:value "true"^^xsd:boolean ];
fhir:EvidenceVariable.characteristic.definitionByCombination [
fhir:EvidenceVariable.characteristic.definitionByCombination.code [ fhir:value "all-of" ];
fhir:EvidenceVariable.characteristic.definitionByCombination.characteristic [
fhir:index 0;
fhir:EvidenceVariable.characteristic.description [ fhir:value "Cancer of any kind" ];
fhir:EvidenceVariable.characteristic.exclude [ fhir:value "false"^^xsd:boolean ];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue [
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.type [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:64572001;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "64572001" ];
fhir:Coding.display [ fhir:value "Disease (disorder)" ]
], [
fhir:index 1;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
fhir:Coding.code [ fhir:value "Condition" ];
fhir:Coding.display [ fhir:value "Condition" ]
]
];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:363346000;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "363346000" ];
fhir:Coding.display [ fhir:value "Malignant neoplastic disease (disorder)" ]
]
]
]
], [
fhir:index 1;
fhir:EvidenceVariable.characteristic.description [ fhir:value "(except basal cell skin cancer)" ];
fhir:EvidenceVariable.characteristic.exclude [ fhir:value "true"^^xsd:boolean ];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue [
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.type [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:64572001;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "64572001" ];
fhir:Coding.display [ fhir:value "Disease (disorder)" ]
], [
fhir:index 1;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
fhir:Coding.code [ fhir:value "Condition" ];
fhir:Coding.display [ fhir:value "Condition" ]
]
];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:254701007;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "254701007" ];
fhir:Coding.display [ fhir:value "Basal cell carcinoma of skin (disorder)" ]
]
]
]
], [
fhir:index 2;
fhir:EvidenceVariable.characteristic.description [ fhir:value "(except cancer in situ)" ];
fhir:EvidenceVariable.characteristic.exclude [ fhir:value "true"^^xsd:boolean ];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue [
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.type [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:64572001;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "64572001" ];
fhir:Coding.display [ fhir:value "Disease (disorder)" ]
], [
fhir:index 1;
fhir:Coding.system [ fhir:value "http://hl7.org/fhir/resource-types" ];
fhir:Coding.code [ fhir:value "Condition" ];
fhir:Coding.display [ fhir:value "Condition" ]
]
];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:109355002;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "109355002" ];
fhir:Coding.display [ fhir:value "Carcinoma in situ (disorder)" ]
]
]
]
], [
fhir:index 3;
fhir:EvidenceVariable.characteristic.description [ fhir:value "unless documented to be disease-free for five years" ];
fhir:EvidenceVariable.characteristic.exclude [ fhir:value "true"^^xsd:boolean ];
fhir:EvidenceVariable.characteristic.definitionCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:395100000;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "395100000" ];
fhir:Coding.display [ fhir:value "No evidence of cancer found (situation)" ]
]
];
fhir:EvidenceVariable.characteristic.timeFromEvent [
fhir:index 0;
fhir:EvidenceVariable.characteristic.timeFromEvent.description [ fhir:value "for five years" ];
fhir:EvidenceVariable.characteristic.timeFromEvent.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "presence throughout the range is equivalent to 'for five years'" ]
];
fhir:EvidenceVariable.characteristic.timeFromEvent.range [
fhir:Range.low [
fhir:Quantity.value [ fhir:value "-5"^^xsd:decimal ];
fhir:Quantity.unit [ fhir:value "years" ];
fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
fhir:Quantity.code [ fhir:value "a" ]
];
fhir:Range.high [
fhir:Quantity.value [ fhir:value "0"^^xsd:decimal ];
fhir:Quantity.unit [ fhir:value "years" ];
fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
fhir:Quantity.code [ fhir:value "a" ]
]
]
]
]
]
], [
fhir:index 9;
fhir:EvidenceVariable.characteristic.description [ fhir:value "History of coagulopathy" ];
fhir:EvidenceVariable.characteristic.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "placeholder for now to represent 'screened surgical candidate'" ]
];
fhir:EvidenceVariable.characteristic.exclude [ fhir:value "true"^^xsd:boolean ];
fhir:EvidenceVariable.characteristic.definitionCodeableConcept [
fhir:CodeableConcept.text [ fhir:value "history of coagulopathy" ]
]
], [
fhir:index 10;
fhir:EvidenceVariable.characteristic.description [ fhir:value "Significant anemia (hemoglobin 1.0 g or more below normal range)" ];
fhir:EvidenceVariable.characteristic.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "placeholder for now to represent 'screened surgical candidate'" ]
];
fhir:EvidenceVariable.characteristic.exclude [ fhir:value "true"^^xsd:boolean ];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue [
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.type [
fhir:CodeableConcept.coding [
fhir:index 0;
a loinc:718-7;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "718-7" ];
fhir:Coding.display [ fhir:value "Hemoglobin [Mass/volume] in Blood" ]
]
];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.valueQuantity [
fhir:Quantity.value [ fhir:value "-1"^^xsd:decimal ];
fhir:Quantity.comparator [ fhir:value "<=" ];
fhir:Quantity.unit [ fhir:value "g/dL" ];
fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
fhir:Quantity.code [ fhir:value "g/dL" ]
];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.offset [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/characteristic-offset" ];
fhir:Coding.code [ fhir:value "LNL" ];
fhir:Coding.display [ fhir:value "Lower Normal Limit" ]
]
]
]
], [
fhir:index 11;
fhir:EvidenceVariable.characteristic.description [ fhir:value "Serum creatinine ≥ 1.5 mg/dl" ];
fhir:EvidenceVariable.characteristic.note [
fhir:index 0;
fhir:Annotation.text [ fhir:value "placeholder for now to represent 'screened surgical candidate'" ]
];
fhir:EvidenceVariable.characteristic.exclude [ fhir:value "true"^^xsd:boolean ];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue [
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.type [
fhir:CodeableConcept.coding [
fhir:index 0;
a loinc:2160-0;
fhir:Coding.system [ fhir:value "http://loinc.org" ];
fhir:Coding.code [ fhir:value "2160-0" ];
fhir:Coding.display [ fhir:value "Creatinine [Mass/volume] in Serum or Plasma" ]
]
];
fhir:EvidenceVariable.characteristic.definitionByTypeAndValue.valueQuantity [
fhir:Quantity.value [ fhir:value "1.5"^^xsd:decimal ];
fhir:Quantity.comparator [ fhir:value ">=" ];
fhir:Quantity.unit [ fhir:value "mg/dl" ];
fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
fhir:Quantity.code [ fhir:value "mg/dL" ]
]
]
]] .
# - ontology header ------------------------------------------------------------
[a owl:Ontology;
owl:imports fhir:fhir.ttl] .
# -------------------------------------------------------------------------------------
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.
FHIR ®© HL7.org 2011+. FHIR R5 Ballot hl7.fhir.core#5.0.0-ballot generated on Wed, Sep 7, 2022 11:08+1000.
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