Generated Narrative: Group example-eligibility-criteria-ada-rec-bariatric

name: Recommend bariatric surgery if BMI 35 or higher

title: RecommendationEligibilityCriteria: Eligibility Criteria for Bariatric Surgery (ADA Recommendation 8.16)

status: active

publisher: Computable Publishing LLC

contact: support@computablepublishing.com

description:

copyright:

type: person

membership: definitional

combinationMethod: all-of

characteristic

code: Age

value: >=18 years (Details: UCUM codea = 'a')

exclude: false

description:

Adult

characteristic

code: Disease (disorder)

value: Diabetes mellitus type 2 (disorder)

exclude: false

description:

Diabetes mellitus type 2 (disorder)

characteristic

code: Defined by Reference

value: 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 with nonsurgical methods

exclude: false

characteristic

code: Disease (disorder)

value: Diabetes mellitus type 2 (disorder)

exclude: false

description:

Diabetes mellitus type 2 (disorder)

characteristic

code: Defined by Reference

value: Cardiovascular event (any of: myocardial infarction, acute coronary syndrome, coronary artery angioplasty or bypass, stroke)

exclude: true

description:

Cardiovascular event (myocardial infarction, acute coronary syndrome, coronary artery angioplasty or bypass, stroke) in the past six months.

Timings

-	Offset[x]	Text
*	-6-0 months	in the past six months

characteristic

code: Disease (disorder)

value: Current evidence of congestive heart failure, angina pectoris, or symptomatic peripheral vascular disease.

exclude: true

description:

Current evidence of congestive heart failure, angina pectoris, or symptomatic peripheral vascular disease. This may be possible to encode as presence of Disease(disorder) without 'in remission. Placeholder for now to represent 'screened surgical candidate'.

characteristic

code: Disease (disorder)

value: Cardiac stress test indicating that surgery or IMM would not be safe.

exclude: true

description:

Cardiac stress test indicating that surgery or IMM would not be safe. Placeholder for now to represent 'screened surgical candidate'.

characteristic

code: Disease (disorder)

value: Pulmonary embolism (disorder)

exclude: true

description:

Pulmonary embolus in the past six months. Placeholder for now to represent 'screened surgical candidate'.

Timings

-	Offset[x]	Text
*	-6-0 months	in the past six months

characteristic

code: Disease (disorder)

value: Thrombophlebitis (disorder)

exclude: true

description:

Thrombophlebitis in the past six months. Placeholder for now to represent 'screened surgical candidate'.

Timings

-	Offset[x]	Text
*	-6-0 months	in the past six months

characteristic

code: Defined by Reference

value: Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented to be disease-free for five years

exclude: true

characteristic

code: Defined by CodeableConcept

value: history of coagulopathy

exclude: true

description:

History of coagulopathy. Placeholder for now to represent 'screened surgical candidate'.

characteristic

code: Hemoglobin [Mass/volume] in Blood

value: <=-1 GramsPerDeciLiter (Details: UCUM codeg/dL = 'g/dL')

exclude: true

description:

Significant anemia (hemoglobin 1.0 g or more below normal range). Placeholder for now to represent 'screened surgical candidate'.

offset: Lower Normal Limit

characteristic

code: Creatinine [Mass/volume] in Serum or Plasma

value: >=1.5 MilliGramsPerDeciLiter (Details: UCUM codemg/dL = 'mg/dL')

exclude: true

description:

Serum creatinine ≥ 1.5 mg/dl. Placeholder for now to represent 'screened surgical candidate'.

Generated Narrative: Group #BMI-Based-Criteria

title: CohortDefinition: BMI-based Criteria

membership: conceptual

Characteristics

-	Code	Value[x]	Exclude	Description
*	Body mass index (BMI) [Ratio]	>=40 kg/m2 (Details: UCUM codekg/m2 = 'kg/m2')	false	Body Mass Index (BMI) ≥ 40.0 kg/m2

Generated Narrative: Group #BMI-Asian-Americans

title: CohortDefinition: BMI ≥ 37.5 kg/m2 in Asian Americans

membership: conceptual

combinationMethod: all-of

characteristic

code: Body mass index (BMI) [Ratio]

value: >=37.5 kilogram per square meter (kg/m2) (Details: UCUM codekg/m2 = 'kg/m2')

exclude: false

description:

BMI ≥ 37.5 kg/m2

characteristic

code: Race

value: Asian American

exclude: false

description:

Asian American. The evidence and guideline panel decision to modify the BMI threshold for Asian Americans is based on data mostly from Asian Americans not generally including Native Hawaiians and other Pacific Islanders, so it is not explicit whether the modified thresholds apply to Native Hawaiians and other Pacific Islanders. See https://diabetesjournals.org/care/article/38/1/150/37769/BMI-Cut-Points-to-Identify-At-Risk-Asian-Americans for details

Generated Narrative: Group #BMI-35-to-less-than-40

title: BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 who do not achieve durable weight loss and improvement in comorbidities with nonsurgical methods

description:

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.

membership: conceptual

combinationMethod: all-of

characteristic

code: Body mass index (BMI) [Ratio]

value: 35-39.9 kilogram per square meter (kg/m2)

exclude: false

description:

BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2

characteristic

code: Defined by CodeableConcept

value: achieving durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods

exclude: true

description:

who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods.

Generated Narrative: Group #BMI-32.5-to-less-than-37.5

title: BMI ≥ 32.5 kg/m2 and ≤ 37.4 kg/m2 in Asian Americans who do not achieve durable weight loss and improvement in comorbidities with nonsurgical methods

description:

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.

membership: conceptual

combinationMethod: all-of

characteristic

code: Body mass index (BMI) [Ratio]

value: 32.5-37.4 kilogram per square meter (kg/m2)

exclude: false

description:

BMI ≥ 32.5 kg/m2 and ≤ 37.4 kg/m2

characteristic

code: Race

value: Asian American

exclude: false

description:

Asian American. The evidence and guideline panel decision to modify the BMI threshold for Asian Americans is based on data mostly from Asian Americans not generally including Native Hawaiians and other Pacific Islanders, so it is not explicit whether the modified thresholds apply to Native Hawaiians and other Pacific Islanders. See https://diabetesjournals.org/care/article/38/1/150/37769/BMI-Cut-Points-to-Identify-At-Risk-Asian-Americans for details

characteristic

code: Defined by CodeableConcept

value: achieving durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods

exclude: true

description:

who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods.

Generated Narrative: Group #BMI-Qualifying-Group

title: 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 with nonsurgical methods

description:

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.

membership: conceptual

combinationMethod: any-of

characteristic

code: Defined by Reference

value: CohortDefinition: BMI-based Criteria

exclude: false

characteristic

code: Defined by Reference

value: CohortDefinition: BMI ≥ 37.5 kg/m2 in Asian Americans

exclude: false

characteristic

code: Defined by Reference

value: BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 who do not achieve durable weight loss and improvement in comorbidities with nonsurgical methods

exclude: false

characteristic

code: Defined by Reference

value: BMI ≥ 32.5 kg/m2 and ≤ 37.4 kg/m2 in Asian Americans who do not achieve durable weight loss and improvement in comorbidities with nonsurgical methods

exclude: false

Generated Narrative: Group #Certain-Cardiovascular-Events

title: Cardiovascular event (any of: myocardial infarction, acute coronary syndrome, coronary artery angioplasty or bypass, stroke)

description:

Cardiovascular event (any of: myocardial infarction, acute coronary syndrome, coronary artery angioplasty or bypass, stroke). Placeholder for now to represent 'screened surgical candidate'.

membership: conceptual

combinationMethod: any-of

characteristic

code: Disease (disorder)

value: Acute Coronary Heart Disease Value Set

exclude: false

description:

acute coronary heart disease (a value set covering many forms)

characteristic

code: Procedure (procedure)

value: Heart revascularization (procedure)

exclude: false

characteristic

code: Disease (disorder)

value: Cerebrovascular accident (disorder)

exclude: false

Generated Narrative: Group #Cancer

title: Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented to be disease-free for five years

description:

Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented to be disease-free for five years. 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'.

membership: conceptual

combinationMethod: all-of

characteristic

code: Disease (disorder)

value: Malignant neoplastic disease (disorder)

exclude: false

description:

Cancer of any kind

characteristic

code: Disease (disorder)

value: Basal cell carcinoma of skin (disorder)

exclude: true

description:

(except basal cell skin cancer)

characteristic

code: Disease (disorder)

value: Carcinoma in situ (disorder)

exclude: true

description:

(except cancer in situ)

characteristic

code: Defined by CodeableConcept

value: No evidence of cancer found (situation)

exclude: true

description:

unless documented to be disease-free for five years

Timings

-	Offset[x]	Text
*	-5-0 years	for five years