Evidencevariable-example-eligibility-criteria-ada-rec-bariatric

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Example EvidenceVariable/example-eligibility-criteria-ada-rec-bariatric (Narrative)

Clinical Decision Support Work Group

Maturity Level: N/A

Standards Status: Informative

Compartments: No defined compartments

This is the narrative for the resource. See also the XML, JSON or Turtle format. This example conforms to the profile EvidenceVariable.

Generated Narrative: EvidenceVariable

Resource EvidenceVariable "example-eligibility-criteria-ada-rec-bariatric"

identifier: FEvIR Object Identifier: 32140

name: RecommendationEligibilityCriteriaEligibilityCriteriaForBariatricSurgeryADARecommendation816

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

shortTitle: Recommend bariatric surgery if BMI 35 or higher

status: active

publisher: Computable Publishing LLC

contact: support@computablepublishing.com

description: 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.

copyright: https://creativecommons.org/licenses/by-nc-sa/4.0/

effectivePeriod: 2021-01 --> (ongoing)

author: Brian S. Alper:

actual: false

characteristic
description: Adult.
exclude: false
DefinitionByTypeAndValues
- Type Value[x]
* Age (SNOMED CT#397669002) >=18 years (Details: UCUM code a = 'a')

characteristic
description: Diagnosed with type 2 diabetes.
exclude: false
DefinitionByTypeAndValues
- Type Value[x]
* Disease (disorder) (SNOMED CT#64572001; resource-types#Condition "Condition") Diabetes mellitus type 2 (disorder) (SNOMED CT#44054006)

characteristic
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.
definitionByCombination
code: any-of
characteristic
description: Body Mass Index (BMI) ≥ 40.0 kg/m2
exclude: false
definitionByTypeAndValue
characteristic
description: BMI ≥ 37.5 kg/m2 in Asian Americans
definitionByCombination
characteristic
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.
definitionByCombination
characteristic
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.
definitionByCombination

characteristic
description: Cardiovascular event (myocardial infarction, acute coronary syndrome, coronary artery angioplasty or bypass, stroke) in the past six months.
note: placeholder for now to represent 'screened surgical candidate'
exclude: true
definitionByCombination
code: any-of
characteristic
description: acute coronary heart disease (a value set covering many forms)
definitionByTypeAndValue
characteristic
description: coronary artery angioplasty or bypass
definitionByTypeAndValue
characteristic
description: stroke
definitionByTypeAndValue
TimeFromEvents
- Description Note Range
* in the past six months occurrence within the range is equivalent to 'in the past six months' -6-0 months

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

characteristic
description: Cardiac stress test indicating that surgery or IMM would not be safe.
note: placeholder for now to represent 'screened surgical candidate'
exclude: true
definitionCodeableConcept: Cardiac stress test indicating that surgery or IMM would not be safe. ()

characteristic
description: Pulmonary embolus in the past six months.
note: placeholder for now to represent 'screened surgical candidate'
exclude: true
DefinitionByTypeAndValues
- Type Value[x]
* Disease (disorder) (SNOMED CT#64572001; resource-types#Condition "Condition") Pulmonary embolism (disorder) (SNOMED CT#59282003)
TimeFromEvents
- Description Note Range
* in the past six months occurrence within the range is equivalent to 'in the past six months' -6-0 months

characteristic
description: Thrombophlebitis in the past six months.
note: placeholder for now to represent 'screened surgical candidate'
exclude: true
DefinitionByTypeAndValues
- Type Value[x]
* Disease (disorder) (SNOMED CT#64572001; resource-types#Condition "Condition") Thrombophlebitis (disorder) (SNOMED CT#64156001)
TimeFromEvents
- Description Note Range
* in the past six months occurrence within the range is equivalent to 'in the past six months' -6-0 months

characteristic
description: Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented to be disease-free for five years.
note: 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'
exclude: true
definitionByCombination
code: all-of
characteristic
description: Cancer of any kind
exclude: false
definitionByTypeAndValue
characteristic
description: (except basal cell skin cancer)
exclude: true
definitionByTypeAndValue
characteristic
description: (except cancer in situ)
exclude: true
definitionByTypeAndValue
characteristic
description: unless documented to be disease-free for five years
exclude: true
definitionCodeableConcept: No evidence of cancer found (situation) (SNOMED CT#395100000)
timeFromEvent

characteristic
description: History of coagulopathy
note: placeholder for now to represent 'screened surgical candidate'
exclude: true
definitionCodeableConcept: history of coagulopathy ()

characteristic
description: Significant anemia (hemoglobin 1.0 g or more below normal range)
note: placeholder for now to represent 'screened surgical candidate'
exclude: true
DefinitionByTypeAndValues
- Type Value[x] Offset
* Hemoglobin [Mass/volume] in Blood (LOINC#718-7) <=-1 g/dL (Details: UCUM code g/dL = 'g/dL') Lower Normal Limit (Characteristic Offset#LNL)

characteristic
description: Serum creatinine ≥ 1.5 mg/dl
note: placeholder for now to represent 'screened surgical candidate'
exclude: true
DefinitionByTypeAndValues
- Type Value[x]
* Creatinine [Mass/volume] in Serum or Plasma (LOINC#2160-0) >=1.5 mg/dl (Details: UCUM code mg/dL = 'mg/dL')

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.