Release 5
Clinical ReasoningThis page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version in it's permanent home (it will always be available at this URL). 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: No defined compartments |
Raw Turtle (+ also see Turtle/RDF Format Specification)
RecommendationEligibilityCriteria: Eligibility Criteria for Bariatric Surgery (ADA Recommendation 8.16)
@prefix fhir: <http://hl7.org/fhir/> .
@prefix loinc: <https://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:id [ fhir:v "example-eligibility-criteria-ada-rec-bariatric"] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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>name</b>: RecommendationEligibilityCriteriaEligibilityCriteriaForBariatricSurgeryADARecommendation816</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><p><b>definitionByTypeAndValue</b></p></blockquote></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: BMI ≥ 37.5 kg/m2 in Asian Americans</p><blockquote><p><b>definitionByCombination</b></p></blockquote></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><p><b>definitionByCombination</b></p></blockquote></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><p><b>definitionByCombination</b></p></blockquote></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><p><b>definitionByTypeAndValue</b></p></blockquote></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: coronary artery angioplasty or bypass</p><blockquote><p><b>definitionByTypeAndValue</b></p></blockquote></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: stroke</p><blockquote><p><b>definitionByTypeAndValue</b></p></blockquote></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><p><b>definitionByTypeAndValue</b></p></blockquote></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: (except basal cell skin cancer)</p><p><b>exclude</b>: true</p><blockquote><p><b>definitionByTypeAndValue</b></p></blockquote></blockquote><blockquote><p><b>characteristic</b></p><p><b>description</b>: (except cancer in situ)</p><p><b>exclude</b>: true</p><blockquote><p><b>definitionByTypeAndValue</b></p></blockquote></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><p><b>timeFromEvent</b></p></blockquote></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\">Characteristic Offset</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:name [ fhir:v "RecommendationEligibilityCriteriaEligibilityCriteriaForBariatricSurgeryADARecommendation816"] ; #
fhir:title [ fhir:v "RecommendationEligibilityCriteria: Eligibility Criteria for Bariatric Surgery (ADA Recommendation 8.16)"] ; #
fhir:shortTitle [ fhir:v "Recommend bariatric surgery if BMI 35 or higher"] ; #
fhir:status [ fhir:v "active"] ; #
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fhir:description [ fhir:v "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."] ; #
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a sct:64572001 ;
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fhir:description [ fhir:v "BMI ≥ 32.5 kg/m2 and ≤ 37.4 kg/m2" ] ;
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a loinc:39156-5 ;
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fhir:high [
fhir:value [ fhir:v "37.4"^^xsd:decimal ] ;
fhir:unit [ fhir:v "kg/m2" ] ;
fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "kg/m2" ]
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fhir:description [ fhir:v "who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods." ] ;
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fhir:text [ fhir:v "achieving durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods" ]
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fhir:description [ fhir:v "Cardiovascular event (myocardial infarction, acute coronary syndrome, coronary artery angioplasty or bypass, stroke) in the past six months." ] ;
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fhir:text [ fhir:v "placeholder for now to represent 'screened surgical candidate'" ]
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fhir:characteristic ( [
fhir:description [ fhir:v "acute coronary heart disease (a value set covering many forms)" ] ;
fhir:definitionByTypeAndValue [
fhir:type [
fhir:coding ( [
a sct:64572001 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "64572001" ] ;
fhir:display [ fhir:v "Disease (disorder)" ]
] [
fhir:system [ fhir:v "http://hl7.org/fhir/resource-types"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Condition" ] ;
fhir:display [ fhir:v "Condition" ]
] )
] ;
fhir:value [
a fhir:Reference ;
fhir:reference [ fhir:v "ValueSet/32152" ] ;
fhir:type [ fhir:v "ValueSet"^^xsd:anyURI ] ;
fhir:display [ fhir:v "Acute Coronary Heart Disease Value Set" ]
]
]
] [
fhir:description [ fhir:v "coronary artery angioplasty or bypass" ] ;
fhir:definitionByTypeAndValue [
fhir:type [
fhir:coding ( [
a sct:71388002 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "71388002" ] ;
fhir:display [ fhir:v "Procedure (procedure)" ]
] [
fhir:system [ fhir:v "http://hl7.org/fhir/resource-types"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Procedure" ] ;
fhir:display [ fhir:v "Procedure" ]
] )
] ;
fhir:value [
a fhir:CodeableConcept ;
fhir:coding ( [
a sct:81266008 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "81266008" ] ;
fhir:display [ fhir:v "Heart revascularization (procedure)" ]
] )
]
]
] [
fhir:description [ fhir:v "stroke" ] ;
fhir:definitionByTypeAndValue [
fhir:type [
fhir:coding ( [
a sct:64572001 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "64572001" ] ;
fhir:display [ fhir:v "Disease (disorder)" ]
] [
fhir:system [ fhir:v "http://hl7.org/fhir/resource-types"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Condition" ] ;
fhir:display [ fhir:v "Condition" ]
] )
] ;
fhir:value [
a fhir:CodeableConcept ;
fhir:coding ( [
a sct:230690007 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "230690007" ] ;
fhir:display [ fhir:v "Cerebrovascular accident (disorder)" ]
] )
]
]
] )
] ;
fhir:timeFromEvent ( [
fhir:description [ fhir:v "in the past six months" ] ;
fhir:note ( [
fhir:text [ fhir:v "occurrence within the range is equivalent to 'in the past six months'" ]
] ) ;
fhir:range [
fhir:low [
fhir:value [ fhir:v "-6"^^xsd:decimal ] ;
fhir:unit [ fhir:v "months" ] ;
fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mo" ]
] ;
fhir:high [
fhir:value [ fhir:v "0"^^xsd:decimal ] ;
fhir:unit [ fhir:v "months" ] ;
fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mo" ]
]
]
] )
] [
fhir:description [ fhir:v "Current evidence of congestive heart failure, angina pectoris, or symptomatic peripheral vascular disease." ] ;
fhir:note ( [
fhir:text [ fhir:v "This may be possible to encode as presence of Disease(disorder) without 'in remission'" ]
] [
fhir:text [ fhir:v "placeholder for now to represent 'screened surgical candidate'" ]
] ) ;
fhir:exclude [ fhir:v "true"^^xsd:boolean ] ;
fhir:definitionCodeableConcept [
fhir:text [ fhir:v "Current evidence of congestive heart failure, angina pectoris, or symptomatic peripheral vascular disease." ]
]
] [
fhir:description [ fhir:v "Cardiac stress test indicating that surgery or IMM would not be safe." ] ;
fhir:note ( [
fhir:text [ fhir:v "placeholder for now to represent 'screened surgical candidate'" ]
] ) ;
fhir:exclude [ fhir:v "true"^^xsd:boolean ] ;
fhir:definitionCodeableConcept [
fhir:text [ fhir:v "Cardiac stress test indicating that surgery or IMM would not be safe." ]
]
] [
fhir:description [ fhir:v "Pulmonary embolus in the past six months." ] ;
fhir:note ( [
fhir:text [ fhir:v "placeholder for now to represent 'screened surgical candidate'" ]
] ) ;
fhir:exclude [ fhir:v "true"^^xsd:boolean ] ;
fhir:definitionByTypeAndValue [
fhir:type [
fhir:coding ( [
a sct:64572001 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "64572001" ] ;
fhir:display [ fhir:v "Disease (disorder)" ]
] [
fhir:system [ fhir:v "http://hl7.org/fhir/resource-types"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Condition" ] ;
fhir:display [ fhir:v "Condition" ]
] )
] ;
fhir:value [
a fhir:CodeableConcept ;
fhir:coding ( [
a sct:59282003 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "59282003" ] ;
fhir:display [ fhir:v "Pulmonary embolism (disorder)" ]
] )
]
] ;
fhir:timeFromEvent ( [
fhir:description [ fhir:v "in the past six months" ] ;
fhir:note ( [
fhir:text [ fhir:v "occurrence within the range is equivalent to 'in the past six months'" ]
] ) ;
fhir:range [
fhir:low [
fhir:value [ fhir:v "-6"^^xsd:decimal ] ;
fhir:unit [ fhir:v "months" ] ;
fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mo" ]
] ;
fhir:high [
fhir:value [ fhir:v "0"^^xsd:decimal ] ;
fhir:unit [ fhir:v "months" ] ;
fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mo" ]
]
]
] )
] [
fhir:description [ fhir:v "Thrombophlebitis in the past six months." ] ;
fhir:note ( [
fhir:text [ fhir:v "placeholder for now to represent 'screened surgical candidate'" ]
] ) ;
fhir:exclude [ fhir:v "true"^^xsd:boolean ] ;
fhir:definitionByTypeAndValue [
fhir:type [
fhir:coding ( [
a sct:64572001 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "64572001" ] ;
fhir:display [ fhir:v "Disease (disorder)" ]
] [
fhir:system [ fhir:v "http://hl7.org/fhir/resource-types"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Condition" ] ;
fhir:display [ fhir:v "Condition" ]
] )
] ;
fhir:value [
a fhir:CodeableConcept ;
fhir:coding ( [
a sct:64156001 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "64156001" ] ;
fhir:display [ fhir:v "Thrombophlebitis (disorder)" ]
] )
]
] ;
fhir:timeFromEvent ( [
fhir:description [ fhir:v "in the past six months" ] ;
fhir:note ( [
fhir:text [ fhir:v "occurrence within the range is equivalent to 'in the past six months'" ]
] ) ;
fhir:range [
fhir:low [
fhir:value [ fhir:v "-6"^^xsd:decimal ] ;
fhir:unit [ fhir:v "months" ] ;
fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mo" ]
] ;
fhir:high [
fhir:value [ fhir:v "0"^^xsd:decimal ] ;
fhir:unit [ fhir:v "months" ] ;
fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "mo" ]
]
]
] )
] [
fhir:description [ fhir:v "Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented to be disease-free for five years." ] ;
fhir:note ( [
fhir:text [ fhir:v "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:text [ fhir:v "placeholder for now to represent 'screened surgical candidate'" ]
] ) ;
fhir:exclude [ fhir:v "true"^^xsd:boolean ] ;
fhir:definitionByCombination [
fhir:code [ fhir:v "all-of" ] ;
fhir:characteristic ( [
fhir:description [ fhir:v "Cancer of any kind" ] ;
fhir:exclude [ fhir:v "false"^^xsd:boolean ] ;
fhir:definitionByTypeAndValue [
fhir:type [
fhir:coding ( [
a sct:64572001 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "64572001" ] ;
fhir:display [ fhir:v "Disease (disorder)" ]
] [
fhir:system [ fhir:v "http://hl7.org/fhir/resource-types"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Condition" ] ;
fhir:display [ fhir:v "Condition" ]
] )
] ;
fhir:value [
a fhir:CodeableConcept ;
fhir:coding ( [
a sct:363346000 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "363346000" ] ;
fhir:display [ fhir:v "Malignant neoplastic disease (disorder)" ]
] )
]
]
] [
fhir:description [ fhir:v "(except basal cell skin cancer)" ] ;
fhir:exclude [ fhir:v "true"^^xsd:boolean ] ;
fhir:definitionByTypeAndValue [
fhir:type [
fhir:coding ( [
a sct:64572001 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "64572001" ] ;
fhir:display [ fhir:v "Disease (disorder)" ]
] [
fhir:system [ fhir:v "http://hl7.org/fhir/resource-types"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Condition" ] ;
fhir:display [ fhir:v "Condition" ]
] )
] ;
fhir:value [
a fhir:CodeableConcept ;
fhir:coding ( [
a sct:254701007 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "254701007" ] ;
fhir:display [ fhir:v "Basal cell carcinoma of skin (disorder)" ]
] )
]
]
] [
fhir:description [ fhir:v "(except cancer in situ)" ] ;
fhir:exclude [ fhir:v "true"^^xsd:boolean ] ;
fhir:definitionByTypeAndValue [
fhir:type [
fhir:coding ( [
a sct:64572001 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "64572001" ] ;
fhir:display [ fhir:v "Disease (disorder)" ]
] [
fhir:system [ fhir:v "http://hl7.org/fhir/resource-types"^^xsd:anyURI ] ;
fhir:code [ fhir:v "Condition" ] ;
fhir:display [ fhir:v "Condition" ]
] )
] ;
fhir:value [
a fhir:CodeableConcept ;
fhir:coding ( [
a sct:109355002 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "109355002" ] ;
fhir:display [ fhir:v "Carcinoma in situ (disorder)" ]
] )
]
]
] [
fhir:description [ fhir:v "unless documented to be disease-free for five years" ] ;
fhir:exclude [ fhir:v "true"^^xsd:boolean ] ;
fhir:definitionCodeableConcept [
fhir:coding ( [
a sct:395100000 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "395100000" ] ;
fhir:display [ fhir:v "No evidence of cancer found (situation)" ]
] )
] ;
fhir:timeFromEvent ( [
fhir:description [ fhir:v "for five years" ] ;
fhir:note ( [
fhir:text [ fhir:v "presence throughout the range is equivalent to 'for five years'" ]
] ) ;
fhir:range [
fhir:low [
fhir:value [ fhir:v "-5"^^xsd:decimal ] ;
fhir:unit [ fhir:v "years" ] ;
fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "a" ]
] ;
fhir:high [
fhir:value [ fhir:v "0"^^xsd:decimal ] ;
fhir:unit [ fhir:v "years" ] ;
fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "a" ]
]
]
] )
] )
]
] [
fhir:description [ fhir:v "History of coagulopathy" ] ;
fhir:note ( [
fhir:text [ fhir:v "placeholder for now to represent 'screened surgical candidate'" ]
] ) ;
fhir:exclude [ fhir:v "true"^^xsd:boolean ] ;
fhir:definitionCodeableConcept [
fhir:text [ fhir:v "history of coagulopathy" ]
]
] [
fhir:description [ fhir:v "Significant anemia (hemoglobin 1.0 g or more below normal range)" ] ;
fhir:note ( [
fhir:text [ fhir:v "placeholder for now to represent 'screened surgical candidate'" ]
] ) ;
fhir:exclude [ fhir:v "true"^^xsd:boolean ] ;
fhir:definitionByTypeAndValue [
fhir:type [
fhir:coding ( [
a loinc:718-7 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "718-7" ] ;
fhir:display [ fhir:v "Hemoglobin [Mass/volume] in Blood" ]
] )
] ;
fhir:value [
a fhir:Quantity ;
fhir:value [ fhir:v "-1"^^xsd:decimal ] ;
fhir:comparator [ fhir:v "<=" ] ;
fhir:unit [ fhir:v "g/dL" ] ;
fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "g/dL" ]
] ;
fhir:offset [
fhir:coding ( [
fhir:system [ fhir:v "http://hl7.org/fhir/characteristic-offset"^^xsd:anyURI ] ;
fhir:code [ fhir:v "LNL" ] ;
fhir:display [ fhir:v "Lower Normal Limit" ]
] )
]
]
] [
fhir:description [ fhir:v "Serum creatinine ≥ 1.5 mg/dl" ] ;
fhir:note ( [
fhir:text [ fhir:v "placeholder for now to represent 'screened surgical candidate'" ]
] ) ;
fhir:exclude [ fhir:v "true"^^xsd:boolean ] ;
fhir:definitionByTypeAndValue [
fhir:type [
fhir:coding ( [
a loinc:2160-0 ;
fhir:system [ fhir:v "http://loinc.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "2160-0" ] ;
fhir:display [ fhir:v "Creatinine [Mass/volume] in Serum or Plasma" ]
] )
] ;
fhir:value [
a fhir:Quantity ;
fhir:value [ fhir:v "1.5"^^xsd:decimal ] ;
fhir:comparator [ fhir:v ">=" ] ;
fhir:unit [ fhir:v "mg/dl" ] ;
fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "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.
FHIR ®© HL7.org 2011+. FHIR R5 hl7.fhir.core#5.0.0 generated on Sun, Mar 26, 2023 15:24+1100.
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