V2-0078.cs.json

HL7-defined code system of concepts which specify a categorical assessment of an observation value. Notes: This is being communicated in v2.x in OBX-8 (Observation Interpretation), in v3 in ObservationInterpretation (CWE) in R1 (Representative Realm) and in FHIR in Observation.interpretation.

{
  "resourceType" : "CodeSystem",
  "id" : "v2-0078",
  "meta" : {
    "profile" : ["http://hl7.org/fhir/StructureDefinition/shareablecodesystem"]
  },
  "language" : "en",
  "text" : {
    "status" : "additional",
    "div" : "<div>!-- Snipped for Brevity --></div>"
  },
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "external"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 0
  }],
  "url" : "http://terminology.hl7.org/CodeSystem/v2-0078",
  "identifier" : [{
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.18.31"
  }],
  "version" : "2.9",
  "name" : "v2.0078",
  "title" : "v2 ABNORMAL FLAGS",
  "status" : "active",
  "experimental" : false,
  "publisher" : "HL7, Inc",
  "contact" : [{
    "telecom" : [{
      "system" : "url",
      "value" : "http://hl7.org"
    }]
  }],
  "description" : "HL7-defined code system of concepts which specify a categorical assessment of an observation value.   \r\n   \r\n   Notes:\r\n   \r\n   This is being communicated in v2.x in OBX-8 (Observation Interpretation), in v3 in ObservationInterpretation (CWE) in R1 (Representative Realm) and in FHIR in    Observation.interpretation.",
  "content" : "complete",
  "property" : [{
    "code" : "status",
    "uri" : "http://hl7.org/fhir/concept-properties#status",
    "description" : "A property that indicates the status of the concept. One of active, experimental, deprecated, retired",
    "type" : "code"
  },
  {
    "code" : "deprecationDate",
    "uri" : "http://hl7.org/fhir/concept-properties#deprecationDate",
    "description" : "The date at which a concept was deprecated. Concepts that are deprecated but not inactive can still be used, but their use is discouraged",
    "type" : "dateTime"
  }],
  "concept" : [{
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The result is below the minimum detection limit (the test procedure or equipment is the limiting factor).\r\nSynonyms: Below analytical limit, low off scale",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Het resultaat is onder de minimum detecteerbare grens (de testprocedure of apparaat is de beperkende factor). Synoniemen: Onder analytische grens, off-scale low"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "<",
    "display" : "Off scale low",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Unter Meßbereich (Extremwertverletzung)"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Onder absolute ondergrens instrumentschaal"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The result is above the maximum quantifiable limit (the test procedure or equipment is the limiting factor).\r\nSynonyms: Above analytical limit, high off scale",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Het resultaat is boven de maximum detecteerbare grens (de testprocedure of apparaat is de beperkende factor). Synoniemen: Boven analytische grens, off-scale high"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : ">",
    "display" : "Off scale high",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Über Meßbereich (Extremwertverletzung)"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Boven absolute bovengrens instrumentschaal"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The result or observation value is outside the reference range or expected norm (as defined for the respective test procedure).\r\nNote: Typically applies to non-numeric results.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Het resultaat of observatiewaarde is buiten de referentiewaarden of afwijkend van de verwachte norm (zoals gedefinieerd voor de betreffende testprocedure. NB: Meest van toepassing op niet-numerieke resultaten."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "A",
    "display" : "Abnormal",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "anormal"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Abnormaal"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The result or observation value is outside a reference range or expected norm at a level at which immediate action should be considered for patient safety (as defined for the respective test procedure).\r\n[Note: Typically applies to non-numeric results.  Analogous to critical/panic limits for numeric results.]",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Het resultaat of observatiewaarde is buiten de referentiewaarden of afwijkend van de verwachte norm waarvoor onmiddellijke actie ondernomen zou moeten worden uit het oogpunt van patiëntveiligheid (zoals gedefinieerd voor de betreffende testprocedure. NB: Meest van toepassing op niet-numerieke resultaten."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "AA",
    "display" : "Critically abnormal",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Pathologisch (nicht numerisch)"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Kritiek abnormaal"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "Deprecated",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Vervallen"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "AC",
    "display" : "Anti-complementary substances present",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Anti-complementaire stoffen aanwezig"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The current result or observation value has improved compared to the previous result or observation value (the change is significant as defined in the respective test procedure).\r\nNote: This can be applied to quantitative or qualitative observations.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Het huidige resultaat of observatiewaarde is verbeterd ten opzichte van vorige resultaat of observatiewaarde (de wijziging is significant zoals gedefinieerd in de betreffende testprocedure). NB: van toepassing op kwantitatieve of kwalitatieve observaties"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "B",
    "display" : "Better",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "besser"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Beter"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The current result has decreased from the previous result for a quantitative observation (the change is significant as defined in the respective test procedure).",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Het huidige resultaat is verlaagd ten opzichte van het vorige resultaat voor een kwantitatieve observatie (de wijziging is significant zoals gedefinieerd voor de betreffende testprocedure)."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "D",
    "display" : "Significant change down",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Deutlicher Trend nach unten"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Significante wijzging omlaag"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The measurement of the specified component / analyte, organism or clinical sign above the limit of detection of the performed test or procedure.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "De meting van het gespecificeerde component / analyte, organisme of klinische teken boven de grenswaarde voor detectie van de uitgevoerde test of procedure."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "DET",
    "display" : "Detected",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Gedetecteerd"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The result for a quantitative observation is above the upper limit of the reference range (as defined for the respective test procedure).\r\nSynonym: Above high normal",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Het resultaat voor een kwalitatieve observatie is boven de bovengrens van de referentiewaarden (zoals gedefinieerd voor de betreffende testprocedure). Synoniem: Boven bovenste normaalgrens"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "H",
    "display" : "High",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Oberhalb oberer Grenze Referenzbereich"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Hoog"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The result for a quantitative observation is above a reference level at which immediate action should be considered for patient safety (as defined for the respective test procedure).\r\nSynonym: Above upper panic limits",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "De resultaten voor een kwantitatieve observatie is boven een referentieniveau waarop onmiddellijke actie overwogen moet worden uit het oogpunt van patiëntveiligheid (zoals gedefinieerd voor betreffende testprocedure. Synoniem: Boven hoogste kritieke grens"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "HH",
    "display" : "Critically high",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Oberhalb oberer pathologischer Grenze"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Kritiek hoog"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "Deprecated",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Vervallen"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "HM",
    "display" : "Hold for Medical Review",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Vastgehouden voor medische review"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "Significantly high: A test result that is significantly higher than the reference (normal) or therapeutic interval, but has not reached the critically high value and might need special attention, as defined by the laboratory or the clinician.\r\n\r\nNote: This level is situated between ‘H’ and ‘HH’.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Significant hoog: Een testresultaat die significant hoger is dan de referentie (normaal) of therapeutisch interval, maar nog niet op de kritiek hoger waarde zit en mogelijke speciale aandacht nodig heeft, zoals gedefinieerd door het laboratorium of de arts. NB: T"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "HU",
    "display" : "Very high",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Zeer hoog"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "Bacterial strain inhibited in vitro by a\r\nconcentration of an antimicrobial agent that is associated with\r\nuncertain therapeutic effect.\r\nReference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized_Terminolo.htm)\r\nProjects: ISO 20776-1, ISO 20776-2\r\n\r\nNote 1: Bacterial strains are categorized as intermediate by applying the appropriate breakpoints in a defined phenotypic test system.\r\n\r\nNote 2: This class of susceptibility implies that an infection due to the\r\nisolate can be appropriately treated in body sites where the drugs are physiologically concentrated or when a high dosage of drug can be used.\r\n\r\nNote 3: This class also indicates a “buffer zone,� to prevent small, uncontrolled, technical factors from causing major discrepancies in interpretations.\r\n\r\nNote 4: These breakpoints can be altered due to changes in circumstances (e.g., changes in commonly used drug dosages, emergence of new resistance mechanisms).",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Bacteriële stam geblokkeerd door in vitro concentratie van een anti-bacteriële agens die is gekoppeld aan een onzekere kans op therapeutisch effect. Referentie: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized_Ter"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "I",
    "display" : "Intermediate",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Intermediär"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Gemiddeld"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "There is insufficient evidence that the species in question is a good target for therapy with the drug.  A categorical interpretation is not possible.\r\nReference: EUCAST\r\n\r\nNote: A MIC with “IE� and/or a comment may be reported (without an accompanying S, I or R-categorization).",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Er is onvoldoende bewijs dat de betreffende soort een goed doel is voor therapie met de medicatie. Een categorische interpretatie is niet mogelijk. Referentie: EUCA. NB: Een MIC met \"IE\" en/of een opmerking wordt mogelijk gerapporteerd (zonder bijbehorende S,"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "IE",
    "display" : "Insufficient evidence",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Onvoldoende bewijs"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The specified component / analyte, organism or clinical sign could neither be declared positive / negative or detected / not detected by the performed test or procedure.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Het gespecificeerde component / analyte, organisme of klinische teken kon niet positief / negatief of gedetecteerd / niet-gedetecteerd door de uitgevoerde test of procedure"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "IND",
    "display" : "Indeterminate",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Onbepaald"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The result for a quantitative observation is below the lower limit of the reference range (as defined for the respective test procedure).\r\nSynonym: Below low normal",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Het resultaat voor een kwalitatieve observatie is onder de ondergrens van de referentiewaarden (zoals gedefinieerd voor de betreffende testprocedure). Synoniem: Onder onderste normaalgrens"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "L",
    "display" : "Low",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Unterhalb unterer Grenze Referenzbereich"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Laag"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The result for a quantitative observation is below a reference level at which immediate action should be considered for patient safety (as defined for the respective test procedure).\r\nSynonym: Below lower panic limits",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "De resultaten voor een kwantitatieve observatie is onder een referentieniveau waarop onmiddellijke actie overwogen moet worden uit het oogpunt van patiëntveiligheid (zoals gedefinieerd voor betreffende testprocedure. Synoniem: Onder laagste kritieke grens"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "LL",
    "display" : "Critically low",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Unterhalb unterer pathologischer Grenze"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Kritiek laag"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "Significantly low: A test result that is significantly lower than the reference (normal) or therapeutic interval, but has not reached the critically low value and might need special attention, as defined by the laboratory or the clinician.\r\n\r\nNote: This level is situated between ‘L’ and ‘LL’.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Significant laag: Een testresultaat die significant lager is dan de referentie (normaal) of therapeutisch interval, maar nog niet op de kritiek lage waarde zit en mogelijke speciale aandacht nodig heeft, zoals gedefinieerd door het laboratorium of de arts. NB: T"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "LU",
    "display" : "Very low",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Zeer laag"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "Deprecated - CLSI now only supports S, I & R. This information can be found in CLSI document M100-S22;  Vol. 32 No.3;  CLSI Performance\r\nStandards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement.  Jan 2012.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Vervallen - CLSI ondersteunt nu alleen nog S, I & R. Deze informatie vindt u in CLSI document M100-S22;  Vol. 32 No.3;  CLSI Performance\r\nStandards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement.  Jan 2012."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "MS",
    "display" : "Moderately susceptible. Indicates for microbiology susceptibilities only.",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "mäßig empfindlich"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Gemiddeld gevoelig. Alleen voor microbiologische gevoeligheid."
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The result or observation value is within the reference range or expected norm (as defined for the respective test procedure).\r\nNote: Applies to numeric or non-numeric results.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Het resultaat of observatiewaarde is binnen de referentiewaarden of verwachte norm (zoals gedefinieerd voor de betreffende testprocedure. NB: Van toepassing op numerieke of niet-numerieke resultaten."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "N",
    "display" : "Normal",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Normal (nicht numerisch)"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Normaal"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The presence of the specified component / analyte, organism or clinical sign could not be determined  within the limit of detection of the performed test or procedure.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "De meting van het gespecificeerde component / analyte, organisme of klinische teken kon niet worden gedetecteerd binnen de grenswaarde voor detectie van de uitgevoerde test of procedure."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "ND",
    "display" : "Not Detected",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Niet-gedetecteerd"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "An absence finding of the specified component / analyte, organism or clinical sign based on the established threshold of the performed test or procedure.\r\nNote: Negative does not necessarily imply the complete absence of the specified item.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Een afwezigheidsbevinding voor het gespecificeerde component / analyte, organisme of klinische teken gebaseerd op de geldende grenswaarde van de uitgevoerde test of procedure.\r\nNB: Negatief betekent niet noodzakelijk de volledige afwezigheid van het het gespecificeerde item."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "NEG",
    "display" : "Negative",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Negatief"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "An absence finding used to indicate that the specified component / analyte did not react measurably with the reagent.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Een afwezigheidsbevinding om aan te geven dat het gespecificeerde component / analyte niet meetbaar reageerde met het reagens."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "NR",
    "display" : "Non-reactive",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Niet-reactief"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "A category used for isolates for which only a susceptible interpretive criterion has been designated because of the absence or rare occurrence of resistant strains. Isolates that have MICs above or zone diameters below the value indicated for the susceptible breakpoint should be reported as non-susceptible.\r\n\r\nSynonym: decreased susceptibility\r\n\r\nNote 1: An isolate that is interpreted as non-susceptible does not necessarily mean that the isolate has a resistance mechanism. It is possible that isolates with MICs above the susceptible breakpoint that lack resistance mechanisms may be encountered within the wild-type distribution subsequent to the time the susceptible-only breakpoint is set.\r\n\r\nNote 2: For strains yielding results in the “nonsusceptible� category, organism identification and antimicrobial susceptibility test results should be confirmed.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Een categorie voor isolaten waarvoor alleen een gevoelig interpretabel criterium is ontworpen vanwege de afwezigheid of zeldzaam voorkomen van resistente stammen. Isolaten met MIC's boven of zonediameters onder de waarde aangewezen voor de gevoeli"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "NS",
    "display" : "Non-susceptible",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Niet-gevoelig"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "Deprecated",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Vervallen"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "null",
    "display" : "No range defined, or normal ranges don't apply",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Kein Referenzbereich / Referenzbereich nicht anwendbar"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Geen referentiewaarden gedefinieerd of normale waarden niet van toepassing"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "Deprecated",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Vervallen"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "OBX",
    "display" : "Interpretation qualifiers in separate OBX segments",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Interpretatie qualifiers in afzonderlijke OBX-segmenten"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "A presence finding of the specified component / analyte, organism or clinical sign based on the established threshold of the performed test or procedure.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Een aanwezigheidsbevinding voor het gespecificeerde component / analyte, organisme of klinische teken gebaseerd op de geldende grenswaarde van de uitgevoerde test of procedure."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "POS",
    "display" : "Positive",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Positief"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "Deprecated",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Vervallen"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "QCF",
    "display" : "Quality Control Failure",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Kwaliteitscontrole fout"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "Bacterial strain inhibited in vitro by a concentration of an antimicrobial agent that is associated with a high likelihood of therapeutic failure.\r\nReference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized_Terminolo.htm)\r\nProjects: ISO 20776-1, ISO 20776-2\r\n\r\nNote 1: Bacterial strains are categorized as resistant by applying the appropriate breakpoints in a defined phenotypic test system.\r\n\r\nNote 2: This breakpoint can be altered due to changes in circumstances (e.g., changes in commonly used drug dosages, emergence of new resistance mechanisms).",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Bacteriële stam geblokkeerd door in vitro concentratie van een anti-bacteriële agens die is gekoppeld aan een hoge kans op therapeutisch falen. Referentie: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmoniz"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "R",
    "display" : "Resistant",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Resistent"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Resistent"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "A presence finding used to indicate that the specified component / analyte reacted with the reagent above the reliably measurable limit of the performed test.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Een aanwezigheidsbevinding om aan te geven dat het gespecificeerde component / analyte reageerde met het reagens, boven de betrouwbaar meetbare grens van de uitgevoerde test."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "RR",
    "display" : "Reactive",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Reactief"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "Bacterial strain inhibited by in vitro concentration of an antimicrobial agent that is associated with a high likelihood of therapeutic success.\r\nReference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized_Terminolo.htm) \r\nProjects: ISO 20776-1, ISO 20776-2\r\n\r\nSynonym (earlier term): Sensitive\r\n\r\nNote 1: Bacterial strains are categorized as susceptible by applying the appropriate breakpoints in a defined phenotypic system.\r\n\r\nNote 2: This breakpoint can be altered due to changes in circumstances (e.g., changes in commonly used drug dosages, emergence of new resistance mechanisms).",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Bacteriële stam geblokkeerd door in vitro concentratie van een anti-bacteriële agens die is gekoppeld aan een hoge kans op therapeutisch succes. Referentie: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmoniz"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "S",
    "display" : "Susceptible",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Empfindlich"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Gevoelig"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "A category that includes isolates with antimicrobial agent minimum inhibitory concentrations (MICs) that approach usually attainable blood and tissue levels and for which response rates may be lower than for susceptible isolates.\r\nReference: CLSI document M44-A2 2009 “Method for antifungal disk diffusion susceptibility testing of yeasts; approved guideline – second edition� – page 2.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Een categorie inclusief isolaten met anti-microben agens minimum blokkerende concentraties (MIC's) die in de buurt van normaal bereikbare bloed en weefsel-niveau's komen en waarvoor antwoordratio's mogelijk lager zijn dan voor gevoelige isolaten. Referentie: CLSI document"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "SDD",
    "display" : "Susceptible-dose dependent",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Gevoelig dosis-afhankelijk"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "A category for isolates where the bacteria (e.g. enterococci) are not susceptible in vitro to a combination therapy (e.g., high-level aminoglycoside and cell wall active agent). This is predictive that this combination therapy will not be effective. \r\n\r\nUsage Note: Since the use of penicillin or ampicillin alone often results in treatment failure of serious enterococcal or other bacterial infections, combination therapy is usually indicated to enhance bactericidal activity. The synergy between a cell wall active agent (such as penicillin, ampicillin, or vancomycin) and an aminoglycoside (such as gentamicin, kanamycin or streptomycin) is best predicted by screening for high-level bacterial resistance to the aminoglycoside.\r\n\r\nOpen Issue: The print name of the code is very general and the description is very specific to a pair of classes of agents, which may lead to confusion of these concepts in the future should other synergies be found.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Een categorie voor isolaten waarbij de bacteriën (bijv. enterococcen) in vitro niet gevoelig zijn voor een combinatietherapie (bijv. een hoog-niveau aminoglycoside en celwand actieve agens). Dit is een goede indicatie dat combinatietherapie niet effectief zal zijn. Gebr"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "SYN-R",
    "display" : "Synergy - resistant",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Synergie - resistent"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "A category for isolates where the bacteria (e.g. enterococci) are susceptible in vitro to a combination therapy (e.g., high-level aminoglycoside and cell wall active agent). This is predictive that this combination therapy will be effective. \r\n\r\nUsage Note: Since the use of penicillin or ampicillin alone often results in treatment failure of serious enterococcal or other bacterial infections, combination therapy is usually indicated to enhance bactericidal activity. The synergy between a cell wall active agent (such as penicillin, ampicillin, or vancomycin) and an aminoglycoside (such as gentamicin, kanamycin or streptomycin) is best predicted by screening for high-level bacterial resistance to the aminoglycoside.\r\n\r\nOpen Issue: The print name of the code is very general and the description is very specific to a pair of classes of agents, which may lead to confusion of these concepts in the future should other synergies be found.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Een categorie voor isolaten waarbij de bacteriën (bijv. enterococcen) in vitro gevoelig zijn voor een combinatietherapie (bijv. een hoog-niveau aminoglycoside en celwand actieve agens). Dit is een goede indicatie dat combinatietherapie effectief zal zijn. Gebr"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "SYN-S",
    "display" : "Synergy - susceptible",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Synergie - gevoelig"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "Deprecated",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Vervallen"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "TOX",
    "display" : "Cytotoxic substance present",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Cytotoxische stoffen aanwezig"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The current result has increased from the previous result for a quantitative observation (the change is significant as defined in the respective test procedure).",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Het huidige resultaat is verhoogd ten opzichte van het vorige resultaat voor een kwantitatieve observatie (de wijziging is significant zoals gedefinieerd voor de betreffende testprocedure)."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "U",
    "display" : "Significant change up",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Deutlicher Trend nach oben"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Significante wijzging omhoog"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "Deprecated - CLSI now only supports S, I & R. This information can be found in CLSI document M100-S22;  Vol. 32 No.3;  CLSI Performance\r\nStandards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement.  Jan 2012.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Vervallen - CLSI ondersteunt nu alleen nog S, I & R. Deze informatie vindt u in CLSI document M100-S22;  Vol. 32 No.3;  CLSI Performance\r\nStandards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement.  Jan 2012."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "VS",
    "display" : "Very susceptible. Indicates for microbiology susceptibilities only.",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Sehr empfindlich"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Zeer gevoelig. Alleen voor microbiologische gevoeligheid."
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "The current result or observation value has degraded compared to the previous result or observation value (the change is significant as defined in the respective test procedure).\r\nNote: This can be applied to quantitative or qualitative observations.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Het huidige resultaat of observatiewaarde is verslechterd ten opzichte van vorige resultaat of observatiewaarde (de wijziging is significant zoals gedefinieerd in de betreffende testprocedure). NB: van toepassing op kwantitatieve of kwalitatieve observaties"
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "W",
    "display" : "Worse",
    "designation" : [{
      "language" : "de",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Verschlechterung"
    },
    {
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Slechter"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/codesystem-concept-comments",
      "valueString" : "A weighted presence finding used to indicate that the specified component / analyte reacted with the reagent, but below the reliably measurable limit of the performed test.",
      "_valueString" : {
        "extension" : [{
          "extension" : [{
            "url" : "lang",
            "valueCode" : "nl"
          },
          {
            "url" : "content",
            "valueString" : "Een gewogen aanwezigheidsbevinding om aan te geven dat het gespecificeerde component / analyte reageerde met het reagens, maar onder de betrouwbaar meetbare grens van de uitgevoerde test."
          }],
          "url" : "http://hl7.org/fhir/StructureDefinition/translation"
        }]
      }
    }],
    "code" : "WR",
    "display" : "Weakly reactive",
    "designation" : [{
      "language" : "nl",
      "use" : {
        "system" : "http://terminology.hl7.org/CodeSystem/designation-usage",
        "code" : "display"
      },
      "value" : "Zwak reactief"
    }],
    "property" : [{
      "code" : "status",
      "valueCode" : "deprecated"
    },
    {
      "code" : "deprecationDate",
      "valueDateTime" : "2015-09"
    }]
  }]
}