Genomics Reporting Implementation Guide
3.0.0-ballot - Ballot International flag

This page is part of the Genetic Reporting Implementation Guide (v3.0.0-ballot: STU 3 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

OperationDefinition: Find Population Treatment Implications

Official URL: http://hl7.org/fhir/uv/genomics-reporting/OperationDefinition/find-population-tx-implications Version: 3.0.0-ballot
Active as of 2023-12-18 Computable Name: FindPopulationTxImplications

Retrieve count or list of patients having therapeutic implications.

Description

Retrieve count or list of patients having therapeutic implications. More specifically, this operation retrieves the count +/- list of patients that have therapeutic implications involving specific treatments and/or conditions, derived from specific variants/haplotypes/genotypes.

A patient meets numerator criteria if they have at least one therapeutic implication matching the query parameters.

As shown in the following picture, this operation can return previously instantiated implications and/or dynamically computed implications. Specific implementations can indicate their capabilities using a FHIR Capability Statement. Rules around the retention of dynamically computed implications are outside the scope of this operation, but a server could potentially instantiate those results based on the Therapeutic Implication, Diagnostic Implication, or Molecular Consequence FHIR profiles.

Instantiated vs Dynamically Computed Implications

Dynamic computation of implications can return a large number of results (e.g. 'find therapeutic implications for cancer'). Results can be curtailed using additional operation parameters (e.g. 'find therapeutic implications for somatic variant NM_007294.4:c.5578del in breast cancer").

Population queries are designed to return a count of patients that match each item sought, with or without a list of patients matching the item(s) sought.

Parameters

UseNameScopeCardinalityTypeBindingDocumentation
INvariants0..*string
(string)

List of variants from which implications are derived. Must be in HGVS or SPDI format.

INhaplotypes0..*string
(token)

List of haplotypes from which implications are derived. Must be in token or codesystem|code format.

INtreatments0..*string
(token)

List of medications and/or other therapeutic interventions for which implications are sought. Must be in token or codesystem|code format.

INconditions0..*string
(token)

List of conditions for which implications are sought. Must be in token or codesystem|code format.

INgenomicSourceClass0..1string
(token)

Enables an App to limit results to those that are 'germline' or 'somatic'. Default is to include variants irrespective of genomic source class.

INincludePatientList0..1boolean

Include list of matching patients if set to true. Default=false.

OUTimplications1..1
OUTimplications.numerator1..1Quantity

Count of patients having this variant

OUTimplications.denominator0..1Quantity

Count of patients in the cohort searched

OUTimplications.subject0..*string

Patient ID. Include if includePatientList=true

Notes:

Contents:

Error Codes

Valid response codes are shown in the following table. Additional response codes (e.g. 5xx server error) may also be encountered.

Response Code Description
200 Successfully executed request
400 ERROR: Invalid query parameters
404 ERROR: Patient not found
422 ERROR: Failed LiftOver

Examples

A health plan establishes a quality assurance program aimed at ensuring that patients with NSCLC who are candidates for molecularly guided treatment are properly identified.

To investigate, the plan queries a repository to obtain a list of patients that have a therapeutic implication involving NSCLC, irrespective of variants/haplotypes/genotypes from which the implication was derived.