ICHOM FHIR Implementation Guide: Breast Cancer
1.0.0-ballot - ballot
ICHOM FHIR Implementation Guide: Breast Cancer
1.0.0-ballot - ballot
This page is part of the ICHOM FHIR Implementation Guide: Breast Cancer (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions 
Bundle DebugBundlePatient-01-Baseline of type transaction
Entry 1
Request:
PUT ValueSet/SACQPatientComorbidityHistory
Resource ValueSet:
This value set includes codes based on the following rules:
- Include these codes as defined in
http://snomed.info/sct
Code Display 373572006 I have no other diseases 56265001 Heart disease (For example, angina, heart attack, or heart failure) 38341003 High blood pressure 19829001 Lung disease (For example, asthma, chronic bronchitis, or emphysema) 73211009 Diabetes 29384001 Ulcer or stomach disease 90708001 Kidney disease 235856003 Liver disease 414022008 Anemia or other blood disease 363346000 Cancer/Other cancer (within the last 5 years) 35489007 Depression 396275006 Osteoarthritis, degenerative arthritis 161891005 Back pain 69896004 Rheumatoid arthritis - Include these codes as defined in
http://terminology.hl7.org/CodeSystem/v3-NullFlavor
Code Display Definition OTH Other medical problems **Description:**The actual value is not a member of the set of permitted data values in the constrained value domain of a variable. (e.g., concept not provided by required code system).
**Usage Notes**: This flavor and its specializations are most commonly used with the CD datatype and its flavors. However, it may apply to \*any\* datatype where the constraints of the type are tighter than can be conveyed. For example, a PQ that is for a true measured amount whose units are not supported in UCUM, a need to convey a REAL when the type has been constrained to INT, etc.
With coded datatypes, this null flavor may only be used if the vocabulary binding has a coding strength of CNE. By definition, all local codes and original text are part of the value set if the coding strength is CWE.
Entry 2
Request:
PUT CodeSystem/AgreementResponseCodeSystem
Resource CodeSystem:
This code system
http://hl7.org/fhir/uv/ichom-breast-cancer/CodeSystem/AgreementResponseCodeSystemdefines the following codes:
Code Display no Not at all little A little quite Quite a bit very Very much
Entry 3
Request:
PUT ValueSet/AgreementResponseVS
Resource ValueSet:
- Include these codes as defined in
http://hl7.org/fhir/uv/ichom-breast-cancer/CodeSystem/AgreementResponseCodeSystem
Code Display no Not at all little A little quite Quite a bit very Very much
Entry 4
Request:
PUT CodeSystem/SatisfactionResponseCodeSystem
Resource CodeSystem:
This code system
http://hl7.org/fhir/uv/ichom-breast-cancer/CodeSystem/SatisfactionResponseCodeSystemdefines the following codes:
Code Display very-dissatisfied Very dissatisfied somewhat-dissatisfied Somewhat dissatisfied somewhat-satisfied Somewhat satisfied very-satisfied Very satisfied
Entry 5
Request:
PUT ValueSet/SatisfactionResponseVS
Resource ValueSet:
- Include these codes as defined in
http://hl7.org/fhir/uv/ichom-breast-cancer/CodeSystem/SatisfactionResponseCodeSystem
Code Display very-dissatisfied Very dissatisfied somewhat-dissatisfied Somewhat dissatisfied somewhat-satisfied Somewhat satisfied very-satisfied Very satisfied
Entry 6
Request:
PUT Questionnaire/PatientReportedBaseline
Resource Questionnaire:
Structure
LinkId Text Cardinality Type Description & Constraints PatientReportedBaseline
Questionnaire http://hl7.org/fhir/uv/ichom-breast-cancer/Questionnaire/PatientReportedBaseline General-Information-Clinical
General information 1..1 group NA-Clinical
What is your medical record number? 1..1 string What is your last name? 1..1 string Demographic factors 1..1 group Sex
Please indicate your sex at birth 1..1 choice Value Set: AdministrativeGender What is your country of residence? 1..1 choice Value Set: Iso 3166 Part 1: 3 Letter Codes Please indicate the ethnicity that you identify with 1..1 choice Value Set: Ethnicity Please indicate the biological race that you identify with 1..1 choice Value Set: Race Please indicate your highest level of schooling 1..1 choice Value Set: Education level of patient ValueSet Please indicate your current relationship status 1..1 choice Value Set: Relationship status of patient ValueSet Please indicate your current menopausal status 1..1 choice Enable When: Sex = Female (AdministrativeGender#female)
Value Set: Menopausal status of patient ValueSetClinical factors 1..1 group Have you been told by a doctor that you have any of the following? 1..* choice Value Set: SACQ Patient's comorbidity history ValueSet ComorbiditiesSACQ_HeartDiseaseFU1
Do you receive treatment for heart disease (For example, angina, heart failure, or heart attack)? 0..1 boolean Enable When: ComorbiditiesSACQ = Heart disease (SNOMED CT#56265001) Does your heart disease limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Heart disease (SNOMED CT#56265001) Do you receive treatment for high blood pressure? 0..1 boolean Enable When: ComorbiditiesSACQ = High blood pressure (SNOMED CT#38341003) Does your high blood pressure limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = High blood pressure (SNOMED CT#38341003) Do you receive treatment for lung disease? 0..1 boolean Enable When: ComorbiditiesSACQ = Lung disorder (SNOMED CT#19829001) Does your lung disease limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Lung disorder (SNOMED CT#19829001) Do you receive treatment for diabetes? 0..1 boolean Enable When: ComorbiditiesSACQ = Diabetes mellitus (SNOMED CT#73211009) Does your diabetes limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Diabetes mellitus (SNOMED CT#73211009) Do you receive treatment for an ulcer or stomach disease? 0..1 boolean Enable When: ComorbiditiesSACQ = Disorder of stomach (SNOMED CT#29384001) Does your ulcer or stomach disease limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Disorder of stomach (SNOMED CT#29384001) Do you receive treatment for kidney disease? 0..1 boolean Enable When: ComorbiditiesSACQ = Kidney disease (SNOMED CT#90708001) Does your kidney disease limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Kidney disease (SNOMED CT#90708001) Do you receive treatment for liver disease? 0..1 boolean Enable When: ComorbiditiesSACQ = Hepatopathy (SNOMED CT#235856003) Does your liver disease limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Hepatopathy (SNOMED CT#235856003) Do you receive treatment for anemia or other blood disease? 0..1 boolean Enable When: ComorbiditiesSACQ = Disorder of cellular component of blood (disorder) (SNOMED CT#414022008) Does your anemia or other blood disease limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Disorder of cellular component of blood (disorder) (SNOMED CT#414022008) Do you receive treatment for cancer/another cancer? 0..1 boolean Enable When: ComorbiditiesSACQ = Malignant tumor (SNOMED CT#363346000) Does your cancer/other cancer limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Malignant tumor (SNOMED CT#363346000) Do you receive treatment for depression? 0..1 boolean Enable When: ComorbiditiesSACQ = Depressive disorder (SNOMED CT#35489007) Does your depression limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Depressive disorder (SNOMED CT#35489007) Do you receive treatment for osteoarthritis/degenerative arthritis? 0..1 boolean Enable When: ComorbiditiesSACQ = Osteoarthritis (disorder) (SNOMED CT#396275006) Does your osteoarthritis/degenerative arthritis limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Osteoarthritis (disorder) (SNOMED CT#396275006) Do you receive treatment for back pain? 0..1 boolean Enable When: ComorbiditiesSACQ = Backache (SNOMED CT#161891005) Does your back pain limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Backache (SNOMED CT#161891005) Do you receive treatment for rheumatoid arthritis? 0..1 boolean Enable When: ComorbiditiesSACQ = Rheumatoid arthritis (SNOMED CT#69896004) Does your rheumatoid arthritis limit your activities? 0..1 boolean Enable When: ComorbiditiesSACQ = Rheumatoid arthritis (SNOMED CT#69896004) ComorbiditiesSACQ_Other
What other medical problems are you experiencing? 0..1 text Enable When: ComorbiditiesSACQ = other (NullFlavor#OTH) Treatment Variables 1..1 group Did you feel you received sufficient information about your treatment options? 1..1 choice Value Set: Patient Treatment Education ValueSet Degree of Health - EORTC-QLQ 0..1 group We are interested in some things about you and your health. Please answer all of the questions yourself by selecting the answer that best applies to you. There are no 'right' or 'wrong' answers. The information that you provide will remain strictly confidential. 0..1 group Do you have any trouble doing strenuous activities, like carrying a heavy shopping bag or a suitcase? 1..1 choice Value Set: Agreement response ValueSet Do you have any trouble taking a long walk? 1..1 choice Value Set: Agreement response ValueSet Do you have any trouble taking a short walk outside of the house? 1..1 choice Value Set: Agreement response ValueSet Do you need to stay in bed or a chair during the day? 1..1 choice Value Set: Agreement response ValueSet Do you need help with eating, dressing, washing yourself or using the toilet? 1..1 choice Value Set: Agreement response ValueSet During the past week: 0..1 group Were you limited in doing either your work or other daily activities? 1..1 choice Value Set: Agreement response ValueSet Were you limited in pursuing your hobbies or other leisure time activities? 1..1 choice Value Set: Agreement response ValueSet Were you short of breath? 1..1 choice Value Set: Agreement response ValueSet Have you had pain? 1..1 choice Value Set: Agreement response ValueSet Did you need to rest? 1..1 choice Value Set: Agreement response ValueSet Have you had trouble sleeping? 1..1 choice Value Set: Agreement response ValueSet Have you felt weak? 1..1 choice Value Set: Agreement response ValueSet Have you lacked appetite? 1..1 choice Value Set: Agreement response ValueSet Have you felt nauseated? 1..1 choice Value Set: Agreement response ValueSet Have you vomited? 1..1 choice Value Set: Agreement response ValueSet Have you been constipated? 1..1 choice Value Set: Agreement response ValueSet Have you had diarrhea? 1..1 choice Value Set: Agreement response ValueSet Were you tired? 1..1 choice Value Set: Agreement response ValueSet Did pain interfere with your daily activities? 1..1 choice Value Set: Agreement response ValueSet Have you had difficulty in concentrating on things, like reading a newspaper or watching television? 1..1 choice Value Set: Agreement response ValueSet Did you feel tense? 1..1 choice Value Set: Agreement response ValueSet Did you worry? 1..1 choice Value Set: Agreement response ValueSet Did you feel irritable? 1..1 choice Value Set: Agreement response ValueSet Did you feel depressed? 1..1 choice Value Set: Agreement response ValueSet Have you had difficulty remembering things? 1..1 choice Value Set: Agreement response ValueSet Has your physical condition or medical treatment interfered with your family life? 1..1 choice Value Set: Agreement response ValueSet Has your physical condition or medical treatment interfered with your social activities? 1..1 choice Value Set: Agreement response ValueSet Has your physical condition or medical treatment caused you financial difficulties? 1..1 choice Value Set: Agreement response ValueSet For the following questions please select the number between 1 and 7 that best applies to you, with 1 = Very poor and 7 = Excellent. 0..1 group How would you rate your overall health during the past week? 1..1 choice Options: 7 options How would you rate your overall quality of life during the past week? 1..1 choice Options: 7 options Patients sometimes report that they have the following symptoms or problems. Please indicate the extent to which you have experienced these symptoms or problems during the past week. Please answer by selecting the answer that best applies to you. During the past week: 0..1 group Have you had dry mouth? 1..1 choice Value Set: Agreement response ValueSet Have food and drink tasted different than usual? 1..1 choice Value Set: Agreement response ValueSet Have your eyes been painful, irritated or watery? 1..1 choice Value Set: Agreement response ValueSet Have you lost any hair? 1..1 choice Value Set: Agreement response ValueSet Have you been upset by the loss of your hair? 0..1 choice Enable When: EORTCQLQBR23_Q34 != Not at all (Agreement response CodeSystem#no)
Value Set: Agreement response ValueSetHave you felt ill or unwell? 1..1 choice Value Set: Agreement response ValueSet Have you had hot flushes? 1..1 choice Value Set: Agreement response ValueSet Have you had headaches? 1..1 choice Value Set: Agreement response ValueSet Have you felt physically less attractive as a result of your disease or treatment? 1..1 choice Value Set: Agreement response ValueSet Have you felt less feminine as a result of your disease or treatment? 1..1 choice Value Set: Agreement response ValueSet Have you had problems looking at yourself naked? 1..1 choice Value Set: Agreement response ValueSet Have you been dissatisfied with your body? 1..1 choice Value Set: Agreement response ValueSet Have you worried about your health in the future? 1..1 choice Value Set: Agreement response ValueSet During the past four weeks: 0..1 group Have you been sexually active? (with or without intercourse) 1..1 choice Value Set: Agreement response ValueSet To what extent were you sexually active? (with or without intercourse) 1..1 choice Value Set: Agreement response ValueSet Has sex been enjoyable for you? 0..1 choice Enable When: EORTCQLQBR23_Q45 != Not at all (Agreement response CodeSystem#no)
Value Set: Agreement response ValueSetDuring the past week: 0..1 group Have you had a swollen arm or hand? 1..1 choice Value Set: Agreement response ValueSet Have you had problems raising your arm or moving it sideways? 1..1 choice Value Set: Agreement response ValueSet Have you had any pain in the area of your affected breast? 1..1 choice Value Set: Agreement response ValueSet Has the area of your affected breast been swollen? 1..1 choice Value Set: Agreement response ValueSet Has the area of your affected breast been oversensitive? 1..1 choice Value Set: Agreement response ValueSet Have you had skin problems on or in the area of your affected breast (e.g., itchy, dry, flaky)? 1..1 choice Value Set: Agreement response ValueSet Have you sweated excessively? 1..1 choice Value Set: Agreement response ValueSet Have you had mood swings? 1..1 choice Value Set: Agreement response ValueSet Have you been dizzy? 1..1 choice Value Set: Agreement response ValueSet Have you had soreness in your mouth? 1..1 choice Value Set: Agreement response ValueSet Have you had any reddening in your mouth? 1..1 choice Value Set: Agreement response ValueSet Have you had pain in your hands or feet? 1..1 choice Value Set: Agreement response ValueSet Have you had any redenning on your hands or feet? 1..1 choice Value Set: Agreement response ValueSet Have you had tingling in your fingers or toes? 1..1 choice Value Set: Agreement response ValueSet Have you had numbness in your fingers or toes? 1..1 choice Value Set: Agreement response ValueSet Have you had problems with your joints? 1..1 choice Value Set: Agreement response ValueSet Have you had stiffness in your joints? 1..1 choice Value Set: Agreement response ValueSet Have you had pain in your joints? 1..1 choice Value Set: Agreement response ValueSet Have you had aches or pains in your bones? 1..1 choice Value Set: Agreement response ValueSet Have you had aches or pains in your muscles? 1..1 choice Value Set: Agreement response ValueSet Have you gained weight? 1..1 choice Value Set: Agreement response ValueSet Has weight gain been a problem for you? 1..1 choice Value Set: Agreement response ValueSet During the past four weeks: 0..1 group Have you had a dry vagina? 1..1 choice Value Set: Agreement response ValueSet Have you had discomfort in your vagina? 1..1 choice Value Set: Agreement response ValueSet Please answer the following two questions only if you have been sexually active: 0..1 group Have you had pain in your vagina during sexual activity? 1..1 choice Value Set: Agreement response ValueSet Have you experienced a dry vagina during sexual activity? 1..1 choice Value Set: Agreement response ValueSet During the past week: 0..1 group Have you been satisfied with the cosmetic result of the surgery? 1..1 choice Value Set: Agreement response ValueSet Have you been satisfied with the appearance of the skin of your affected breast (thoracic area)? 1..1 choice Value Set: Agreement response ValueSet Degree of Health - BreastQ: 0..1 group With your breasts in mind, or if you have had a mastectomy, with your breast area in mind, in the past 2 weeks, how satisfied or dissatisfied have you been with: 0..1 group How you look in the mirror clothed? 1..1 choice Value Set: Satisfaction response ValueSet How comfortable your bras fit? 1..1 choice Value Set: Satisfaction response ValueSet Being able to wear clothing that is more fitted? 1..1 choice Value Set: Satisfaction response ValueSet How you look in the mirror unclothed? 1..1 choice Value Set: Satisfaction response ValueSet Documentation for this format
Option Sets
Answer options for EORTCQLQC30_Q29
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- 7
Answer options for EORTCQLQC30_Q30
- 1
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- 3
- 4
- 5
- 6
- 7
IG © 2021+ HL7 International - Clinical Interoperability Council Group. Package hl7.fhir.uv.ichom-breast-cancer#1.0.0-ballot based on FHIR 4.0.1. Generated 2022-12-07
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