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-02-Follow-Up of type transaction
Entry 1
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 2
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 3
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 4
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 5
Request:
PUT Questionnaire/PatientReportedFollowUp
Resource Questionnaire:
Structure
LinkId Text Cardinality Type Description & Constraints PatientReportedFollowUp
Questionnaire http://hl7.org/fhir/uv/ichom-breast-cancer/Questionnaire/PatientReportedFollowUp General-Information-Clinical
General information 1..1 group NA-Clinical
What is the patient's medical record number? 1..1 string What is the patient's last name? 1..1 string 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 EORTCQLQC30_Q01
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 Which type of surgery did you receive? 1..1 choice Value Set: Types of breast surgery ValueSet With your breast area in mind, in the past 2 weeks, how satisfied or dissatisfied have you been with: 0..1 group Enable When: BreastQ_Surgery = Mastectomy without immediate reconstruction (Breast surgery types CodeSystem#mastectomy-without-immediate-reconstruction) How you look in the mirror clothed? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy without immediate reconstruction (Breast surgery types CodeSystem#mastectomy-without-immediate-reconstruction)
Value Set: Satisfaction response ValueSetHow comfortably your bras fit? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy without immediate reconstruction (Breast surgery types CodeSystem#mastectomy-without-immediate-reconstruction)
Value Set: Satisfaction response ValueSetBeing able to wear clothing that is more fitted? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy without immediate reconstruction (Breast surgery types CodeSystem#mastectomy-without-immediate-reconstruction)
Value Set: Satisfaction response ValueSetHow you look in the mirror unclothed? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy without immediate reconstruction (Breast surgery types CodeSystem#mastectomy-without-immediate-reconstruction)
Value Set: Satisfaction response ValueSetThe following questions are about your breasts and your breast cancer treatment (by treatment, we mean lumpectomy with or without radiation). If you have had a lumpectomy and radiation of both breasts, answer these questions thinking of the breast you are least satisfied with. With your breasts in mind, in the past week, how satisfied or dissatisfied have you been with: 0..1 group Enable When:
- BreastQ_Surgery = Breast conserving surgery (BCS) (Breast surgery types CodeSystem#bcs)
- BreastQ_Surgery = BCS with mammoplasty (Breast surgery types CodeSystem#bcs-with-mammoplasty)
How you look in the mirror clothed? 0..1 choice Enable When:
- BreastQ_Surgery = Breast conserving surgery (BCS) (Breast surgery types CodeSystem#bcs)
- BreastQ_Surgery = BCS with mammoplasty (Breast surgery types CodeSystem#bcs-with-mammoplasty)
Value Set: Satisfaction response ValueSetThe shape of your lumpectomy breast when you are wearing a bra? 0..1 choice Enable When:
- BreastQ_Surgery = Breast conserving surgery (BCS) (Breast surgery types CodeSystem#bcs)
- BreastQ_Surgery = BCS with mammoplasty (Breast surgery types CodeSystem#bcs-with-mammoplasty)
Value Set: Satisfaction response ValueSetHow normal you feel in your clothes? 0..1 choice Enable When:
- BreastQ_Surgery = Breast conserving surgery (BCS) (Breast surgery types CodeSystem#bcs)
- BreastQ_Surgery = BCS with mammoplasty (Breast surgery types CodeSystem#bcs-with-mammoplasty)
Value Set: Satisfaction response ValueSetBeing able to wear clothing that is more fitted? 0..1 choice Enable When:
- BreastQ_Surgery = Breast conserving surgery (BCS) (Breast surgery types CodeSystem#bcs)
- BreastQ_Surgery = BCS with mammoplasty (Breast surgery types CodeSystem#bcs-with-mammoplasty)
Value Set: Satisfaction response ValueSetHow your lumpectomy breast sits/hangs? 0..1 choice Enable When:
- BreastQ_Surgery = Breast conserving surgery (BCS) (Breast surgery types CodeSystem#bcs)
- BreastQ_Surgery = BCS with mammoplasty (Breast surgery types CodeSystem#bcs-with-mammoplasty)
Value Set: Satisfaction response ValueSetHow smoothly shaped your lumpectomy breast looks? 0..1 choice Enable When:
- BreastQ_Surgery = Breast conserving surgery (BCS) (Breast surgery types CodeSystem#bcs)
- BreastQ_Surgery = BCS with mammoplasty (Breast surgery types CodeSystem#bcs-with-mammoplasty)
Value Set: Satisfaction response ValueSetThe contour (outline) of your lumpectomy breast? 0..1 choice Enable When:
- BreastQ_Surgery = Breast conserving surgery (BCS) (Breast surgery types CodeSystem#bcs)
- BreastQ_Surgery = BCS with mammoplasty (Breast surgery types CodeSystem#bcs-with-mammoplasty)
Value Set: Satisfaction response ValueSetHow equal in size your breasts are to each other? 0..1 choice Enable When:
- BreastQ_Surgery = Breast conserving surgery (BCS) (Breast surgery types CodeSystem#bcs)
- BreastQ_Surgery = BCS with mammoplasty (Breast surgery types CodeSystem#bcs-with-mammoplasty)
Value Set: Satisfaction response ValueSetHow normal your lumpectomy breast looks? 0..1 choice Enable When:
- BreastQ_Surgery = Breast conserving surgery (BCS) (Breast surgery types CodeSystem#bcs)
- BreastQ_Surgery = BCS with mammoplasty (Breast surgery types CodeSystem#bcs-with-mammoplasty)
Value Set: Satisfaction response ValueSetHow much your breast look the same? 0..1 choice Enable When:
- BreastQ_Surgery = Breast conserving surgery (BCS) (Breast surgery types CodeSystem#bcs)
- BreastQ_Surgery = BCS with mammoplasty (Breast surgery types CodeSystem#bcs-with-mammoplasty)
Value Set: Satisfaction response ValueSetHow you look in the mirror unclothed? 0..1 choice Enable When:
- BreastQ_Surgery = Breast conserving surgery (BCS) (Breast surgery types CodeSystem#bcs)
- BreastQ_Surgery = BCS with mammoplasty (Breast surgery types CodeSystem#bcs-with-mammoplasty)
Value Set: Satisfaction response ValueSetIf you have had a mastectomy and reconstruction of both breasts, answer these questions thinking of the breast you are least satisfied with. With your breasts in mind ,in the past week, how satisfied or dissatisfied have you been with: 0..1 group Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction) How you look in the mirror clothed? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetThe shape of your reconstructed breast(s) when you are wearing a bra? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetHow normal you feel in your clothes? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetThe size of your reconstructed breast(s)? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetBeing able to wear clothing that is more fitted? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetHow your breasts are lined up in relation to each other? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetHow comfortably your bras fit? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetThe softness of your reconstructed breast(s)? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetHow equal in size your breasts are to each other? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetHow natural your reconstructed breast(s) looks? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetHow naturally your reconstructed breast(s) sits/hangs? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetHow your reconstructed breast(s) feel to touch? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetHow much your reconstructed breast(s) feels like a natural part of your body? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetHow closely matched (similar) your breasts are to each other? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetHow your reconstructed breast(s) look now compared to before you had any breast surgery? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetHow you look in the mirror unclothed? 0..1 choice Enable When: BreastQ_Surgery = Mastectomy with immediate reconstruction (Breast surgery types CodeSystem#mastectomy-with-immediate-reconstruction)
Value Set: Satisfaction response ValueSetDocumentation for this format
Option Sets
Answer options for EORTCQLQC30_Q29
- 1
- 2
- 3
- 4
- 5
- 6
- 7
Answer options for EORTCQLQC30_Q30
- 1
- 2
- 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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QA Report
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