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Aktuelle Version vom 23. Januar 2018, 03:26 Uhr

Id1.3.6.1.4.1.19376.1.3.10.9.42Effective Date valid from 2016‑10‑10 11:33:36
StatusKyellow.png DraftVersion Label2.0
NameAssessmentScoringSystemAPSR2.0Display NameAssessment Scoring System APSR 2.0
DescriptionSupportive Observation entry for describing a scoring system
ContextParent nodes of template element with id 1.3.6.1.4.1.19376.1.3.10.9.42
ClassificationCDA Entry Level Template
Open/ClosedOpen (other than defined elements are allowed)
Used by / Uses
Used by 0 transactions and 2 templates, Uses 4 templates
Used by as NameVersion
1.3.6.1.4.1.19376.1.3.10.4.4ContainmentKyellow.png Assessment Scales Observation for Scoring Systems APSR2 (2.0)2016‑10‑06 13:12:00
1.3.6.1.4.1.19376.1.3.10.4.3Link.pngKyellow.png ICD-O-3 Typing and Grading Observation (2.0)2015‑11‑29 17:03:18
Uses as NameVersion
1.3.6.1.4.1.19376.1.3.10.9.1IncludeKyellow.png X Specimen Identified2014‑12‑22 15:54:30
1.3.6.1.4.1.19376.1.3.10.9.43ContainmentKyellow.png Assessment Scoring Item APSR 2.0 (2.0)2016‑10‑11 10:26:17
2.16.840.1.113883.10.12.324ContainmentKgreen.png CDA Reference2005‑09‑07
2.16.840.1.113883.10.12.329ContainmentKgreen.png CDA Precondition2005‑09‑07
RelationshipSpecialization: template 1.3.6.1.4.1.19376.1.8.1.4.9 (2014‑05‑14 17:09:54)
Example
generated example for use case #1, ER-Allred Score
<observation negationInd="false" classCode="OBS" moodCode="EVN">
  <templateId root="1.3.6.1.4.1.19376.1.3.10.9.42"/>  <id root="1.2.3.999" extension="--example only--"/>  <code code="278061009 | Scores (qualifier value) |" codeSystem="2.16.840.1.113883.6.96" displayName="Score"/>  <derivationExpr text="sum"/>  <text/>  <statusCode code="completed"/>  <effectiveTime>
    <low value="20170224134516"/>  </effectiveTime>  <value code="445104009" codeSystem="2.16.840.1.113883.6.96" displayName="Sum of proportion of positive staining neoplastic cells score and average intensity of staining score for hormone receptors using immunohistochemistry (observable entity)"/>  <methodCode code="0107" displayName="Microscopy" codeSystem="2.16.840.1.113883.5.84"/>  <!-- include template 1.3.6.1.4.1.19376.1.3.10.9.1 'X Specimen Identified' (2014-12-22T15:54:30) 1..* R -->
  <entryRelationship>
    <sequenceNumber value="1"/>    <seperatableInd value="false"/>    <!-- template 1.3.6.1.4.1.19376.1.3.10.9.43 'Assessment Scoring Item APSR 2.0' (2016-10-11T10:26:17) -->
  </entryRelationship>  <reference>
    <!-- template 2.16.840.1.113883.10.12.324 'CDA Reference' (2005-09-07T00:00:00) -->
  </reference>  <precondition>
    <!-- template 2.16.840.1.113883.10.12.329 'CDA Precondition' (2005-09-07T00:00:00) -->
  </precondition>  <referenceRange typeCode="REFV">
    <observationRange classCode="OBS" moodCode="EVN.CRT">
      <code code="--code--" codeSystem="2.16.840.1.113883.5.4"/>      <text/>      <value xsi:type="ANY"/>      <interpretationCode code="EXP" displayName="Expected" codeSystem="2.16.840.1.113883.5.83"/>    </observationRange>  </referenceRange></observation>
ItemDTCardConfDescriptionLabel
hl7:observation
0 … 1R(Ass...2.0)
Treetree.png@classCode
cs1 … 1FOBS
Treetree.png@moodCode
cs1 … 1FEVN
Treetree.png@negationInd
bl0 … 1 
Treetree.pnghl7:templateId
II1 … 1M(Ass...2.0)
Treeblank.pngTreetree.png@root
uid1 … 1F1.3.6.1.4.1.19376.1.3.10.9.42
Treetree.pnghl7:id
II0 … *R(Ass...2.0)
Treetree.pnghl7:code
CV (extensible)1 … 1M(Ass...2.0)
Treeblank.pngTreetree.png@code
CONF1 … 1 @code shall be out of choice:
  • 246262008
  • Score (attribute)
Treeblank.pngTreetree.png@codeSystem
1 … 1F2.16.840.1.113883.6.96 (SNOMED Clinical Terms)
Treeblank.pngTreetree.png@codeSystemName
1 … 1FSCT
Treeblank.pngTreetree.png@displayName
1 … 1FScore
Treetree.pnghl7:derivationExpr
ST0 … 1RThis optional field can be used to specify how the total score is calculated. In most cases the total score will be the sum of its components. But complex mathematical functions and/or logical operations are possible as well.
(Ass...2.0)
Treetree.pnghl7:text
ED0 … 1RScoring system used(Ass...2.0)
Treetree.pnghl7:statusCode
CS (required)1 … 1M(Ass...2.0)
 ConstraintThe observation statusCode is “

completed ” if the observation was actually performed and has produced a result in the  value  element. In other cases the status of the intended observation is “ aborted ” and the result will never come.


 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.15933 ActStatus (2014‑03‑26)
Treetree.pnghl7:effectiveTime
IVL_TS0 … 1R(Ass...2.0)
Treetree.pnghl7:value
CE (extensible)1 … *R(Ass...2.0)
 CONF
@code shall be "any codes from 395531003 | Tumor observable (observable entity) |"
@codeSystem shall be "2.16.840.1.113883.6.96"
@codeSystemName shall be "SCT"
@displayName shall be "any score systems from Tumor observables"
or
@code shall be "any codes from 273249006 | Assessment scales"
@codeSystem shall be "2.16.840.1.113883.6.96"
@codeSystemName shall be "SCT"
@displayName shall be "any score systems from Assessment scales"
Treetree.pnghl7:methodCode
CE0 … *R(Ass...2.0)
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.14079 ObservationMethod (2014‑03‑26)
Included1 … *R from 1.3.6.1.4.1.19376.1.3.10.9.1 X Specimen Identified (2014‑12‑22 15:54:30)
Treetree.pnghl7:specimen
1 … *RRequired in XD-LAB when more than one specimen is documented at this level. Always required in APSR.
PaLM Suppl. APSR 2.0‑3: 6.3.6.9 X Specimen identified
Treeblank.pngTreetree.png@typeCode
cs0 … 1FSPC
Treeblank.pngTreetree.pnghl7:specimenRole
1 … 1MPaLM Suppl. APSR 2.0‑3: 6.3.6.9 X Specimen identified
Treeblank.pngTreeblank.pngTreetree.png@classCode
cs0 … 1FSPEC
Treeblank.pngTreeblank.pngTreetree.pnghl7:id
II1 … 1RSpecimen ID, coming from the LISPaLM Suppl. APSR 2.0‑3: 6.3.6.9 X Specimen identified
Treetree.pnghl7:entryRelationship
0 … *RContains 1.3.6.1.4.1.19376.1.3.10.9.43 Assessment Scoring Item APSR 2.0 (2016‑10‑11 10:26:17)(Ass...2.0)
Treeblank.png where [@typeCode='COMP'] [hl7:observation [hl7:templateId ​[@root​=​'1.3.6.1.4.1.19376.1.3.10.9.43']]]
Treeblank.pngTreetree.png@typeCode
cs1 … 1FCOMP
Treeblank.pngTreetree.png@context​Conduction​Ind
bl0 … 1Ftrue
Treeblank.pngTreetree.png@inversionInd
bl0 … 1 
Treeblank.pngTreetree.png@negationInd
bl0 … 1 
Treeblank.pngTreetree.pnghl7:sequenceNumber
INT0 … 1(Ass...2.0)
Treeblank.pngTreetree.pnghl7:seperatableInd
BL0 … 1(Ass...2.0)
Treetree.pnghl7:reference
0 … *RContains 2.16.840.1.113883.10.12.324 CDA Reference (2005‑09‑07)(Ass...2.0)
Treetree.pnghl7:precondition
0 … *RContains 2.16.840.1.113883.10.12.329 CDA Precondition (2005‑09‑07)(Ass...2.0)
Treetree.pnghl7:referenceRange
0 … *R(Ass...2.0)
Treeblank.pngTreetree.png@typeCode
cs1 … 1FREFV
Treeblank.pngTreetree.pnghl7:observationRange
1 … 1R(Ass...2.0)
Treeblank.pngTreeblank.pngTreetree.png@classCode
cs0 … 1FOBS
Treeblank.pngTreeblank.pngTreetree.png@moodCode
cs0 … 1FEVN.CRT
Treeblank.pngTreeblank.pngTreetree.pnghl7:code
CD0 … 1R(Ass...2.0)
Treeblank.pngTreeblank.pngTreeblank.pngTreetree.png@codeSystem
CONF0 … 1F2.16.840.1.113883.5.4 (Act Code)
Treeblank.pngTreeblank.pngTreetree.pnghl7:text
ED0 … 1R(Ass...2.0)
Treeblank.pngTreeblank.pngTreetree.pnghl7:value
ANY0 … 1R(Ass...2.0)
Treeblank.pngTreeblank.pngTreetree.pnghl7:interpretationCode
CE0 … 1R(Ass...2.0)
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.78 ObservationInterpretation (2014‑03‑26)
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