Data Set APSR 2.0 - Concept Diagnostic conclusion

ID: 2.16.840.1.113883.2.6.60.6.1.1Version Label: Live VersionConcepts: 38 (Groups: 6 - Items: 32)

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Name ID[‑] Datatype[‑] Property[‑] Example[‑] Codes[‑] Description[‑] Source[‑] Rationale[‑] Operationalizations[‑] Comment[‑] Status[‑] Terminology[‑] Value Set[‑] Type[‑] Parent concept[‑] Inherit from[‑]
Diagnostic conclusion psr-dataelement-45 Diagnoses on all specimens that are delivered to the pathology department from one operation or patient visit from a single clinician (ordering provider) on a particular day. This is a critical summary of findings, giving an answer to the clinical question.  The diagnoses for each specimen or group of specimens should be reported separately from each other. Additional pathologic finding(s) and the results of ancillary study(ies), diagrams and still images or virtual slides, if taken, may be included. In case of cancer, the tumor formula should be and any cancer checklist may be included. IHE_PAT_Suppl_APSR_Rev2 0_TI_2015_20_05
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      		Group
      diagnostic conclusion text psr-dataelement-108 Text Text of the diagnostic conclusion
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          		Item Diagnostic conclusion
          Generic AP observation psr-dataelement-65 Code Atomic unit of a Generic AP observation, coded or as measurement value. 
          Each generic observation must have a textual part for human readibility.
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              AP Observation 2015-11-22T12:20:34 (dynamic / Extensible/CWE)
              		 Item Diagnostic conclusion
              Embedded Image psr-dataelement-71 Image of a specimen, or a schematic drawing, or part of a specimen, or a tissue section, embedded in an observation
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                  		Group Diagnostic conclusion
                  Image ID psr-dataelement-69 Identifier Identifier of the image, issued by the LIS (Order filler or Image manager) as Image ID.
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                      		Item Embedded Image
                      Drawing psr-dataelement-91 Binary Schematic drawing of a specimen processing, e.g. grossing
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                          		Item Embedded Image
                          Macroscopic image psr-dataelement-92 Binary Image obtained by a macro-camera from specimen or part of a specimen
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                              		Item Embedded Image
                              Microscopic Image psr-dataelement-37 Binary Microscopic image (e.g. WSI) of a slide or part of a slide
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                                  		Item Embedded Image
                                  ROI psr-dataelement-93 Binary Region of interest in an image
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                                      		Item Embedded Image
                                      Scoring systems psr-dataelement-57 Code Systems for semiquantitative assessment of grading, (immunohistochemical) staining results, and other observable entities.
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                                        Assessment scales (assessment scale) (SNOMED Clinical Terms: 273249006)
                                        Total Gleason score (observable entity) (SNOMED Clinical Terms: 384997002)
                                        Nottingham Combined Grade (qualifier value) (SNOMED Clinical Terms: 372276001)
                                          		 Item Diagnostic conclusion
                                          Tumor classification (ICD-O-3) psr-dataelement-54 System for the classification of tumors according their site (location) and their histology (morphology). Hosted by WHO (IARC) in the ICD-O (International classification of diseases (oncology) http://www.who.int/classifications/icd/adaptations/oncology/en/ Classification structureA multi-axial classification of the site, morphology, behaviour, and grading of neoplasms.The topography axis uses the ICD-10 classification of malignant neoplasms (except those categories which relate to secondary neoplasms and to specified morphological types of tumours) for all types of tumours, thereby providing greater site detail for non-malignant tumours than is provided in ICD-10. In contrast to ICD-10, the ICD-O includes topography for sites of haematopoietic and reticuloendothelial tumours.The morphology axis provides five-digit codes ranging from 8000/0 to 9989/3. The first four digits indicate the specific histological term. The fifth digit after the slash (/) is the behaviour code, which indicates whether a tumour is malignant, benign, in situ, or uncertain (whether benign or malignant). A separate one-digit code is also provided for histologic grading (differentiation) or cell type in lymphomas and leukemias.A complete code consists of 10 digits (4 for topography, 6 for morphology, behavior and grading), separated by a "." after the 3rd digit in topography and a "/" after the 4th digit in morphology (8th digit in total). Qualifier for laterality (1 additional digit) may be given after the topography code.
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                                            Histology and Behavior ICD-O-3 Cancer (Logical Observation Identifier Names and Codes: 59847-4)
                                            ICD-O-3 (International Classification of Diseases for Oncology: ICD-O: 2.16.840.1.113883.6.43.1)
                                              		 Group Diagnostic conclusion
                                              Topography (Tumor site) psr-dataelement-73 Code Indicates the tumor site. The topography axis of ICD-O-3 uses the ICD-10 classification of malignant neoplasms (except those categories which relate to secondary neoplasms and to specified morphological types of tumours) for all types of tumours, thereby providing greater site detail for non-malignant tumours than is provided in ICD-10. In contrast to ICD-10, the ICD-O includes topography for sites of haematopoietic and reticuloendothelial tumours. http://www.who.int/classifications/icd/adaptations/oncology/en/
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                                                Site coding system.current Cancer site (Logical Observation Identifier Names and Codes: 42129-7)
                                                  ICD-O-3 Topography 2015-11-13T19:16:23 (dynamic)
                                                  		 Item Tumor classification (ICD-O-3)
                                                  Morphology (Typing) psr-dataelement-56 Code Classification of tumors according their morphology, resulting in tumor type. Classification System, part of ICD-O,  hosted by WHO, published in the famous "blue books".
                                                  Coded by the first 4 digits in the M chapter (Morphology axis) of ICD-O-3 (M-8000/0 to M-9989/3)                                                  		 http://www.who.int/classifications/icd/adaptations/oncology/en/ Tumors are classified according their morphological properties, assuming that the morphology is an indicator for the original tissue component the tumor stems from.
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                                                    Histology ICD-O-3 Cancer (Logical Observation Identifier Names and Codes: 31205-8)
                                                      ICD-O-3 Morphology 2015-11-13T14:08:46 (dynamic)
                                                      		 Item Tumor classification (ICD-O-3)
                                                      Behavior psr-dataelement-72 Code
                                                      • /0
                                                      • /1
                                                      • /2
                                                      • /3
                                                      • /6
                                                      • /9
                                                      • asked but unknown
                                                      		 Indicates whether a tumour is malignant, benign, in situ, or uncertain (whether benign or malignant).
                                                      Coded by the first digit after the slash in the M chapter (Morphology axis) of ICD-O-3                                                      		 http://www.who.int/classifications/icd/adaptations/oncology/en/
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                                                        Behavior ICD-O-3 Cancer (Logical Observation Identifier Names and Codes: 31206-6)
                                                          ICD-O-3 Behavior 2015-11-13T18:54:30 (dynamic)
                                                          		 Item Tumor classification (ICD-O-3)
                                                          Differentiation psr-dataelement-55 Differentiation means Grading as classification of tumors according their assumed grade of malignancy. The most often three-tiered grading system is used. Furthermore, the cell type of lympoproliferative neoplasias is classified in that system, too.
                                                          Both are coded by the second digit after the slash in the M chapter (Morphology axis) of ICD-O-3

                                                          It also means differentiation according the lymphocyte type in malignant lymphomas.                                                          		 http://www.who.int/classifications/icd/adaptations/oncology/en/  All grading systems share the assumption that a tumor is as more malignant as it differs morphologically from the original tissue. Highly differentiated tumors (very similar to the original tissue) are low malignant (low grade, grade 1), poorly differentiated tumors are highly malignant ones (high grade, grade 3 or 4).
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                                                            Histological grade finding (finding) (SNOMED Clinical Terms: 373372005)
                                                              		 Group Tumor classification (ICD-O-3)
                                                              Grading/Immunophenotype psr-dataelement-104 Code
                                                              • 1
                                                              • 2
                                                              • 3
                                                              • 4
                                                              • 5
                                                              • 6
                                                              • 7
                                                              • 8
                                                              • 9
                                                              • Asked but unknown
                                                              		 Differentiation of a malignant tumor, both as grading in a 4-tiered grading system (WHO-grading) and as immunophenotype for malignant lymphomas and some leukemias http://www.who.int/classifications/icd/adaptations/oncology/en/
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                                                                Grade Cancer (Logical Observation Identifier Names and Codes: 21858-6)
                                                                  ICD-O-3 Differentiation 2015-11-13T19:07:32 (dynamic)
                                                                  		 Item Differentiation
                                                                  Assessment Scales (Score) psr-dataelement-99 Code
                                                                  • Scoring systems
                                                                  		 Assessment scales or scores are a special, highly structured form of clinical findings (see scoring systems)
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                                                                    Assessment scales (assessment scale) (SNOMED Clinical Terms: 273249006)
                                                                      		 Item Differentiation
                                                                      Tumor formula (TNM) psr-dataelement-3 Tumor formula including T-, M- and N-values as well as further details (staging) and grading, well known as TNM classification, hosted by UICC Sobin LH, Gospodarowicz MK, Wittekind Ch: TNM classification of malignant tumors.7th ed. 2010, 4th corrected postprint, Wiley&Sons
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                                                                        Pathologic TNM stage grouping (observable entity) (SNOMED Clinical Terms: 399588009)
                                                                        Clinical TNM stage grouping (observable entity) (SNOMED Clinical Terms: 399537006)
                                                                          		 Group Diagnostic conclusion
                                                                          Stage psr-dataelement-74 Code IVB
                                                                          • stage X
                                                                          • stage 0
                                                                          • stage 0a
                                                                          • stage 0is
                                                                          • stage I
                                                                          • stage IA1
                                                                          • stage IA2
                                                                          • stage IB
                                                                          • stage IB1
                                                                          • stage IB2
                                                                          • stage IC
                                                                          • stage IS
                                                                          • stage II
                                                                          • stage IIA
                                                                          • stage IIA1
                                                                          • stage IIA2
                                                                          • stage IIB
                                                                          • stage IIC
                                                                          • stage III
                                                                          • stage IIIA
                                                                          • stage IIIB
                                                                          • stage IIIC
                                                                          • stage IV
                                                                          • stage IVA
                                                                          • stage IVB
                                                                          • stage IVC
                                                                          		 Stage system (hosted by UICC) of a tumor disease, compiling the elements of TNM classification
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                                                                            Stage group.pathology Cancer (Logical Observation Identifier Names and Codes: 21902-2)
                                                                              UICC Stage (7ed) 2015-06-23T16:43:02 (dynamic)
                                                                              		 Item Tumor formula (TNM)
                                                                              Posttherapeutic psr-dataelement-29 Code
                                                                              • Fixed value: y
                                                                              		 Symbol for TNM: Is this Observation performed after a multimodal therapy?
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                                                                                y - During therapy/following treatment (tumor staging) (SNOMED Clinical Terms: 277649004)
                                                                                  		 Item Tumor formula (TNM)
                                                                                  Autopsy psr-dataelement-28 Code
                                                                                  • Fixed value: a
                                                                                  		 Symbol for TNM: Has this tumor formula been derived first at autopsy?
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                                                                                    a - At autopsy (tumor staging) (SNOMED Clinical Terms: 277646006)
                                                                                      		 Item Tumor formula (TNM)
                                                                                      Postoperative psr-dataelement-59 Boolean
                                                                                      • Fixed value: p
                                                                                      		 Qualifier (prefix)  for T, N, and M category: Is this Observation performed after operative therapy, i.e. information comes from the pathologist
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                                                                                        p-pathological (1.2.276.0.76.3.1.131.1.5.1: tnmCp)
                                                                                          		 Item Tumor formula (TNM)
                                                                                          Clinical psr-dataelement-60 Code
                                                                                          • Fixed value: c
                                                                                          • p
                                                                                          • c
                                                                                          • Asked but unknown
                                                                                          		 Qualifier  (prefix) for T, N, and M category: Is this Observation performed by clinical methods?
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                                                                                            c-clinical (1.2.276.0.76.3.1.131.1.5.1: tnmCp)
                                                                                              TNM_Praefix_CP_UICC 2015-11-04T15:52:34 (dynamic)
                                                                                              		 Item Tumor formula (TNM)
                                                                                              Multiplicity psr-dataelement-61 Code pT2(m); pT2(3)
                                                                                              • (m)
                                                                                              • (2)
                                                                                              • (3)
                                                                                              • (4)
                                                                                              • (5)
                                                                                              • (6)
                                                                                              • (7)
                                                                                              • (8)
                                                                                              • (9)
                                                                                              • (10)
                                                                                              • Asked but unknown
                                                                                              		 Qualifier for pT category: Are there multiple tumors in the specimen removed or how many multiple tumors are in the specimen? 
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                                                                                                m-multiple tumors (1.2.276.0.76.3.1.131.1.5.1: tnmMultiplicity)
                                                                                                  UICC Multiplicity 2015-11-06T10:44:54 (dynamic)
                                                                                                  		 Item Tumor formula (TNM)
                                                                                                  Recurrence psr-dataelement-26 Code
                                                                                                  • Fixed value: r
                                                                                                  		 Symbol for TNM: Is this tumor recurring from a previous disease..
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                                                                                                    r - Tumor recurrence (tumor staging) (SNOMED Clinical Terms: 277647002)
                                                                                                    r (TNM Edition7 UICC: r)
                                                                                                    r (TNM Edition6 UICC: r)
                                                                                                    r (TNM Edition5 UICC: r)
                                                                                                      		 Item Tumor formula (TNM)
                                                                                                      Observation Timestamp psr-dataelement-13 Date/time
                                                                                                      • Timestamp precision: at least day (DD), month (MM) and year (YYYY)
                                                                                                      		 point in time when this observation was made
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                                                                                                          		Item Tumor formula (TNM)
                                                                                                          Nodes Affected psr-dataelement-12 Quantity How many nodes are affected by tumor?
                                                                                                            		draft
                                                                                                              		Item Tumor formula (TNM)
                                                                                                              Nodes Examined psr-dataelement-11 Quantity number of nodes examined
                                                                                                                		draft
                                                                                                                  		Item Tumor formula (TNM)
                                                                                                                  Sentinel Lymph Nodes psr-dataelement-102 Code Regional lymph nodes according the sentinel concept: first draining lymph node for a tumor site
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                                                                                                                    Specimen from sentinel lymph node (specimen) (SNOMED Clinical Terms: 441709004)
                                                                                                                      		 Item Tumor formula (TNM)
                                                                                                                      Isolated tumor cells (ITC) psr-dataelement-103 Code
                                                                                                                      • (i+)
                                                                                                                      • (i-)
                                                                                                                      • (mol+)
                                                                                                                      • (mol-)
                                                                                                                      • Asked but unknown
                                                                                                                      		 Single tumor cells or small cluster of tumor cells, not larger than 0.2 mm in diameter, usually detected by immunohistochemistry or molecular pathology. No typical characteristics of metastases (stromal reaction, proliferation).
                                                                                                                      If such ITC are detected in lymph nodes, those are classified as pN0(i+) or pN0(mol+) (regional) or as pM0(i+) or pM0(mol+) (non-regional).
                                                                                                                      For negativity of immunohistochemical or molecular pathologic findings in lymph nodes the same rules are applied (i- or mol-)
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                                                                                                                          UICC Isolated Tumor Cells 2017-03-13T09:48:35 (dynamic)
                                                                                                                          		 Item Tumor formula (TNM)
                                                                                                                          Micrometasis psr-dataelement-106 Code
                                                                                                                          • mi ((mi))
                                                                                                                          		 Micrometasis (equal or less than 0.2 mm in largest diameter) in regional or extra-regional lymph nodes (pN1 or pM1). Used as suffix for N- and M-category in TNM
                                                                                                                            		draft
                                                                                                                              		Item Tumor formula (TNM)
                                                                                                                              N-category psr-dataelement-8 Code
                                                                                                                              • N0
                                                                                                                              • N1
                                                                                                                              • N1mi
                                                                                                                              • N1a
                                                                                                                              • N1b
                                                                                                                              • N1c
                                                                                                                              • N2
                                                                                                                              • N2a
                                                                                                                              • N2b
                                                                                                                              • N2c
                                                                                                                              • N3
                                                                                                                              • N3a
                                                                                                                              • N3b
                                                                                                                              • N3c
                                                                                                                              • Nx
                                                                                                                              • N0
                                                                                                                              • N1
                                                                                                                              • N1mi
                                                                                                                              • N1a
                                                                                                                              • N1b
                                                                                                                              • N1c
                                                                                                                              • N2
                                                                                                                              • N2mi
                                                                                                                              • N2a
                                                                                                                              • N2b
                                                                                                                              • N2c
                                                                                                                              • N3
                                                                                                                              • N3mi
                                                                                                                              • N3a
                                                                                                                              • N3b
                                                                                                                              • N3c
                                                                                                                              • Nx
                                                                                                                              • Asked but unknown
                                                                                                                              		 N-category (regional lymph nodes) of the TNM classification
                                                                                                                                		draft
                                                                                                                                Regional lymph nodes.pathology [Class] Cancer (Logical Observation Identifier Names and Codes: 21900-6)
                                                                                                                                  UICC N category 2017-07-21T10:00:53 (dynamic)
                                                                                                                                  		 Item Tumor formula (TNM)
                                                                                                                                  M-category psr-dataelement-7 Code M0, i.e. no distant metastases
                                                                                                                                  • M0
                                                                                                                                  • M1
                                                                                                                                  • M1(mi)
                                                                                                                                  • M1a
                                                                                                                                  • M1b
                                                                                                                                  • M1c
                                                                                                                                  • M1d
                                                                                                                                  • M1e
                                                                                                                                  • M1(cy)
                                                                                                                                  • MX
                                                                                                                                  • M0
                                                                                                                                  • M1
                                                                                                                                  • M1a
                                                                                                                                  • M1b
                                                                                                                                  • M1c
                                                                                                                                  • M1d
                                                                                                                                  • M1(cy)
                                                                                                                                  • MX
                                                                                                                                  • Asked but unknown
                                                                                                                                  		 M-category (distant metastases) of the  TNM classification
                                                                                                                                    		draft
                                                                                                                                    Distant metastases.pathology [Class] Cancer (Logical Observation Identifier Names and Codes: 21901-4)
                                                                                                                                      UICC M category 2017-07-21T10:31:38 (dynamic)
                                                                                                                                      		 Item Tumor formula (TNM)
                                                                                                                                      T-category psr-dataelement-6 Code
                                                                                                                                      • Ta
                                                                                                                                      • Tis
                                                                                                                                      • Tis(DCIS)
                                                                                                                                      • Tis(LCIS)
                                                                                                                                      • Tis(Paget)
                                                                                                                                      • Tis(pu)
                                                                                                                                      • Tis(pd)
                                                                                                                                      • T0
                                                                                                                                      • T1
                                                                                                                                      • T1mi
                                                                                                                                      • T1a
                                                                                                                                      • T1a1
                                                                                                                                      • T1a2
                                                                                                                                      • T1b
                                                                                                                                      • T1b1
                                                                                                                                      • T1b2
                                                                                                                                      • T1c
                                                                                                                                      • T1d
                                                                                                                                      • T2
                                                                                                                                      • T2a
                                                                                                                                      • T2a1
                                                                                                                                      • T2a2
                                                                                                                                      • T2b
                                                                                                                                      • T2c
                                                                                                                                      • T2d
                                                                                                                                      • T3
                                                                                                                                      • T3a
                                                                                                                                      • T3b
                                                                                                                                      • T3c
                                                                                                                                      • T3d
                                                                                                                                      • T4
                                                                                                                                      • T4a
                                                                                                                                      • T4b
                                                                                                                                      • T4c
                                                                                                                                      • T4d
                                                                                                                                      • T4e
                                                                                                                                      • TX
                                                                                                                                      • Ta
                                                                                                                                      • Tis
                                                                                                                                      • Tis(LAMN)
                                                                                                                                      • Tis(DCIS)
                                                                                                                                      • Tis(LCIS)
                                                                                                                                      • Tis(Paget)
                                                                                                                                      • Tis(pu)
                                                                                                                                      • Tis(pd)
                                                                                                                                      • T0
                                                                                                                                      • T1
                                                                                                                                      • T1mi
                                                                                                                                      • T1a
                                                                                                                                      • T1a1
                                                                                                                                      • T1a2
                                                                                                                                      • T1b
                                                                                                                                      • T1b1
                                                                                                                                      • T1b2
                                                                                                                                      • T1c
                                                                                                                                      • T1c1
                                                                                                                                      • T1c2
                                                                                                                                      • T1c3
                                                                                                                                      • T1d
                                                                                                                                      • T2
                                                                                                                                      • T2a
                                                                                                                                      • T2a1
                                                                                                                                      • T2a2
                                                                                                                                      • T2b
                                                                                                                                      • T2c
                                                                                                                                      • T2d
                                                                                                                                      • T3
                                                                                                                                      • T3a
                                                                                                                                      • T3b
                                                                                                                                      • T3c
                                                                                                                                      • T3d
                                                                                                                                      • T3e
                                                                                                                                      • T4
                                                                                                                                      • T4a
                                                                                                                                      • T4b
                                                                                                                                      • T4c
                                                                                                                                      • T4d
                                                                                                                                      • T4e
                                                                                                                                      • TX
                                                                                                                                      • Asked, but unknown
                                                                                                                                      		 T-category of the TNM classification
                                                                                                                                        		draft
                                                                                                                                        Primary tumor.pathology Cancer (Logical Observation Identifier Names and Codes: 21899-0)
                                                                                                                                          UICC T category 2017-07-07T15:06:39 (dynamic)
                                                                                                                                          		 Item Tumor formula (TNM)
                                                                                                                                          Residual tumor status psr-dataelement-46 Code
                                                                                                                                          • Residual tumor stage R0 (finding)
                                                                                                                                          • Surgical circumferential margin is closest uninvolved margin to malignant neoplasm (finding)
                                                                                                                                          • Residual tumor stage R1 (finding)
                                                                                                                                          • Surgical circumferential margin involved by malignant neoplasm (tumor present 0-1 mm from circumferential resection margin) (finding)
                                                                                                                                          • Residual tumor stage R2 (finding)
                                                                                                                                          • Residual tumor stage RX (finding)
                                                                                                                                          • RX
                                                                                                                                          • R0 > 1mm
                                                                                                                                          • R0 < 1mm
                                                                                                                                          • R1
                                                                                                                                          • R1-dir
                                                                                                                                          • R1(is)
                                                                                                                                          • R1(cy)
                                                                                                                                          • R2
                                                                                                                                          • R2a
                                                                                                                                          • R2b
                                                                                                                                          • R2c
                                                                                                                                          • CRM positive
                                                                                                                                          • CRM negative
                                                                                                                                          • Asked but unknown

                                                                                                                                          Status of residual tumor after any therapy
                                                                                                                                            		draft
                                                                                                                                            Status of residual neoplasm (observable entity) (SNOMED Clinical Terms: 445200009)
                                                                                                                                              UICC Residual tumor (R) classification 2015-06-25T11:23:51 (dynamic)
                                                                                                                                              		 Item Tumor formula (TNM)
                                                                                                                                              Grading psr-dataelement-53 Code
                                                                                                                                              • G1
                                                                                                                                              • G2
                                                                                                                                              • G3
                                                                                                                                              • G4
                                                                                                                                              • GX
                                                                                                                                              • 0
                                                                                                                                              • X
                                                                                                                                              • lG
                                                                                                                                              • mG
                                                                                                                                              • hG
                                                                                                                                              • B
                                                                                                                                              • U
                                                                                                                                              • T
                                                                                                                                              • Asked but unknown
                                                                                                                                              		 Method of histopathology to describe semiquantitatively resp. to classify  the grade of differentiation / grade of malignancy of a malignant tumor. It results in four-tiered, three-tiered or two-tiered tumor grades. There is a tendency to reduce all systems to a two-tiered grading of low and high grade. Large deviations from normal histoarchitecture, high pleomorphism of cells, and high proliferative activity correspond with a highly malignant behaviour. Low structural abnormalities, low pleomorphism and a low proliferative activity correspond with a rather good prognosis. This holds true for the vast majority of malignant tumors.
                                                                                                                                                		draft
                                                                                                                                                Histological grade finding (finding) (SNOMED Clinical Terms: 373372005)
                                                                                                                                                  UICC Grade 4 tiered 2015-11-13T19:46:53 (dynamic)
                                                                                                                                                  		 Item Tumor formula (TNM)