Template

Show index

Template Assessment Scoring System APSR 2.0 2016‑10‑10 11:33:36

Id1.3.6.1.4.1.19376.1.3.10.9.42Effective Date2016‑10‑10 11:33:36
Statusdraft 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
LabelPaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
ClassificationCDA Entry Level Template
Open/ClosedOpen (other than defined elements are allowed)
Associated with
Associated with 6 concepts
IdNameData Set
psr-dataelement-95draft Parent ID draft APSR 2.0
psr-dataelement-17draft Specimen identification draft APSR 2.0
psr-dataelement-67draft Block ID draft APSR 2.0
psr-dataelement-68draft Tissue section ID draft APSR 2.0
psr-dataelement-98draft Specimen ID draft APSR 2.0
psr-dataelement-66draft Part ID draft APSR 2.0
Used by / Uses
Used by 0 transactions and 2 templates, Uses 4 templates
Used by as NameVersion
1.3.6.1.4.1.19376.1.3.10.4.3linkdraft ICD-O-3 Typing and Grading Observation (2.0)2015‑11‑29 17:03:18
1.3.6.1.4.1.19376.1.3.10.4.4Containmentdraft Assessment Scales Observation for Scoring Systems (2.0)2016‑10‑06 13:12:00
Uses as NameVersion
1.3.6.1.4.1.19376.1.3.10.9.1Includedraft X Specimen Identified (2.0)2014‑12‑22 15:54:30
1.3.6.1.4.1.19376.1.3.10.9.43Containmentdraft Assessment Scoring Item APSR 2.0 (2.0)2016‑10‑11 10:26:17
2.16.840.1.113883.10.12.324Containmentactive CDA Reference2005‑09‑07
2.16.840.1.113883.10.12.329Containmentactive CDA Precondition2005‑09‑07
RelationshipSpecialization: template 1.3.6.1.4.1.19376.1.8.1.4.9 AP Observation Entry (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="1.3.6.1.4.1.19376.1.8.9.1" extension="A7102400008_AllredScoreSystem"/>  <code code="278061009 | Scores (qualifier value) |" codeSystem="2.16.840.1.113883.6.96" displayName="Score"/>  <derivationExpr text="sum"/>  <statusCode code="completed"/>  <effectiveTime>
    <low value="201001041405-0500"/>  </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"/>  <specimen typeCode="SPC">
    <specimenRole classCode="SPEC">
      <id root="1.3.6.1.4.1.19376.1.8.9" extension="A7102400008_slide_A1_ER"/>    </specimenRole>  </specimen>  <entryRelationship>
    <sequenceNumber value="1"/>    <!-- 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></observation>
ItemDTCardConfDescriptionLabel
hl7:observation
0 … 1RPaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
@classCode
cs1 … 1FOBS
@moodCode
cs1 … 1FEVN
@negationInd
bl0 … 1 
hl7:templateId
II1 … 1MPaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
@root
uid1 … 1F1.3.6.1.4.1.19376.1.3.10.9.42
hl7:id
II0 … *RPaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
hl7:code
CV (extensible)1 … 1MPaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
@code
CONF1 … 1 @code shall be out of choice:
  • 246262008
  • Score (attribute)
@codeSystem
1 … 1F2.16.840.1.113883.6.96
@codeSystemName
1 … 1FSCT
@displayName
1 … 1FScore
hl7: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.PaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
hl7:text
ED0 … 1RScoring system usedPaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
hl7:statusCode
CS (required)1 … 1MThe 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. PaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
 Constraint
@code shall be "completed"
or
@code shall be "aborted"

 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.15933 ActStatus (2014‑03‑26)
hl7:effectiveTime
IVL_TS0 … 1RPaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
hl7:value
CE (extensible)1 … *RPaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
 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"
hl7:methodCode
CE0 … *RPaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
 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)
hl7:specimen
1 … *RRequired in XD-LAB when more than one specimen is documented at this level. Always required in APSR.PaLM Suppl. APSR 2.1‑3: 6.3.5.7 X Specimen identified
 
target
psr-dataelement-17draft Specimen identification draft APSR 2.0
@typeCode
cs0 … 1FSPC
hl7:specimenRole
1 … 1MPaLM Suppl. APSR 2.1‑3: 6.3.5.7 X Specimen identified
@classCode
cs0 … 1FSPEC
hl7:id
II1 … 1RSpecimen ID, coming from the LISPaLM Suppl. APSR 2.1‑3: 6.3.5.7 X Specimen identified
 
target
psr-dataelement-95draft Parent ID draft APSR 2.0
psr-dataelement-67draft Block ID draft APSR 2.0
psr-dataelement-68draft Tissue section ID draft APSR 2.0
psr-dataelement-98draft Specimen ID draft APSR 2.0
psr-dataelement-66draft Part ID draft APSR 2.0
hl7: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)PaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
@typeCode
cs1 … 1FCOMP
@contextConductionInd
bl0 … 1Ftrue
hl7:sequenceNumber
INT0 … 1PaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
hl7:reference
0 … *RContains 2.16.840.1.113883.10.12.324 CDA Reference (2005‑09‑07)PaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
hl7:precondition
0 … *RContains 2.16.840.1.113883.10.12.329 CDA Precondition (2005‑09‑07)PaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
hl7:referenceRange
0 … *RPaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
@typeCode
cs1 … 1FREFV
hl7:observationRange
1 … 1RPaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
@classCode
cs0 … 1FOBS
@moodCode
cs0 … 1FEVN.CRT
hl7:code
CD0 … 1RPaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
@codeSystem
CONF0 … 1F2.16.840.1.113883.5.4
hl7:text
ED0 … 1RPaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
hl7:value
ANY0 … 1RPaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
hl7:interpretationCode
CE0 … 1RPaLM Suppl. APSR 2.1‑3: 6.3.5.10 Assessment scales
 CONF
The value of @code shall be drawn from value set 2.16.840.1.113883.1.11.78 ObservationInterpretation (2014‑03‑26)