FHIR CI-Build
AdministrationThis is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions
| FHIR Infrastructure Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Device, Patient, Practitioner |
Raw JSON (canonical form + also see JSON Format Specification)
Inclusion Criteria: [[1]] Adults. [[2]] Diagnosed with type 2 diabetes. [[3]] Body Mass Index (BMI) ≥ 40.0 kg/m2 (BMI ≥ 37.5 kg/m2 in Asian Americans), or BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 (BMI 32.5-37.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods. [[4]] Screened surgical candidates.
{
"resourceType" : "Group",
"id" : "example-eligibility-criteria-ada-rec-bariatric",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Group</b><a name=\"example-eligibility-criteria-ada-rec-bariatric\"> </a><a name=\"hcexample-eligibility-criteria-ada-rec-bariatric\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Group "example-eligibility-criteria-ada-rec-bariatric" </p></div><p><b>name</b>: Recommend bariatric surgery if BMI 35 or higher</p><p><b>title</b>: RecommendationEligibilityCriteria: Eligibility Criteria for Bariatric Surgery (ADA Recommendation 8.16)</p><p><b>status</b>: active</p><p><b>publisher</b>: Computable Publishing LLC</p><p><b>contact</b>: <a href=\"mailto:support@computablepublishing.com\">support@computablepublishing.com</a></p><p><b>description</b>: Inclusion Criteria: [[1]] Adults. [[2]] Diagnosed with type 2 diabetes. [[3]] Body Mass Index (BMI) ≥ 40.0 kg/m2 (BMI ≥ 37.5 kg/m2 in Asian Americans), or BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 (BMI 32.5-37.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods. [[4]] Screened surgical candidates.</p><p><b>copyright</b>: https://creativecommons.org/licenses/by-nc-sa/4.0/</p><p><b>type</b>: person</p><p><b>membership</b>: definitional</p><p><b>combinationMethod</b>: all-of</p><blockquote><p><b>characteristic</b></p><p><b>code</b>: Age <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#397669002)</span></p><p><b>value</b>: >=18 years<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code a = 'a')</span></p><p><b>exclude</b>: false</p><p><b>description</b>: Adult</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: Diabetes mellitus type 2 (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#44054006)</span></p><p><b>exclude</b>: false</p><p><b>description</b>: Diabetes mellitus type 2 (disorder)</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by Reference <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: <a name=\"hcBMI-Qualifying-Group\"> </a></p><blockquote><p/><p><a name=\"BMI-Qualifying-Group\"> </a></p><p><a name=\"hcBMI-Qualifying-Group\"> </a></p><p><b>title</b>: Body Mass Index (BMI) ≥ 40.0 kg/m2 (BMI ≥ 37.5 kg/m2 in Asian Americans), or BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 (BMI 32.5-37.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities with nonsurgical methods</p><p><b>description</b>: Body Mass Index (BMI) ≥ 40.0 kg/m2 (BMI ≥ 37.5 kg/m2 in Asian Americans), or BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 (BMI 32.5-37.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods.</p><p><b>membership</b>: conceptual</p><p><b>combinationMethod</b>: any-of</p><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by Reference <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: <a href=\"#hcBMI-Based-Criteria\">#BMI-Based-Criteria: CohortDefinition: BMI-based Criteria</a></p><p><b>exclude</b>: false</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by Reference <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: <a href=\"#hcBMI-Asian-Americans\">#BMI-Asian-Americans: CohortDefinition: BMI ≥ 37.5 kg/m2 in Asian Americans</a></p><p><b>exclude</b>: false</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by Reference <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: <a href=\"#hcBMI-35-to-less-than-40\">#BMI-35-to-less-than-40: BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 who do not achieve durable weight loss and improvement in comorbidities with nonsurgical methods</a></p><p><b>exclude</b>: false</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by Reference <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: <a href=\"#hcBMI-32.5-to-less-than-37.5\">#BMI-32.5-to-less-than-37.5: BMI ≥ 32.5 kg/m2 and ≤ 37.4 kg/m2 in Asian Americans who do not achieve durable weight loss and improvement in comorbidities with nonsurgical methods</a></p><p><b>exclude</b>: false</p></blockquote></blockquote><p><b>exclude</b>: false</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: Diabetes mellitus type 2 (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#44054006)</span></p><p><b>exclude</b>: false</p><p><b>description</b>: Diabetes mellitus type 2 (disorder)</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by Reference <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: <a name=\"hcCertain-Cardiovascular-Events\"> </a></p><blockquote><p/><p><a name=\"Certain-Cardiovascular-Events\"> </a></p><p><a name=\"hcCertain-Cardiovascular-Events\"> </a></p><p><b>title</b>: Cardiovascular event (any of: myocardial infarction, acute coronary syndrome, coronary artery angioplasty or bypass, stroke)</p><p><b>description</b>: Cardiovascular event (any of: myocardial infarction, acute coronary syndrome, coronary artery angioplasty or bypass, stroke). Placeholder for now to represent 'screened surgical candidate'.</p><p><b>membership</b>: conceptual</p><p><b>combinationMethod</b>: any-of</p><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: <a href=\"broken-link.html\">ValueSet/Acute-Coronary-Heart-Disease-Value-Set: Acute Coronary Heart Disease Value Set</a></p><p><b>exclude</b>: false</p><p><b>description</b>: acute coronary heart disease (a value set covering many forms)</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Procedure (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#71388002)</span></p><p><b>value</b>: Heart revascularization (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#81266008)</span></p><p><b>exclude</b>: false</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: Cerebrovascular accident (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#230690007)</span></p><p><b>exclude</b>: false</p></blockquote></blockquote><p><b>exclude</b>: true</p><p><b>description</b>: Cardiovascular event (myocardial infarction, acute coronary syndrome, coronary artery angioplasty or bypass, stroke) in the past six months.</p><h3>Timings</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Offset[x]</b></td><td><b>Text</b></td></tr><tr><td style=\"display: none\">*</td><td>-6-0 months</td><td>in the past six months</td></tr></table></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: Current evidence of congestive heart failure, angina pectoris, or symptomatic peripheral vascular disease. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>exclude</b>: true</p><p><b>description</b>: Current evidence of congestive heart failure, angina pectoris, or symptomatic peripheral vascular disease. This may be possible to encode as presence of Disease(disorder) without 'in remission. Placeholder for now to represent 'screened surgical candidate'.</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: Cardiac stress test indicating that surgery or IMM would not be safe. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>exclude</b>: true</p><p><b>description</b>: Cardiac stress test indicating that surgery or IMM would not be safe. Placeholder for now to represent 'screened surgical candidate'.</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: Pulmonary embolism (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#59282003)</span></p><p><b>exclude</b>: true</p><p><b>description</b>: Pulmonary embolus in the past six months. Placeholder for now to represent 'screened surgical candidate'.</p><h3>Timings</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Offset[x]</b></td><td><b>Text</b></td></tr><tr><td style=\"display: none\">*</td><td>-6-0 months</td><td>in the past six months</td></tr></table></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: Thrombophlebitis (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64156001)</span></p><p><b>exclude</b>: true</p><p><b>description</b>: Thrombophlebitis in the past six months. Placeholder for now to represent 'screened surgical candidate'.</p><h3>Timings</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Offset[x]</b></td><td><b>Text</b></td></tr><tr><td style=\"display: none\">*</td><td>-6-0 months</td><td>in the past six months</td></tr></table></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by Reference <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: <a name=\"hcCancer\"> </a></p><blockquote><p/><p><a name=\"Cancer\"> </a></p><p><a name=\"hcCancer\"> </a></p><p><b>title</b>: Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented to be disease-free for five years</p><p><b>description</b>: Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented to be disease-free for five years. This combination logic fails if the patient has both a basal cell skin cancer or cancer in situ and a cancer of another kind. Placeholder for now to represent 'screened surgical candidate'.</p><p><b>membership</b>: conceptual</p><p><b>combinationMethod</b>: all-of</p><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: Malignant neoplastic disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#363346000)</span></p><p><b>exclude</b>: false</p><p><b>description</b>: Cancer of any kind</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: Basal cell carcinoma of skin (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#254701007)</span></p><p><b>exclude</b>: true</p><p><b>description</b>: (except basal cell skin cancer)</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: Carcinoma in situ (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#109355002)</span></p><p><b>exclude</b>: true</p><p><b>description</b>: (except cancer in situ)</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by CodeableConcept <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: No evidence of cancer found (situation) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#395100000)</span></p><p><b>exclude</b>: true</p><p><b>description</b>: unless documented to be disease-free for five years</p><h3>Timings</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Offset[x]</b></td><td><b>Text</b></td></tr><tr><td style=\"display: none\">*</td><td>-5-0 years</td><td>for five years</td></tr></table></blockquote></blockquote><p><b>exclude</b>: true</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by CodeableConcept <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: history of coagulopathy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>exclude</b>: true</p><p><b>description</b>: History of coagulopathy. Placeholder for now to represent 'screened surgical candidate'.</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Hemoglobin [Mass/volume] in Blood <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#718-7)</span></p><p><b>value</b>: <=-1 GramsPerDeciLiter<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code g/dL = 'g/dL')</span></p><p><b>exclude</b>: true</p><p><b>description</b>: Significant anemia (hemoglobin 1.0 g or more below normal range). Placeholder for now to represent 'screened surgical candidate'.</p><p><b>offset</b>: Lower Normal Limit <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"codesystem-characteristic-offset.html\">Characteristic Offset</a>#LNL)</span></p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Creatinine [Mass/volume] in Serum or Plasma <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#2160-0)</span></p><p><b>value</b>: >=1.5 MilliGramsPerDeciLiter<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code mg/dL = 'mg/dL')</span></p><p><b>exclude</b>: true</p><p><b>description</b>: Serum creatinine ≥ 1.5 mg/dl. Placeholder for now to represent 'screened surgical candidate'.</p></blockquote><hr/><blockquote><p><b>Generated Narrative: Group #BMI-Based-Criteria</b><a name=\"BMI-Based-Criteria\"> </a><a name=\"hcBMI-Based-Criteria\"> </a></p><p><b>title</b>: CohortDefinition: BMI-based Criteria</p><p><b>membership</b>: conceptual</p><h3>Characteristics</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td><td><b>Value[x]</b></td><td><b>Exclude</b></td><td><b>Description</b></td></tr><tr><td style=\"display: none\">*</td><td>Body mass index (BMI) [Ratio] <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#39156-5)</span></td><td>>=40 kg/m2<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code kg/m2 = 'kg/m2')</span></td><td>false</td><td>Body Mass Index (BMI) ≥ 40.0 kg/m2</td></tr></table></blockquote><hr/><blockquote><p><b>Generated Narrative: Group #BMI-Asian-Americans</b><a name=\"BMI-Asian-Americans\"> </a><a name=\"hcBMI-Asian-Americans\"> </a></p><p><b>title</b>: CohortDefinition: BMI ≥ 37.5 kg/m2 in Asian Americans</p><p><b>membership</b>: conceptual</p><p><b>combinationMethod</b>: all-of</p><blockquote><p><b>characteristic</b></p><p><b>code</b>: Body mass index (BMI) [Ratio] <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#39156-5)</span></p><p><b>value</b>: >=37.5 kilogram per square meter (kg/m2)<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code kg/m2 = 'kg/m2')</span></p><p><b>exclude</b>: false</p><p><b>description</b>: BMI ≥ 37.5 kg/m2</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Race <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#103579009)</span></p><p><b>value</b>: Asian American <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#103579009; <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-CDCREC.html\">CDC Race and Ethnicity</a>#2028-9 "Asian")</span></p><p><b>exclude</b>: false</p><p><b>description</b>: Asian American. The evidence and guideline panel decision to modify the BMI threshold for Asian Americans is based on data mostly from Asian Americans not generally including Native Hawaiians and other Pacific Islanders, so it is not explicit whether the modified thresholds apply to Native Hawaiians and other Pacific Islanders. See https://diabetesjournals.org/care/article/38/1/150/37769/BMI-Cut-Points-to-Identify-At-Risk-Asian-Americans for details</p></blockquote></blockquote><hr/><blockquote><p><b>Generated Narrative: Group #BMI-35-to-less-than-40</b><a name=\"BMI-35-to-less-than-40\"> </a><a name=\"hcBMI-35-to-less-than-40\"> </a></p><p><b>title</b>: BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 who do not achieve durable weight loss and improvement in comorbidities with nonsurgical methods</p><p><b>description</b>: BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods.</p><p><b>membership</b>: conceptual</p><p><b>combinationMethod</b>: all-of</p><blockquote><p><b>characteristic</b></p><p><b>code</b>: Body mass index (BMI) [Ratio] <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#39156-5)</span></p><p><b>value</b>: 35-39.9 kilogram per square meter (kg/m2)</p><p><b>exclude</b>: false</p><p><b>description</b>: BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by CodeableConcept <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: achieving durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>exclude</b>: true</p><p><b>description</b>: who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods.</p></blockquote></blockquote><hr/><blockquote><p><b>Generated Narrative: Group #BMI-32.5-to-less-than-37.5</b><a name=\"BMI-32.5-to-less-than-37.5\"> </a><a name=\"hcBMI-32.5-to-less-than-37.5\"> </a></p><p><b>title</b>: BMI ≥ 32.5 kg/m2 and ≤ 37.4 kg/m2 in Asian Americans who do not achieve durable weight loss and improvement in comorbidities with nonsurgical methods</p><p><b>description</b>: BMI ≥ 32.5 kg/m2 and ≤ 37.4 kg/m2 in Asian Americans who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods.</p><p><b>membership</b>: conceptual</p><p><b>combinationMethod</b>: all-of</p><blockquote><p><b>characteristic</b></p><p><b>code</b>: Body mass index (BMI) [Ratio] <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#39156-5)</span></p><p><b>value</b>: 32.5-37.4 kilogram per square meter (kg/m2)</p><p><b>exclude</b>: false</p><p><b>description</b>: BMI ≥ 32.5 kg/m2 and ≤ 37.4 kg/m2</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Race <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#103579009)</span></p><p><b>value</b>: Asian American <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#103579009; <a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-CDCREC.html\">CDC Race and Ethnicity</a>#2028-9 "Asian")</span></p><p><b>exclude</b>: false</p><p><b>description</b>: Asian American. The evidence and guideline panel decision to modify the BMI threshold for Asian Americans is based on data mostly from Asian Americans not generally including Native Hawaiians and other Pacific Islanders, so it is not explicit whether the modified thresholds apply to Native Hawaiians and other Pacific Islanders. See https://diabetesjournals.org/care/article/38/1/150/37769/BMI-Cut-Points-to-Identify-At-Risk-Asian-Americans for details</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by CodeableConcept <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: achieving durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>exclude</b>: true</p><p><b>description</b>: who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods.</p></blockquote></blockquote><hr/><blockquote><p><b>Generated Narrative: Group #BMI-Qualifying-Group</b><a name=\"BMI-Qualifying-Group\"> </a><a name=\"hcBMI-Qualifying-Group\"> </a></p><p><b>title</b>: Body Mass Index (BMI) ≥ 40.0 kg/m2 (BMI ≥ 37.5 kg/m2 in Asian Americans), or BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 (BMI 32.5-37.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities with nonsurgical methods</p><p><b>description</b>: Body Mass Index (BMI) ≥ 40.0 kg/m2 (BMI ≥ 37.5 kg/m2 in Asian Americans), or BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 (BMI 32.5-37.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods.</p><p><b>membership</b>: conceptual</p><p><b>combinationMethod</b>: any-of</p><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by Reference <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: <a href=\"#hcBMI-Based-Criteria\">#BMI-Based-Criteria: CohortDefinition: BMI-based Criteria</a></p><p><b>exclude</b>: false</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by Reference <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: <a href=\"#hcBMI-Asian-Americans\">#BMI-Asian-Americans: CohortDefinition: BMI ≥ 37.5 kg/m2 in Asian Americans</a></p><p><b>exclude</b>: false</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by Reference <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: <a href=\"#hcBMI-35-to-less-than-40\">#BMI-35-to-less-than-40: BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 who do not achieve durable weight loss and improvement in comorbidities with nonsurgical methods</a></p><p><b>exclude</b>: false</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by Reference <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: <a href=\"#hcBMI-32.5-to-less-than-37.5\">#BMI-32.5-to-less-than-37.5: BMI ≥ 32.5 kg/m2 and ≤ 37.4 kg/m2 in Asian Americans who do not achieve durable weight loss and improvement in comorbidities with nonsurgical methods</a></p><p><b>exclude</b>: false</p></blockquote></blockquote><hr/><blockquote><p><b>Generated Narrative: Group #Certain-Cardiovascular-Events</b><a name=\"Certain-Cardiovascular-Events\"> </a><a name=\"hcCertain-Cardiovascular-Events\"> </a></p><p><b>title</b>: Cardiovascular event (any of: myocardial infarction, acute coronary syndrome, coronary artery angioplasty or bypass, stroke)</p><p><b>description</b>: Cardiovascular event (any of: myocardial infarction, acute coronary syndrome, coronary artery angioplasty or bypass, stroke). Placeholder for now to represent 'screened surgical candidate'.</p><p><b>membership</b>: conceptual</p><p><b>combinationMethod</b>: any-of</p><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: <a href=\"broken-link.html\">ValueSet/Acute-Coronary-Heart-Disease-Value-Set: Acute Coronary Heart Disease Value Set</a></p><p><b>exclude</b>: false</p><p><b>description</b>: acute coronary heart disease (a value set covering many forms)</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Procedure (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#71388002)</span></p><p><b>value</b>: Heart revascularization (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#81266008)</span></p><p><b>exclude</b>: false</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: Cerebrovascular accident (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#230690007)</span></p><p><b>exclude</b>: false</p></blockquote></blockquote><hr/><blockquote><p><b>Generated Narrative: Group #Cancer</b><a name=\"Cancer\"> </a><a name=\"hcCancer\"> </a></p><p><b>title</b>: Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented to be disease-free for five years</p><p><b>description</b>: Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented to be disease-free for five years. This combination logic fails if the patient has both a basal cell skin cancer or cancer in situ and a cancer of another kind. Placeholder for now to represent 'screened surgical candidate'.</p><p><b>membership</b>: conceptual</p><p><b>combinationMethod</b>: all-of</p><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: Malignant neoplastic disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#363346000)</span></p><p><b>exclude</b>: false</p><p><b>description</b>: Cancer of any kind</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: Basal cell carcinoma of skin (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#254701007)</span></p><p><b>exclude</b>: true</p><p><b>description</b>: (except basal cell skin cancer)</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Disease (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#64572001)</span></p><p><b>value</b>: Carcinoma in situ (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#109355002)</span></p><p><b>exclude</b>: true</p><p><b>description</b>: (except cancer in situ)</p></blockquote><blockquote><p><b>characteristic</b></p><p><b>code</b>: Defined by CodeableConcept <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>value</b>: No evidence of cancer found (situation) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#395100000)</span></p><p><b>exclude</b>: true</p><p><b>description</b>: unless documented to be disease-free for five years</p><h3>Timings</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Offset[x]</b></td><td><b>Text</b></td></tr><tr><td style=\"display: none\">*</td><td>-5-0 years</td><td>for five years</td></tr></table></blockquote></blockquote></div>"
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"value" : 0,
"unit" : "years",
"system" : "http://unitsofmeasure.org",
"code" : "a"
}
},
"text" : "for five years"
}]
}]
}],
"name" : "Recommend bariatric surgery if BMI 35 or higher",
"title" : "RecommendationEligibilityCriteria: Eligibility Criteria for Bariatric Surgery (ADA Recommendation 8.16)",
"status" : "active",
"publisher" : "Computable Publishing LLC",
"contact" : [{
"telecom" : [{
"system" : "email",
"value" : "support@computablepublishing.com"
}]
}],
"description" : "Inclusion Criteria: [[1]] Adults. [[2]] Diagnosed with type 2 diabetes. [[3]] Body Mass Index (BMI) ≥ 40.0 kg/m2 (BMI ≥ 37.5 kg/m2 in Asian Americans), or BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 (BMI 32.5-37.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with nonsurgical methods. [[4]] Screened surgical candidates.",
"copyright" : "https://creativecommons.org/licenses/by-nc-sa/4.0/",
"type" : "person",
"membership" : "definitional",
"combinationMethod" : "all-of",
"characteristic" : [{
"code" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "397669002",
"display" : "Age"
}]
},
"valueQuantity" : {
"value" : 18,
"comparator" : ">=",
"unit" : "years",
"system" : "http://unitsofmeasure.org",
"code" : "a"
},
"exclude" : false,
"description" : "Adult"
},
{
"code" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "64572001",
"display" : "Disease (disorder)"
}]
},
"valueCodeableConcept" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "44054006",
"display" : "Diabetes mellitus type 2 (disorder)"
}]
},
"exclude" : false,
"description" : "Diabetes mellitus type 2 (disorder)"
},
{
"code" : {
"text" : "Defined by Reference"
},
"valueReference" : {
"reference" : "#BMI-Qualifying-Group",
"type" : "Group",
"display" : "Body Mass Index (BMI) ≥ 40.0 kg/m2 (BMI ≥ 37.5 kg/m2 in Asian Americans), or BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 (BMI 32.5-37.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities with nonsurgical methods"
},
"exclude" : false
},
{
"code" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "64572001",
"display" : "Disease (disorder)"
}]
},
"valueCodeableConcept" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "44054006",
"display" : "Diabetes mellitus type 2 (disorder)"
}]
},
"exclude" : false,
"description" : "Diabetes mellitus type 2 (disorder)"
},
{
"code" : {
"text" : "Defined by Reference"
},
"valueReference" : {
"reference" : "#Certain-Cardiovascular-Events",
"type" : "Group",
"display" : "Cardiovascular event (any of: myocardial infarction, acute coronary syndrome, coronary artery angioplasty or bypass, stroke)"
},
"exclude" : true,
"description" : "Cardiovascular event (myocardial infarction, acute coronary syndrome, coronary artery angioplasty or bypass, stroke) in the past six months.",
"timing" : [{
"offsetRange" : {
"low" : {
"value" : -6,
"unit" : "months",
"system" : "http://unitsofmeasure.org",
"code" : "mo"
},
"high" : {
"value" : 0,
"unit" : "months",
"system" : "http://unitsofmeasure.org",
"code" : "mo"
}
},
"text" : "in the past six months"
}]
},
{
"code" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "64572001",
"display" : "Disease (disorder)"
}]
},
"valueCodeableConcept" : {
"text" : "Current evidence of congestive heart failure, angina pectoris, or symptomatic peripheral vascular disease."
},
"exclude" : true,
"description" : "Current evidence of congestive heart failure, angina pectoris, or symptomatic peripheral vascular disease. This may be possible to encode as presence of Disease(disorder) without 'in remission. Placeholder for now to represent 'screened surgical candidate'."
},
{
"code" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "64572001",
"display" : "Disease (disorder)"
}]
},
"valueCodeableConcept" : {
"text" : "Cardiac stress test indicating that surgery or IMM would not be safe."
},
"exclude" : true,
"description" : "Cardiac stress test indicating that surgery or IMM would not be safe. Placeholder for now to represent 'screened surgical candidate'."
},
{
"code" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "64572001",
"display" : "Disease (disorder)"
}]
},
"valueCodeableConcept" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "59282003",
"display" : "Pulmonary embolism (disorder)"
}]
},
"exclude" : true,
"description" : "Pulmonary embolus in the past six months. Placeholder for now to represent 'screened surgical candidate'.",
"timing" : [{
"offsetRange" : {
"low" : {
"value" : -6,
"unit" : "months",
"system" : "http://unitsofmeasure.org",
"code" : "mo"
},
"high" : {
"value" : 0,
"unit" : "months",
"system" : "http://unitsofmeasure.org",
"code" : "mo"
}
},
"text" : "in the past six months"
}]
},
{
"code" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "64572001",
"display" : "Disease (disorder)"
}]
},
"valueCodeableConcept" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "64156001",
"display" : "Thrombophlebitis (disorder)"
}]
},
"exclude" : true,
"description" : "Thrombophlebitis in the past six months. Placeholder for now to represent 'screened surgical candidate'.",
"timing" : [{
"offsetRange" : {
"low" : {
"value" : -6,
"unit" : "months",
"system" : "http://unitsofmeasure.org",
"code" : "mo"
},
"high" : {
"value" : 0,
"unit" : "months",
"system" : "http://unitsofmeasure.org",
"code" : "mo"
}
},
"text" : "in the past six months"
}]
},
{
"code" : {
"text" : "Defined by Reference"
},
"valueReference" : {
"reference" : "#Cancer",
"type" : "Group",
"display" : "Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented to be disease-free for five years"
},
"exclude" : true
},
{
"code" : {
"text" : "Defined by CodeableConcept"
},
"valueCodeableConcept" : {
"text" : "history of coagulopathy"
},
"exclude" : true,
"description" : "History of coagulopathy. Placeholder for now to represent 'screened surgical candidate'."
},
{
"code" : {
"coding" : [{
"system" : "http://loinc.org",
"code" : "718-7",
"display" : "Hemoglobin [Mass/volume] in Blood"
}]
},
"valueQuantity" : {
"value" : -1,
"comparator" : "<=",
"unit" : "GramsPerDeciLiter",
"system" : "http://unitsofmeasure.org",
"code" : "g/dL"
},
"exclude" : true,
"description" : "Significant anemia (hemoglobin 1.0 g or more below normal range). Placeholder for now to represent 'screened surgical candidate'.",
"offset" : {
"coding" : [{
"system" : "http://hl7.org/fhir/characteristic-offset",
"code" : "LNL",
"display" : "Lower Normal Limit"
}]
}
},
{
"code" : {
"coding" : [{
"system" : "http://loinc.org",
"code" : "2160-0",
"display" : "Creatinine [Mass/volume] in Serum or Plasma"
}]
},
"valueQuantity" : {
"value" : 1.5,
"comparator" : ">=",
"unit" : "MilliGramsPerDeciLiter",
"system" : "http://unitsofmeasure.org",
"code" : "mg/dL"
},
"exclude" : true,
"description" : "Serum creatinine ≥ 1.5 mg/dl. Placeholder for now to represent 'screened surgical candidate'."
}]
}
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.
FHIR ®© HL7.org 2011+. FHIR R6 hl7.fhir.core#6.0.0-cibuild generated on Sat, May 4, 2024 22:01+0000.
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