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Example Group/example-eligibility-criteria-ada-rec-bariatric (XML)

FHIR Infrastructure Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Device, Patient, Practitioner

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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. (id = "example-eligibility-criteria-ada-rec-bariatric")

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<Group xmlns="http://hl7.org/fhir">
  <id value="example-eligibility-criteria-ada-rec-bariatric"/> 
  <text> <status value="generated"/> <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 &quot;example-eligibility-criteria-ada-rec-bariatric&quot; </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> : &gt;=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> : &lt;=-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> : &gt;=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> &gt;=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> : &gt;=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 &quot;Asian&quot;)</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-Ri
            sk-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 &quot;Asian&quot;)</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-Ri
            sk-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> </text> <contained> 
  <Group> 
    <id value="BMI-Based-Criteria"/> 
    <title value="CohortDefinition: BMI-based Criteria"/> 
    <membership value="conceptual"/> 
    <characteristic> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="39156-5"/> 
          <display value="Body mass index (BMI) [Ratio]"/> 
        </coding> 
      </code> 
      <valueQuantity> 
        <value value="40"/> 
        <comparator value="&gt;="/> 
        <unit value="kg/m2"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="kg/m2"/> 
      </valueQuantity> 
      <exclude value="false"/> 
      <description value="Body Mass Index (BMI) ≥ 40.0 kg/m2"/> 
    </characteristic> 
  </Group> 
  </contained> 
  <contained> 
  <Group> 
    <id value="BMI-Asian-Americans"/> 
    <title value="CohortDefinition: BMI ≥ 37.5 kg/m2 in Asian Americans"/> 
    <membership value="conceptual"/> 
    <combinationMethod value="all-of"/> 
    <characteristic> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="39156-5"/> 
          <display value="Body mass index (BMI) [Ratio]"/> 
        </coding> 
      </code> 
      <valueQuantity> 
        <value value="37.5"/> 
        <comparator value="&gt;="/> 
        <unit value="kilogram per square meter (kg/m2)"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="kg/m2"/> 
      </valueQuantity> 
      <exclude value="false"/> 
      <description value="BMI ≥ 37.5 kg/m2"/> 
    </characteristic> 
    <characteristic> 
      <code> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="103579009"/> 
          <display value="Race"/> 
        </coding> 
      </code> 
      <valueCodeableConcept> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="103579009"/> 
        </coding> 
        <coding> 
          <system value="urn:oid:2.16.840.1.113883.6.238"/> 
          <code value="2028-9"/> 
          <display value="Asian"/> 
        </coding> 
        <text value="Asian American"/> 
      </valueCodeableConcept> 
      <exclude value="false"/> 
      <description value="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-Ri
        sk-Asian-Americans for details"/> 
    </characteristic> 
  </Group> 
  </contained> 
  <contained> 
  <Group> 
    <id value="BMI-35-to-less-than-40"/> 
    <title value="BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 who do not achieve durable weight loss and improvement
       in comorbidities with nonsurgical methods"/> 
    <description value="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."/> 
    <membership value="conceptual"/> 
    <combinationMethod value="all-of"/> 
    <characteristic> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="39156-5"/> 
          <display value="Body mass index (BMI) [Ratio]"/> 
        </coding> 
      </code> 
      <valueRange> 
        <low> 
          <value value="35"/> 
          <unit value="kilogram per square meter (kg/m2)"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="kg/m2"/> 
        </low> 
        <high> 
          <value value="39.9"/> 
          <unit value="kilogram per square meter (kg/m2)"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="kg/m2"/> 
        </high> 
      </valueRange> 
      <exclude value="false"/> 
      <description value="BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2"/> 
    </characteristic> 
    <characteristic> 
      <code> 
        <text value="Defined by CodeableConcept"/> 
      </code> 
      <valueCodeableConcept> 
        <text value="achieving durable weight loss and improvement in comorbidities (including hyperglycemia)
           with nonsurgical methods"/> 
      </valueCodeableConcept> 
      <exclude value="true"/> 
      <description value="who do not achieve durable weight loss and improvement in comorbidities (including
         hyperglycemia) with nonsurgical methods."/> 
    </characteristic> 
  </Group> 
  </contained> 
  <contained> 
  <Group> 
    <id value="BMI-32.5-to-less-than-37.5"/> 
    <title value="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"/> 
    <description value="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."/> 
    <membership value="conceptual"/> 
    <combinationMethod value="all-of"/> 
    <characteristic> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="39156-5"/> 
          <display value="Body mass index (BMI) [Ratio]"/> 
        </coding> 
      </code> 
      <valueRange> 
        <low> 
          <value value="32.5"/> 
          <unit value="kilogram per square meter (kg/m2)"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="kg/m2"/> 
        </low> 
        <high> 
          <value value="37.4"/> 
          <unit value="kilogram per square meter (kg/m2)"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="kg/m2"/> 
        </high> 
      </valueRange> 
      <exclude value="false"/> 
      <description value="BMI ≥ 32.5 kg/m2 and ≤ 37.4 kg/m2"/> 
    </characteristic> 
    <characteristic> 
      <code> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="103579009"/> 
          <display value="Race"/> 
        </coding> 
      </code> 
      <valueCodeableConcept> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="103579009"/> 
        </coding> 
        <coding> 
          <system value="urn:oid:2.16.840.1.113883.6.238"/> 
          <code value="2028-9"/> 
          <display value="Asian"/> 
        </coding> 
        <text value="Asian American"/> 
      </valueCodeableConcept> 
      <exclude value="false"/> 
      <description value="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-Ri
        sk-Asian-Americans for details"/> 
    </characteristic> 
    <characteristic> 
      <code> 
        <text value="Defined by CodeableConcept"/> 
      </code> 
      <valueCodeableConcept> 
        <text value="achieving durable weight loss and improvement in comorbidities (including hyperglycemia)
           with nonsurgical methods"/> 
      </valueCodeableConcept> 
      <exclude value="true"/> 
      <description value="who do not achieve durable weight loss and improvement in comorbidities (including
         hyperglycemia) with nonsurgical methods."/> 
    </characteristic> 
  </Group> 
  </contained> 
  <contained> 
  <Group> 
    <id value="BMI-Qualifying-Group"/> 
    <title value="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"/> 
    <description value="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."/> 
    <membership value="conceptual"/> 
    <combinationMethod value="any-of"/> 
    <characteristic> 
      <code> 
        <text value="Defined by Reference"/> 
      </code> 
      <valueReference> 
        <reference value="#BMI-Based-Criteria"/> 
        <type value="Group"/> 
        <display value="CohortDefinition: BMI-based Criteria"/> 
      </valueReference> 
      <exclude value="false"/> 
    </characteristic> 
    <characteristic> 
      <code> 
        <text value="Defined by Reference"/> 
      </code> 
      <valueReference> 
        <reference value="#BMI-Asian-Americans"/> 
        <type value="Group"/> 
        <display value="CohortDefinition: BMI ≥ 37.5 kg/m2 in Asian Americans"/> 
      </valueReference> 
      <exclude value="false"/> 
    </characteristic> 
    <characteristic> 
      <code> 
        <text value="Defined by Reference"/> 
      </code> 
      <valueReference> 
        <reference value="#BMI-35-to-less-than-40"/> 
        <type value="Group"/> 
        <display value="BMI ≥ 35.0 kg/m2 and ≤ 39.9 kg/m2 who do not achieve durable weight loss and improvement
           in comorbidities with nonsurgical methods"/> 
      </valueReference> 
      <exclude value="false"/> 
    </characteristic> 
    <characteristic> 
      <code> 
        <text value="Defined by Reference"/> 
      </code> 
      <valueReference> 
        <reference value="#BMI-32.5-to-less-than-37.5"/> 
        <type value="Group"/> 
        <display value="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"/> 
      </valueReference> 
      <exclude value="false"/> 
    </characteristic> 
  </Group> 
  </contained> 
  <contained> 
  <Group> 
    <id value="Certain-Cardiovascular-Events"/> 
    <title value="Cardiovascular event (any of: myocardial infarction, acute coronary syndrome, coronary
       artery angioplasty or bypass, stroke)"/> 
    <description value="Cardiovascular event (any of: myocardial infarction, acute coronary syndrome, coronary
       artery angioplasty or bypass, stroke). Placeholder for now to represent 'screened
       surgical candidate'."/> 
    <membership value="conceptual"/> 
    <combinationMethod value="any-of"/> 
    <characteristic> 
      <code> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="64572001"/> 
          <display value="Disease (disorder)"/> 
        </coding> 
      </code> 
      <valueReference> 
        <reference value="ValueSet/Acute-Coronary-Heart-Disease-Value-Set"/> 
        <type value="ValueSet"/> 
        <display value="Acute Coronary Heart Disease Value Set"/> 
      </valueReference> 
      <exclude value="false"/> 
      <description value="acute coronary heart disease (a value set covering many forms)"/> 
    </characteristic> 
    <characteristic> 
      <code> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="71388002"/> 
          <display value="Procedure (procedure)"/> 
        </coding> 
      </code> 
      <valueCodeableConcept> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="81266008"/> 
          <display value="Heart revascularization (procedure)"/> 
        </coding> 
      </valueCodeableConcept> 
      <exclude value="false"/> 
    </characteristic> 
    <characteristic> 
      <code> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="64572001"/> 
          <display value="Disease (disorder)"/> 
        </coding> 
      </code> 
      <valueCodeableConcept> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="230690007"/> 
          <display value="Cerebrovascular accident (disorder)"/> 
        </coding> 
      </valueCodeableConcept> 
      <exclude value="false"/> 
    </characteristic> 
  </Group> 
  </contained> 
  <contained> 
  <Group> 
    <id value="Cancer"/> 
    <resourceType value="Group"/> 
    <title value="Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented
       to be disease-free for five years"/> 
    <description value="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'."/> 
    <membership value="conceptual"/> 
    <combinationMethod value="all-of"/> 
    <characteristic> 
    <code> 
      <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="64572001"/> 
      <display value="Disease (disorder)"/> 
      </coding> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="363346000"/> 
      <display value="Malignant neoplastic disease (disorder)"/> 
      </coding> 
    </valueCodeableConcept> 
    <exclude value="false"/> 
    <description value="Cancer of any kind"/> 
    </characteristic> 
    <characteristic> 
    <code> 
      <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="64572001"/> 
      <display value="Disease (disorder)"/> 
      </coding> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="254701007"/> 
      <display value="Basal cell carcinoma of skin (disorder)"/> 
      </coding> 
    </valueCodeableConcept> 
    <exclude value="true"/> 
    <description value="(except basal cell skin cancer)"/> 
    </characteristic> 
    <characteristic> 
    <code> 
      <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="64572001"/> 
      <display value="Disease (disorder)"/> 
      </coding> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="109355002"/> 
      <display value="Carcinoma in situ (disorder)"/> 
      </coding> 
    </valueCodeableConcept> 
    <exclude value="true"/> 
    <description value="(except cancer in situ)"/> 
    </characteristic> 
    <characteristic> 
    <code> 
      <text value="Defined by CodeableConcept"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="395100000"/> 
      <display value="No evidence of cancer found (situation)"/> 
      </coding> 
    </valueCodeableConcept> 
    <exclude value="true"/> 
    <description value="unless documented to be disease-free for five years"/> 
    <timing> 
      <offsetRange> 
      <low> 
        <value value="-5"/> 
        <unit value="years"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="a"/> 
      </low> 
      <high> 
        <value value="0"/> 
        <unit value="years"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="a"/> 
      </high> 
      </offsetRange> 
      <text value="for five years"/> 
    </timing> 
    </characteristic> 
  </Group> 
  </contained> 
  <name value="Recommend bariatric surgery if BMI 35 or higher"/> 
  <title value="RecommendationEligibilityCriteria: Eligibility Criteria for Bariatric Surgery (ADA
   Recommendation 8.16)"/> 
  <status value="active"/> 
  <publisher value="Computable Publishing LLC"/> 
  <contact> 
    <telecom> 
      <system value="email"/> 
      <value value="support@computablepublishing.com"/> 
    </telecom> 
  </contact> 
  <description value="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 value="https://creativecommons.org/licenses/by-nc-sa/4.0/"/> 
  <type value="person"/> 
  <membership value="definitional"/> 
  <combinationMethod value="all-of"/> 
  <characteristic> 
  <code> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="397669002"/> 
      <display value="Age"/> 
    </coding> 
  </code> 
  <valueQuantity> 
    <value value="18"/> 
    <comparator value="&gt;="/> 
    <unit value="years"/> 
    <system value="http://unitsofmeasure.org"/> 
    <code value="a"/> 
  </valueQuantity> 
  <exclude value="false"/> 
  <description value="Adult"/> 
  </characteristic> 
  <characteristic> 
  <code> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="64572001"/> 
      <display value="Disease (disorder)"/> 
    </coding> 
  </code> 
  <valueCodeableConcept> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="44054006"/> 
      <display value="Diabetes mellitus type 2 (disorder)"/> 
    </coding> 
  </valueCodeableConcept> 
  <exclude value="false"/> 
  <description value="Diabetes mellitus type 2 (disorder)"/> 
  </characteristic> 
  <characteristic> 
  <code> 
    <text value="Defined by Reference"/> 
  </code> 
  <valueReference> 
    <reference value="#BMI-Qualifying-Group"/> 
    <type value="Group"/> 
    <display value="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"/> 
  </valueReference> 
  <exclude value="false"/> 
  </characteristic> 
  <characteristic> 
  <code> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="64572001"/> 
      <display value="Disease (disorder)"/> 
    </coding> 
  </code> 
  <valueCodeableConcept> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="44054006"/> 
      <display value="Diabetes mellitus type 2 (disorder)"/> 
    </coding> 
  </valueCodeableConcept> 
  <exclude value="false"/> 
  <description value="Diabetes mellitus type 2 (disorder)"/> 
  </characteristic> 
  <characteristic> 
  <code> 
    <text value="Defined by Reference"/> 
  </code> 
  <valueReference> 
    <reference value="#Certain-Cardiovascular-Events"/> 
    <type value="Group"/> 
    <display value="Cardiovascular event (any of: myocardial infarction, acute coronary syndrome, coronary
       artery angioplasty or bypass, stroke)"/> 
  </valueReference> 
  <exclude value="true"/> 
    <description value="Cardiovascular event (myocardial infarction, acute coronary syndrome, coronary
     artery angioplasty or bypass, stroke) in the past six months."/> 
  <timing> 
      <offsetRange> 
        <low> 
          <value value="-6"/> 
          <unit value="months"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="mo"/> 
        </low> 
        <high> 
          <value value="0"/> 
          <unit value="months"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="mo"/> 
        </high> 
      </offsetRange> 
      <text value="in the past six months"/> 
  </timing> 
  </characteristic> 
  <characteristic> 
  <code> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="64572001"/> 
      <display value="Disease (disorder)"/> 
    </coding> 
  </code> 
  <valueCodeableConcept> 
    <text value="Current evidence of congestive heart failure, angina pectoris, or symptomatic peripheral
       vascular disease."/> 
  </valueCodeableConcept> 
  <exclude value="true"/> 
  <description value="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'."/> 
  </characteristic> 
  <characteristic> 
  <code> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="64572001"/> 
      <display value="Disease (disorder)"/> 
    </coding> 
  </code> 
  <valueCodeableConcept> 
    <text value="Cardiac stress test indicating that surgery or IMM would not be safe."/> 
  </valueCodeableConcept> 
  <exclude value="true"/> 
  <description value="Cardiac stress test indicating that surgery or IMM would not be safe. Placeholder
     for now to represent 'screened surgical candidate'."/> 
  </characteristic> 
  <characteristic> 
  <code> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="64572001"/> 
      <display value="Disease (disorder)"/> 
    </coding> 
  </code> 
  <valueCodeableConcept> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="59282003"/> 
      <display value="Pulmonary embolism (disorder)"/> 
    </coding> 
  </valueCodeableConcept> 
  <exclude value="true"/> 
  <description value="Pulmonary embolus in the past six months. Placeholder for now to represent 'screened
     surgical candidate'."/> 
  <timing> 
      <offsetRange> 
        <low> 
          <value value="-6"/> 
          <unit value="months"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="mo"/> 
        </low> 
        <high> 
          <value value="0"/> 
          <unit value="months"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="mo"/> 
        </high> 
      </offsetRange> 
      <text value="in the past six months"/> 
  </timing> 
  </characteristic> 
  <characteristic> 
  <code> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="64572001"/> 
      <display value="Disease (disorder)"/> 
    </coding> 
  </code> 
  <valueCodeableConcept> 
    <coding> 
      <system value="http://snomed.info/sct"/> 
      <code value="64156001"/> 
      <display value="Thrombophlebitis (disorder)"/> 
    </coding> 
  </valueCodeableConcept> 
  <exclude value="true"/> 
  <description value="Thrombophlebitis in the past six months. Placeholder for now to represent 'screened
     surgical candidate'."/> 
  <timing> 
      <offsetRange> 
        <low> 
          <value value="-6"/> 
          <unit value="months"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="mo"/> 
        </low> 
        <high> 
          <value value="0"/> 
          <unit value="months"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="mo"/> 
        </high> 
      </offsetRange> 
      <text value="in the past six months"/> 
  </timing> 
  </characteristic> 
  <characteristic> 
  <code> 
    <text value="Defined by Reference"/> 
  </code> 
  <valueReference> 
    <reference value="#Cancer"/> 
    <type value="Group"/> 
    <display value="Cancer of any kind (except basal cell skin cancer or cancer in situ) unless documented
       to be disease-free for five years"/> 
  </valueReference> 
  <exclude value="true"/> 
  </characteristic> 
  <characteristic> 
  <code> 
    <text value="Defined by CodeableConcept"/> 
  </code> 
  <valueCodeableConcept> 
    <text value="history of coagulopathy"/> 
  </valueCodeableConcept> 
  <exclude value="true"/> 
  <description value="History of coagulopathy. Placeholder for now to represent 'screened surgical candidate'."/> 
  </characteristic> 
  <characteristic> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="718-7"/> 
        <display value="Hemoglobin [Mass/volume] in Blood"/> 
      </coding> 
    </code> 
    <valueQuantity> 
      <value value="-1"/> 
      <comparator value="&lt;="/> 
      <unit value="GramsPerDeciLiter"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="g/dL"/> 
    </valueQuantity> 
    <exclude value="true"/> 
    <description value="Significant anemia (hemoglobin 1.0 g or more below normal range). Placeholder for
     now to represent 'screened surgical candidate'."/> 
    <offset> 
      <coding> 
        <system value="http://hl7.org/fhir/characteristic-offset"/> 
        <code value="LNL"/> 
        <display value="Lower Normal Limit"/> 
      </coding> 
    </offset> 
  </characteristic> 
  <characteristic> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="2160-0"/> 
        <display value="Creatinine [Mass/volume] in Serum or Plasma"/> 
      </coding> 
    </code> 
    <valueQuantity> 
      <value value="1.5"/> 
      <comparator value="&gt;="/> 
      <unit value="MilliGramsPerDeciLiter"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="mg/dL"/> 
    </valueQuantity> 
    <exclude value="true"/> 
    <description value="Serum creatinine ≥ 1.5 mg/dl. Placeholder for now to represent 'screened surgical
     candidate'."/> 
  </characteristic> 
</Group> 

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.