Guideline Recommendation Example - Clinical Practice Guidelines (CPG) on EBMonFHIR v1.0.2

Clinical Practice Guidelines (CPG) on EBMonFHIR, published by Universitätsmedizin Greifswald. This guide is not an authorized publication; it is the continuous build for version 1.0.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/CEOsys/cpg-on-ebm-on-fhir/ and changes regularly. See the Directory of published versions

Example Bundle: Guideline Recommendation Example

Generated Narrative: Bundle GuidelineRecommendationExample

Bundle GuidelineRecommendationExample of type collection

Entry 1 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/guideline-example

Resource Composition:

Generated Narrative: Composition GuidelineExample

identifier: Resource identifier/guideline example
version: 0.1.0
status: Final
type: Guidelines
category: Evidence- and consensus-based guideline
date: 2022-01-28
author: Organization Example Organization
title: Example Guideline
RelatesTos
- Type ResourceReference
* Citation Citation ExampleGuidelineCitation

Entry 2 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/guideline-example/citation

Resource Citation:

Generated Narrative: Citation ExampleGuidelineCitation

name: ExampleGuidelineCitation
status: Active
citedArtifact
identifier: ceoysy/exampleIdentifier
Versions
- Value
* 1.0-alpha1
currentState: Archived
Titles
- Text
*
Example Citation

WebLocations
- Url
* https://example.com/guideline/exampleIdentifier
Classifications
- Type Classifier
* Publication Type Clinical practice guideline

Entry 3 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/guideline-example/recommendation

Resource PlanDefinition:

Generated Narrative: PlanDefinition ExampleRecommendation

knowledgeCapability: computable
knowledgeRepresentationLevel: structured
Action Combination Method
method: At Least
threshold: 2
url: PlanDefinition Recommendation
version: 1.0
name: Recommendation
title: Recommendation
type: Workflow Definition
status: Active
experimental: true
date: 2022-02-14
publisher: CPGonEBMonFHIR
description:
Example Recommendation

RelatedArtifacts
- Type Classifier ResourceReference
* Justification Recommendation rating ArtifactAssessment: extension = 0.1.0,active; date = 2020-01-03; artifact[x] = ->PlanDefinition Recommendation Plan
* Citation Clinical practice guideline recommendation Citation ExampleRecommendationCitation
* Citation Clinical practice guideline Citation ExampleGuidelineCitation
action
title: example recommendation
description:
Example recommendation

code: Guideline-based Care
definition: Recommendation Plan
action
title: example recommendation
description:
Example recommendation

code: Guideline-based Care
definition: Recommendation Plan

Entry 4 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/guideline-example/recommendation-plan

Resource PlanDefinition:

Generated Narrative: PlanDefinition ExampleRecommendationPlan

knowledgeCapability: computable
knowledgeRepresentationLevel: structured
partOf: Recommendation
Action Combination Method
method: Exactly
threshold: 1
url: PlanDefinition Recommendation Plan
version: 1.0
name: RecommendationPlan
title: Recommendation Plan
type: ECA Rule
status: Active
experimental: true
subject: PopulationExample
date: 2022-02-14
publisher: CPGonEBMonFHIR
description:
Example Recommendation Plan

goal
id
ventilator-management-goal
category: Ventilator care and adjustment (regime/therapy)
description: The ventilator should be set up to provide a breath reate of at least 20 and at most per minute.
Targets
- Measure Detail[x]
* Breath rate mechanical --on ventilator 20-24
goal
id
lab-ddimer-concentration-goal
category: Lab findings surveillance (regime/therapy)
description: D-Dimer concentration shall be below 250 ng/mL
Targets
- Measure Detail[x]
* Fibrin D-dimer DDU [Mass/volume] in Platelet poor plasma ?-250
action
code: Administration of substance (procedure)
definition: DrugAdministrationAction
action
code: Positioning patient (procedure)
goalId: ventilator-management-goal
definition: DrugAdministrationAction
action
code: Ventilator care management (procedure)
goalId: ventilator-management-goal
action
Action Combination Method
method: One or More
code: Combined (qualifier value)
Actions
- Code GoalId
* Ventilator care management (procedure) ventilator-management-goal

Entry 5 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/guideline-example/recommendation-action

Resource ActivityDefinition:

Generated Narrative: ActivityDefinition ExampleDrugAdministrationAction

knowledgeCapability: computable
knowledgeRepresentationLevel: structured
url: ActivityDefinition DrugAdministrationAction
version: 1.0
name: DrugAdministrationAction
status: Active
experimental: true
subject: Patient
publisher: CPGonEBMonFHIR
description:
A drug administration that should be performed.

kind: MedicationRequest
code: Administration of substance (procedure)
product: Dexamethasone (substance)
dosage
Dosage Condition
type: Body weight
value: ?-70
timing: Count 10 times, Duration 10days , Once per 1 days
route: Oral route
DoseAndRates
- Dose[x] Rate[x]
* 6 mg (Details: UCUM codemg = 'mg') 1 /d (Details: UCUM code/d = '/d')

Entry 6 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/guideline-example/population

Resource EvidenceVariable:

Generated Narrative: EvidenceVariable ExampleRecommendationEligibilityCriteria

url: EvidenceVariable PopulationExample
name: PopulationExample
status: Active
characteristic
DefinitionByTypeAndValues
- Type Value[x]
* Clinical finding (finding) Disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder)

Entry 7 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/guideline-example/recommendation-justification

Resource ArtifactAssessment:

Generated Narrative: ArtifactAssessment ExampleRecommendationJustification

ArtifactAssessment Version: 0.1.0
ArtifactAssessment Publication Status: active
date: 2020-01-03
artifact: PlanDefinition Recommendation Plan
content
informationType: Rating
type: Strength of recommendation
classifier: Strong for an intervention
content
informationType: Rating
type: Overall certainty
classifier: Very low quality
content
informationType: Rating
type: Consensus
classifier: Strong
content
informationType: Container
type: Certainty of evidence rating
RelatedArtifacts
- Type Classifier ResourceReference
* Justification Certainty of evidence rating ArtifactAssessment: extension = 0.1.1,active; date = 2022-03-11; artifact[x] = ->Evidence ExampleStudyOutcomeEvidence
content
informationType: Container
type: Net effect
RelatedArtifacts
- Type Classifier ResourceReference
* Supported With Net effect Evidence NetEffectExample

Entry 8 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/guideline-example/certainty-of-evidence-rating

Resource ArtifactAssessment:

Generated Narrative: ArtifactAssessment ExampleCertaintyOfEvidenceRating

ArtifactAssessment Version: 0.1.1
ArtifactAssessment Publication Status: active
date: 2022-03-11
artifact: Evidence ExampleStudyOutcomeEvidence
content
informationType: Rating
type: Overall certainty
classifier: Moderate quality
content
informationType: Rating
type: Risk of bias
classifier: serious concern
content
informationType: Rating
type: Imprecision
classifier: serious concern
content
informationType: Rating
type: Large effect
classifier: increase rating: +2
content
informationType: Rating
type: Plausible confounding
classifier: increase rating: +1

Entry 9 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/guideline-example/study-outcome-evidence

Resource Evidence:

Generated Narrative: Evidence ExampleStudyOutcomeEvidence

name: ExampleStudyOutcomeEvidence
status: Active
RelatedArtifacts
- Type ResourceReference
* Citation Citation ExampleCitation
variableDefinition
variableRole: population
observed: Group: type = person; membership = definitional; quantity = 20
intended: EvidenceVariable ExampleStudyEligibilityCriteria
variableDefinition
variableRole: measured variable
observed: EvidenceVariable Mortality
synthesisType: not applicable

Entry 10 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/guideline-example/outcome-evidence-synthesis

Resource Evidence:

Generated Narrative: Evidence ExampleOutcomeEvidenceSynthesis

name: ExampleOutcomeEvidenceSynthesis
status: Active
RelatedArtifacts
- Type ResourceReference
* Citation Citation ExampleCitation
variableDefinition
variableRole: population
observed: Group: type = person; membership = definitional; quantity = 20
intended: EvidenceVariable ExampleStudyEligibilityCriteria
variableDefinition
variableRole: measured variable
observed: EvidenceVariable Mortality
synthesisType: not applicable

Entry 11 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/guideline-example/study-eligbility-criteria

Resource EvidenceVariable:

Generated Narrative: EvidenceVariable ExampleStudyEligibilityCriteria

name: ExampleStudyEligibilityCriteria
status: Active
characteristic
DefinitionByTypeAndValues
- Type Value[x]
* Clinical finding (finding) Disease caused by Severe acute respiratory syndrome coronavirus 2 (disorder)

Entry 12 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/guideline-example/study-citation

Resource Citation:

Generated Narrative: Citation ExampleStudyCitation

name: ExampleCitation
status: Active
citedArtifact
identifier: ceoysy/exampleIdentifier
Titles
- Text
*
Example Citation

Classifications
- Type Classifier
* Publication Type Journal Article

Entry 13 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/guideline-example/outcome

Resource EvidenceVariable:

Generated Narrative: EvidenceVariable ExampleOutcome

identifier: https://www.ceosys.de/outcome-example
name: Mortality
status: Active
characteristic
exclude: false
DefinitionByTypeAndValues
- Type Value[x]
* Mortality rate (observable entity) percent (Details: UCUM code% = '%')
handling: dichotomous variable

Entry 14 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/guideline-example/recommendation-citation

Resource Citation:

Generated Narrative: Citation ExampleRecommendationCitation

name: ExampleRecommendationCitation
status: Active
citedArtifact
identifier: ceoysy/exampleIdentifier
Versions
- Value
* 1.0-alpha1
currentState: Archived
Titles
- Text
*
Example Citation

Classifications
- Type Classifier
* Publication Type Clinical practice guideline recommendation

Entry 15 - fullUrl = https://www.netzwerk-universitaetsmedizin.de/fhir/cpg-on-ebm-on-fhir/example/guidelines/guideline-example/net-effect-estimate

Resource Evidence:

Generated Narrative: Evidence ExampleNetEffectEstimate

name: NetEffectExample
status: Unknown
VariableDefinitions
- VariableRole Intended
* measured variable EvidenceVariable Mortality
statistic
description:
Net Effect

statisticType: Net Effect
quantity: 1.7 % (Details: UCUM code% = '%')
AttributeEstimates
- Type Level Range
* Confidence interval 0.95 1.5-1.9
modelCharacteristic
code: Relative importance weighting for use in weighted linear combinations
value: 1
Variables
- VariableDefinition
* EvidenceVariable Mortality