Clinical Practice Guidelines (CPG) on EBMonFHIR
1.0.1 - ci-build

Clinical Practice Guidelines (CPG) on EBMonFHIR, published by Universitätsmedizin Greifswald. This guide is not an authorized publication; it is the continuous build for version 1.0.1 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

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Structures: Abstract Profiles

These are profiles on resources or data types that describe patterns used by other profiles, but cannot be instantiated directly. I.e. instances can conform to profiles based on these abstract profiles, but do not declare conformance to the abstract profiles themselves.

CPGComputablePlanDefinition

Defines the minimum expectations and behavior for a computable plan definition

CPGRecommendationDefinition

Profile of PlanDefinition as a Recommendation Definition for use with CPG Implementation Guide

CPGShareablePlanDefinition

Defines the minimum expectations for a shareable plan definition for use with computable guideline content. This profile derives from the ShareablePlanDefinition profile defined in the base FHIR specification, and adds support for declaring knowledge representation level and knowledge artifact capabilities.

CPGStrategyDefinition

Profile of PlanDefinition as a Strategy Definition for use with CPG Implementation Guide. Strategies are used to group recommendations together, typically focused on a particular condition or state within the overall guideline or pathway

Cohorts

The actual group observed in a study or groups of groups in an evidence synthesis.

Eligibility Criteria

Definition of a population (e.g. for guideline recommendation, clinical study) via the eligibility criteria.

Outcome Evidence

A single evidence for an outcome from a specific study, meta analysis or systematic review.

PICO Evidence Variable

Description of the a PICO element that knowledge is about. This abstract resource is used as parent for all PICO (population, intervention, comparison, outcome) evidence variables.

Recommendation Action

Definition of an activity that is part of an intervention in the context of a clinical practice guideline recommendation.

Shareable PlanDefinition

Enforces the minimum information set for the plan definition metadata required by HL7 and other organizations that share and publish plan definitions

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

Assessment Action

Definition of an assessment action.

Body Positioning Action

Definition of a body positioning action as part of a recommended intervention.

Certainty of Evidence Rating

Rating of a single outcome (evidence) underlying a clinical practice guideline recommendation

Clinical Practice Guideline

Representation of an evidence-based clinical practice guideline.

Drug Administration Action

Definition of a drug administration action as part of a recommended intervention.

Evidence Data Set

Definition of the outcome used as the observed measured variable for an evidence synthesis.

Evidence Synthesis Cohorts

The actual group of Groups observed in an evidence synthesis.

Guideline Bundle

Collection of all resources that represent a single clinical practice guideline.

Guideline Citation

Citation of a clinical practice guideline

Intervention Definition

Description of the intervention element of a PICO construct that evidence is about.

Net Effect Estimate

The net effect is the overall expected effect of a recommendation, calculated by an importance-weighted average of the individual outcome effects

Outcome Definition

Description of the outcome element of a PICO construct that evidence is about.

Outcome Evidence Synthesis

A single evidence for an outcome from an evidence synthesis.

Procedure Action

Definition of a procedure action.

Recommendation

A recommendation as part of a clinical practice guideline.

Recommendation Citation

Citation of a clinical practice guideline recommendation

Recommendation Eligibility Criteria

Eligibility Criteria for a Clinical Guideline Recommendation

Recommendation Justification

Justification of a clinical guideline recommendation through the underlying evidence and their ratings

Recommendation Plan

Definition of an activity that is part of an intervention in the context of a clinical practice guideline recommendation.

Study Citation

Citation of a study from which evidence is determined.

Study Cohort

The actual group observed in a study.

Study Eligibility Criteria

Eligibility Criteria for a clinical study

Study Outcome Evidence

A single evidence for an outcome from a primary study.

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

Action Combination Method

Extension used on PlanDefinition.action to specify a method for combining the actions.

ArtifactAssessment Publication Status

Adds publication status attribute to ArtifactAssessment.

ArtifactAssessment Version

Adds version attribute to Artifact Assessment.

CQFM Artifact Comment

A comment containing additional documentation, a review comment, usage guidance, or other relevant information from a particular user.

Characteristic Dosage

Adds Dosage type to characteristic

Dosage Condition

Adds type/value pair to elements of datatype Dosage to express a condition on the dosage.

RelativeTime

Timing in which the characteristic is determined.

qualityOfEvidence

The quality of the evidence described. The code system used specifies the quality scale used to grade this evidence source while the code specifies the actual quality score (represented as a coded value) associated with the evidence.

strengthOfRecommendation

The strength of the recommendation assigned to this reference. The code system used specifies the rating scale used to rate this recommendation while the code specifies the actual recommendation rating (represented as a coded value) associated with this recommendation.

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

Action Combination Method

Value set for the method used to combine actions in a PlanDefinition.

Action Selection Behavior Required

Action selection behavior with only codes that require at least one action to be performed.

Allergic Disposition SCT

Allergic Dispositions from SNOMED CT

Assessment

Assessments

Assessment Scales

Codes for assessment scales (scores etc.)

Body Positioning SNOMED CT

Body positioning procedure codes from SNOMED CT

Clinical Importance of Outcome

Clinical Importance of Outcome

Cochrane PICO

All codes from the Cochrane PICO ontology.

Cochrane PICO Intervention

All intervention codes from the Cochrane PICO ontology.

Cochrane PICO Outcome

All outcome codes from the Cochrane PICO ontology.

Cochrane PICO Population

All population codes from the Cochrane PICO ontology.

Drugs

Drugs

Episode Of Care Type

Episode Of Care Type

Guideline Recommendation Status

Current status of a clinical practice guideline recommendation

Guideline Stage Classification

Stage classification according to systematics

Mean Difference Type

Mean difference types

Observations

Observations are measurements of a patient’s state of health. They are typically made by a healthcare professional, but can also be self-reported by the patient.

Procedures

Procedures

Radiologic Finding SCT

Radiologic findings from SNOMED CT

Rating Acceptability

Are the alternatives acceptable for the target population and its implementors?

Rating Benefit And Harms

Summary of most important benefits and harms

Rating Certainty Of Evidence

Codes from EvidenceCertaintyRating related to certainty of evidence

Rating Concern Degree

Codes from EvidenceCertaintyRating related to degree of concern

Rating Consensus

Degree of consensus reached

Rating Equity

How do the different alternatives affect equity?

Rating Feasibility

How feasible will it be to implement the different alternatives? Any issues?

Rating Preference And Values

Typical patient preferences and values? Common issues or expected variability?

Rating Resources

Issues with costs or resource use? For whom? Cost-benefit analysis? Implementation or other issues?

Rating Up Rating One Level

Ratings for factors that might cause rating up the certainty

Rating Up Rating Two Levels

Ratings for factors that might cause rating up the certainty

Recommendation Strength

Strength of a clinical guideline recommendation.

Relative Effect Type

Relative effect types

Substances SNOMED CT

All substance codes from SNOMED CT

VS MII ICU Code Observation Beatmung [LOINC]

Dieses ValueSet enthält Codes für die im Kontext einer Beatmung eingestellten oder gemessenen Parametern.

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

Action Combination Method

Code system for the combination of actions in a PlanDefinition.

CEOsys Code System

Codes for clinical guideline recommendation representation missing from other code systems.

Clinical Importance of Outcome

Clinical Importance of Outcome

Cochrane Core Ontology

The Cochrane Core ontology describes the entities and concepts that exist in the domain of evidence based healthcare.

Cochrane PICO Ontology

The PICO ontology describes questions in evidence based healthcare with the intention of supporting the publishing of evidence as linked data.

Evidence Certainty Rating

The assessment of quality, confidence, or certainty.

Evidence To Decision Certainty Rating

GRADE Evidence to Decision (EtD) Framework Certainty Ratings

Evidence To Decision Certainty type

GRADE Evidence to Decision (EtD) Framework Certainty Type

Guideline Stage Classification

As part of the project planning for the creation or updating of a guideline, a decision should be made at an early stage about the planned level classification (“S classification”) according to the AWMF’s system of rules (1-3). The S-classification scheme of the AWMF differentiates between the classes S1 treatment recommendation as well as S2e, S2k and S3 guideline. The “S” stands for the extent of the applied systematic approach in the development process of a guideline. Each class thus stands for a specific methodological concept that must be presented in a way that is comprehensible to the users. The choice of class is based on the question of how much effort is appropriate and feasible. The need for legitimacy for the implementation of the guideline (convincing the target group) must be taken into account. When choosing a higher S-classification in the context of updating a guideline, the adaptation to the corresponding methodology has to be considered.

KontaktArtDe

Klassifizierung eines Kontaktes mit einer Gesundheitseinrichtung

Recommendation Strength

Strength of a clinical guideline recommendation.

SynthesisType

Types of combining results from a body of evidence (eg. summary data meta-analysis).

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

All-cause mortality

All-cause mortality.

Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) e.V

Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) e.V

COVID19 Intensive Care Treatment Guideline

COVID19 Intensive Care Treatment Guideline (Bundle).

COVID19 Intensive Care Treatment Guideline

COVID19 Intensive Care Treatment Guideline.

Certainty of Evidence for outcome: mortality of Dexamethasone application

Certainty of evidence rating for mortality outcome of Dexamethasonse application recommendation

Dexamethasone Application

Application of Dexamethasone for ventilated patients only

Dexamethasone Application

Application of Dexamethasone: 6 mg once per day for 10 days p.o. or i.v. for ventilated COVID-19 patients

Dexamethasone Application (Intravenous)

Application of Dexamethasone: 6 mg once per day for 10 days (intravenous route)

Dexamethasone Application (Oral)

Application of Dexamethasone: 6 mg once per day for 10 days (oral route)

Dexamethasone Recommendation

Citation of Dexamethasone Recommenation from COVID-19 intensive care patients treatment guideline

Dexamethasone for critically ill COVID-19 patients

Dexamethasone in critically ill patients with COVID-19.

Example Assessment Action

Example of an assessment action.

Example Body Positioning Action

Example of a body positioning action.

Example Certainty Of Evidence Rating

Example Certainty Of Evidence Rating

Example DrugAdministration Action

A drug administration that should be performed.

Example Evidence Data Set

Example of an evidence data set

Example Evidence Synthesis Cohorts

Example of a cohort in an evidence synthesis

Example Guideline

Example of a guideline resource.

Example Guideline Citation

Example of a Citation of a clinical practice guideline

Example Intervention

Example of an intervention definition.

Example Net Effect Estimate

Example of a net effect estimate

Example No DrugAdministration Action

A drug administration that should not be performed.

Example Organization

Example of a organization resource.

Example Outcome

Example of an outcome evidence variable.

Example Outcome Evidence Synthesis

Example Outcome Evidence Synthesis

Example Procedure Action

Example of a procedure action.

Example Recommendation Citation

Example of a Citation of a clinical practice guideline recommendation

Example Recommendation Eligibility Criteria

Example of a population element of a PICO construct that evidence is about.

Example Recommendation Eligibility Criteria

Example of a population element of a PICO construct that evidence is about.

Example Recommendation Eligibility Criteria

Example of a population element of a PICO construct that evidence is about.

Example Recommendation Justification

Example of a recommendation justification

Example Recommendation plan

An active recommendation plan.

Example Study Citation

Example Study Citation

Example Study Cohort

Example study cohort of 20 patients

Example Study Eligibility Criteria

Example of Study Eligbility Criteria

Example Study Outcome Evidence

Example Study Outcome Evidence

Guideline Recommendation Example

Example of a clinical practice guideline representation bundle.

Mortality Outcome for Dexamethasone application

Mortality Outcome for Dexamethasone application in hospitalized COVID-19 patients

NO Dexamethasone for moderately ill COVID-19 patients

No Dexamethasone in moderately ill patients with COVID-19.

No Dexamethasone Application

No Application of Dexamethasone

No dexamethasone application for non-ventilated COVID-19 patients

No application of Dexamethasone for non-ventilated COVID-19 patients

Population: COVID19 Non-Ventilated

Population for guideline from https://app.magicapp.org/#/guidelines / 5691 with characteristics: COVID-19, not ventilated

Population: COVID19 Ventilated

Population for guideline from https://app.magicapp.org/#/guidelines / 5691 with characteristics: COVID-19, Ventilated

Study cohort for Systemic corticosteroids plus standard care vs. standard care (plus/minus placebo)

Study cohort for for Systemic corticosteroids plus standard care vs. standard care (plus/minus placebo)

Study eligibility criteria for Systemic corticosteroids plus standard care vs. standard care (plus/minus placebo)

Study eligibility criteria for Systemic corticosteroids plus standard care vs. standard care (plus/minus placebo)

Systemic corticosteroids for the treatment of COVID-19

Systemic corticosteroids for the treatment of COVID-19

Therapy of hospitalized COVID-19 patients

Guideline for therapy of hospitalized COVID-19 patients

recommendation

Recommendation