Lithuanian Prostate Diagnostics Implementation Guide
0.0.1 - ci-build
Lithuanian Prostate Diagnostics Implementation Guide
0.0.1 - ci-build
Lithuanian Prostate Diagnostics Implementation Guide, published by Lithuanian Medical Library. This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7LT/ig-lt-prostate/ and changes regularly. See the Directory of published versions
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Lithuanian prostate cancer prevention and early diagnosis programme documentation includes electronic forms aligned with national spreadsheets (e.g. dr-prostate pathology, ADPP / consultation sheets in the same workbook). This IG provides Questionnaire / QuestionnaireResponse examples and machine-readable mapping via ConceptMap resources.
The Questionnaires in this IG do not reproduce every field from the source files. They are illustrative and expanded over time.
| Form | Questionnaire | Example response | Coverage |
|---|---|---|---|
| ADPP primary assessment (E025/E027) | Questionnaire | QuestionnaireResponse | Clinical blocks, family history, vital signs, PSA history, prior mpMRI, prior treatment, programme flags, race, DRE (multiselect with SNOMED codes), systemic diseases. Demographics from PatientLt. |
| Radiologist referral (E027) | Questionnaire | — | Referral to radiologist for mpMRI. Diagnosis with optional Grade Group, screening flag, clinical/family history, DRE, anthropometrics, PSA, prior imaging/treatments, anticoagulants. |
| Pathologist referral (E014) | Questionnaire | — | Referral to pathologist for biopsy (form 014-1-1/a). Biopsy type, tissue fixing, clinical diagnosis with staging, procedure type, specimen counts per location, PSA/PSAT/volume, PI-RADS. |
| Pathology ESPBI (dr-prostate subset) | Questionnaire | QuestionnaireResponse | Specimen, treatment effect, histology, ISUP, IDC, cribriform, burden/invasion items. Missing (non-exhaustive): repeatable per-biopsy-core structure, full Pattern 4/5 percentage steps, seminal vesicle / lymphovascular rows. |
Mappings from Questionnaire linkId to logical FHIR targets (profiles, elements, or example instances) are defined in FHIR Shorthand as ConceptMap instances:
| ConceptMap | Source codes (linkId) |
Target codes (logical mapping) |
|---|---|---|
| ConceptMap: ADPP Questionnaire → FHIR | CodeSystem: prostate-adpp-questionnaire-item | CodeSystem: prostate-fhir-mapping-target |
| ConceptMap: Pathology Questionnaire → FHIR | CodeSystem: prostate-pathology-questionnaire-item | CodeSystem: prostate-fhir-mapping-target |
Note: The radiologist and pathologist referral questionnaires do not yet have dedicated ConceptMaps. Their items map to the same target profiles described in the ADPP ConceptMap (family history, DRE, anthropometrics, PSA, prior imaging) plus Lab IG profiles for pathology orders and specimens.
| Questionnaire item | Target profile / resource |
|---|---|
| DRE findings | DreObservationLtProstate |
| Family history | FamilyMemberScreeningHistoryLtLifestyle |
| Height / Weight / BMI | BodyHeight / BodyWeight / BMI |
| Anticoagulant use | MedicationStatementLtLifestyle |
| ISUP Grade Group | GleasonIsupObservationLtProstate |
| Specimen quality | SpecimenAdequacyLtLab |
| Biopsy procedure | BiopsyProcedureLtLab |
| Pathology order | PathologyOrderLtLab |
| Tumour observables | TumorObservableLtLab |
| Screening programme | ScreeningCarePlanLtProstate |
Each ConceptMap.group.element has:
code — Questionnaire linkId (same as source CodeSystem code).target.code — target code from prostate-fhir-mapping-target (e.g. observation-psa-serum, encounter-period).target.comment — narrative mapping to LT Base, LT Lab, LT Prostate, LT VitalSigns, or LT Lifestyle profiles and examples (including CI build URLs where applicable).Maintainers: when adding or renaming a Questionnaire linkId, add a code to the corresponding source CodeSystem, add a ConceptMap row, and extend the target CodeSystem if you introduce a new mapping target.
| Approach | Typical use |
|---|---|
| Questionnaire / QuestionnaireResponse | Screen-faithful capture; audit of filled forms. |
| Observation, DiagnosticReport, Condition (profiles in LT Prostate, LT Lab, LT Base) | Clinical interoperability, decision support, longitudinal follow-up. |
The Prostate report bundle does not require a Questionnaire reference; ConceptMap describes how to derive or align structured resources from form answers.