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Andrew Sills

Andrew Sills

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Code Block
languagexml
<?xml version="1.0" encoding="UTF-8"?>
<Questionnaire xmlns="http://hl7.org/fhir">
    <id value="12345"/>
    <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml">
            <pre>
                ---------------------------------
                Systolic Blood Pressure 120 mmHg, 
                Taken on Right Brachial Artery, 
                UsingDiastolic BPBlood CuffPressure Adult75 SizemmHG,
Patient in Sitting Position for at Least 5 Minutes,        Taken on Right        Urinated Not More Than 30 Minutes Prior to MeasurementBrachial Artery
                 ---------------------------------

                1. Blood Pressure Measurements:
                    1.1 Systolic: 120 mm[Hg]
                    1.2 Diastolic: 75 mm[Hg]
          1.1.1 Procedure Site: Structure of right brachial artery (body structure)
       2. Blood Pressure Measurement Details:         1.2 Diastolic: 75 mm[Hg]
        2.1 Cuff Size: Adult Cuff            1.2.1 Procedure Site: Structure of right brachial artery  2.2 Patient Position: Sitting(body structure)
            </pre>
        </div>
    </text>
 2.2.1 Duration of Position (minutes): 5 minutes<url value="http://hl7.org/fhir/Questionnaire/12345"/>
    <title value="Complex Blood Pressure Questionnaire"/>
    <status value="draft"/>
    <subjectType value="Patient"/>
 2.3 Cuff Location: Brachial Artery
   <date value="2020-07-22"/>
    <contained>
        <ValueSet>
      2.3.1  Cuff Laterality: Left side <id value="a773d2b4-cb02-4eff-ad1f-6043c36cb0c9"/>
            <name value="Blood Pressure Procedure Site"/>
 2.4 Micturition: true         <status value="active"/>
            <compose>
 2.4.1 Duration prior to Measurement: 30 minutes         <include>
       3. Interpretation: Hypertensive Disorder
             <system value="http://snomed.info/sct"/>
           </pre>         </div><concept>
    </text>     <url value="http://hl7.org/fhir/Questionnaire/12345"/>     <title value="Complex Blood Pressure Questionnaire"/>     <status<code value="draft723962009"/>
    <subjectType value="Patient"/>                    <date<display value="2020-07-22"/>
    <contained>
Structure of right brachial artery (body structure)"/>
       <ValueSet>             <id value="2a86ac45-8383-488a-a3ba-d83e69f01189"/></concept>
            <name value="Blood Pressure Cuff Size ValueSet"/>   <concept>
         <status value="active"/>             <compose> <code value="723961002"/>
              <include>          <display value="Structure of left brachial artery (body structure)"/>
   <system value="http://snomed.info/sct"/>                 </concept>
   <concept>             </include>
           <code value="720738005"/></compose>
        </ValueSet>
    </contained>
    <item>
      <display  <linkId value="Blood pressure cuff, adult size large (physical object)"/>
 e62be151-86f0-49cd-ab05-0a9badbea800"/>
        <code>
            <system value="http://snomed.info/sct"/>
    </concept>        <code value="75367002"/>
           <concept> <display value="Blood pressure (observable entity)"/>
        </code>
        <prefix  <code valuevalue="7207390021.0"/>
                        <display<text value="Blood pressure cuff, adult size small (physical object)Pressure Measurement"/>
        <type value="group"/>
        <item>
 </concept>           <linkId value="08bdd3d0-ba68-4589-afad-b11dd2445c47"/>
        <concept>    <code>
                    <code value="720740000<system value="http://snomed.info/sct"/>
                        <display<code value="Blood pressure cuff, adult thigh type (physical object)271649006"/>
                <display value="Systolic blood  </concept>pressure (observable entity)"/>
            </code>
       <concept>     <prefix value="1.1"/>
            <text value="Systolic Blood Pressure"/>
   <code         <type value="720736009integer"/>
            <item>
           <display value="Blood pressure cuff, pediatric size (physical object)<linkId value="fb5166c2-3d21-41c9-b0db-a51710d7886e"/>
                <code>
   </concept>                 <system value="http://snomed.info/sct"/>
  <concept>                         <code value="720737000<code value="363704007"/>
                        <display value="BloodProcedure pressure cuff, adult sizesite (attribute)"/>
                    </concept>code>
                 </include><prefix value="1.1.1"/>
                <exclude><text value="Procedure site"/>
                  <system<type value="http://snomed.info/sctchoice"/>
                  <answerValueSet value="#a773d2b4-cb02-4eff-ad1f-6043c36cb0c9"/>
 <concept>           </item>
             <code value="466806008"/></item>
        <item>
               <display<linkId value="Blood pressure cuff, reusable (physical object)5772af68-dcdb-4cc1-b4cc-00dd396c245b"/>
            <code>
       </concept>               <system value="http://snomed.info/sct"/>
     <concept>           <code value="271650006"/>
                <code<display value="466802005Diastolic blood pressure (observable entity)"/>
            </code>
            <display<prefix value="Blood pressure cuff, single-use (physical object)1.2"/>
            <text value="Diastolic Blood Pressure"/>
    </concept>        <type value="integer"/>
       </exclude>     <item>
        </compose>         </ValueSet><linkId value="47b5f243-a118-45c4-b366-45f480f32db1"/>
          </contained>     <contained> <code>
       <ValueSet>             <id<system value="4d9a69f5-7a09-4f19-908b-abaed3352154http://snomed.info/sct"/>
            <name  value="American Heart Association Blood Pressure Diagnosis ValueSet <code value="363704007"/>
            <status value="active"/>       <display value="Procedure site (attribute)"/>
  <compose>              </code>
  <include>                     <system<prefix value="http://snomed.info/sct1.2.1"/>
                <text    <concept>value="Procedure site"/>
                         <code <type value="2004005choice"/>
                        <display value="Normal blood pressure (finding)<answerValueSet value="#a773d2b4-cb02-4eff-ad1f-6043c36cb0c9"/>
            </item>
        </concept>item>
    </item>
</Questionnaire>

FHIR Questionnaire Response

Code Block
languagexml
<?xml version="1.0" encoding="UTF-8"?>
   <QuestionnaireResponse xmlns="http://hl7.org/fhir">
    <id value="3141"/>
  <concept>  <text>
                      <code <status value="24184005generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml">
              <display value="Finding of increased blood pressure (finding)"/><pre>---------------------------------
                Systolic Blood Pressure 120 mmHg, 
  </concept>              Taken on Right Brachial Artery, 
 <concept>               Diastolic Blood Pressure 75 mmHG,
     <code value="827069000"/>          Taken on Right Brachial Artery
          <display value="Stage 1 hypertension (finding)"/>
   ---------------------------------

                1. </concept>Blood Pressure Measurements:
                  <concept>  1.1 Systolic: 120 mm[Hg]
                   <code value="827068008"/>    1.1.1 Procedure Site: Structure of right brachial artery (body structure)
           <display value="Stage 2 hypertension (finding)"/>     1.2 Diastolic: 75 mm[Hg]
            </concept>            1.2.1 Procedure Site: Structure of right brachial artery (body <concept>structure)
          </pre>
        </div>
    <code value="706882009"/></text>
    <identifier>
           <value value="d41198f3-15f6-4274-8ef9-344580a01070"/>
    </identifier>
  <display  <status value=" Hypertensive crisis (disorder)ecompleted"/>
    <item>
        <linkId value="e62be151-86f0-49cd-ab05-0a9badbea800"/>
     </concept>   <item>
             </include><linkId value="08bdd3d0-ba68-4589-afad-b11dd2445c47"/>
            <answer>
</compose>         </ValueSet>     </contained>  <valueInteger value="120"/>
          <item>  </answer>
      <linkId value="e62be151-86f0-49cd-ab05-0a9badbea800"/>     <item>
   <code>             <system<linkId value="http://snomed.info/sctfb5166c2-3d21-41c9-b0db-a51710d7886e"/>
            <code value="75367002"/>   <answer>
         <display value="Blood pressure (observable entity)"/>       <valueCoding>
 </code>         <prefix value="1.0"/>         <text value="Blood Pressure Measurement"/>         <type<system value="grouphttp://snomed.info/sct"/>
        <item>                <linkId<code value="08bdd3d0-ba68-4589-afad-b11dd2445c47723962009"/>
            <code>            <display value="Structure of right brachial <system value="http://snomed.info/sct"/>
artery (body structure)"/>
               <code value="271649006"/>    </valueCoding>
            <display value="Systolic blood pressure (observable entity)"/> </answer>
            </code>item>
            <prefix value="1.1"/></item>
        <item>
   <text value="Systolic Blood Pressure"/>             <type value="integer<linkId value="5772af68-dcdb-4cc1-b4cc-00dd396c245b"/>
        </item>     <answer>
   <item>             <linkId<valueInteger value="5772af68-dcdb-4cc1-b4cc-00dd396c245b75"/>
            <code></answer>
                <system value="http://snomed.info/sct"/><item>
                <code<linkId value="27165000647b5f243-a118-45c4-b366-45f480f32db1"/>
                <display value="Diastolic blood pressure (observable entity)"/><answer>
                  </code>  <valueCoding>
          <prefix value="1.2"/>             <text<system value="Diastolic Blood Pressurehttp://snomed.info/sct"/>
                        <type<code value="integer723962009"/>
        </item>     </item>     <item>      <display   <linkId value="70362967-4d2e-4353-952a-36eb258cdb38Structure of right brachial artery (body structure)"/>
        <code>             <system value="http://snomed.info/sct"/></valueCoding>
            <code value="75367002"/>   </answer>
         <display value="Blood pressure (observable entity)"</>item>
        </code>item>
        <prefix value="2.0"/>
        <text value="Blood Pressure Measurement Details"/>
        <type value="group"/>
        <item>
    </item>
</QuestionnaireResponse>

Attribute Refinement ANF Transformation (XSLT)

Code Block
languagexml
<?xml version="1.0" encoding="UTF-8"?>
<xsl:stylesheet version="3.0" xmlns:xsl="http://www.w3.org/1999/XSL/Transform" xpath-default-namespace="http://hl7.org/fhir">
    <xsl:output indent="yes" omit-xml-declaration="no"/>
    <xsl:template match="/">
       <linkId value="afaee033-6ca4-496f-a613-ade246a88ed3"/> <anf>
            <code><xsl:for-each select="//item">
                <system<xsl:if valuetest="http://snomed.info/sct"type/>@value != 'group' and count(./item) = 1">
          <code value="722471002"/>         <xsl:variable        <display value="Size of blood pressure cuff (observable entity)"name="attributeValuelinkId" select="./item/linkId/@value" />
            </code>        <xsl:variable     <prefix valuename="resultValueLinkId" select="2.1/linkId/@value"/>
             <text value="Cuff Size"/>     <statement>
       <type value="choice"/>             <answerValueSet   <topic><xsl:value="#2a86ac45-8383-488a-a3ba-d83e69f01189"/>
        </item>
        <item>
            <linkId value="7ec135f3-ca89-4703-9e5d-bb8cc059c8a0"/>
            <code>
                <system value="http://snomed.info/sct"/>
                <code value="229824005"/>
                <display value="Positioning patient (procedure)"/>
            </code>
            <prefix value="2.2"/>
            <text value="Patient Position"/>
            <type value="choice"/>
            <answerValueSet value="http://hl7.org/fhir/us/qicore/ValueSet/qicore-observation-body-position"/>
            <item>
                <linkId value="87026002-5a86-4095-a775-8fd5d338d13a"/>
                <code>
                    <system value="http://snomed.info/sct"/>
                    <code value="272116003"/>
                    <display value="Durations (qualifier value)"/>
                </code>
                <code>
                    <system value="http://snomed.info/sct"/>
                    <code value="258701004"/>
                    <display value="min (qualifier value)"/>
                </code>
                <prefix value="2.2.1"/>
                <text value="Duration of Position (minutes)"/>
                <type value="integer"/>
            </item>
        </item>
        <item>
            <linkId value="47b5f243-a118-45c4-b366-45f480f32db1"/>
            <code>
                <system value="http://snomed.info/sct"/>
                <code value="70665002"/>
                <display value="Blood pressure cuff, device (physical object)"/>
            </code>
            <code>
                <system value="http://snomed.info/sct"/>
                <code value="246267002"/>
                <display value="Location (attribute)"/>
            </code>
            <prefix value="2.3"/>
            <text value="Cuff Location"/>
            <type value="choice"/>
            <answerValueSet value="http://hl7.org/fhir/ValueSet/body-site"/>
            <item>
                <linkId value="49ed6346-358f-4add-8c5b-69ef701ad513"/>
                <code>
                    <system value="http://snomed.info/sct"/>
                    <code value="70665002"/>
                    <display value="Blood pressure cuff, device (physical object)"/>
                </code>
                <code>
                    <system value="http://snomed.info/sct"/>
                    <code value="272741003"/>
                    <display value="Laterality (attribute)"/>
                </code>
                <prefix value="2.3.1"/>
                <text value="Cuff Laterality"/>
                <type value="choice"/>
                <answerValueSet value="http://hl7.org/fhir/ValueSet/bodysite-laterality"/>
            </item>
        </item>
        <item>
            <linkId value="a4e9a46c-6f28-4b26-a95b-13e7487a066d"/>
            <code>
                <system value="http://snomed.info/sct"/>
                <code value="252041008"/>
                <display value="Micturition finding (finding)"/>
            </code>
            <prefix value="2.4"/>
            <text value="Micturition"/>
            <type value="choice"/>
            <answerValueSet value="http://hl7.org/fhir/ValueSet/yesnodontknow"/>
            <item>
                <linkId value="7d764d1c-4020-4bf7-bf08-b3245b5ef3ce"/>
                <code>
                    <system value="http://snomed.info/sct"/>-of select="./code/code/@value" />|<xsl:value-of select="./code/display/@value" />|:<xsl:value-of select="./item/code/code/@value" />|<xsl:value-of select="./item/code/display/@value" />|=<xsl:value-of select="document('questionnaireResponse.xml')//item/linkId[@value = $attributeValuelinkId]/../answer/valueCoding/code/@value"/>|<xsl:value-of select="document('questionnaireResponse.xml')//item/linkId[@value = $attributeValuelinkId]/../answer/valueCoding/display/@value"/>|</topic>
                     <code value   <circumstance type="251411003performance"/>
                    <display value="Time since previous micturition (observable entity)"/>                 </code>
     <status><xsl:value-of select="document('questionnaireResponse.xml')/QuestionnaireResponse/status/@value"/></status>
          <code>                     <system value="http://snomed.info/sct"/>
                    <code value="258701004"/><result>[<xsl:value-of select="document('questionnaireResponse.xml')//item/linkId[@value = $resultValueLinkId]/../answer/valueInteger/@value"/>,<xsl:value-of select="document('questionnaireResponse.xml')//item/linkId[@value = $resultValueLinkId]/../answer/valueInteger/@value"/>]</result>
                     <display value="min (qualifier value)"</>circumstance>
                </code>                 <prefix value="2.4.1"/></statement>
                </xsl:if>
 <text value="Duration prior to Blood Pressure Measurement (minutes)"/>           </xsl:for-each>
        </anf>
    </xsl:template>
</xsl:stylesheet>

ANF Logical Representation (XML)

Code Block
languagexml
<?xml  <type value="integer"/>
version="1.0" encoding="UTF-8"?>
<anf>
   <statement>
       </item>
        </item>
    </item><topic>271649006|Systolic blood pressure (observable entity)|:363704007|Procedure site (attribute)|=723962009|Structure of right brachial artery (body structure)|</topic>
    <item>         <linkId value="4062f291-11e3-4c2b-9438-d82e6012a1d5"/>
 <circumstance type="performance">
      <code>   <status>completed</status>
         <system value="http://snomed.info/sct"/><result>[120,120]</result>
      </circumstance>
     <code value="243814003"/></statement>
   <statement>
      <topic>271650006|Diastolic blood <display value="Interpretation of findings (observable entity)"/>
        </code>pressure (observable entity)|:363704007|Procedure site (attribute)|=723962009|Structure of right brachial artery (body structure)|</topic>
      <circumstance  <prefix valuetype="3.0performance"/>
        <text value="Interpretation"/><status>completed</status>
        <type value="choice"/> <result>[75,75]</result>
        <answerValueSet value="#4d9a69f5-7a09-4f19-908b-abaed3352154"/></circumstance>
    </item>statement>
</Questionnaire>anf>