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Observation-example-glasgow.ttl

Example Observation/glasgow (Turtle)

Maturity Level : N/A
Responsible Owner: Orders and Observations Work Group Ballot Standards Status : Informative Compartments : Device , Encounter , Group , Patient , Practitioner , RelatedPerson

Raw Turtle , JSON-LD (+ also see Turtle/RDF Format Specification )

Clinical assessment tool example - GCS using related Observations with individual score as components 

@prefix fhir: <http://hl7.org/fhir/> .
@prefix loinc: <http://loinc.org/owl#> .

@prefix loinc: <https://loinc.org/rdf/> .

@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .

@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/Observation/glasgow> a fhir:Observation;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "glasgow"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: glasgow</p><p><b>contained</b>: , , </p><p><b>status</b>: final</p><p><b>code</b>: Glasgow Coma Scale , (GCS) <span>(Details : {LOINC code '9269-2' = 'Glasgow coma score total', given as 'Glasgow coma score total'})</span></p><p><b>subject</b>: <a>Peter James Chalmers</a></p><p><b>effective</b>: 11/12/2014 4:44:16 AM</p><p><b>value</b>: 13 {score}<span> (Details: UCUM code {score} = '{score}')</span></p><blockquote><p><b>referenceRange</b></p><p><b>high</b>: 8 {score}<span> (Details: UCUM code {score} = '{score}')</span></p><p><b>type</b>: Severe TBI <span>(Details )</span></p></blockquote><blockquote><p><b>referenceRange</b></p><p><b>low</b>: 9 {score}<span> (Details: UCUM code {score} = '{score}')</span></p><p><b>high</b>: 12 {score}<span> (Details: UCUM code {score} = '{score}')</span></p><p><b>type</b>: Moderate TBI <span>(Details )</span></p></blockquote><blockquote><p><b>referenceRange</b></p><p><b>low</b>: 13 {score}<span> (Details: UCUM code {score} = '{score}')</span></p><p><b>type</b>: Mild TBI <span>(Details )</span></p></blockquote><blockquote><p><b>related</b></p><p><b>type</b>: derived-from</p><p><b>target</b>: Motor score. Generated Summary: id: motor; status: final; GCS motor <span>(Details : {LOINC code '9268-4' = 'Glasgow coma score motor', given as 'Glasgow coma score motor'})</span>; ????; effective: 11/12/2014 4:44:16 AM; 5 (Localizes painful stimuli) <span>(Details : {http:/acme.ec/gcsmotor code '5' = '5', given as 'Localizes painful stimuli'}; {LOINC code 'LA6566-9' = 'Localizing pain', given as 'Localizing pain'})</span></p></blockquote><blockquote><p><b>related</b></p><p><b>type</b>: derived-from</p><p><b>target</b>: Verbal score. Generated Summary: id: verbal; status: final; Verbal <span>(Details : {LOINC code '9270-0' = 'Glasgow coma score verbal', given as 'Glasgow coma score verbal'})</span>; ????; effective: 11/12/2014 4:44:16 AM; 4 (Confused, disoriented) <span>(Details : {http:/acme.ec/gcsverbal code '4' = '4', given as 'Confused, disoriented'}; {LOINC code 'LA6560-2' = 'Confused', given as 'Confused'})</span></p></blockquote><blockquote><p><b>related</b></p><p><b>type</b>: derived-from</p><p><b>target</b>: Eyes score. Generated Summary: id: eyes; status: final; Eyes <span>(Details : {LOINC code '9267-6' = 'Glasgow coma score eye opening', given as 'Glasgow coma score eye opening'})</span>; ????; effective: 11/12/2014 4:44:16 AM; 4 (Opens eyes spontaneously) <span>(Details : {http:/acme.ec/gcseye code '4' = '4', given as 'Opens eyes spontaneously'}; {LOINC code 'LA6556-0' = 'Eyes open spontaneously', given as 'Eyes open spontaneously'})</span></p></blockquote></div>"
  ];
  fhir:DomainResource.contained [
     a fhir:Observation;
     fhir:index 0;
     fhir:Resource.id [ fhir:value "motor" ];
     fhir:Observation.status [ fhir:value "final" ];
     fhir:Observation.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         a loinc:9268-4;
         fhir:Coding.system [ fhir:value "http://loinc.org" ];
         fhir:Coding.code [ fhir:value "9268-4" ];
         fhir:Coding.display [ fhir:value "Glasgow coma score motor" ]
       ];
       fhir:CodeableConcept.text [ fhir:value "GCS motor" ]
     ];
     fhir:Observation.subject [
       fhir:link <http://hl7.org/fhir/Patient/example>;
       fhir:Reference.reference [ fhir:value "Patient/example" ]
     ];
     fhir:Observation.effectiveDateTime [ fhir:value "2014-12-11T04:44:16Z"^^xsd:dateTime ];
     fhir:Observation.valueCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http:/acme.ec/gcsmotor" ];
         fhir:Coding.code [ fhir:value "5" ];
         fhir:Coding.display [ fhir:value "Localizes painful stimuli" ]
       ], [
         fhir:index 1;
         a loinc:LA6566-9;
         fhir:Element.extension [
           fhir:index 0;
           fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/iso21090-CO-value" ];
           fhir:Extension.valueDecimal [ fhir:value "5"^^xsd:decimal ]
         ];
         fhir:Coding.system [ fhir:value "http://loinc.org" ];
         fhir:Coding.code [ fhir:value "LA6566-9" ];
         fhir:Coding.display [ fhir:value "Localizing pain" ]
       ];
       fhir:CodeableConcept.text [ fhir:value "5 (Localizes painful stimuli)" ]
     ]
  ], [
     a fhir:Observation;
     fhir:index 1;
     fhir:Resource.id [ fhir:value "verbal" ];
     fhir:Observation.status [ fhir:value "final" ];
     fhir:Observation.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         a loinc:9270-0;
         fhir:Coding.system [ fhir:value "http://loinc.org" ];
         fhir:Coding.code [ fhir:value "9270-0" ];
         fhir:Coding.display [ fhir:value "Glasgow coma score verbal" ]
       ];
       fhir:CodeableConcept.text [ fhir:value "Verbal" ]
     ];
     fhir:Observation.subject [
       fhir:link <http://hl7.org/fhir/Patient/example>;
       fhir:Reference.reference [ fhir:value "Patient/example" ]
     ];
     fhir:Observation.effectiveDateTime [ fhir:value "2014-12-11T04:44:16Z"^^xsd:dateTime ];
     fhir:Observation.valueCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http:/acme.ec/gcsverbal" ];
         fhir:Coding.code [ fhir:value "4" ];
         fhir:Coding.display [ fhir:value "Confused, disoriented" ]
       ], [
         fhir:index 1;
         a loinc:LA6560-2;
         fhir:Element.extension [
           fhir:index 0;
           fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/iso21090-CO-value" ];
           fhir:Extension.valueDecimal [ fhir:value "4"^^xsd:decimal ]
         ];
         fhir:Coding.system [ fhir:value "http://loinc.org" ];
         fhir:Coding.code [ fhir:value "LA6560-2" ];
         fhir:Coding.display [ fhir:value "Confused" ]
       ];
       fhir:CodeableConcept.text [ fhir:value "4 (Confused, disoriented)" ]
     ]
  ], [
     a fhir:Observation;
     fhir:index 2;
     fhir:Resource.id [ fhir:value "eyes" ];
     fhir:Observation.status [ fhir:value "final" ];
     fhir:Observation.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         a loinc:9267-6;
         fhir:Coding.system [ fhir:value "http://loinc.org" ];
         fhir:Coding.code [ fhir:value "9267-6" ];
         fhir:Coding.display [ fhir:value "Glasgow coma score eye opening" ]
       ];
       fhir:CodeableConcept.text [ fhir:value "Eyes" ]
     ];
     fhir:Observation.subject [
       fhir:link <http://hl7.org/fhir/Patient/example>;
       fhir:Reference.reference [ fhir:value "Patient/example" ]
     ];
     fhir:Observation.effectiveDateTime [ fhir:value "2014-12-11T04:44:16Z"^^xsd:dateTime ];
     fhir:Observation.valueCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http:/acme.ec/gcseye" ];
         fhir:Coding.code [ fhir:value "4" ];
         fhir:Coding.display [ fhir:value "Opens eyes spontaneously" ]
       ], [
         fhir:index 1;
         a loinc:LA6556-0;
         fhir:Element.extension [
           fhir:index 0;
           fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/iso21090-CO-value" ];
           fhir:Extension.valueDecimal [ fhir:value "4"^^xsd:decimal ]
         ];
         fhir:Coding.system [ fhir:value "http://loinc.org" ];
         fhir:Coding.code [ fhir:value "LA6556-0" ];
         fhir:Coding.display [ fhir:value "Eyes open spontaneously" ]
       ];
       fhir:CodeableConcept.text [ fhir:value "4 (Opens eyes spontaneously)" ]
     ]
  ];
  fhir:Observation.status [ fhir:value "final"];
  fhir:Observation.code [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       a loinc:9269-2;
       fhir:Coding.system [ fhir:value "http://loinc.org" ];
       fhir:Coding.code [ fhir:value "9269-2" ];
       fhir:Coding.display [ fhir:value "Glasgow coma score total" ]
     ];
     fhir:CodeableConcept.text [ fhir:value "Glasgow Coma Scale , (GCS)" ]
  ];
  fhir:Observation.subject [
     fhir:link <http://hl7.org/fhir/Patient/example>;
     fhir:Reference.reference [ fhir:value "Patient/example" ];
     fhir:Reference.display [ fhir:value "Peter James Chalmers" ]
  ];
  fhir:Observation.effectiveDateTime [ fhir:value "2014-12-11T04:44:16Z"^^xsd:dateTime];
  fhir:Observation.valueQuantity [
     fhir:Quantity.value [ fhir:value "13"^^xsd:decimal ];
     fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
     fhir:Quantity.code [ fhir:value "{score}" ]
  ];
  fhir:Observation.referenceRange [
     fhir:index 0;
     fhir:Observation.referenceRange.high [
       fhir:Quantity.value [ fhir:value "8"^^xsd:decimal ];
       fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
       fhir:Quantity.code [ fhir:value "{score}" ]
     ];
     fhir:Observation.referenceRange.type [
       fhir:CodeableConcept.text [ fhir:value "Severe TBI" ]
     ]
  ], [
     fhir:index 1;
     fhir:Observation.referenceRange.low [
       fhir:Quantity.value [ fhir:value "9"^^xsd:decimal ];
       fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
       fhir:Quantity.code [ fhir:value "{score}" ]
     ];
     fhir:Observation.referenceRange.high [
       fhir:Quantity.value [ fhir:value "12"^^xsd:decimal ];
       fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
       fhir:Quantity.code [ fhir:value "{score}" ]
     ];
     fhir:Observation.referenceRange.type [
       fhir:CodeableConcept.text [ fhir:value "Moderate TBI" ]
     ]
  ], [
     fhir:index 2;
     fhir:Observation.referenceRange.low [
       fhir:Quantity.value [ fhir:value "13"^^xsd:decimal ];
       fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ];
       fhir:Quantity.code [ fhir:value "{score}" ]
     ];
     fhir:Observation.referenceRange.type [
       fhir:CodeableConcept.text [ fhir:value "Mild TBI" ]
     ]
  ];
  fhir:Observation.related [
     fhir:index 0;
     fhir:Observation.related.type [ fhir:value "derived-from" ];
     fhir:Observation.related.target [
       fhir:Reference.reference [ fhir:value "#motor" ];
       fhir:Reference.display [ fhir:value "Motor score" ]

#   
# This is an example of a Glasgow Coma Score using components to group  the measurements  source http://www.choa.org/~/media/CHOA/Documents/Services/Concussion/Concussion-glasgow-coma-scale.pdf
#  

<http://hl7.org/fhir/Observation/glasgow> a fhir:Observation ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "glasgow"] ; # 
  fhir:status [ fhir:v "final"] ; #    the mandatory quality flags:   
  fhir:code [
     fhir:coding ( [
       a loinc:9269-2 ;
       fhir:system [
         fhir:v "http://loinc.org"^^xsd:anyURI ;
         fhir:l <http://loinc.org>
       ] ;
       fhir:code [ fhir:v "9269-2" ] ;
       fhir:display [ fhir:v "Glasgow coma score total" ]
     ] ) ; #    LOINC - always recommended to have a LOINC code   
     fhir:text [ fhir:v "Glasgow Coma Scale , (GCS)" ]
  ] ; #   
#    Observations are often coded in multiple code systems.
#      - LOINC
#		- or SNOMED
#      -and/or the source system may provides its own "local" code, which may be less or more granular than LOINC.
#	In this example there is only LOINC.
#	The LOINC definitions already have "built" into their definitions, and the codes can be combined with ordinalValue extensions to achieve a score.
#    
  fhir:subject [
     fhir:l <http://hl7.org/fhir/Patient/example> ;
     fhir:reference [ fhir:v "Patient/example" ] ;
     fhir:display [ fhir:v "Peter James Chalmers" ]
  ] ; # 
  fhir:effective [
     a fhir:DateTime ;
     fhir:v "2014-12-11T04:44:16Z"^^xsd:dateTime
  ] ; # 
  fhir:value [
     a fhir:Quantity ;
     fhir:value [ fhir:v "13"^^xsd:decimal ] ;
     fhir:system [
       fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ;
       fhir:l <http://unitsofmeasure.org>
     ] ;
     fhir:code [ fhir:v "{score}" ]
  ] ; #    In FHIR, units may be represented twice. Once in the
#    agreed human representation, and once in a coded form.
#    In this example the UCUM unit is provided but no human representation since this is often not displayed
#     
  fhir:referenceRange ( [
     fhir:high [
       fhir:value [ fhir:v "8"^^xsd:decimal ] ;
       fhir:system [
         fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ;
         fhir:l <http://unitsofmeasure.org>
       ] ;
       fhir:code [ fhir:v "{score}" ]
     ] ;
     fhir:type [
       fhir:text [ fhir:v "Severe TBI" ]
     ] #    meaning as text   
  ] [
     fhir:low [
       fhir:value [ fhir:v "9"^^xsd:decimal ] ;
       fhir:system [
         fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ;
         fhir:l <http://unitsofmeasure.org>
       ] ;
       fhir:code [ fhir:v "{score}" ]
     ] ;
     fhir:high [
       fhir:value [ fhir:v "12"^^xsd:decimal ] ;
       fhir:system [
         fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ;
         fhir:l <http://unitsofmeasure.org>
       ] ;
       fhir:code [ fhir:v "{score}" ]
     ] ;
     fhir:type [
       fhir:text [ fhir:v "Moderate TBI" ]
     ] #    meaning as text   
  ] [
     fhir:low [
       fhir:value [ fhir:v "13"^^xsd:decimal ] ;
       fhir:system [
         fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ;
         fhir:l <http://unitsofmeasure.org>
       ] ;
       fhir:code [ fhir:v "{score}" ]
     ] ;
     fhir:type [
       fhir:text [ fhir:v "Mild TBI" ]
     ] #    meaning as text   
  ] ) ; # 
  fhir:component ( [
     fhir:code [
       fhir:coding ( [
         a loinc:9268-4 ;
         fhir:system [
           fhir:v "http://loinc.org"^^xsd:anyURI ;
           fhir:l <http://loinc.org>
         ] ;
         fhir:code [ fhir:v "9268-4" ] ;
         fhir:display [ fhir:v "Glasgow coma score motor" ]
       ] ) ;
       fhir:text [ fhir:v "GCS Motor" ]
     ] ;
     fhir:value [
       a fhir:CodeableConcept ;
       fhir:coding ( [
         fhir:system [
           fhir:v "http://example.org/codes"^^xsd:anyURI ;
           fhir:l <http://example.org/codes>
         ] ;
         fhir:code [ fhir:v "5" ] ;
         fhir:display [ fhir:v "Localizes painful stimuli" ]
       ] [
         a loinc:LA6566-9 ;
         fhir:extension ( [
           fhir:url [
             fhir:v "http://hl7.org/fhir/StructureDefinition/itemWeight"^^xsd:anyURI ;
             fhir:l <http://hl7.org/fhir/StructureDefinition/itemWeight>
           ] ;
           fhir:value [
             a fhir:Decimal ;
             fhir:v "5"^^xsd:decimal
           ] #    from Element: extension   
         ] ) ; #     This example has the extension which maps a numeric score to the code this may already be known and unecessary in the Observation resource   ,    0..1 Value of extension   
         fhir:system [
           fhir:v "http://loinc.org"^^xsd:anyURI ;
           fhir:l <http://loinc.org>
         ] ;
         fhir:code [ fhir:v "LA6566-9" ] ;
         fhir:display [ fhir:v "Localizing pain" ]
       ] ) ;
       fhir:text [ fhir:v "5 (Localizes painful stimuli)" ]

     ]
  ], [
     fhir:index 1;
     fhir:Observation.related.type [ fhir:value "derived-from" ];
     fhir:Observation.related.target [
       fhir:Reference.reference [ fhir:value "#verbal" ];
       fhir:Reference.display [ fhir:value "Verbal score" ]

  ] [
     fhir:code [
       fhir:coding ( [
         a loinc:9270-0 ;
         fhir:system [
           fhir:v "http://loinc.org"^^xsd:anyURI ;
           fhir:l <http://loinc.org>
         ] ;
         fhir:code [ fhir:v "9270-0" ] ;
         fhir:display [ fhir:v "Glasgow coma score verbal" ]
       ] ) ;
       fhir:text [ fhir:v "GSC Verbal" ]
     ] ;
     fhir:value [
       a fhir:CodeableConcept ;
       fhir:coding ( [
         fhir:system [
           fhir:v "http://example.org/codes"^^xsd:anyURI ;
           fhir:l <http://example.org/codes>
         ] ;
         fhir:code [ fhir:v "4" ] ;
         fhir:display [ fhir:v "Confused, disoriented" ]
       ] [
         a loinc:LA6560-2 ;
         fhir:extension ( [
           fhir:url [
             fhir:v "http://hl7.org/fhir/StructureDefinition/itemWeight"^^xsd:anyURI ;
             fhir:l <http://hl7.org/fhir/StructureDefinition/itemWeight>
           ] ;
           fhir:value [
             a fhir:Decimal ;
             fhir:v "4"^^xsd:decimal
           ] #    from Element: extension   
         ] ) ; #     This example has the extension which maps a numeric score to the code this may already be known and unecessary in the Observation resource   ,    0..1 Value of extension   
         fhir:system [
           fhir:v "http://loinc.org"^^xsd:anyURI ;
           fhir:l <http://loinc.org>
         ] ;
         fhir:code [ fhir:v "LA6560-2" ] ; #   technicallly the code is '5' and the LA is the identifier to do hav e both  would require an extention  
         fhir:display [ fhir:v "Confused" ]
       ] ) ;
       fhir:text [ fhir:v "4 (Confused, disoriented)" ]

     ]
  ], [
     fhir:index 2;
     fhir:Observation.related.type [ fhir:value "derived-from" ];
     fhir:Observation.related.target [
       fhir:Reference.reference [ fhir:value "#eyes" ];
       fhir:Reference.display [ fhir:value "Eyes score" ]

  ] [
     fhir:code [
       fhir:coding ( [
         a loinc:9267-6 ;
         fhir:system [
           fhir:v "http://loinc.org"^^xsd:anyURI ;
           fhir:l <http://loinc.org>
         ] ;
         fhir:code [ fhir:v "9267-6" ] ;
         fhir:display [ fhir:v "Glasgow coma score eye opening" ]
       ] ) ;
       fhir:text [ fhir:v "Eyes" ]
     ] ;
     fhir:value [
       a fhir:CodeableConcept ;
       fhir:coding ( [
         fhir:system [
           fhir:v "http://example.org/codes"^^xsd:anyURI ;
           fhir:l <http://example.org/codes>
         ] ;
         fhir:code [ fhir:v "4" ] ;
         fhir:display [ fhir:v "Opens eyes spontaneously" ]
       ] [
         a loinc:LA6556-0 ;
         fhir:extension ( [
           fhir:url [
             fhir:v "http://hl7.org/fhir/StructureDefinition/itemWeight"^^xsd:anyURI ;
             fhir:l <http://hl7.org/fhir/StructureDefinition/itemWeight>
           ] ;
           fhir:value [
             a fhir:Decimal ;
             fhir:v "4"^^xsd:decimal
           ] #    from Element: extension   
         ] ) ; #     This example has the extension which maps a numeric score to the code this may already be known and unecessary in the Observation resource   ,    0..1 Value of extension   
         fhir:system [
           fhir:v "http://loinc.org"^^xsd:anyURI ;
           fhir:l <http://loinc.org>
         ] ;
         fhir:code [ fhir:v "LA6556-0" ] ; #   technicallly the code is '4' and the LA is the identifier to do hav e both  would require an extention  
         fhir:display [ fhir:v "Eyes open spontaneously" ]
       ] ) ;
       fhir:text [ fhir:v "4 (Opens eyes spontaneously)" ]

     ]
  ] .

  ] ) . #   Using components since these measurements are typically reported and interpreted together  ,   GCS motor Component  


<http://hl7.org/fhir/Patient/example> a fhir:Patient .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/Observation/glasgow.ttl> a owl:Ontology;
  owl:imports fhir:fhir.ttl;
  owl:versionIRI <http://hl7.org/fhir/STU3/Observation/glasgow.ttl> .


# -------------------------------------------------------------------------------------

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.