Clinical assessment tool example - GCS with individual score as components (id = "glasgow")

<?xml version="1.0" encoding="UTF-8"?>

<!--   
 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-com
a-scale.pdf
   --><Observation xmlns="http://hl7.org/fhir">

  <id value="glasgow"/> 
      
  display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border:
       1px solid #8da1b4; border-radius: 5px; line-height: 60%  
    Observations are often coded in multiple code systems.
      - LOINC
    - or SNOMED
      -and/or the source system may provides its own &quot;local&quot; code, which
         may be less or more granular than LOINC.
  In this example there is only LOINC
       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
     
      <!--    

  <!--    the mandatory quality flags:    -->
  <status value="final"/> 
  <!--   
    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
      -->

     -->

  <code> 
        

    <!--    LOINC - always recommended to have a LOINC code    -->
    <coding> 
      <system value="http://loinc.org"/> 
      <code value="9269-2"/> 
      <display value="Glasgow coma score total"/> 
    </coding> 
    <text value="Glasgow Coma Scale , (GCS)"/> 
  </code> 
  <subject> 
    <reference value="Patient/example"/> 
    <display value="Peter James Chalmers"/> 
  </subject> 
  <effectiveDateTime value="2014-12-11T04:44:16Z"/> 
      <!--     In FHIR, units may be represented twice. Once in the

  <!--    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
       -->

      -->

  <valueQuantity> 
    <value value="13"/> 
    <system value="http://unitsofmeasure.org"/> 
    <code value="{score}"/> 
  </valueQuantity> 
  <referenceRange> 
    <high> 
      <value value="8"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="{score}"/> 
    </high> 
        

    <!--    meaning as text    -->
    <type> 
      <text value="Severe TBI"/> 
    </type> 
  </referenceRange> 
  <referenceRange> 
    <low> 
      <value value="9"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="{score}"/> 
    </low> 
    <high> 
      <value value="12"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="{score}"/> 
    </high> 
        

    <!--    meaning as text    -->
    <type> 
      <text value="Moderate TBI"/> 
    </type> 
  </referenceRange> 
  <referenceRange> 
    <low> 
      <value value="13"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="{score}"/> 
    </low> 
        

    <!--    meaning as text    -->
    <type> 
      <text value="Mild TBI"/> 
    </type> 
  </referenceRange> 
      <!--    Using components since these measurements are typically reported and interpreted
   together    -->
      

  <!--   Using components since these measurements are typically reported and interpreted
   together   -->
  <!--   GCS motor Component   -->
  <component> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="9268-4"/> 
        <display value="Glasgow coma score motor"/> 
      </coding> 
      <text value="GCS Motor"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://acme.ec/codes"/> 
        <code value="5"/> 
        <display value="Localizes painful stimuli"/> 
      </coding> 
      <coding> 
            <!--      This example has the extension which maps a numeric score to the code this
         may already be known and unecessary in the Observation resource     -->

        <!--     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    -->
        <extension url="http://hl7.org/fhir/StructureDefinition/itemWeight">
              

          <!--    from Element: extension    -->
          <valueDecimal value="5"/> 
              

        </extension> 
        <system value="http://loinc.org"/> 
        <code value="LA6566-9"/> 
        <display value="Localizing pain"/> 
      </coding> 
      <text value="5 (Localizes painful stimuli)"/> 
    </valueCodeableConcept> 
  </component> 
      

  <!--   GCS verbal Component   -->
  <component> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="9270-0"/> 
        <display value="Glasgow coma score verbal"/> 
      </coding> 
      <text value="GSC Verbal"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://acme.ec/codes"/> 
        <code value="4"/> 
        <display value="Confused, disoriented"/> 
      </coding> 
      <coding> 
            <!--      This example has the extension which maps a numeric score to the code this
         may already be known and unecessary in the Observation resource     -->

        <!--     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    -->
        <extension url="http://hl7.org/fhir/StructureDefinition/itemWeight">
              

          <!--    from Element: extension    -->
          <valueDecimal value="4"/> 
              

        </extension> 
        <system value="http://loinc.org"/> 
            <!--    technicallly the code is '5' and the LA is the identifier to do hav e both 
         would require an extention    -->

        <!--   technicallly the code is '5' and the LA is the identifier to do hav e both  would
         require an extention   -->

        <code value="LA6560-2"/> 
        <display value="Confused"/> 
      </coding> 
      <text value="4 (Confused, disoriented)"/> 
    </valueCodeableConcept> 
  </component> 
      

  <!--   GCS eyes Component   -->
  <component> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="9267-6"/> 
        <display value="Glasgow coma score eye opening"/> 
      </coding> 
      <text value="Eyes"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://acme.ec/codes"/> 
        <code value="4"/> 
        <display value="Opens eyes spontaneously"/> 
      </coding> 
      <coding> 
            <!--      This example has the extension which maps a numeric score to the code this
         may already be known and unecessary in the Observation resource     -->

        <!--     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    -->
        <extension url="http://hl7.org/fhir/StructureDefinition/itemWeight">
              

          <!--    from Element: extension    -->
          <valueDecimal value="4"/> 
              

        </extension> 
        <system value="http://loinc.org"/> 
            <!--    technicallly the code is '4' and the LA is the identifier to do hav e both 
         would require an extention    -->

        <!--   technicallly the code is '4' and the LA is the identifier to do hav e both  would
         require an extention   -->

        <code value="LA6556-0"/> 
        <display value="Eyes open spontaneously"/> 
      </coding> 
      <text value="4 (Opens eyes spontaneously)"/> 
    </valueCodeableConcept> 
  </component> 


</

Observation

>