FHIR Release 3 (STU) 4

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Clinical Decision Support Work Group Maturity Level : 1   Trial Use Security Category : Patient Compartments : Device , Patient , Practitioner

Detailed Descriptions for the elements in the RiskAssessment resource.

RiskAssessment
Element Id RiskAssessment
Definition

An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood of each outcome.

Control Cardinality 1..1 0..*
Type DomainResource
Alternate Names Prognosis
RiskAssessment.identifier
Element Id RiskAssessment.identifier
Definition

Business identifier assigned to the risk assessment.

Note This is a business identifer, identifier, not a resource identifier (see discussion )
Control Cardinality 0..1 0..*
Type Identifier
Summary true
RiskAssessment.basedOn
Element Id RiskAssessment.basedOn
Definition

A reference to the request that is fulfilled by this risk assessment.

Control Cardinality 0..1
Type Reference ( Any )
RiskAssessment.parent
Element Id RiskAssessment.parent
Definition

A reference to a resource that this risk assessment is part of, such as a Procedure.

Control Cardinality 0..1
Type Reference ( Any )
RiskAssessment.status
Element Id RiskAssessment.status
Definition

The status of the RiskAssessment, using the same statuses as an Observation.

Control Cardinality 1..1
Terminology Binding ObservationStatus ( Required )
Type code
Summary true
RiskAssessment.method
Element Id RiskAssessment.method
Definition

The algorithm, process or mechanism used to evaluate the risk.

Control Cardinality 0..1
Terminology Binding RiskAssessmentMethod :
Type CodeableConcept
Requirements

The method can influence the results of the assessment.

Summary true
RiskAssessment.code
Element Id RiskAssessment.code
Definition

The type of the risk assessment performed.

Control Cardinality 0..1
Type CodeableConcept
Summary true
RiskAssessment.subject
Element Id RiskAssessment.subject
Definition

The patient or group the risk assessment applies to.

Control Cardinality 0..1 1..1
Type Reference ( Patient | Group )
Summary true
RiskAssessment.context RiskAssessment.encounter
Element Id RiskAssessment.encounter
Definition

The encounter where the assessment was performed.

Control Cardinality 0..1
Type Reference ( Encounter | EpisodeOfCare )
Summary true
RiskAssessment.occurrence[x]
Element Id RiskAssessment.occurrence[x]
Definition

The date (and possibly time) the risk assessment was performed.

Control Cardinality 0..1
Type dateTime | Period
[x] Note See Choice of Data Types for further information about how to use [x]
Requirements

The assessment results lose validity the more time elapses from when they are first made.

Summary true
RiskAssessment.condition
Element Id RiskAssessment.condition
Definition

For assessments or prognosis specific to a particular condition, indicates the condition being assessed.

Control Cardinality 0..1
Type Reference ( Condition )
Summary true
RiskAssessment.performer
Element Id RiskAssessment.performer
Definition

The provider or software application that performed the assessment.

Control Cardinality 0..1
Type Reference ( Practitioner | PractitionerRole | Device )
Summary true
RiskAssessment.reason[x] RiskAssessment.reasonCode
Element Id RiskAssessment.reasonCode
Definition

The reason the risk assessment was performed.

Control Cardinality 0..1 0..*
Type CodeableConcept | Reference
( Any RiskAssessment.reasonReference
Element Id RiskAssessment.reasonReference
Definition

Resources supporting the reason the risk assessment was performed.

Cardinality ) 0..*
[x] Note Type See Choice of Data Types Reference for further information about how to use [x] ( Condition | Observation | DiagnosticReport | DocumentReference )
RiskAssessment.basis
Element Id RiskAssessment.basis
Definition

Indicates the source data considered as part of the assessment (FamilyHistory, (for example, FamilyHistory, Observations, Procedures, Conditions, etc.).

Control Cardinality 0..*
Type Reference ( Any )
RiskAssessment.prediction
Element Id RiskAssessment.prediction
Definition

Describes the expected outcome for the subject.

Control Cardinality 0..*
Comments

Multiple repetitions can be used to identify the same type of outcome in different timeframes as well as different types of outcomes.

Invariants :
Defined on this element
ras-2 : Rule Must be <= 100 ( expression probability is decimal implies probability.as(decimal) <= 100, xpath: not(f:probabilityDecimal) or f:probabilityDecimal/@value (probability as decimal) <= 100) 100
RiskAssessment.prediction.outcome
Element Id RiskAssessment.prediction.outcome
Definition

One of the potential outcomes for the patient (e.g. remission, death, a particular condition).

Control Cardinality 1..1 0..1
Terminology Binding RiskAssessmentOutcome :
Type CodeableConcept
RiskAssessment.prediction.probability[x]
Element Id RiskAssessment.prediction.probability[x]
Definition

How Indicates how likely is the outcome is (in the specified timeframe).

Control Cardinality 0..1
Type decimal | Range
[x] Note See Choice of Data Types for further information about how to use [x]
Comments

If range is used, it represents the lower and upper bounds of certainty; e.g. 40-60% Decimal values are expressed as percentages as well (max = 100).

Invariants :
Defined on this element
ras-1 : Rule low and high must be percentages, if present ( expression (low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum))), xpath: (not(f:low) or f:low[f:code/@value='%' and f:system/@value='http://unitsofmeasure.org']) and (not(f:high) or f:high[f:code/@value='%' and f:system/@value='http://unitsofmeasure.org'])) %ucum)))
RiskAssessment.prediction.qualitativeRisk
Element Id RiskAssessment.prediction.qualitativeRisk
Definition

How Indicates how likely is the outcome is (in the specified timeframe), expressed as a qualitative value (e.g. low, medium, or high).

Control Cardinality 0..1
Terminology Binding Risk Probability ( Example )
Type CodeableConcept
RiskAssessment.prediction.relativeRisk
Element Id RiskAssessment.prediction.relativeRisk
Definition

Indicates the risk for this particular subject (with their specific characteristics) divided by the risk of the population in general. (Numbers greater than 1 = higher risk than the population, numbers less than 1 = lower risk.).

Control Cardinality 0..1
Type decimal
Requirements

Absolute risk is less meaningful than relative risk.

RiskAssessment.prediction.when[x]
Element Id RiskAssessment.prediction.when[x]
Definition

Indicates the period of time or age range of the subject to which the specified probability applies.

Control Cardinality 0..1
Type Period | Range
[x] Note See Choice of Data Types for further information about how to use [x]
Comments

If not specified, the risk applies "over "over the subject's lifespan". lifespan".

RiskAssessment.prediction.rationale
Element Id RiskAssessment.prediction.rationale
Definition

Additional information explaining the basis for the prediction.

Control Cardinality 0..1
Type string
RiskAssessment.mitigation
Element Id RiskAssessment.mitigation
Definition

A description of the steps that might be taken to reduce the identified risk(s).

Control Cardinality 0..1
Type string
Requirements

One of the main reasons for assessing risks is to identify whether interventional steps are needed to reduce risk.

RiskAssessment.comment RiskAssessment.note
Element Id RiskAssessment.note
Definition

Additional comments about the risk assessment.

Control Cardinality 0..1 0..*
Type string Annotation