From d5021e8fbdf327ddbab4fd7b519a4079526a9b26 Mon Sep 17 00:00:00 2001 From: CarolinePotteiger <55993444+CarolinePotteiger@users.noreply.github.com> Date: Tue, 3 Sep 2024 14:53:26 -0400 Subject: [PATCH] block vote 3 --- input/fsh/AL_USCore.fsh | 5 +- input/fsh/EX_Basic.fsh | 18 ++++++-- input/fsh/EX_ExtendedExample.fsh | 11 +++++ input/fsh/EX_ExtendedExample_Pediatric.fsh | 4 +- input/fsh/EX_Staging_Other.fsh | 3 ++ input/fsh/SD_ComorbidCondition.fsh | 2 +- input/fsh/SD_Genomics.fsh | 2 +- input/fsh/SD_Histology.fsh | 4 +- input/fsh/SD_HistoryOfMetastaticCancer.fsh | 3 +- input/fsh/SD_PerformanceStatus.fsh | 8 ++-- input/fsh/SD_RiskAssessment.fsh | 2 +- input/fsh/SD_Staging.fsh | 45 +++++++++--------- input/fsh/SD_Staging_Other.fsh | 2 + input/fsh/SD_Staging_TNM.fsh | 2 +- input/fsh/VS_Staging.fsh | 19 ++++++++ input/fsh/VS_Staging_Other.fsh | 46 +++++++++++++++++++ ...finition-mcode-cancer-stage-group-intro.md | 32 +++++++++++++ ...code-history-of-metastatic-cancer-intro.md | 4 ++ ...ValueSet-mcode-deauville-scale-vs-intro.md | 8 ++++ ...ode-neuroblastoma-INRGSS-value-vs-intro.md | 7 +++ ...mcode-neuroblastoma-inss-value-vs-intro.md | 9 ++++ ...de-rhabdomyosarcoma-assessment-vs-intro.md | 2 + ...lueSet-mcode-wilms-tumor-stage-vs-intro.md | 9 ++++ input/pagecontent/group-disease.md | 4 +- 24 files changed, 210 insertions(+), 41 deletions(-) create mode 100644 input/pagecontent/ValueSet-mcode-deauville-scale-vs-intro.md create mode 100644 input/pagecontent/ValueSet-mcode-neuroblastoma-INRGSS-value-vs-intro.md create mode 100644 input/pagecontent/ValueSet-mcode-neuroblastoma-inss-value-vs-intro.md create mode 100644 input/pagecontent/ValueSet-mcode-rhabdomyosarcoma-assessment-vs-intro.md create mode 100644 input/pagecontent/ValueSet-mcode-wilms-tumor-stage-vs-intro.md diff --git a/input/fsh/AL_USCore.fsh b/input/fsh/AL_USCore.fsh index dae7afe2..51204104 100644 --- a/input/fsh/AL_USCore.fsh +++ b/input/fsh/AL_USCore.fsh @@ -7,9 +7,10 @@ Alias: USCorePractitioner = http://hl7.org/fhir/us/core/StructureDefinition/us Alias: USCoreProcedure = http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure Alias: USCoreObservationLab = http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab Alias: USCoreOrganization = http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization -Alias: USCoreClinicalTest = http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-test +Alias: USCoreClinicalResult = http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result Alias: USCoreVitalSigns = http://hl7.org/fhir/us/core/StructureDefinition/us-core-vital-signs -Alias: USCoreObservationImaging = http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-imaging +Alias: USCoreObservationSimple = http://hl7.org/fhir/us/core/StructureDefinition/us-core-simple-observation +Alias: USCoreSpecimen = http://hl7.org/fhir/us/core/StructureDefinition/us-core-specimen // Extensions Alias: USCoreBirthSex = http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex diff --git a/input/fsh/EX_Basic.fsh b/input/fsh/EX_Basic.fsh index 7cd6a356..070b28df 100644 --- a/input/fsh/EX_Basic.fsh +++ b/input/fsh/EX_Basic.fsh @@ -25,7 +25,7 @@ Description: "Example of Primary Cancer Condition - hematologic cancer" * onsetDateTime = "2020-05-12" * asserter = Reference(us-core-practitioner-kyle-anydoc) * stage.summary = NCIT#C80135 "Binet Stage B" -* stage.assessment = Reference(binet-stage-group-B) +//* stage.assessment = Reference(binet-stage-group-B) Instance: secondary-cancer-condition-brain-mets InstanceOf: SecondaryCancerCondition @@ -62,6 +62,7 @@ Description: "Example of Cancer-Related Comorbidities" // absent * extension[comorbidConditionAbsent][0].valueCodeableConcept = SCT#414916001 "Obesity (disorder)" * extension[comorbidConditionAbsent][1].valueCodeableConcept = SCT#19829001 "Disorder of lung (disorder)" +* category = ObsCat#social-history "Social History" Instance: john-anyperson-chf InstanceOf: USCoreCondition @@ -196,6 +197,7 @@ Description: "Example of ECOG Performance Status" * performer = Reference(us-core-practitioner-kyle-anydoc) * valueInteger = 0 * interpretation = LNC#LA9622-7 "Fully active, able to carry on all pre-disease performance without restriction" +* category = ObsCat#survey "Survey" Instance: karnofsky-performance-status-normal-activity InstanceOf: KarnofskyPerformanceStatus @@ -208,7 +210,7 @@ Description: "Example of Karnofsky Performance Status" * performer = Reference(us-core-practitioner-kyle-anydoc) * valueInteger = 90 * interpretation = LNC#LA29176-7 "Able to carry on normal activity; minor signs or symptoms of disease" - +* category = ObsCat#survey "Survey" Instance: cancer-related-surgical-procedure-lobectomy InstanceOf: CancerRelatedSurgicalProcedure @@ -248,6 +250,7 @@ Description: "Example of TNM Clinical Stage Group" * hasMember[0] = Reference(tnm-clinical-primary-tumor-category-cT3) * hasMember[1] = Reference(tnm-clinical-regional-nodes-category-cN3) * hasMember[2] = Reference(tnm-clinical-distant-metastases-category-cM0) +* category = ObsCat#imaging "Imaging" Instance: tnm-clinical-distant-metastases-category-cM0 InstanceOf: TNMDistantMetastasesCategory @@ -260,6 +263,7 @@ Description: "Example of TNM Clinical Distant Metastases Category" * performer = Reference(us-core-practitioner-kyle-anydoc) * effectiveDateTime = "2019-04-01" * valueCodeableConcept = SCT#1229901006 "American Joint Committee on Cancer cM0 (qualifier value)" +* category = ObsCat#imaging "Imaging" Instance: tnm-clinical-primary-tumor-category-cT3 InstanceOf: TNMPrimaryTumorCategory @@ -272,6 +276,7 @@ Description: "Example of TNM Clinical Primary Tumor Category" * subject = Reference(cancer-patient-john-anyperson) * performer = Reference(us-core-practitioner-kyle-anydoc) * effectiveDateTime = "2019-04-01" +* category = ObsCat#imaging "Imaging" Instance: tnm-clinical-regional-nodes-category-cN3 InstanceOf: TNMRegionalNodesCategory @@ -284,6 +289,7 @@ Description: "Example of TNM Clinical Regional Nodes Category" * subject = Reference(cancer-patient-john-anyperson) * performer = Reference(us-core-practitioner-kyle-anydoc) * effectiveDateTime = "2019-04-01" +* category = ObsCat#imaging "Imaging" Instance: cancer-related-medication-request-gefitinib InstanceOf: CancerRelatedMedicationRequest @@ -351,6 +357,7 @@ Description: "Hemoglobin lab result to support TNMStageGroup example" * effectiveDateTime = "2020-03-06" * performer = Reference(us-core-practitioner-owen-oncologist) * valueQuantity = 13.5 'g/dl' "g/dl" +* category = ObsCat#laboratory "laboratory" Instance: history-of-cancer-metastatic-to-liver InstanceOf: HistoryOfMetastaticCancer @@ -360,6 +367,7 @@ Description: "Example showing history of metastatic cancer in liver." * subject = Reference(cancer-patient-adam-everyman) * effectiveDateTime = "2018-11-16" * performer = Reference(us-core-practitioner-owen-oncologist) +* category = ObsCat#social-history "Social History" Instance: no-history-of-metastatic-cancer InstanceOf: HistoryOfMetastaticCancer @@ -370,6 +378,7 @@ Description: "Example showing no history of metastatic cancer" * effectiveDateTime = "2018-11-16" * performer = Reference(us-core-practitioner-owen-oncologist) * valueBoolean = false +* category = ObsCat#social-history "Social History" Instance: histologic-behavior-and-type-non-small-cell InstanceOf: HistologicBehaviorAndType @@ -406,6 +415,7 @@ Description: "Example of intermediate histologic grade." //* status = #final "final" //* issued = "2019-04-15T13:28:17.239+02:00" +/* Instance: rhabdomyosarcoma-risk-assessment-low InstanceOf: RhabdomyosarcomaRiskAssessment Description: "Example of rhabdomyosarcoma with a low risk assessment." @@ -416,7 +426,6 @@ Description: "Example of rhabdomyosarcoma with a low risk assessment." * effectiveDateTime = "2021-04-01" * performer = Reference(us-core-practitioner-kyle-anydoc) - Instance: all-risk-assessment-high InstanceOf: ALLRiskAssessment Description: "Example of leukemia with a standard risk assessment." @@ -426,6 +435,7 @@ Description: "Example of leukemia with a standard risk assessment." * focus = Reference(primary-cancer-condition-nonspecific) * effectiveDateTime = "2021-04-01" * performer = Reference(us-core-practitioner-kyle-anydoc) +*/ Instance: john-anyperson-hd InstanceOf: USCoreCondition @@ -462,6 +472,7 @@ Description: "Example of Patient" * extension[USCoreEthnicity].extension[text].valueString = "Not Hispanic or Latino" * extension[USCoreBirthSex].valueCode = #F +/* Instance: lansky-play-performance-status-twenty InstanceOf: LanskyPlayPerformanceStatus Description: "Example of Lansky Play Performance Status." @@ -483,6 +494,7 @@ Description: "Example of Deauville Scale." * interpretation = NCIT#C99750 "London Deauville Criteria Point Scale 5" * status = #final "final" * effectiveDateTime = "2019-04-01" +*/ Instance: body-surface-area-example InstanceOf: BodySurfaceArea diff --git a/input/fsh/EX_ExtendedExample.fsh b/input/fsh/EX_ExtendedExample.fsh index a0b354f7..e0db91da 100644 --- a/input/fsh/EX_ExtendedExample.fsh +++ b/input/fsh/EX_ExtendedExample.fsh @@ -160,6 +160,7 @@ Description: "mCODE Example for Cancer-Related Comorbidities" // absent -- These could also be references, but having a resource representing a non-condition would be unusual * extension[comorbidConditionAbsent][0].valueCodeableConcept = SCT#414916001 "Obesity (disorder)" * extension[comorbidConditionAbsent][1].valueCodeableConcept = SCT#19829001 "Disorder of lung (disorder)" +* category = ObsCat#social-history "Social History" /* Not used -- model of comorbidities as Questionnaire Instance: cancer-related-comorbidity-response-jenny-m @@ -195,6 +196,7 @@ Description: "Extended example: example showing ECOG performance status" * valueInteger = 0 * interpretation = LNC#LA9622-7 "Fully active, able to carry on all pre-disease performance without restriction" * method = SCT#5880005 "Physical examination procedure (procedure)" +* category = ObsCat#survey "Survey" // body weight and height added to calculate BSA needed to convert chemotherapy relative dose orders to absolute doses for CancerRelatedMedicationAdministration @@ -248,6 +250,7 @@ Description: "Extended example: example showing TNM staging (stage group)" * hasMember[1] = Reference(tnm-pathologic-regional-nodes-category-jenny-m) * hasMember[2] = Reference(tnm-pathologic-distant-metastases-category-jenny-m) * performer = Reference(us-core-practitioner-owen-oncologist) +* category = ObsCat#imaging "Imaging" Instance: tnm-clinical-primary-tumor-category-jenny-m InstanceOf: TNMPrimaryTumorCategory @@ -260,6 +263,8 @@ Description: "Extended example: example showing TNM staging (T)" * valueCodeableConcept = SCT#1228938002 "American Joint Committee on Cancer cT3 (qualifier value)" * method = SCT#897275008 "American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)" * performer = Reference(us-core-practitioner-owen-oncologist) +* category = ObsCat#imaging "Imaging" + Instance: tnm-clinical-regional-nodes-category-jenny-m InstanceOf: TNMRegionalNodesCategory @@ -272,6 +277,7 @@ Description: "Extended example: example showing TNM staging (N)" * valueCodeableConcept = SCT#1229967007 "American Joint Committee on Cancer cN0 (qualifier value)" * method = SCT#897275008 "American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)" * performer = Reference(us-core-practitioner-owen-oncologist) +* category = ObsCat#imaging "Imaging" Instance: tnm-clinical-distant-metastases-category-jenny-m InstanceOf: TNMDistantMetastasesCategory @@ -284,6 +290,7 @@ Description: "Extended example: example showing TNM staging (M)" * valueCodeableConcept = SCT#1229901006 "American Joint Committee on Cancer cM0 (qualifier value)" * method = SCT#897275008 "American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)" * performer = Reference(us-core-practitioner-owen-oncologist) +* category = ObsCat#imaging "Imaging" // Tumor marker test results 3-16-2018 @@ -503,6 +510,7 @@ Description: "Extended example: example showing TNM staging (stage group)" * hasMember[1] = Reference(tnm-pathologic-regional-nodes-category-jenny-m) * hasMember[2] = Reference(tnm-pathologic-distant-metastases-category-jenny-m) * performer = Reference(us-core-practitioner-owen-oncologist) +* category = ObsCat#imaging "Imaging" Instance: tnm-pathologic-primary-tumor-category-jenny-m InstanceOf: TNMPrimaryTumorCategory @@ -515,6 +523,7 @@ Description: "Extended example: example showing TNM staging (T)" * valueCodeableConcept = SCT#1229859000 "American Joint Committee on Cancer pT3 (qualifier value)" * method = SCT#897275008 "American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)" * performer = Reference(us-core-practitioner-owen-oncologist) +* category = ObsCat#imaging "Imaging" Instance: tnm-pathologic-regional-nodes-category-jenny-m InstanceOf: TNMRegionalNodesCategory @@ -527,6 +536,7 @@ Description: "Extended example: example showing TNM staging (N)" * valueCodeableConcept = SCT#1229947003 "American Joint Committee on Cancer pN0 (qualifier value)" * method = SCT#897275008 "American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)" * performer = Reference(us-core-practitioner-owen-oncologist) +* category = ObsCat#imaging "Imaging" Instance: tnm-pathologic-distant-metastases-category-jenny-m InstanceOf: TNMDistantMetastasesCategory @@ -539,6 +549,7 @@ Description: "Extended example: example showing TNM staging (M)" * valueCodeableConcept = AbsentReason#not-applicable "Not Applicable" // cancer is not metastatic, pM0 is not valid * method = SCT#897275008 "American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)" * performer = Reference(us-core-practitioner-owen-oncologist) +* category = ObsCat#imaging "Imaging" // 21-Gene Assay diff --git a/input/fsh/EX_ExtendedExample_Pediatric.fsh b/input/fsh/EX_ExtendedExample_Pediatric.fsh index 434884dc..ff4e2c94 100644 --- a/input/fsh/EX_ExtendedExample_Pediatric.fsh +++ b/input/fsh/EX_ExtendedExample_Pediatric.fsh @@ -168,6 +168,7 @@ Description: "Extended pediatric example: example showing Lansky performance sta * valueInteger = 80 * interpretation = NCIT#C69424 "Lansky Performance Status 80" * method = SCT#5880005 "Physical examination procedure (procedure)" +* category = ObsCat#survy "Survey" Instance: cancer-related-medication-request-cyclophosphamide-brian-l InstanceOf: CancerRelatedMedicationRequest @@ -373,6 +374,7 @@ Description: "Extended pediatric example: body surface area" * performer = Reference(us-core-practitioner-owen-oncologist) * valueQuantity = 0.59 'm2' "square meter" +/* Instance: all-risk-assessment-standard-brian-l InstanceOf: ALLRiskAssessment Description: "Extended pediatric example: ALL risk assessment standard" @@ -382,6 +384,6 @@ Description: "Extended pediatric example: ALL risk assessment standard" * focus = Reference(primary-cancer-condition-brian-l) * effectiveDateTime = "2021-02-08" * performer = Reference(us-core-practitioner-owen-oncologist) - +*/ diff --git a/input/fsh/EX_Staging_Other.fsh b/input/fsh/EX_Staging_Other.fsh index 08f4b8f7..00e75fd8 100644 --- a/input/fsh/EX_Staging_Other.fsh +++ b/input/fsh/EX_Staging_Other.fsh @@ -18,6 +18,7 @@ RuleSet: StagingInstanceRuleSet //------------------------------------------------- +/* Instance: binet-stage-group-B InstanceOf: CLLBinetStage Description: "Example of Binet staging for CLL." @@ -116,3 +117,5 @@ InstanceOf: RhabdomyosarcomaClinicalGroupStage Description: "Example of Rhabdomyosarcoma Clinical Group Stage for rhabdomyosarcoma staging." * insert StagingInstanceRuleSet * valueCodeableConcept = SCT#405957007 "Intergroup rhabdomyosarcoma study post-surgical clinical group IA: localized tumor, confined to site of origin, completely resected (finding)" + +*/ \ No newline at end of file diff --git a/input/fsh/SD_ComorbidCondition.fsh b/input/fsh/SD_ComorbidCondition.fsh index c5b0f029..5a3873b3 100644 --- a/input/fsh/SD_ComorbidCondition.fsh +++ b/input/fsh/SD_ComorbidCondition.fsh @@ -1,5 +1,5 @@ Profile: Comorbidities -Parent: Observation +Parent: USCoreObservationSimple Id: mcode-comorbidities Title: "Comorbidities Profile" Description: "General structure for capturing comorbid conditions with respect to a primary ('index') condition. The user can use this profile in three ways: (1) free-form, listing any conditions they wish to highlight as significant comorbidities, (2) following a formal paradigm such as the Charlson Comorbidity Index or the NCI Comorbidity Index, or (3) use disease categories defined for registry reporting purposes, such as those defined by Center for International Blood and Marrow Transplant Research (CIBMTR)." diff --git a/input/fsh/SD_Genomics.fsh b/input/fsh/SD_Genomics.fsh index f1a4c0d0..e27c71b9 100644 --- a/input/fsh/SD_Genomics.fsh +++ b/input/fsh/SD_Genomics.fsh @@ -81,7 +81,7 @@ Description: "The result of a tumor marker test. Tumor marker tests are generall * extension[relatedCondition] ^definition = "Associates the tumor marker test with a condition, if one exists. Condition can be given by a reference or a code. In the case of a screening test such as prostate-specific antigen (PSA), there may be no existing condition to reference." Profile: HumanSpecimen -Parent: Specimen +Parent: USCoreSpecimen Id: mcode-human-specimen Title: "Human Specimen Profile" Description: "A specimen taken from a Patient for the purpose of oncology-related testing. The profile includes extensions to specify a more precise body site and an identifier of source body structure at that site (for example, a tumor identifier)." diff --git a/input/fsh/SD_Histology.fsh b/input/fsh/SD_Histology.fsh index a48f83a1..ac98acde 100644 --- a/input/fsh/SD_Histology.fsh +++ b/input/fsh/SD_Histology.fsh @@ -1,5 +1,5 @@ Profile: TumorMorphology -Parent: Observation +Parent: USCoreObservationSimple Id: mcode-tumor-morphology Title: "Tumor Morphology Report" Description: "Tumor morphology can include information on the type of cell (type), the malignant potential of the tumor (behavior), and the degree of differentiation (grade). For some cancers, the type and behavior are described in the ICD-O-3 code." @@ -42,7 +42,7 @@ Profile: HistologicGrade Parent: USCoreObservationLab Id: mcode-histologic-grade Title: "Histologic Grade" -Description: "Histologic grade determined from examination of tumor sample." +Description: "Histologic grade determined from examination of tumor sample. The grade system should be captured using the method data element." * ^extension[FMM].valueInteger = 4 * specimen only Reference(HumanSpecimen) * specimen 0..1 MS // is not MS in US Core 4.0.0 and 5.0.1 diff --git a/input/fsh/SD_HistoryOfMetastaticCancer.fsh b/input/fsh/SD_HistoryOfMetastaticCancer.fsh index ac7ae3c2..0b82b60c 100644 --- a/input/fsh/SD_HistoryOfMetastaticCancer.fsh +++ b/input/fsh/SD_HistoryOfMetastaticCancer.fsh @@ -1,7 +1,7 @@ // This profile requires an exception from the CGP WG for use of Observation // In USCore STU6, it could be based on the SimpleObservation profile, but that does not exist in STU5 Profile: HistoryOfMetastaticCancer -Parent: Observation +Parent: USCoreObservationSimple Id: mcode-history-of-metastatic-cancer Title: "History of Metastatic Cancer" Description: "Records the existence of a past episode of metastatic cancer, for the purpose of long term management and tracking." @@ -9,6 +9,7 @@ Description: "Records the existence of a past episode of metastatic cancer, for * value[x] only boolean // If false indicates no history of metastatic cancer * value[x] 0..1 MS ?! // modifies meaning of the observation * value[x] ^isModifierReason = "When value is false, the resource semantics are reversed and the resource represents an assertion of NO history of metastatic cancer (either absolutely, or of the type indicated by Observation.code)" +* extension contains RelatedCondition named relatedCondition 0..* // Cannot have a default value; Rule sdf-21: 'Default values can only be specified on specializations' //* value[x] ^defaultValueBoolean = true // If absent, value is true. diff --git a/input/fsh/SD_PerformanceStatus.fsh b/input/fsh/SD_PerformanceStatus.fsh index 7a035828..6eb09853 100644 --- a/input/fsh/SD_PerformanceStatus.fsh +++ b/input/fsh/SD_PerformanceStatus.fsh @@ -15,7 +15,7 @@ RuleSet: PerformanceStatusCommonRules * status and code and subject and effective[x] and value[x] and interpretation MS Profile: KarnofskyPerformanceStatus -Parent: USCoreClinicalTest +Parent: USCoreClinicalResult Id: mcode-karnofsky-performance-status Title: "Karnofsky Performance Status Profile" Description: "The Karnofsky Performance Status (KPS) is a tool used to measure a patient's functional status. It can be used to compare the effectiveness of different therapies and to help assess the prognosis of certain patients, such as those with certain cancers. The KPS score ranges from 0 to 100 in intervals of 10. Higher scores are associated with better functional status, with 100 representing no symptoms or evidence of disease, and 0 representing death." @@ -26,7 +26,7 @@ Description: "The Karnofsky Performance Status (KPS) is a tool used to measur Profile: ECOGPerformanceStatus -Parent: USCoreClinicalTest +Parent: USCoreClinicalResult Id: mcode-ecog-performance-status Title: "ECOG Performance Status Profile" Description: "The Eastern Cooperative Oncology Group (ECOG) Performance Status represents the patient's functional status and is used to determine their ability to tolerate therapies in serious illness, specifically for chemotherapy. (Definition from: [LOINC](https://loinc.org/89262-0/))" @@ -37,7 +37,7 @@ Description: "The Eastern Cooperative Oncology Group (ECOG) Performance Statu Profile: LanskyPlayPerformanceStatus -Parent: USCoreClinicalTest +Parent: USCoreClinicalResult Id: mcode-lansky-play-performance-status Title: "Lansky Play Performance Status Profile" Description: "The Lansky Play-Performance Status for children is a parent-rated instrument which records usual play activity as the index of performance. It is similar to the Karnofsky Performance Scale for adults (Definition from: [NCI Thesaurus](https://ncithesaurus.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C38144&ns=ncit))." @@ -49,7 +49,7 @@ Description: "The Lansky Play-Performance Status for children is a parent-rated Profile: DeauvilleScale Id: mcode-deauville-scale -Parent: USCoreObservationImaging +Parent: USCoreClinicalResult Title: "Deauville Scale Profile" Description: "Profile for Deauville Scale. A 5 point scale devised to assess the response to treatment of Hodgkin and aggressive Non-Hodgkin lymphoma." * code = SCT#708895006 "Deauville five point scale (assessment scale)" diff --git a/input/fsh/SD_RiskAssessment.fsh b/input/fsh/SD_RiskAssessment.fsh index 14a63a5f..48262c29 100644 --- a/input/fsh/SD_RiskAssessment.fsh +++ b/input/fsh/SD_RiskAssessment.fsh @@ -1,7 +1,7 @@ //Parent// Profile: CancerRiskAssessment Id: mcode-cancer-risk-assessment -Parent: Observation +Parent: USCoreObservationSimple Title: "Cancer Risk Assessment Profile" Description: "Parent profile for observations regarding cancer risk assessment. Risk assessment is a process used to estimate the risk that a certain event will happen. In medicine, this may include a person’s risk of having a child with a certain condition or disease, such as cancer. It may also be used to estimate the risk of carrying a certain gene mutation (change), or of having an adverse event (unexpected medical problem) in response to certain types of drugs or other substances. A risk assessment may be done by collecting information about a person’s age, sex, personal and family medical history, ethnic background, lifestyle, and other factors and using statistics tools to calculate risk (Definition from: [NCI Dictionary of Cancer Terms](https://www.cancer.gov/publications/dictionaries/cancer-terms/def/risk-assessment)). diff --git a/input/fsh/SD_Staging.fsh b/input/fsh/SD_Staging.fsh index 222a478b..b69d7361 100644 --- a/input/fsh/SD_Staging.fsh +++ b/input/fsh/SD_Staging.fsh @@ -1,28 +1,9 @@ -Profile: CancerStage // introduced 8/30/2020 to handle non-TNM staging more clearly +Profile: CancerStage Id: mcode-cancer-stage -Parent: Observation +Parent: USCoreObservationSimple Title: "Cancer Stage Profile" -Description: "Parent profile for observations regarding cancer stage, grade, or classification. The stage is an assessment of the extent of the cancer in the body, according to a given cancer staging classification system. Profiles for different staging systems (e.g., TNM stage group, Rai stage, FIGO stage, etc.) must derive from this profile. - -Despite its name, the CancerStage profile can also be used as a parent for cancer grade or classification. This is because the structure of the profiles are the same or very similar. The key elements are the code, method, value, and optionally, prognostic factors referenced in the hasMember element." +Description: "Profile for observations regarding cancer stage, grade, or classification. The stage is an assessment of the extent of the cancer in the body, according to a given cancer staging classification system. The key elements are the code, method, value, and optionally, prognostic factors referenced in the hasMember (if the prognostic factor is captured in a different profile) or component (if the prognostic factor is not captured in a different profile) element." * ^abstract = true -* code from CancerStageTypeVS (preferred) -* code ^short = "The type of stage information reported." -* code ^definition = """The kind of stage reported, e.g., a pathologic TNM stage, a Lugano lymphoma stage, or a Rai stage for leukemia. This element identifies the type of value that is reported in Observation.value and is necessary for the correct interpretation of that value. - -The distinction between Observation.code and Observation.method is important. Observation.code identifies the kind of stage being reported while Observation.method represents the staging system used to determine the code. Observation.code may imply the staging system. For example, the SNOMED CT 103420007 says the reported value is a modified Dukes stage, implying the Modified Dukes staging system (SNOMED CT 385359000) was used to determine the stage. When the staging system is implied by Observation.code, Observation.method is not required. However, when Observation.code does not imply a staging system (for example, if the code is SNOMED CT 385388004 Lymphoma stage), then the staging system must be specified in Observation.method. - -The value (Observation.valueCodeableConcept) may also imply certain things about the kind of stage being reported. For example, the value cN0 implies the value is a clinical stage. However, even if the value is partly or wholly self-identifying, it is not a reliable indicator of the type of stage being reported or the method of staging. Therefore, Observation.code must in all cases be reported.""" - -* method from CancerStagingMethodVS (extensible) -* method ^short = "The staging system used." -* method ^definition = "The staging system or protocol used to determine the stage, stage group, or category of the cancer based on its extent. When the staging system is implied by Observation.code, Observation.method is not required. However, when Observation.code does not imply a staging system (for example, if the code is SNOMED CT 385388004 Lymphoma stage), then the staging system must be specified in Observation.method. " - -* value[x] only CodeableConcept // SEER extent of disease codings are strings -- this might have to be generalized to include strings -* value[x] from CancerStageValueVS (example) -* value[x] ^comment = "" // suppress QA error on #notes link -* value[x] ^short = "The value of the stage" -* value[x] ^definition = "The stage, stage group, category, or classification resulting from the staging evaluation." * insert NotUsed(device) * insert NotUsed(referenceRange) * focus only Reference(PrimaryCancerCondition) @@ -34,3 +15,23 @@ The value (Observation.valueCodeableConcept) may also imply certain things about * subject ^definition = "The patient associated with staging assessment." * status and code and subject and effective[x] and value[x] and method and focus MS +* code from CancerStageTypeVS (preferred) +* code ^short = "The type of stage information reported." +* code ^definition = """The kind of stage reported, e.g., a pathologic TNM stage, a Lugano lymphoma stage, or a Rai stage for leukemia. This element identifies the type of value that is reported in Observation.value and is necessary for the correct interpretation of that value. The distinction between Observation.code and Observation.method is important. Observation.code identifies the kind of stage being reported while Observation.method represents the staging system used to determine the code. Observation.code may imply the staging system. For example, the SNOMED CT 103420007 says the reported value is a modified Dukes stage, implying the Modified Dukes staging system (SNOMED CT 385359000) was used to determine the stage. When the staging system is implied by Observation.code, Observation.method is not required. However, when Observation.code does not imply a staging system (for example, if the code is SNOMED CT 385388004 Lymphoma stage), then the staging system must be specified in Observation.method. The value (Observation.valueCodeableConcept) may also imply certain things about the kind of stage being reported. For example, the value cN0 implies the value is a clinical stage. However, even if the value is partly or wholly self-identifying, it is not a reliable indicator of the type of stage being reported or the method of staging. Therefore, Observation.code must in all cases be reported.""" + +* method from CancerStagingMethodVS (preferred) +* method ^short = "The staging system used." +* method ^definition = "The staging system or protocol used to determine the stage, stage group, or category of the cancer based on its extent. When the staging system is implied by Observation.code, Observation.method is not required. However, when Observation.code does not imply a staging system (for example, if the code is SNOMED CT 385388004 Lymphoma stage), then the staging system must be specified in Observation.method. " + +* value[x] only CodeableConcept // SEER extent of disease codings are strings -- this might have to be generalized to include strings +* value[x] from CancerStageValueVS (preferred) +* value[x] ^comment = "" // suppress QA error on #notes link +* value[x] ^short = "The value of the stage" +* value[x] ^definition = "The stage, stage group, category, or classification resulting from the staging evaluation." + +* component.code only CodeableConcept +* component.code from CancerStagingPrognosticFactorTypeVS (preferred) +* component.code ^short = "Type of prognostic factor" +* component.value[x] only CodeableConcept +* component.value[x] from CancerStagingPrognosticFactorValueVS (preferred) +* component.value[x] ^short = "Prognostic factor value" \ No newline at end of file diff --git a/input/fsh/SD_Staging_Other.fsh b/input/fsh/SD_Staging_Other.fsh index 38916c5f..8612deb8 100644 --- a/input/fsh/SD_Staging_Other.fsh +++ b/input/fsh/SD_Staging_Other.fsh @@ -1,3 +1,4 @@ +/* // Leukemia Stage Profile: CLLBinetStage @@ -160,3 +161,4 @@ Description: "Clinical stage group for rhabdomyocaroma." * ^extension[FMM].valueInteger = 0 * code = SCT#405916000 // Intergroup rhabdomyosarcoma study post-surgical clinical group (observable entity) * value[x] from RhabdomyosarcomaClinicalGroupValueVS (required) +*/ \ No newline at end of file diff --git a/input/fsh/SD_Staging_TNM.fsh b/input/fsh/SD_Staging_TNM.fsh index 0abfc1bb..632b9cc3 100644 --- a/input/fsh/SD_Staging_TNM.fsh +++ b/input/fsh/SD_Staging_TNM.fsh @@ -1,7 +1,7 @@ //----------- AJCC TNM Staging Profiles-------------- Profile: TNMCategory Id: mcode-tnm-category -Parent: Observation +Parent: USCoreObservationSimple Title: "Parent for T, N, and M Categories." Description: "Parent profile for T, N, and M category profiles." * ^abstract = true diff --git a/input/fsh/VS_Staging.fsh b/input/fsh/VS_Staging.fsh index abd9bae8..74ca4eb0 100644 --- a/input/fsh/VS_Staging.fsh +++ b/input/fsh/VS_Staging.fsh @@ -48,6 +48,7 @@ Description: "Codes that identify the kind of stage reported in an Observation, * SCT#405931009 "National Wilms Tumor Study Group Stage (observable entity)" * SCT#405916000 "Intergroup rhabdomyosarcoma study post-surgical clinical group (observable entity)" * SCT#385377005 "Gleason grade finding for prostatic cancer (finding)" +* SCT#1342413004 "International Intraocular Retinoblastoma Classification (tumor staging)" // unapproved attribute, do not include! * include codes from system SCT where concept is-a #260760003 "Staging of disease (attribute)" // NCI Thesaurus terms * NCIT#C134969 "AIDS-Related Kaposi Sarcoma Stage" @@ -78,6 +79,7 @@ Description: "Codes that identify the kind of stage reported in an Observation, * NCIT#C174125 "Neoplastic Disease Extent Indicator" * NCIT#C141461 "Occult Stage" * NCIT#C133427 "International Neuroblastoma Risk Group Staging System" +* NCIT#C198190 "Childhood Hepatoblastoma by Toronto Guidelines v2 Stage, Tier 2" // Observation.method ValueSet: CancerStagingMethodVS @@ -186,3 +188,20 @@ Description: "A non-exhaustive value set containing codes that result from cance * NCIT#C148012 "Intergroup Rhabdomyosarcoma Group I" * NCIT#C148015 "Intergroup Rhabdomyosarcoma Group II" * NCIT#C148019 "Intergroup Rhabdomyosarcoma Group III" +* NCIT#C198180 "Stage 0 Childhood Retinoblastoma by Toronto Guidelines v2" +* NCIT#C198181 "Stage I Childhood Retinoblastoma by Toronto Guidelines v2" +* NCIT#C198182 "Stage II Childhood Retinoblastoma by Toronto Guidelines v2" +* NCIT#C198183 "Stage III Childhood Retinoblastoma by Toronto Guidelines v2" +* NCIT#CL1914012 "Stage IV Childhood Retinoblastoma by Toronto Guidelines v2" +* NCIT#C7139 "PRETEXT I Hepatoblastoma" +* NCIT#C198011 "Localized PRETEX I Hepatoblastoma" +* NCIT#C198015 "Metastatic PRETEX I Hepatoblastoma" +* NCIT#C7140 "PRETEXT II Hepatoblastoma" +* NCIT#C198012 "Localized PRETEX II Hepatoblastoma" +* NCIT#C198016 "Metastatic PRETEX II Hepatoblastoma" +* NCIT#C7141 "PRETEXT III Hepatoblastoma" +* NCIT#C198013 "Localized PRETEX III Hepatoblastoma" +* NCIT#C198017 "Metastatic PRETEX III Hepatoblastoma" +* NCIT#C7142 "PRETEXT IV Hepatoblastoma" +* NCIT#C198014 "Localized PRETEX IV Hepatoblastoma" +* NCIT#C198018 "Metastatic PRETEX IV Hepatoblastoma" diff --git a/input/fsh/VS_Staging_Other.fsh b/input/fsh/VS_Staging_Other.fsh index 0d6bfe47..92d31c1c 100644 --- a/input/fsh/VS_Staging_Other.fsh +++ b/input/fsh/VS_Staging_Other.fsh @@ -205,6 +205,52 @@ Description: "Intergroup code indicating whether the rhabdomyosarcoma is confine * NCIT#C148015 "Intergroup Rhabdomyosarcoma Group II" * NCIT#C148019 "Intergroup Rhabdomyosarcoma Group III" +ValueSet: CancerStagingPrognosticFactorTypeVS +Id: mcode-cancer-staging-prognostic-factor-type-vs +Title: "Cancer Staging Prognostic Factors Types" +Description: "Types of prognostic factors used to determine cancer stage" +* insert SNOMEDCopyrightForVS +* SCT#106252000 "Staging classification for lymphoma (tumor staging)" +* SCT#277366005 "Nature of staging values (qualifier value)" +* SCT#260873006 "Bulky disease status (attribute)" + +ValueSet: CancerStagingPrognosticFactorValueVS +Id: mcode-cancer-staging-prognostic-factor-value-vs +Title: "Cancer Staging Prognostic Factors Value" +Description: "Values of prognostic factors used to determine cancer stage" +* insert SNOMEDCopyrightForVS +* include codes from system SCT where concept descendant-of #106252000 "Staging classification for lymphoma (tumor staging)" +* SCT#260998006 "Clinical staging (qualifier value)" +* SCT#261023001 "Pathological staging (qualifier value)" +* SCT#2667000 "Absent (qualifier value)" +* SCT#52101004 "Present (qualifier value)" + +ValueSet: InternationalRetinoblastomaStageValueVS +Id: mcode-international-retinoblastoma-stage-value-vs +Title: "International Retinoblastoma Stage Value" +Description: "Codes in the international retinoblastoma staging system representing retinoblastoma stage." +* NCIT#C198180 "Stage 0 Childhood Retinoblastoma by Toronto Guidelines v2" +* NCIT#C198181 "Stage I Childhood Retinoblastoma by Toronto Guidelines v2" +* NCIT#C198182 "Stage II Childhood Retinoblastoma by Toronto Guidelines v2" +* NCIT#C198183 "Stage III Childhood Retinoblastoma by Toronto Guidelines v2" +* NCIT#CL1914012 "Stage IV Childhood Retinoblastoma by Toronto Guidelines v2" + +ValueSet: PRETEXTValueVS +Id: mcode-pretext-stage-value-vs +Title: "PRETEXT Stage Value" +Description: "Codes in the PRETEXT staging system representing hepatoblastoma stage." +* NCIT#C7139 "PRETEXT I Hepatoblastoma" +* NCIT#C198011 "Localized PRETEX I Hepatoblastoma" +* NCIT#C198015 "Metastatic PRETEX I Hepatoblastoma" +* NCIT#C7140 "PRETEXT II Hepatoblastoma" +* NCIT#C198012 "Localized PRETEX II Hepatoblastoma" +* NCIT#C198016 "Metastatic PRETEX II Hepatoblastoma" +* NCIT#C7141 "PRETEXT III Hepatoblastoma" +* NCIT#C198013 "Localized PRETEX III Hepatoblastoma" +* NCIT#C198017 "Metastatic PRETEX III Hepatoblastoma" +* NCIT#C7142 "PRETEXT IV Hepatoblastoma" +* NCIT#C198014 "Localized PRETEX IV Hepatoblastoma" +* NCIT#C198018 "Metastatic PRETEX IV Hepatoblastoma" /* not used diff --git a/input/pagecontent/StructureDefinition-mcode-cancer-stage-group-intro.md b/input/pagecontent/StructureDefinition-mcode-cancer-stage-group-intro.md index 82cdec1e..177b882a 100644 --- a/input/pagecontent/StructureDefinition-mcode-cancer-stage-group-intro.md +++ b/input/pagecontent/StructureDefinition-mcode-cancer-stage-group-intro.md @@ -1,3 +1,35 @@ +Rather than offer a separate staging profile for each stage system type, this profile can support any stage system type. Based on the code selected for Observation.code slice, the Table below provides the preferred valuesets for Observation.method and Observation.value[x]. If the value for Observation.method is "N/A", it means no specific method values have been identified. + +| `Observation.code` | `Observation.method` ValueSet | `Observation.value[x]` ValueSet | +|---------|--------------------|--------------------------| +| SNOMED 385361009 "International Federation of Gynecology and Obstetrics stage for gynecological malignancy (observable entity)" | FIGOStagingMethodVS | FIGOStageValueVS | +| NCI Thesaurus C141212 "Binet Stage" | N/A | BinetStageValueVS | +| NCI Thesaurus C141207 "Rai Stage" | RaiStagingMethodVS | RaiStageValueVS | +| SNOMED 385388004 "Lymphoma stage (observable entity)" | LymphomaStagingMethodVS | LymphomaStageValueVS | +| SNOMED 106243009 "Breslow depth staging for melanoma of skin (observable entity)" | N/A | BreslowDepthStageValueVS | +| SNOMED 103419001 "Clark melanoma level of invasion of excised malignant melanoma of skin (observable entity)" | N/A | ClarkLevelValueVS | +| NCI Thesaurus C139007 "International Staging System Stage" | N/A | MyelomaISSValueVS | +| NCI Thesaurus C141392 "RISS Stage" | N/A | MyelomaRISSValueVS | +| SNOMED 409720004 "International neuroblastoma staging system stage (observable entity)" | N/A | NeuroblastomaINSSValueVS | +| NCI Thesaurus C133427 "International Neuroblastoma Risk Group Staging System" | N/A | NeuroblastomaINRGSSValueVS | +| SNOMED 385377005 "Gleason grade finding for prostatic cancer (finding)" | N/A | GleasonGradeGroupValueVS | +| SNOMED 405916000 "Intergroup rhabdomyosarcoma study post-surgical clinical group (observable entity)" | N/A | RhabdomyosarcomaClinicalGroupValueVS | +| SNOMED 405931009 "National Wilms Tumor Study Group Stage (observable entity)" | N/A | WilmsTumorStageValueVS | +| SNOMED 1342413004 "International Intraocular Retinoblastoma Classification (tumor staging)" | N/A | InternationalRetinoblastomaStageValueVS | +| NCI Thesaurus C198190 "Childhood Hepatoblastoma by Toronto Guidelines v2 Stage, Tier 2" | N/A | + +{: .grid } + +Some staging systems use specific prognostic factors, represented by the component data element. Based on the code selected for Observation.code slice, the Table below provides the preferred codes and valuesets for Observation.component.code and Observation.component.value[x]. + +| `Observation.code` | `Observation.component.code` | `Observation.code.value[x]` ValueSet | +|---------|--------------------|--------------------------| +| SNOMED 385388004 "Lymphoma stage (observable entity)" | SNOMED 106252000 "Staging classification for lymphoma (tumor staging)" | LymphomaStageValueModifierVS | +| SNOMED 385388004 "Lymphoma stage (observable entity)" | SNOMED 277366005 "Nature of staging values (qualifier value)" | ClinOrPathModifierVS | +| SNOMED 385388004 "Lymphoma stage (observable entity)" | SNOMED 260873006 "Bulky disease status (attribute)" | LymphomaStageBulkyModifierVS | +{: .grid } + + ### Conformance Observation resources associated with an [in-scope patient] representing cancer stage information SHALL conform to this profile. diff --git a/input/pagecontent/StructureDefinition-mcode-history-of-metastatic-cancer-intro.md b/input/pagecontent/StructureDefinition-mcode-history-of-metastatic-cancer-intro.md index e324e448..46e46730 100644 --- a/input/pagecontent/StructureDefinition-mcode-history-of-metastatic-cancer-intro.md +++ b/input/pagecontent/StructureDefinition-mcode-history-of-metastatic-cancer-intro.md @@ -7,8 +7,12 @@ To query for a history of metastatic cancer implementers should look for Observa To represent a negative answer to a question regarding history of metastatic disease, the value of the Observation should be set to `false`. +To indicate the primary cancer in which the metastatic cancer was metastatic from, use the relatedCondition extension. + ### Conformance Observation resources associated with an [in-scope patient] with a Observation.code in the value set [HistoryOfMetastaticMalignantNeoplasmVS] SHALL conform to this profile. Any resource intended to conform to this profile SHOULD populate `meta.profile` accordingly. +When possible, specify the location of the metastatic site. If this is unknown, use the parent value (history of metastatic cancer) in the valueset. + {% include markdown-link-references.md %} diff --git a/input/pagecontent/ValueSet-mcode-deauville-scale-vs-intro.md b/input/pagecontent/ValueSet-mcode-deauville-scale-vs-intro.md new file mode 100644 index 00000000..d958d42c --- /dev/null +++ b/input/pagecontent/ValueSet-mcode-deauville-scale-vs-intro.md @@ -0,0 +1,8 @@ +### Usage +The following information from [this article](https://radiopaedia.org/articles/deauville-five-point-scale?lang=us) describes the values. The scale ranges from 1 to 5, where 1 is best and 5 is the worst. Each lesion is rated independently: + +* 1 means there was no uptake or no residual uptake (when used interim) +* 2 means there was slight uptake, but equal to or below blood pool (mediastinum) +* 3 means there was uptake above mediastinal, but below or equal to uptake in the liver +* 4 means there was uptake slightly to moderately higher than liver +* 5 means there was markedly increased uptake or any new lesion (on response evaluation) \ No newline at end of file diff --git a/input/pagecontent/ValueSet-mcode-neuroblastoma-INRGSS-value-vs-intro.md b/input/pagecontent/ValueSet-mcode-neuroblastoma-INRGSS-value-vs-intro.md new file mode 100644 index 00000000..6818d8b6 --- /dev/null +++ b/input/pagecontent/ValueSet-mcode-neuroblastoma-INRGSS-value-vs-intro.md @@ -0,0 +1,7 @@ +### Usage +The following information from [this article](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2650389/) describes the values. + +* Stage L1 = Localized tumor not involving vital structures as defined by the list of image-defined risk factors and confined to one body compartment +* Stage L2 = Locoregional tumor with presence of one or more image-defined risk factors +* Stage M = Distant metastatic disease (except stage MS) +* Stage MS = Metastatic disease in children younger than 18 months with metastases confined to skin, liver, and/or bone marrow diff --git a/input/pagecontent/ValueSet-mcode-neuroblastoma-inss-value-vs-intro.md b/input/pagecontent/ValueSet-mcode-neuroblastoma-inss-value-vs-intro.md new file mode 100644 index 00000000..dc9ba665 --- /dev/null +++ b/input/pagecontent/ValueSet-mcode-neuroblastoma-inss-value-vs-intro.md @@ -0,0 +1,9 @@ +### Usage +The following information from [the American Cancer Society](https://www.cancer.org/cancer/types/neuroblastoma/detection-diagnosis-staging/staging.html) describes the values. + +* Stage 1: The cancer is still in the area where it started. It is on one side of the body (right or left). All visible tumor has been removed completely by surgery (although looking at the tumor’s edges under the microscope after surgery may show some cancer cells). Lymph nodes near the tumor are free of cancer (although nodes enclosed within the tumor may contain neuroblastoma cells). +* Stage 2A: The cancer is still in the area where it started and on one side of the body, but not all of the visible tumor could be removed by surgery. Lymph nodes near the tumor are free of cancer (although nodes enclosed within the tumor may contain neuroblastoma cells). +* Stage 2B: The cancer is on one side of the body, and it may or may not have been removed completely by surgery. Nearby lymph nodes outside the tumor contain neuroblastoma cells, but the cancer has not spread to lymph nodes on the other side of the body or elsewhere. +* Stage 3: The cancer has not spread to distant parts of the body, but one of the following is true: The cancer can't be removed completely by surgery, and it has crossed the midline (defined as the spine) to the other side of the body. It may or may not have spread to nearby lymph nodes; the cancer is still in the area where it started and is on one side of the body. It has spread to lymph nodes that are relatively nearby but on the other side of the body; the cancer is in the middle of the body and is growing toward both sides (either directly or by spreading to nearby lymph nodes). +* Stage 4: The cancer has spread to distant parts of the body such as distant lymph nodes, bones, liver, skin, bone marrow, or other organs (but the child does not meet the criteria for stage 4S). +* Stage 4S (also called “special” neuroblastoma): The child is younger than 1 year old. The cancer is on one side of the body. It might have spread to lymph nodes on the same side of the body but not to nodes on the other side. The neuroblastoma has spread to the liver, skin, and/or the bone marrow. However, no more than 10% of marrow cells are cancer cells, and imaging tests such as an MIBG scan do not show cancer in the bone marrow. diff --git a/input/pagecontent/ValueSet-mcode-rhabdomyosarcoma-assessment-vs-intro.md b/input/pagecontent/ValueSet-mcode-rhabdomyosarcoma-assessment-vs-intro.md new file mode 100644 index 00000000..17fc05e1 --- /dev/null +++ b/input/pagecontent/ValueSet-mcode-rhabdomyosarcoma-assessment-vs-intro.md @@ -0,0 +1,2 @@ +### Usage +[This article](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8976559/) describes the different risk assessment values. \ No newline at end of file diff --git a/input/pagecontent/ValueSet-mcode-wilms-tumor-stage-vs-intro.md b/input/pagecontent/ValueSet-mcode-wilms-tumor-stage-vs-intro.md new file mode 100644 index 00000000..23240c53 --- /dev/null +++ b/input/pagecontent/ValueSet-mcode-wilms-tumor-stage-vs-intro.md @@ -0,0 +1,9 @@ +### Usage +The folowing information [from NLM](https://www.ncbi.nlm.nih.gov/books/NBK442004/) describes the different stages. + +* Stage I indicates the tumor was completely contained within the kidney without any breaks or spillage outside the renal capsule and no vascular invasion. +* Stage II would be a tumor that has grown outside the kidney to some degree, such as into surrounding fatty tissue. Usually, the tumor would be completely removable by surgery, and regional lymph nodes are negative. +* Stage III indicates a tumor which could not be completely removed surgically such as the following. Cancer has spread to the regional lymph nodes but not to more distant nodes, such as in the chest; Cancer has grown into nearby vital structures so it could not be surgically removed completely; Deposits of the tumor (tumor implants) are found in the peritoneum, or there are positive surgical margins, cancer cells were accidentally “spilled” into the abdominal cavity during surgery, the tumor was removed in separate pieces surgically; such as one piece from the kidney and another from the adrenal gland; A renal biopsy of the tumor was done before it was surgically removed +* Stage IV tumors are those that have spread through the vascular system to distant organs such as the lungs, liver, brain, or bones, or to distant lymph nodes. +* Stage V are those cases where both kidneys are involved with tumor at the time of initial diagnosis. Individual staging of each renal unit is needed as well. + diff --git a/input/pagecontent/group-disease.md b/input/pagecontent/group-disease.md index f90fb685..fa3130ec 100644 --- a/input/pagecontent/group-disease.md +++ b/input/pagecontent/group-disease.md @@ -58,7 +58,7 @@ The data sender must assure that the values in these three fields are self-consi #### How to Report Staging or Risk Assessment Information -Staging or risk assessment information should be provided as Observation resource(s) conforming to the [CancerStage] or [CancerRiskAssessment] profile or a constrained version of those profiles. CancerStage and CancerRiskAssessment are parent profiles that should be used only if a more specific profile corresponding to a particular staging system or risk assessment is unavailable. If a patient has been staged or assessed more than once, there will be multiple CancerStage or RiskAssessment observations. +Staging or risk assessment information SHOULD be provided as Observation resource(s) conforming to the [CancerStage] or [CancerRiskAssessment] profile or a constrained version of those profiles. CancerStage and CancerRiskAssessment are parent profiles that should be used only if a more specific profile corresponding to a particular staging system or risk assessment is unavailable. If a patient has been staged or assessed more than once, there will be multiple CancerStage or RiskAssessment observations. In the CancerStage and CancerRiskAssessment profile and its descendants, the following elements are used to describe a stage or classification: @@ -71,7 +71,7 @@ In the CancerStage and CancerRiskAssessment profile and its descendants, the fol | Prognostic Factors | `Observation.derivedFrom` | A reference to Observations contributing to the stage or risk assessment. | {: .grid } -A reference to the CancerStage observation should be given in the PrimaryCancerCondition's `Condition.stage.assessment` element. If staging has been repeated for a patient, the reference in PrimaryCancerCondition should point to the most recent staging information. +A reference to the CancerStage observation SHOULD be given in the PrimaryCancerCondition's `Condition.stage.assessment` element. If staging has been repeated for a patient, the reference in PrimaryCancerCondition SHOULD point to the most recent staging information. #### TNM Staging