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Draft revision to tumor morphology profiles #408

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Draft revision to tumor morphology profiles #408

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Draft revision to tumor morphology profiles
CarolinePotteiger Aug 5, 2024
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CarolinePotteiger Sep 3, 2024
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CarolinePotteiger Sep 3, 2024
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23 changes: 11 additions & 12 deletions input/fsh/EX_Basic.fsh
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Original file line number Diff line number Diff line change
Expand Up @@ -394,18 +394,17 @@ Description: "Example of intermediate histologic grade."
* status = #final "final"
* performer = Reference(us-core-practitioner-kyle-anydoc)


Instance: tumor-morphology-report-non-small-cell-intermediate-grade
InstanceOf: TumorMorphology
Description: "Example of a tumor morphology report showing non-small cell cancer with an intermediate histologic grade."
* extension[relatedCondition].valueReference = Reference(primary-cancer-condition-nsclc)
* subject = Reference(cancer-patient-john-anyperson)
* effectiveDateTime = "2019-04-01"
* specimen = Reference(human-specimen-lung)
* result[0] = Reference(histologic-grade-intermediate)
* result[1] = Reference(histologic-behavior-and-type-non-small-cell)
* status = #final "final"
* issued = "2019-04-15T13:28:17.239+02:00"
//Instance: tumor-morphology-report-non-small-cell-intermediate-grade
//InstanceOf: TumorMorphology
//Description: "Example of a tumor morphology report showing non-small cell cancer with an intermediate histologic grade."
//* extension[relatedCondition].valueReference = Reference(primary-cancer-condition-nsclc)
//* subject = Reference(cancer-patient-john-anyperson)
//* effectiveDateTime = "2019-04-01"
//* specimen = Reference(human-specimen-lung)
//* result[0] = Reference(histologic-grade-intermediate)
//* result[1] = Reference(histologic-behavior-and-type-non-small-cell)
//* status = #final "final"
//* issued = "2019-04-15T13:28:17.239+02:00"

Instance: rhabdomyosarcoma-risk-assessment-low
InstanceOf: RhabdomyosarcomaRiskAssessment
Expand Down
19 changes: 7 additions & 12 deletions input/fsh/SD_Histology.fsh
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Original file line number Diff line number Diff line change
@@ -1,11 +1,11 @@
Profile: TumorMorphology
Parent: USCoreDiagnosticReportProfileLaboratoryReporting
Parent: Observation
Id: mcode-tumor-morphology
Title: "Tumor Morphology Report"
Description: "ICD-O-3 morphology determined from examination of tumor sample, composed of three parts: histologic type, the malignant potential of the tumor (behavior) and the tumor grade (degree of differentiation)."
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."
* ^extension[FMM].valueInteger = 4
* specimen only Reference(HumanSpecimen)
* specimen 0..1 MS
* specimen MS
* code = LNC#77753-2 // Tumor morphology panel Cancer
* subject only Reference(CancerPatient)
* subject ^definition = "Patient whose test result is recorded."
Expand All @@ -14,14 +14,8 @@ Description: "ICD-O-3 morphology determined from examination of tumor sample, co
* extension contains RelatedCondition named relatedCondition 0..* MS
* extension[relatedCondition] ^short = "Condition associated with this test."
* 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."
* insert SliceReferenceOnProfile(result)
* result contains histologyBehaviorAndType 0..1 and grade 0..1
* result[histologyBehaviorAndType] only Reference(HistologicBehaviorAndType)
* result[histologyBehaviorAndType] ^short = "Histology Behavior Type being reported using ICD-O-3"
* result[histologyBehaviorAndType] ^definition = "The ICD-O-3 4-digit histology code for the tumor, with the 5th digit behavior code for the tumor"
* result[grade] only Reference(HistologicGrade)
* result[grade] ^short = "Tumor grade code being reported using SNOMED"
* result[grade] ^definition = "The histologic grade of the tumor"
* hasMember only Reference(HistologicBehaviorAndType or HistologicGrade)


Profile: HistologicBehaviorAndType
Parent: USCoreObservationLab
Expand Down Expand Up @@ -52,7 +46,7 @@ Description: "Histologic grade determined from examination of tumor sample."
* ^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
* code = LNC#33732-9 // Histology grade [Identifier] in Cancer specimen (could be 21858-6 Grade Cancer)
* code = NCIT#C18000 // Histologic Grade
* value[x] 1..1
* value[x] only CodeableConcept
* value[x] from HistologicGradeVS (extensible)
Expand All @@ -70,3 +64,4 @@ Description: "Histologic grade determined from examination of tumor sample."
// RelatedCondition added 11/14/2022, see https://chat.fhir.org/#narrow/stream/229074-CodeX/topic/Reference.20between.20tumor.20characteristics.20and.20cancer.20diagnosis