INCISIVE Implementation Guide
0.1.1 - draft
INCISIVE Implementation Guide - Local Development build (v0.1.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
Bundle Colorectal-Cancer-Message-Bundle-Example of type transaction
Entry 1
Request:
POST MessageHeader
Resource MessageHeader:
Generated Narrative: MessageHeader
Resource MessageHeader "colorectalmessageheader"
event: Malignant neoplasm of colon and/or rectum (disorder) (Details: http://snomed.org code 781382000 = '781382000', stated as 'Malignant neoplasm of colon and/or rectum (disorder)')
Destinations
Name Endpoint example https://exemple.com/services?wsdl sender: See above (Organization/colorectalorganization01)
Sources
Name Contact Endpoint example example@example.com https://exemple.cat/origin
Entry 2
Request:
POST Organization
Resource Organization:
Generated Narrative: Organization
Resource Organization "colorectalorganization01"
Profile: Organization for Breast, Colorectal, Lung and Prostate cancer
identifier: AUTH/?ngen-9?
name: Aristotle university of Thessaloniki
Entry 3
Request:
POST Medication
Resource Medication:
Generated Narrative: Medication
Resource Medication "colorectalmedication01"
code: Medication therapy (snomed.org#373873005 "Pharmaceutical / biologic product (product)")
status: ACTIVE
Entry 4
Request:
POST Patient
Resource Patient:
Female, DoB: ( Pseudo-anonimized Identifier: 004-000001)
Entry 5
Request:
POST Condition
Resource Condition:
Generated Narrative: Condition
Resource Condition "colorectalcondition01"
Profile: Condition for Breast, Colorectal, Lung and Prostate cancer
code: N39.8 (SNOMED CT#417662000 "History of clinical finding in subject (situation)")
subject: See above (Patient/colorectalpatient01)
evidence
Entry 6
Request:
POST Observation
Resource Observation:
Generated Narrative: Observation
Resource Observation "colorectalobservation01"
Profile: Observation for Colorectal cancer
status: FINAL
code: Malignant neoplasm of colon and/or rectum (disorder) (snomed.org#781382000)
subject: See above (Patient/colorectalpatient01)
note: Observation note
component
code: |Family history of cancer (situation)|:|Subject relationship context (attribute)|=|Father (person)| (snomed.org#275937001:408732007=66839005)
value: true
component
code: |Family history of cancer (situation)|:|Subject relationship context (attribute)|=|Mother (person)| (snomed.org#275937001:408732007=72705000)
value: true
component
code: Carcinoembryonic Ag [Mass/volume] in Serum or Plasma (LOINC#2039-6)
value: 11.9 nanogram per millliiter (Details: UCUM code ng/mL = 'ng/mL')
component
code: Cancer Ag 19-9 [Units/volume] in Serum or Plasma (LOINC#24108-3)
value: 37 enzyme unit per millilitre (Details: UCUM code U/mL = 'U/mL')
Entry 7
Request:
POST DiagnosticReport
Resource DiagnosticReport:
Malignant neoplasm of colon and/or rectum (disorder)
Subject Not done yet Report Details
Code Value Note Malignant neoplasm of colon and/or rectum (disorder) Observation note
Entry 8
Request:
POST Observation
Resource Observation:
Generated Narrative: Observation
Resource Observation "colorectalobservation02"
Profile: Observation for Colorectal cancer
status: FINAL
code: Malignant neoplasm of colon and/or rectum (disorder) (snomed.org#781382000)
subject: See above (Patient/colorectalpatient01)
bodySite: Ovary (Distant_metastasis_location_Colorectal#3)
component
code: Altered bowel function (finding) (snomed.org#88111009)
value: true
component
code: Iron deficiency anemia (disorder) (snomed.org#87522002)
value: true
component
code: Intestinal obstruction (disorder) (snomed.org#81060008)
value: true
component
code: Weight loss (finding) (snomed.org#89362005)
value: true
component
code: Laboratory procedure performed (situation) (snomed.org#165331007)
value: true
component
code: Primary tumor size (observable entity) (snomed.org#399734001)
value: 4.8 centimetre (Details: UCUM code cm = 'cm')
component
code: Structure of lymph node (body structure) (snomed.org#59441001)
value: true
component
code: Lymph node station of involved lymph nodes (observable entity) (snomed.org#443097008)
value: 13
component
code: Length of lymph node in excised specimen (observable entity) (snomed.org#364109001)
value: 9 centimetre (Details: UCUM code cm = 'cm')
component
code: pM category (observable entity) (snomed.org#371497001)
value: true
component
code: T category (observable entity) (snomed.org#78873005)
value: Tis
component
code: N category (observable entity) (snomed.org#277206009)
value: N0
component
code: M category (observable entity) (snomed.org#277208005)
value: M0
component
code: Tumor stage finding (finding) (snomed.org#385356007)
value: IIA
component
code: Malignant tumor of rectum (disorder) (snomed.org#363351006)
value: true
component
code: Melanocyte stimulating hormone releasing factor (substance) (snomed.org#43440003)
value: true
component
code: Venous (large vessel) extramural invasion by tumor present (finding) (snomed.org#369734008)
value: true
Entry 9
Request:
POST Condition
Resource Condition:
Generated Narrative: Condition
Resource Condition "colorectalcondition02"
Profile: Condition for Breast, Colorectal, Lung and Prostate cancer
subject: See above (Patient/colorectalpatient01)
evidence
Entry 10
Request:
POST Observation
Resource Observation:
Generated Narrative: Observation
Resource Observation "colorectalobservation03"
Profile: Observation for Colorectal cancer
status: FINAL
code: Malignant neoplasm of colon and/or rectum (disorder) (snomed.org#781382000)
subject: See above (Patient/colorectalpatient01)
bodySite: Rectal (Location_Colorectal#6; Location_for_rectal_cancer_Colorectal#3 "High rectal")
component
code: CT.dcm-path (snomed.org#77477000 "Computed tomography (procedure)")
value: true
component
code: Annotated CT.dcm-path (snomed.org#118247008:418775008=77477000 "|Radiologic finding (finding)|:|Finding method (attribute)|=|Computed tomography (procedure)|")
value: Positive annotation (Annotated_Dicom_files_Colorectal#1)
component
code: MRI.dcm-path (snomed.org#113091000 "Magnetic resonance imaging (procedure)")
value: true
component
code: Annotated MRI.dcm-path (snomed.org#365853002:418775008=113091000 "|Imaging finding (finding)|:|Finding method (attribute)|=|Magnetic resonance imaging (procedure)|")
value: Positive annotation (Annotated_Dicom_files_Colorectal#1)
component
code: PET/CT.dcm-path (snomed.org#82918005 "Positron emission tomography (procedure)")
value: true
component
code: Annotated PET/CT.dcm-path (snomed.org#118247008:418775008=450436003 "|Radiologic finding (finding)|:|Finding method (attribute)|=|Positron emission tomography with computed tomography (procedure)|")
value: Positive annotation (Annotated_Dicom_files_Colorectal#1)
component
code: Histopathology Image.dcm-path (snomed.org#252416005 "Histopathology test (procedure)")
value: true
component
code: Annotated Histopathology Image.dcm-path (snomed.org#250537006 "Histopathology finding (finding)")
value: Positive annotation (Annotated_Dicom_files_Colorectal#1)
component
code: Xray.dcm-path (snomed.org#363680008 "Radiographic imaging procedure (procedure)")
value: true
component
code: Annotated Xray.dcm-path (snomed.org#118247008:418775008=168537006 "|Radiologic finding (finding)|:|Finding method (attribute)|=|Plain radiography (procedure)|")
value: Positive annotation (Annotated_Dicom_files_Colorectal#1)
Entry 11
Request:
POST Observation
Resource Observation:
Generated Narrative: Observation
Resource Observation "colorectalobservation04"
Profile: Observation for Colorectal cancer
status: FINAL
category: Between 1st and 2nd dose of CT (), Label timepoints ()
code: After 1st Treatment (Label_Timepoints#1)
subject: See above (Patient/colorectalpatient01)
value: 2
bodySite: Ovary (Distant_metastasis_location_Colorectal#3)
component
code: Altered bowel function (finding) (snomed.org#88111009)
value: true
component
code: Iron deficiency anemia (disorder) (snomed.org#87522002)
value: true
component
code: Intestinal obstruction (disorder) (snomed.org#81060008)
value: true
component
code: Weight loss (finding) (snomed.org#89362005)
value: true
component
code: Performance measure status (finding) (snomed.org#241000124106)
value: 5
component
code: CT.dcm-path (snomed.org#77477000 "Computed tomography (procedure)")
value: true
component
code: Annotated CT.dcm-path (snomed.org#118247008:418775008=77477000 "|Radiologic finding (finding)|:|Finding method (attribute)|=|Computed tomography (procedure)|")
value: Positive annotation (Annotated_Dicom_files_Colorectal#1)
component
code: MRI.dcm-path (snomed.org#113091000 "Magnetic resonance imaging (procedure)")
value: true
component
code: Annotated MRI.dcm-path (snomed.org#365853002:418775008=113091000 "|Imaging finding (finding)|:|Finding method (attribute)|=|Magnetic resonance imaging (procedure)|")
value: Positive annotation (Annotated_Dicom_files_Colorectal#1)
component
code: PET/CT.dcm-path (snomed.org#82918005 "Positron emission tomography (procedure)")
value: true
component
code: Annotated PET/CT.dcm-path (snomed.org#118247008:418775008=450436003 "|Radiologic finding (finding)|:|Finding method (attribute)|=|Positron emission tomography with computed tomography (procedure)|")
value: Positive annotation (Annotated_Dicom_files_Colorectal#1)
component
code: Histopathology Image.dcm-path (snomed.org#252416005 "Histopathology test (procedure)")
value: true
component
code: Annotated Histopathology Image.dcm-path (snomed.org#250537006 "Histopathology finding (finding)")
value: Positive annotation (Annotated_Dicom_files_Colorectal#1)
component
code: Xray.dcm-path (snomed.org#363680008 "Radiographic imaging procedure (procedure)")
value: true
component
code: Annotated Xray.dcm-path (snomed.org#118247008:418775008=168537006 "|Radiologic finding (finding)|:|Finding method (attribute)|=|Plain radiography (procedure)|")
value: Positive annotation (Annotated_Dicom_files_Colorectal#1)
component
code: Laboratory procedure performed (situation) (snomed.org#165331007)
value: true
component
code: Primary tumor size (observable entity) (snomed.org#399734001)
value: 4.8 centimetre (Details: UCUM code cm = 'cm')
component
code: Structure of lymph node (body structure) (snomed.org#59441001)
value: true
component
code: Lymph node station of involved lymph nodes (observable entity) (snomed.org#443097008)
value: 13
component
code: Length of lymph node in excised specimen (observable entity) (snomed.org#364109001)
value: 9 centimetre (Details: UCUM code cm = 'cm')
component
code: pM category (observable entity) (snomed.org#371497001)
value: true
component
code: Response to treatment (situation) (snomed.org#182985004)
value: CR (Response_to_treatment_Colorectal#1)
component
code: T category (observable entity) (snomed.org#78873005)
value: Tis
component
code: N category (observable entity) (snomed.org#277206009)
value: N0
component
code: M category (observable entity) (snomed.org#277208005)
value: M0
Entry 12
Request:
POST Condition
Resource Condition:
Generated Narrative: Condition
Resource Condition "colorectalcondition03"
Profile: Condition for Breast, Colorectal, Lung and Prostate cancer
subject: See above (Patient/colorectalpatient01)
evidence
Entry 13
Request:
POST MedicationAdministration
Resource MedicationAdministration:
Generated Narrative: MedicationAdministration
Resource MedicationAdministration "colorectalmedicationAdministration01"
status: COMPLETED
subject: See above (Patient/colorectalpatient01)
Dosages
Route Dose |Delivered radiation dose (observable entity)|:|Direct site (attribute)|=|Breast structure (body structure)|, |Units (attribute)|=|Gray (qualifier value)| (snomed.org#371892002:704327008=76752008, 246514001=229029004) 40.4
Entry 14
Request:
POST MedicationAdministration
Resource MedicationAdministration:
Generated Narrative: MedicationAdministration
Resource MedicationAdministration "colorectalmedicationAdministration02"
status: COMPLETED
subject: See above (Patient/colorectalpatient01)
Dosages
Route Dose Rate[x] |Delivered radiation dose (observable entity)|:|Direct site (attribute)|=|Structure of lymph node (body structure)|, |Units (attribute)|=|Gray (qualifier value)| (snomed.org#371892002:704327008=59441001, 246514001=229029004) 50.4 28 fractions
Entry 15
Request:
POST Observation
Resource Observation:
Generated Narrative: Observation
Resource Observation "colorectalobservation05"
Profile: Observation for Colorectal cancer
partOf:
- See above (MedicationAdministration/colorectalmedicationAdministration01)
- See above (MedicationAdministration/colorectalmedicationAdministration02)
status: FINAL
category: Between 1st and 2nd dose of CT (), Label treatment ()
code: After 1st Treatment-1st FollowUp (Label_Treatment#1)
subject: See above (Patient/colorectalpatient01)
Components
Code Value[x] |Administration of drug or medicament (procedure)|:|Has intent (attribute)|=|Neo-adjuvant - intent (qualifier value)| (snomed.org#18629005:363703001=373847000) true
Entry 16
Request:
POST Procedure
Resource Procedure:
Generated Narrative: Procedure
Resource Procedure "colorectalprocedure01"
status: COMPLETED
category: Segmentomy (snomed.org#387713003:370130000=410656007 "|Surgical procedure (procedure)|:|Property (attribute)|=|Type (property) (qualifier value)|")
code: Surgical procedure (procedure) (snomed.org#387713003)
Entry 17
Request:
POST Procedure
Resource Procedure:
Generated Narrative: Procedure
Resource Procedure "colorectalprocedure02"
status: COMPLETED
code: Capecitabine (snomed.org#367336001:370130000=410656007 "|Chemotherapy (procedure)|:|Property (attribute)|=|Type (property) (qualifier value)|")
Entry 18
Request:
POST Procedure
Resource Procedure:
Generated Narrative: Procedure
Resource Procedure "colorectalprocedure03"
status: COMPLETED
code: Nitrosoureas (snomed.org#703423002:370130000=410656007 "|Combined chemotherapy and radiation therapy (procedure)|:|Property (attribute)|=|Type (property) (qualifier value)|")
Entry 19
Request:
POST Procedure
Resource Procedure:
Generated Narrative: Procedure
Resource Procedure "colorectalprocedure04"
status: COMPLETED
code: Tamoxifen (snomed.org#897713009:370130000=410656007 "|Antineoplastic chemoimmunotherapy (regime/therapy)|:|Property (attribute)|=|Type (property) (qualifier value)|")
Entry 20
Request:
POST Procedure
Resource Procedure:
Generated Narrative: Procedure
Resource Procedure "colorectalprocedure05"
status: COMPLETED
code: Radiation therapy care (regime/therapy) (snomed.org#385798007)
subject: See above (Patient/colorectalpatient01)
bodySite: Rectum (Location_of_RT_Colorectal#1)
Entry 21
Request:
POST Procedure
Resource Procedure:
Generated Narrative: Procedure
Resource Procedure "colorectalprocedure06"
status: COMPLETED
category: Segmentomy (snomed.org#387713003 "Surgical procedure (procedure)")
Entry 22
Request:
POST Observation
Resource Observation:
Generated Narrative: Observation
Resource Observation "colorectalobservation06"
Profile: Observation for Colorectal cancer
status: FINAL
code: Malignant neoplasm of colon and/or rectum (disorder) (snomed.org#781382000)
subject: See above (Patient/colorectalpatient01)
component
code: KRAS gene mutations tested for in Blood or Tissue by Molecular genetics method Nominal (LOINC#21703-4)
value: true
component
code: GSTP1 gene+APC gene methylation [Presence] in Tissue by Molecular genetics method (LOINC#59585-0)
value: true
component
code: TP53 gene mutations found [Identifier] in Blood or Tissue by Molecular genetics method Nominal (LOINC#21739-8)
value: true
component
code: 18q chromosome deletion [Identifier] in Blood or Tissue by Molecular genetics method Nominal (LOINC#46108-7)
value: true
component
code: TGFBR1 gene+TGFBR2 gene targeted mutation analysis in Blood or Tissue by Molecular genetics method (LOINC#53899-1)
value: true
component
code: PIK3CA gene [VCF] in Cancer specimen by Sequencing (snomed.org#83062-0)
value: true
component
code: Microsatellite markers exhibiting instability/Microsatellite instability markers assessed in Cancer specimen (snomed.org#81708-0)
value: true
component
code: DNA mismatch repair protein Msh3 [Presence] in Cancer specimen by Immune stain (snomed.org#96271-2)
value: true
Entry 23
Request:
POST Observation
Resource Observation:
Generated Narrative: Observation
Resource Observation "colorectalobservation07"
Profile: Observation for Colorectal cancer
status: FINAL
code: Malignant neoplasm of colon and/or rectum (disorder) (snomed.org#781382000)
subject: See above (Patient/colorectalpatient01)
component
code: Sampling - action (qualifier value) (snomed.org#257915005)
value: Light microscopy
component
code: Staining method (procedure) (snomed.org#127790008)
value: Hematoxylin
component
code: Microscopic specimen observation (finding) (snomed.org#395538009)
value: x10
component
code: Biopsy finding (finding) (snomed.org#365855009)
value: example
Entry 24
Request:
POST Procedure
Resource Procedure:
Generated Narrative: Procedure
Resource Procedure "colorectalprocedure07"
status: COMPLETED
statusReason: Biopsy label (Label_Biopsy#1 "After 1st Treatment")
category: Between 1st and 2nd dose of CT ()
code: Biopsy (procedure) (snomed.org#86273004)
Entry 25
Request:
POST Procedure
Resource Procedure:
Generated Narrative: Procedure
Resource Procedure "colorectalprocedure08"
status: COMPLETED
code: Surgical procedure (procedure) (snomed.org#387713003)
Entry 26
Request:
POST Observation
Resource Observation:
Generated Narrative: Observation
Resource Observation "colorectalobservation08"
Profile: Observation for Colorectal cancer
status: FINAL
category: Adenocarcinoma (Colorectal_Cancer_Type#1)
code: Malignant neoplasm of colon (disorder) (snomed.org#363406005)
subject: See above (Patient/colorectalpatient01)
Components
Code Value[x] |Malignant neoplasm of colon (disorder)|:|Interprets (attribute)|=|Edition of American Joint Commission on Cancer, Cancer Staging Manual used for TNM staging (observable entity)| (snomed.org#363406005:363714003=443941007) 1
Entry 27
Request:
POST Observation
Resource Observation:
Generated Narrative: Observation
Resource Observation "colorectalobservation09"
Profile: Observation for Colorectal cancer
status: FINAL
category: Between 1st and 2nd dose of CT (), Exam label ()
code: After 1st Treatment (Label_Exam#1)
subject: See above (Patient/colorectalpatient01)
value: 2
component
code: Leukocytes [#/volume] in Stem cell product (LOINC#95218-4)
value: 15.8 per microlitre (Details: UCUM code x10^9/L = 'x10^9/L')
component
code: Hemoglobin [Mass/volume] in Blood (LOINC#718-7)
value: 16.7 gram per decilitre (Details: UCUM code gr/dL = 'gr/dL')
component
code: Hematocrit [Volume Fraction] of Blood (LOINC#20570-8)
value: 47.4 % percent (Details: UCUM code % = '%')
component
code: Platelets [#/volume] in Blood (LOINC#26515-7)
value: 287 per nanolitre (Details: UCUM code x10^3/μL = 'x10^3/μL')
component
code: Glucose [Mass/volume] in Venous blood (LOINC#41652-9)
value: 87 milligram per decilitre (Details: UCUM code mg/dL = 'mg/dL')
component
code: Insulin [Units/volume] in Serum or Plasma (LOINC#20448-7)
value: 4 milli-international unit per litre (Details: UCUM code mlU/L = 'mlU/L')
component
code: Urea [Mass/volume] in Blood (LOINC#20977-5)
value: 36 milligram per decilitre (Details: UCUM code mg/dL = 'mg/dL')
component
code: Creatinine [Mass/volume] in Blood (LOINC#38483-4)
value: 0.72 milligram per decilitre (Details: UCUM code mg/dL = 'mg/dL')
component
code: Urate [Mass/volume] in Blood (LOINC#98981-4)
value: 3.5 milligram per decilitre (Details: UCUM code mg/dL = 'mg/dL')
component
code: Potassium [Mass/volume] in Blood (LOINC#75940-7)
value: 4.8 millimole per litre (Details: UCUM code mmol/L = 'mmol/L')
component
code: Sodium [Moles/volume] in Blood (LOINC#2947-0)
value: 142 millimole per litre (Details: UCUM code mmol/L = 'mmol/L')
component
code: Calcium [Mass/volume] in Blood (LOINC#49765-1)
value: 9.31 milligram per decilitre (Details: UCUM code mg/dL = 'mg/dL')
component
code: Cholesterol [Mass/volume] in Serum or Plasma (LOINC#2093-3)
value: 197 milligram per decilitre (Details: UCUM code mg/dL = 'mg/dL')
component
code: Triglyceride [Mass/volume] in Blood (LOINC#3043-7)
value: 59 milligram per decilitre (Details: UCUM code mg/dL = 'mg/dL')
component
code: Cholesterol in HDL [Mass/volume] in Serum or Plasma (LOINC#2085-9)
value: 60 milligram per decilitre (Details: UCUM code mg/dL = 'mg/dL')
component
code: Cholesterol in LDL [Mass/volume] in Serum or Plasma (LOINC#2089-1)
value: 120 milligram per decilitre (Details: UCUM code mg/dL = 'mg/dL')
component
code: Aspartate aminotransferase [Enzymatic activity/volume] in Serum or Plasma (LOINC#1920-8)
value: 19 enzyme unit per litre (Details: UCUM code U/L = 'U/L')
component
code: Alanine aminotransferase [Enzymatic activity/volume] in Blood (LOINC#76625-3)
value: 33 enzyme unit per litre (Details: UCUM code U/L = 'U/L')
component
code: Gamma glutamyl transferase [Enzymatic activity/volume] in Serum or Plasma (LOINC#2324-2)
value: 14 enzyme unit per litre (Details: UCUM code U/L = 'U/L')
component
code: Alkaline phosphatase [Enzymatic activity/volume] in Blood (LOINC#1783-0)
value: 227 enzyme unit per litre (Details: UCUM code U/L = 'U/L')
component
code: Lactate dehydrogenase [Enzymatic activity/volume] in Red Blood Cells (LOINC#11053-6)
value: 270 enzyme unit per litre (Details: UCUM code U/L = 'U/L')
component
code: Thyrotropin [Units/volume] in Blood (LOINC#3015-5)
value: 0.73 milli-international unit per litre (Details: UCUM code mlU/L = 'mlU/L')
component
code: Cortisol [Mass/volume] in Serum or Plasma (LOINC#2143-6)
value: 22 gram per decilitre (Details: UCUM code g/dL = 'g/dL')
component
code: C reactive protein [Mass/volume] in Blood by High sensitivity method (LOINC#71426-1)
value: 0.5 milligram per decilitre (Details: UCUM code mg/dL = 'mg/dL')
component
code: Natriuretic peptide B [Mass/volume] in Blood (LOINC#42637-9)
value: 120 picogram per millilitre (Details: UCUM code pg/mL = 'pg/mL')
component
code: Hemoglobin A1c/Hemoglobin.total in Blood by HPLC (LOINC#17856-6)
value: 5.1 % percent (Details: UCUM code % = '%')
component
code: Albumin/Protein.total in 24 hour Urine by Electrophoresis (LOINC#13986-5)
value: 80 milligram per 24 hour (Details: UCUM code mg/24h = 'mg/24h')
component
code: Creatinine [Mass/volume] in Urine (LOINC#2161-8)
value: 100 milligram per decilitre (Details: UCUM code mg/dL = 'mg/dL')
component
code: Carcinoembryonic Ag [Mass/volume] in Serum or Plasma (LOINC#2039-6)
value: 11.9 nanogram per millliiter (Details: UCUM code ng/mL = 'ng/mL')