INCISIVE Implementation Guide - Local Development build (v0.1.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

General Guidance

This guide describes some usage aids for understanding this implementation guide.

• Cardinality: Most of the representations described have a cardinality defined in the core FHIR specification (generic in nature), which is required to avoid or support use cases where content is not required.
• Terminology Binding: The value that can be bound to a term is a set of values that fits the cancer concept, it can be a SNOMED CT code, a LOINC code, or a specific code defined by a use case.
• Search Syntax: The searches to be carried out for the training models have also been defined. It also describe some examples of how these searches are performed technically, using FHIR parameters and the FHIR RESTful API.

SNOMED CT

SNOMED CT (Systematized Nomenclature of Medicine-Clinical Terms) is a comprehensive clinical terminology widely used in healthcare to support the electronic exchange of clinical health information. INCISIVE uses the International Edition of SNOEMD CT, all codes and descrptions are in English, and are idetified by the international OID 2.16.840.1.113883.6.96. It is used extensively in INCISIVE for various clinical concepts, including democraphics, procedures, treatments and observations. When using SNOMED codes in INCISIVE, implementers MAY use the default system URI which refers to an unspecified edition/version as shown in below.

"code": {
    "coding":  [
        {
            "system": "urn:oid:2.16.840.1.113883.6.96",
            "code": "254837009",
            "display": "Malignant neoplasm of breast (disorder)"
        }
    ]
},

LOINC

LOINC (Logical Observation Identifiers Names and Codes) is the terminology used to identify laboratory data such as laboratory tests, measurements, etc. INCISIVE uses the International Edition of LOINC, all codes and descrptions are in English, and are idetified by the international OID 2.16.840.1.113883.6.1. It is used extensively in INCISIVE for various clinical and laboratory data. When using LOINC codes in INCISIVE, implementers MAY use the default system URI which refers to an unspecified edition/version as shown in below.

"code": {
    "coding":  [
        {
            "system": "urn:oid:2.16.840.1.113883.6.1",
            "code": "718-7",
            "display": "Hemoglobin [Mass/volume] in Blood"
        }
    ]
},

Using UCUM codes in the Quantity datatype

Unified Code for Units of Measure (UCUM) is a code system intended to include all units of measures being contemporarily used in international science, engineering, and business. INCISIVE uses some valueQuantity datatypes to the UCUM code system, all codes and units are in English, and are idetified by the international OID 2.16.840.1.113883.6.8. When using UCUM codes in INCISIVE, implementers MAY use the default system URI which refers to an unspecified edition/version as shown in below.

 "valueQuantity": {
    "value": 26.0,
    "unit": "nanogram per milliliter",
   "system": "urn:oid:2.16.840.1.113883.6.8",
   "code": "ng/mL"
  }

Representing Entered in Error Information

Before uploading the data to the FHIR server, it is first uploaded to the data quality check tool to ensure that data is in the correct format. On the other hand, in the Message Support Guidance, INCISIVE informs whether each variable is mandatory or optional in the message based on compliance with the FHIR specification. Details of which can be found in the following message guide.

• Breast Cancer Message Support Guidance
• Colorectal Cancer Message Support Guidance
• Lung Cancer Message Support Guidance
• Prostate Cancer Message Support Guidance

Search Syntax

Searching resources is defined by the FHIR RESTful API, for more information, see the FHIR RESTful Search API.

All the search interactions in this guide use the GET command with the following syntax:

GET [serverBaseR4]/[Resource-type]?[parameter1]{:m1|m2|...}={c1|c2|...}[value1{,value2,...}]{&[parameter2]{:m1|m2|...}={c1|c2|...}[value1{,value2,...}]&...}

GET is the HTTP verb used for fetching a resource. A few examples of INCISIVE searches are shown next.

For more searches, can be found in the following deliverable D3.4 Standardization Suggestions.

• INCISIVE_D3.4_StandardizationSuggestions(PDF file)

Tools

The tools used by INCISIVE are as follows:

• Forge: used to design FHIR resources.
• Simplifier: used to display, share and publish FHIR resources and terminologies.
• Github: used for versisoning of resources.
• FSH: used to modeling of FHIR Logical Model and defining the content of the FHIR Implemetation Guide.
• Sushi: used to convert files required for FHIR Implemetation Guide.
• IG Publisher: used to generate FHIR Implemetation Guide.
• Github: used to share IG source code.