{
  "resourceType": "StructureDefinition",
  "id": "logicalmodel-Has-bledscore-R4",
  "url": "http://linkehr.com/fhir/logicalmodel-has-bledscore-R4",
  "identifier": [
    {
      "system": "openEHR-CKM",
      "value": "openEHR-EHR-OBSERVATION.has_bled.v0"
    }
  ],
  "version": "0",
  "name": "Has-bledscore",
  "title": "HAS-BLED score",
  "status": "draft",
  "date": "2024-06-18",
  "publisher": "openEHR",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.veratech.es"
        }
      ]
    }
  ],
  "description": "A risk assessment score to assess the bleeding risk in individuals with atrial fibrillation.",
  "purpose": "To record the results for each component parameter and their total sum for the HAS-BLED bleeding risk score.",
  "fhirVersion": "4.0.0",
  "mapping": [
    {
      "identity": "openEHR",
      "uri": "http://openehr.org",
      "name": "openEHR Mapping"
    },
    {
      "identity": "openEHR-natural",
      "uri": "http://openehr.org",
      "name": "openEHR natural path"
    }
  ],
  "kind": "logical",
  "abstract": false,
  "type": "StructureDefinition",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Element",
  "snapshot": {
    "element": [
      {
        "id": "HAS_BLED_score",
        "path": "HAS_BLED_score",
        "short": "HAS-BLED score",
        "definition": "A risk assessment score to assess the bleeding risk in individuals with atrial fibrillation.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "HAS_BLED_score.protocol",
        "path": "HAS_BLED_score.protocol",
        "short": "Item tree",
        "definition": "@ internal @",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.protocol",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "HAS_BLED_score.protocol.Extension",
        "path": "HAS_BLED_score.protocol.Extension",
        "short": "Extension",
        "definition": "Additional information required to extend the model with local content or to align with other reference models/formalisms.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "HAS_BLED_score.protocol.Extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "HAS_BLED_score.Event_Series",
        "path": "HAS_BLED_score.Event_Series",
        "short": "Event Series",
        "definition": "@ internal @",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event",
        "short": "Any point in time event",
        "definition": "Default, unspecified point in time event which may be explicitly defined in a template or at run-time.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data",
        "short": "Tree",
        "definition": "@ internal @",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Hypertension",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Hypertension",
        "short": "Hypertension",
        "definition": "The systolic blood pressure is >160 mmHg.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Hypertension",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Hypertension.value",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Hypertension.value",
        "short": "Hypertension",
        "definition": "The systolic blood pressure is >160 mmHg.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Hypertension.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Abnormal_renal_function",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Abnormal_renal_function",
        "short": "Abnormal renal function",
        "definition": "The presence of chronic dialysis or renal transplantation or serum creatinine ≥200µmol/L.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Abnormal_renal_function",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Abnormal_renal_function.value",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Abnormal_renal_function.value",
        "short": "Abnormal renal function",
        "definition": "The presence of chronic dialysis or renal transplantation or serum creatinine ≥200µmol/L.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Abnormal_renal_function.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Abnormal_liver_function",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Abnormal_liver_function",
        "short": "Abnormal liver function",
        "definition": "Chronic hepatic disease (eg. cirrhosis) or biochemical evidence of significant hepatic derangement (eg. bilirubin >2x upper limit of normal, in association with AST/ALT/ALP >3x upper limit normal, etc).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Abnormal_liver_function",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Abnormal_liver_function.value",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Abnormal_liver_function.value",
        "short": "Abnormal liver function",
        "definition": "Chronic hepatic disease (eg. cirrhosis) or biochemical evidence of significant hepatic derangement (eg. bilirubin >2x upper limit of normal, in association with AST/ALT/ALP >3x upper limit normal, etc).",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Abnormal_liver_function.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Stroke",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Stroke",
        "short": "Stroke",
        "definition": "A previous history of stroke, particularly lacunar.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Stroke",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Stroke.value",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Stroke.value",
        "short": "Stroke",
        "definition": "A previous history of stroke, particularly lacunar.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Stroke.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Bleeding_history_or_predisposition",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Bleeding_history_or_predisposition",
        "short": "Bleeding history or predisposition",
        "definition": "A previous bleeding history and/or predisposition to bleeding .",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Bleeding_history_or_predisposition",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Bleeding_history_or_predisposition.value",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Bleeding_history_or_predisposition.value",
        "short": "Bleeding history or predisposition",
        "definition": "A previous bleeding history and/or predisposition to bleeding .",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Bleeding_history_or_predisposition.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Labile_INR",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Labile_INR",
        "short": "Labile INR",
        "definition": "Unstable/high INRs or poor time in therapeutic range.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Labile_INR",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Labile_INR.value",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Labile_INR.value",
        "short": "Labile INR",
        "definition": "Unstable/high INRs or poor time in therapeutic range.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Labile_INR.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
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        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Elderly",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Elderly",
        "short": "Elderly",
        "definition": "Age >65 yrs.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Elderly",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Elderly.value",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Elderly.value",
        "short": "Elderly",
        "definition": "Age >65 yrs.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Elderly.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
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        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Drugs_concomitantly",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Drugs_concomitantly",
        "short": "Drugs concomitantly",
        "definition": "The concomitant use of drugs, such as antiplatelet agents, non-steroidal anti-inflammatory drugs, etc.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Drugs_concomitantly",
          "min": 0,
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        }
      },
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        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Drugs_concomitantly.value",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Drugs_concomitantly.value",
        "short": "Drugs concomitantly",
        "definition": "The concomitant use of drugs, such as antiplatelet agents, non-steroidal anti-inflammatory drugs, etc.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Drugs_concomitantly.value",
          "min": 0,
          "max": "1"
        },
        "type": [
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            "code": "CodeableConcept"
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        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Alcohol_concomitantly",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Alcohol_concomitantly",
        "short": "Alcohol concomitantly",
        "definition": "Alcohol consumption ≥ 8 units per week.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Alcohol_concomitantly",
          "min": 0,
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        }
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Alcohol_concomitantly.value",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Alcohol_concomitantly.value",
        "short": "Alcohol concomitantly",
        "definition": "Alcohol consumption ≥ 8 units per week.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Alcohol_concomitantly.value",
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          "max": "1"
        },
        "type": [
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            "code": "CodeableConcept"
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        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Total_score",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Total_score",
        "short": "Total score",
        "definition": "Sum of points assigned for each of the component parameters.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Total_score",
          "min": 0,
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        }
      },
      {
        "id": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Total_score.value",
        "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Total_score.value",
        "short": "Total score",
        "definition": "Sum of points assigned for each of the component parameters.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "HAS_BLED_score.Event_Series.Any_point_in_time_event.data.Total_score.value",
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          "max": "1"
        },
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      }
    ]
  }
}