Disorders of cardiovascular system


Parameter Case Report Form and Response Options

Does the patient suffer from a cardiovascular disease? Yes No Unknown
High blood pressure
History of myocardial infarction
Cardiac arrhythmia
Heart failure
Peripheral arterial occlusive disease
History of heart revascularization
Coronary arteriosclerosis
Carotid artery stenosis
Other

This is an example of how the case report form could look like when such a data collection tool is used.


To integrate data from clinical care and research such as clinical trials, the guide relies on FHIR resources for data-exchange from the clinical and diagnostic healthcare process rather than constructing a plain questionnaire.

This profile of a FHIR Condition is derived from the Diagnosis-profile of the Medical Informatics Initiative (MII). The valueset bindings on the Condition.code element have been constrained to solely feature the response options for this particular parameter of the case report form. For the explicitly listed diseases in the case report form, the SNOMED and ICD codes are also explicitly specified in the ValueSets below. Note that for the 'Other' option the ValueSets contain filters that allow a number of other codes for this category that are included in the expansion.

A separate instance of a Condition resource is created for each of the requested diseases.

To represent the presence, absence or uncertainty of findings, use Condition.verificationStatus or uncertaintyOfPresence on Condition.modifierExtension. This is used to map the Yes/No/Unknown scheme from case report forms to the Condition resource. Note the additional constraint on Condition that checks if either verificationStatus or the extension is present:

keyseverityhumanexpression
unk-1errorIf verificationStatus is present, uncertaintyOfPresence-Extension SHALL NOT be present.verificationStatus.exists() != Condition.modifierExtension.where(url = 'https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/uncertainty-of-presence').exists()

Profile - Cardiovascular Diseases

Canonical: https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/cardiovascular-diseases

Snapshot

ReferenzPrimaerdiagnoseS I0..1Extension(Reference(Condition))
uncertaintyOfPresenceS ?! I0..1Extension(CodeableConcept)
identifierΣ0..*Identifier
clinicalStatusS Σ ?! I0..1CodeableConceptBinding
systemΣ1..1uri
versionΣ0..1string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
systemΣ1..1uri
versionΣ0..1string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
systemS Σ1..1uri
versionΣ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
severity0..1CodeableConceptBinding
Mehrfachcodierungs-KennzeichenS I0..1Extension(Coding)
SeitenlokalisationS I0..1Extension(Coding)
DiagnosesicherheitS I0..1Extension(Coding)
systemS Σ1..1uriFixed Value
versionS Σ1..1string
codeS Σ I1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
systemS Σ1..1uriFixed Value
versionΣ1..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
systemS Σ1..1uri
versionΣ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
systemS Σ1..1uri
versionΣ0..1string
codeS Σ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
systemS Σ1..1uri
versionΣ0..1string
codeΣ1..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
subjectS Σ I1..1MII-Reference(Patient | Group)
encounterS Σ I0..1MII-Reference(Encounter)
lebensphase-vonS I0..1Extension(CodeableConcept)
lebensphase-bisS I0..1Extension(CodeableConcept)
onsetDateTimeS Σ0..1dateTime
abatementDateTimedateTime
abatementAgeAge
abatementPeriodPeriod
abatementRangeRange
abatementStringstring
recordedDateS Σ1..1dateTime
recorderΣ I0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)
asserterΣ I0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)
summaryI0..1CodeableConcept
assessmentI0..*Reference(ClinicalImpression | DiagnosticReport | Observation)
type0..1CodeableConcept
codeΣ I0..*CodeableConcept
detailΣ I0..*Reference(Resource)
noteS0..*Annotation


Extension - Uncertainty of Presence

Canonical: https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/uncertainty-of-presence

Snapshot

extensionI0..0Extension
url1..1System.StringFixed Value
systemΣ1..1uriFixed Value
versionΣ0..1string
codeΣ1..1codeFixed Value
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string


ValueSets

Valuesets are provided with both SNOMED-CT and ICD-10-GM codes.


Canonical: https://www.netzwerk-universitaetsmedizin.de/fhir/ValueSet/cardiovascular-diseases

ValueSet 'CardiovascularDiseases'

Version1.0.6
Published byBerlin Institute of Health at Charité (BIH)
StatusActive
ExperimentalFalse

Cardiovascular diseases in the context of Covid-19

Contact Information

Website: https://www.bihealth.org/en/re...

This value set includes codes from the following code systems:

  • The following codes from system: SNOMED_CT

    CodeDisplay
    38341003Hypertensive disorder, systemic arterial (disorder)
    399211009History of myocardial infarction (situation)
    698247007Cardiac arrhythmia (disorder)
    84114007Heart failure (disorder)
    399957001Peripheral arterial occlusive disease (disorder)
    399261000History of coronary artery bypass grafting (situation)
    53741008Coronary arteriosclerosis (disorder)
    64586002Carotid artery stenosis (disorder)
  • Include codes from SNOMED_CT where concept IsA 49601007


Canonical: https://www.netzwerk-universitaetsmedizin.de/fhir/ValueSet/cardiovascular-diseases-icd

ValueSet 'CardiovascularDiseasesICD'

Version1.0.6
Published byBerlin Institute of Health at Charité (BIH)
StatusActive
ExperimentalFalse

Cardiovascular diseases in the context of Covid-19 from ICD-10-GM

Contact Information

Website: https://www.bihealth.org/en/re...

This value set includes codes from the following code systems:

  • The following codes from system: ICD10GM

    CodeDisplay
    I25.29Alter Myokardinfarkt Nicht näher bezeichnet
    I10.90Essentielle Hypertonie, nicht näher bezeichnet : Ohne Angabe einer hypertensiven Krise
    I73.9Periphere Gefäßkrankheit, nicht näher bezeichnet
    I49.9Kardiale Arrhythmie, nicht näher bezeichnet
    I50.9Herzinsuffizienz, nicht näher bezeichnet
    I25.1Atherosklerotische Herzkrankheit
    I65.2Verschluss und Stenose der A. carotis
    Z95.1Vorhandensein eines aortokoronaren Bypasses
    Z95.5Vorhandensein eines Implantates oder Transplantates nach koronarer Gefäßplastik
  • Include codes from ICD10GM where concept Regex ^I.*Include codes from ICD10GM where child Exists false
  • Include codes from ICD10GM where concept Regex ^I.*Include codes from ICD10GM where child Exists false
  • Include codes from ICD10GM where concept Regex ^I.*Include codes from ICD10GM where child Exists false


Examples

Cardiovascular Disease present
Example condition that is confirmed present

{
    "resourceType": "Condition",
    "id": "cardiovascular-disease-ho-myocardial-infarction-present",
    "meta": {
        "profile":  [
            "https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/cardiovascular-diseases"
        ]
    },
    "category":  [
        {
            "coding":  [
                {
                    "code": "722414000",
                    "system": "http://snomed.info/sct",
                    "display": "Vascular medicine"
                }
            ]
        }
    ],
    "verificationStatus": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
                "code": "confirmed",
                "display": "Confirmed"
            },
            {
                "system": "http://snomed.info/sct",
                "code": "410605003",
                "display": "Confirmed present (qualifier value)"
            }
        ]
    },
    "clinicalStatus": {
        "coding":  [
            {
                "code": "active",
                "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
                "display": "Active"
            }
        ]
    },
    "code": {
        "coding":  [
            {
                "code": "399211009",
                "system": "http://snomed.info/sct",
                "display": "History of myocardial infarction (situation)"
            }
        ]
    },
    "subject": {
        "reference": "Patient/gecco-patient"
    },
    "recordedDate": "2020-10-06"
}


Cardiovascular Disease absent
Example condition that is confirmed absent

{
    "resourceType": "Condition",
    "id": "cardiovascular-disease-bypass-absent",
    "meta": {
        "profile":  [
            "https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/cardiovascular-diseases"
        ]
    },
    "category":  [
        {
            "coding":  [
                {
                    "code": "722414000",
                    "system": "http://snomed.info/sct",
                    "display": "Vascular medicine"
                }
            ]
        }
    ],
    "verificationStatus": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
                "code": "refuted",
                "display": "Refuted"
            },
            {
                "system": "http://snomed.info/sct",
                "code": "410594000",
                "display": "Definitely NOT present (qualifier value)"
            }
        ]
    },
    "code": {
        "coding":  [
            {
                "code": "399261000",
                "system": "http://snomed.info/sct",
                "display": "History of coronary artery bypass grafting (situation)"
            }
        ]
    },
    "subject": {
        "reference": "Patient/gecco-patient"
    },
    "recordedDate": "2020-10-06"
}


Cardiovascular Disease unknown
Example condition where the presence is unknown

{
    "resourceType": "Condition",
    "id": "cardiovascular-disease-carotid-artery-stenosis-unknown",
    "meta": {
        "profile":  [
            "https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/cardiovascular-diseases"
        ]
    },
    "category":  [
        {
            "coding":  [
                {
                    "code": "722414000",
                    "system": "http://snomed.info/sct",
                    "display": "Vascular medicine"
                }
            ]
        }
    ],
    "modifierExtension":  [
        {
            "url": "https://www.netzwerk-universitaetsmedizin.de/fhir/StructureDefinition/uncertainty-of-presence",
            "valueCodeableConcept": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "261665006",
                        "display": "Unknown (qualifier value)"
                    }
                ],
                "text": "Presence of condition is unknown."
            }
        }
    ],
    "code": {
        "coding":  [
            {
                "code": "64586002",
                "system": "http://snomed.info/sct",
                "display": "Carotid artery stenosis"
            }
        ]
    },
    "subject": {
        "reference": "Patient/gecco-patient"
    },
    "recordedDate": "2020-10-06"
}