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HdBe-TabakGebruik

CBB	Concept	Status
HdBe-SmokingStatus	Tabak is een product afkomstig van de bladeren van de tabaksplant dat als genotmiddel wordt gerookt. Rookbare vormen van tabak zijn shag, sigaretten, sigaren en pijptabak. Deze bouwsteen beschrijft de bij de patiënt uitgevraagde gegevens over het gebruik van tabak. Purpose Tijdens de sociale anamnese wordt frequent gevraagd naar het gebruik van tabak of blootstellingen aan tabaksrook thuis of elders. Informatie over tabakgebruik kan van belang zijn i.v.m. behandeling en diagnostiek. Evidence Base De blootstelling aan tabak is een belangrijke risicofactor voor onder andere nieuwvormingen, degeneratieve afwijkingen en vasculaire incidenten. Tijdens de anamnese wordt vaak het huidige rookgedrag en het aantal packyears (pakjaren) uitgevraagd. Het aantal packyears is de eenheid waarin de totale blootstelling aan tabaksrook bij rokers beschreven wordt, namelijk het aantal gerookte pakjes sigaretten per dag (inhoud pakje is 20 stuks) maal het aantal jaren dat werd gerookt. Bij shag en pijp wordt vaak een andere formule genomen, waarin het aantal gram per week een parameter is. Instructions De packyear is een maat voor blootstelling aan tabaksrook bij rokers. De berekening wordt niet meegenomen in het model. Deze vindt plaats in het EPD dan wel tijdens de anamnese en wordt uitsluitend doorgegeven als deze bekend is. Het is niet de bedoeling dat deze wordt berekend op basis van de overige waarden in deze klinische bouwsteen.	active

CBB

Concept

Status

HdBe-SmokingStatus

Tabak is een product afkomstig van de bladeren van de tabaksplant dat als genotmiddel wordt gerookt. Rookbare vormen van tabak zijn shag, sigaretten, sigaren en pijptabak. Deze bouwsteen beschrijft de bij de patiënt uitgevraagde gegevens over het gebruik van tabak.

Purpose

Tijdens de sociale anamnese wordt frequent gevraagd naar het gebruik van tabak of blootstellingen aan tabaksrook thuis of elders. Informatie over tabakgebruik kan van belang zijn i.v.m. behandeling en diagnostiek.

Evidence Base

De blootstelling aan tabak is een belangrijke risicofactor voor onder andere nieuwvormingen, degeneratieve afwijkingen en vasculaire incidenten. Tijdens de anamnese wordt vaak het huidige rookgedrag en het aantal packyears (pakjaren) uitgevraagd. Het aantal packyears is de eenheid waarin de totale blootstelling aan tabaksrook bij rokers beschreven wordt, namelijk het aantal gerookte pakjes sigaretten per dag (inhoud pakje is 20 stuks) maal het aantal jaren dat werd gerookt. Bij shag en pijp wordt vaak een andere formule genomen, waarin het aantal gram per week een parameter is.

Instructions

De packyear is een maat voor blootstelling aan tabaksrook bij rokers. De berekening wordt niet meegenomen in het model. Deze vindt plaats in het EPD dan wel tijdens de anamnese en wordt uitsluitend doorgegeven als deze bekend is. Het is niet de bedoeling dat deze wordt berekend op basis van de overige waarden in deze klinische bouwsteen.

active

SmokingStatus			SmokingStatus	Element id SmokingStatus Short description TabakGebruik Definition Rootconcept van de bouwsteen TabakGebruik. Dit concept bevat alle gegevenselementen van de bouwsteen TabakGebruik. Data type SmokingStatus Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id SmokingStatus.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id SmokingStatus.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
SmokingStatus		1..1	CodeableConceptBinding	Element id SmokingStatus.SmokingStatus Short description TabakGebruikStatus Definition De status van het tabaksgebruik van de patiënt. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding SmokingStatus codes SmokingStatus (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
TypeOfSmokingOrTobacco		0..1	CodeableConceptBinding	Element id SmokingStatus.TypeOfSmokingOrTobacco Short description SoortTabakGebruik Definition Soort tabak die de patiënt gebruikt. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding TypeOfSmokingOrTobacco codes TypeOfSmokingOrTobacco (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
ObservationOfUse		0..1	BackboneElement	Element id SmokingStatus.ObservationOfUse Short description WaarnemingGebruik Definition Deze container bevat alle gegevens over de mate waarin de patiënt aan tabak is blootgesteld geweest of wordt blootgesteld. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id SmokingStatus.ObservationOfUse.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id SmokingStatus.ObservationOfUse.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id SmokingStatus.ObservationOfUse.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers Definition May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Requirements Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
StartDate		0..1	dateTime	Element id SmokingStatus.ObservationOfUse.StartDate Short description StartDatum Definition De datum waarop is gestart met roken. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
StopDate		0..1	dateTime	Element id SmokingStatus.ObservationOfUse.StopDate Short description StopDatum Definition De datum waarop is gestopt met roken Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
Frequency		0..1	CodeableConceptBinding	Element id SmokingStatus.ObservationOfUse.Frequency Short description Frequency Definition The frequency of smoking or tobacco use. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding Frequency qualifier values FrequencyQualifier (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
Amount	I	0..1	Quantity	Element id SmokingStatus.ObservationOfUse.Amount Short description Hoeveelheid Definition Het aantal sigaretten, sigaren of gram shag per dag, week, maand of jaar. Comments The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator. Data type Quantity Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()` Mappings rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
PackYears		0..1	positiveInt	Element id SmokingStatus.ObservationOfUse.PackYears Short description PackYears Definition De eenheid waarin de totale blootstelling aan tabaksrook bij rokers beschreven wordt. Bij sigaretten wordt dit berekend aan de hand van het aantal gerookte pakjes sigaretten per dag (inhoud pakje is 20 stuks) en het aantal jaren dat werd gerookt. Bij andere rookwaren wordt vaak een omrekening naar equivalente sigarettenconsumptie gehanteerd. Vaak wordt ook alleen het aantal packyears geschat. Comments 32 bit number; for values larger than this, use decimal Data type positiveInt Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
Comment		0..1	string	Element id SmokingStatus.Comment Short description Toelichting Definition Relevante opmerkingen over het gebruik. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a

SmokingStatus		0..*
SmokingStatus.SmokingStatus	CodeableConcept	1..1
SmokingStatus.TypeOfSmokingOrTobacco	CodeableConcept	0..1
SmokingStatus.ObservationOfUse	BackboneElement	0..1
SmokingStatus.ObservationOfUse.StartDate	dateTime	0..1
SmokingStatus.ObservationOfUse.StopDate	dateTime	0..1
SmokingStatus.ObservationOfUse.Frequency	CodeableConcept	0..1
SmokingStatus.ObservationOfUse.Amount	Quantity	0..1
SmokingStatus.ObservationOfUse.PackYears	positiveInt	0..1
SmokingStatus.Comment	string	0..1

SmokingStatus
Definition	Root concept of the SmokingStatus information model. This concept contains all data elements of the SmokingStatus information model.
Cardinality	0...*
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
SmokingStatus.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
SmokingStatus.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
SmokingStatus.SmokingStatus
Definition	The patient’s smoking status or usage of (smokeless) tobacco.
Cardinality	1...1
Type	CodeableConcept
Binding	SmokingStatus codes SmokingStatus (extensible)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
SmokingStatus.TypeOfSmokingOrTobacco
Definition	The patient's type of smoking or tobacco use.
Cardinality	0...1
Type	CodeableConcept
Binding	TypeOfSmokingOrTobacco codes TypeOfSmokingOrTobacco (extensible)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
SmokingStatus.ObservationOfUse
Definition	This container contains all information on the extent to which the patient is or was exposed to tobacco.
Cardinality	0...1
Type	BackboneElement
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
SmokingStatus.ObservationOfUse.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
SmokingStatus.ObservationOfUse.extension
Definition	May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
SmokingStatus.ObservationOfUse.modifierExtension
Definition	May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
Requirements	Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Comments	There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
SmokingStatus.ObservationOfUse.StartDate
Definition	The date on which the patient started smoking.
Cardinality	0...1
Type	dateTime
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
SmokingStatus.ObservationOfUse.StopDate
Definition	The date on which the patient quit smoking
Cardinality	0...1
Type	dateTime
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
SmokingStatus.ObservationOfUse.Frequency
Definition	The frequency of smoking or tobacco use.
Cardinality	0...1
Type	CodeableConcept
Binding	Frequency qualifier values FrequencyQualifier (extensible)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
SmokingStatus.ObservationOfUse.Amount
Definition	The number of cigarettes, cigars or grams of rolling tobacco consumed per day, week, month or year.
Cardinality	0...1
Type	Quantity
Comments	The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` qty-3: If a code for the unit is present, the system SHALL also be present `code.empty() or system.exists()`
Mappings	rim: n/a v2: SN (see also Range) or CQ rim: PQ, IVL<PQ>, MO, CO, depending on the values
SmokingStatus.ObservationOfUse.PackYears
Definition	The unit indicating the smoker’s total exposure to tobacco smoke. For cigarettes, this is calculated using the number of smoked packs of cigarettes per day (one pack = 20 cigarettes) times the number of years of smoking. For other forms of tobacco, this is usually converted to an equivalent cigarette consumption. Often, only the number of pack years is estimated.
Cardinality	0...1
Type	positiveInt
Comments	32 bit number; for values larger than this, use decimal
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
SmokingStatus.Comment
Definition	Relevant comments on the patient’s use of tobacco.
Cardinality	0...1
Type	string
Comments	Note that FHIR strings SHALL NOT exceed 1MB in size
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a

Example instances

SmokingStatus
SmokingStatus	722499006 - Electronic cigarette user (code by SNOMED CT)
TypeOfSmokingOrTobacco	785889008 - Nicotine-filled electronic cigarette user (code by SNOMED CT)
ObservationOfUse.StartDate	1985
ObservationOfUse.StopDate
ObservationOfUse.Frequency	69620002 - Daily (code by SNOMED CT)
ObservationOfUse.Amount	16mg Nicotine per day
ObservationOfUse.PackYears
Comment	Tries to quit. Partner also smokes.

zib TobaccoUse-v3.2 difference

Concept	Category	Description
description	textual	Widened the scope of the CBB to smoking status to include the use of e-cigarette smoking.
`SmokingStatus`	element	Renamed element from TobaccoUseStatus to SmokingStatus.
`SmokingStatus`	terminology	Added codes to define electronic cigarette users. Removed codes that contained frequency information because this is replaced by the `ObservationOfUse.Frequency`element. Added Unkown and Other qualifier codes.
`TypeOfSmokingOrTobacco`	element	Renamed element from TypeOfTobaccoUsed to accomodate e-cigarettes.
`TypeOfSmokingOrTobacco`	terminology	Added type of e-cigarette codes and Unkown and Other qualifier codes.
`ObservationOfUse.Frequency`	element	Added element to capture the frequency of the smoking or tobacco use. This may have some overlap with amount.

Terminology Bindings

Path	Name	Strength	URL
SmokingStatus	SmokingStatus	extensible	https://fhir.healthdata.be/ValueSet/SmokingStatus
TypeOfSmokingOrTobacco	TypeOfSmokingOrTobacco	extensible	https://fhir.healthdata.be/ValueSet/TypeOfSmokingOrTobacco
ObservationOfUse.Frequency	FrequencyQualifier	extensible	https://fhir.healthdata.be/ValueSet/FrequencyQualifier