HdBe-DAS

CBB	Concept	Status
HdBe-DAS	The Disease Activity Score (DAS) is a combined index developed in Nijmegen around 1990 to measure disease activity in patients with rheumatoid arthritis (RA). It concerns a formula with 28 or 44 painful and swollen joints, a blood value for inflammation (BSE or CRP) and the overall experience of disease activity by the patient. The DAS results in a number between 0 and 10, which indicates how active rheumatoid arthritis is at present. The score has been validated for use in clinical trials in combination with the EULAR response criteria. Purpose In addition to frequent use in trials, the DAS is used to measure the disease activity of RA patients in daily clinical practice, supporting the "treat-to-target" strategy recommended in guidelines. The DAS is also used as an outcome measure for the care of RA patients in a national quality registration. Patient Population Adult patients with rheumatoid arthritis (RA).	draft

CBB

Concept

Status

HdBe-DAS

The Disease Activity Score (DAS) is a combined index developed in Nijmegen around 1990 to measure disease activity in patients with rheumatoid arthritis (RA). It concerns a formula with 28 or 44 painful and swollen joints, a blood value for inflammation (BSE or CRP) and the overall experience of disease activity by the patient. The DAS results in a number between 0 and 10, which indicates how active rheumatoid arthritis is at present. The score has been validated for use in clinical trials in combination with the EULAR response criteria.

Purpose

In addition to frequent use in trials, the DAS is used to measure the disease activity of RA patients in daily clinical practice, supporting the "treat-to-target" strategy recommended in guidelines. The DAS is also used as an outcome measure for the care of RA patients in a national quality registration.

Patient Population

Adult patients with rheumatoid arthritis (RA).

draft

Das		Das	There are no (further) constraints on this element Element Id Das Short description DAS Definition Root concept of the information model.This root concept contains all data elements of the information model DAS. Data Type Das
Dasvalue	0..1	Quantity	There are no (further) constraints on this element Element Id Das.Dasvalue Short description DASValue Definition The result (value). Data Type Quantity
Dasmethod	1..1	CodeableConceptBinding	There are no (further) constraints on this element Element Id Das.Dasmethod Short description DASMethod Definition The specification of the DAS method used. There are different DAS scores. Each type has a different formula. DAS-28 or DAS-44 stands for 28 or 44 painful and swollen joints. One blood value for inflammation (a ESR or a CRP laboratory result) and the overall experience of disease activity by the patient via a Visual Analog Scale (VAS). Data Type CodeableConcept Binding DASMethod codes DASMethode (extensible)
Dasformula	0..1	string	There are no (further) constraints on this element Element Id Das.Dasformula Short description DASFormula Definition The specification of the type of DAS. There are different DAS scores. Each type has a different formula. Data Type string
AffectedJoint	0..*	BackboneElement	There are no (further) constraints on this element Element Id Das.AffectedJoint Short description AffectedJoint Definition Container of the AffectedJoint concept.This container contains all data elements of the AffectedJoint concept. Data Type BackboneElement
AnatomicalLocation	0..1	Reference(HdBe AnatomicalLocation)	There are no (further) constraints on this element Element Id Das.AffectedJoint.AnatomicalLocation Short description AnatomicalLocation Definition Joints that are tender and/or swollen. Data Type Reference(HdBe AnatomicalLocation)
Swollen	0..1	boolean	There are no (further) constraints on this element Element Id Das.AffectedJoint.Swollen Short description Swollen Definition Swolen joint indicator. Data Type boolean
Tender	0..1	boolean	There are no (further) constraints on this element Element Id Das.AffectedJoint.Tender Short description Tender Definition Tender joint indicator. Data Type boolean
CountOfTenderJoints	0..1	Count	There are no (further) constraints on this element Element Id Das.CountOfTenderJoints Short description CountOfTenderJoints Definition Count of tender joints as reported by the patient. Data Type Count
CountOfSwolenJoints	0..1	Count	There are no (further) constraints on this element Element Id Das.CountOfSwolenJoints Short description CountOfSwolenJoints Definition Count of swollen joints. Data Type Count
InflammationIndicator	0..1	BackboneElement	There are no (further) constraints on this element Element Id Das.InflammationIndicator Short description InflammationIndicator Definition Container of the InflammationIndicator concept.This container contains all data elements of the InflammationIndicator concept. Data Type BackboneElement
Esr	0..1	Reference(HdBe LaboratoryTestResult)	There are no (further) constraints on this element Element Id Das.InflammationIndicator.Esr Short description ESR Definition The C-reactive protein (CRP) is a laboratory measurment valuable for determining the presence of inflammation or to monitor the effect of a medical treatment on the inflammation. The erythrocyte sedimentation rate (ESR or sed rate) is the rate at which red blood cells in anticoagulated whole blood descend in a standardized tube over a period of one hour. Both test results can be used to calculate the DAS. Data Type Reference(HdBe LaboratoryTestResult)
Crp	0..1	Reference(HdBe LaboratoryTestResult)	There are no (further) constraints on this element Element Id Das.InflammationIndicator.Crp Short description CRP Definition The C-reactive protein (CRP) is a laboratory measurment valuable for determining the presence of inflammation or to monitor the effect of a medical treatment on the inflammation. The erythrocyte sedimentation rate (ESR or sed rate) is the rate at which red blood cells in anticoagulated whole blood descend in a standardized tube over a period of one hour. Both test results can be used to calculate the DAS. Data Type Reference(HdBe LaboratoryTestResult)
DasdateTime	0..1	dateTime	There are no (further) constraints on this element Element Id Das.DasdateTime Short description DASDateTime Definition The date and possibly time when the DAS score measurement was carried out. Data Type dateTime
VasgeneralHealth	0..1	Count	There are no (further) constraints on this element Element Id Das.VasgeneralHealth Short description VASGeneralHealth Definition The VAS score for general health as experienced by the patient on a scale of 1 to 100 Data Type Count

Das		0..*
Das.Dasvalue	Quantity	0..1
Das.Dasmethod	CodeableConcept	1..1
Das.Dasformula	string	0..1
Das.AffectedJoint	BackboneElement	0..*
Das.AffectedJoint.AnatomicalLocation	Reference(HdBe AnatomicalLocation)	0..1
Das.AffectedJoint.Swollen	boolean	0..1
Das.AffectedJoint.Tender	boolean	0..1
Das.CountOfTenderJoints	Count	0..1
Das.CountOfSwolenJoints	Count	0..1
Das.InflammationIndicator	BackboneElement	0..1
Das.InflammationIndicator.Esr	Reference(HdBe LaboratoryTestResult)	0..1
Das.InflammationIndicator.Crp	Reference(HdBe LaboratoryTestResult)	0..1
Das.DasdateTime	dateTime	0..1
Das.VasgeneralHealth	Count	0..1

DAS
Definition	Base definition for all elements in a resource.
Cardinality	0...*
Invariants	ele-1:All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim:n/a
DAS.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	System.String
Mappings	rim:n/a
DAS.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
DAS.Das
Definition	Root concept of the information model.This root concept contains all data elements of the information model DAS.
Cardinality	0...*

Example instances

[CBB name]
[Concept name ]	[example value]

// example of NameInformation

## Example instances

| NameInformation      |                   |
|----------------------|-------------------|
| FirstNames | Johanna Petronella Maria   
| Initials | J.P.M. 
| GivenName | Jo 
| NameUsage | Geslachtsnaam partner gevolgd door eigen geslachtsnaam
| LastName.Prefix | van
| LastName.LastName | Putten
| LastNamePartner.PartnerPrefix | van der
| LastNamePartner.PartnerLastName | Giessen
| Titles |

zib [zib name + version](https://zibs.nl/wiki/[zib name + version(release)]) difference

Concept	Category	Description
`[element.path]`	[category of change]	[Description of change]([Reference to ticket/issue/zulip chat using MarkDown link])

Terminology Bindings

Path	Name	Strength	URL
Dasmethod	DASMethode	extensible	https://fhir.healthdata.be/ValueSet/DASMethode