Complex drug indications articulating semantics reasoning logic and
- Slides: 6
Complex drug indications articulating semantics, reasoning logic, and data structures drug indication: Curative treatment of renal osteodystrophy, radiologically evident and/or with elevation of alkaline phosphatase and hypocalcemia (<95 mg/L) in patients with renal insufficiency with a creatinine clearance <30 m. L/min and in hemodialysis patients 1
Complex drug indications articulating semantics, reasoning logic, and data structures 1) Linguistic identification of blocs Curative treatment of renal osteodystrophy, radiologically evident and/or with elevation of alkaline phosphatase and hypocalcemia (<95 mg/L) in patients with renal insufficiency with a creatinine clearance <30 m. L/min and in hemodialysis patients Medication. Knowledge administration. Guideline curative treatment indication Administration treatment target of treatment logic conditioning the target Clinical. Use. Issue indication disease. Symptom. Procedure: renal osteodystrophy applicability expression: logic in CQL 2
Complex drug indications articulating semantics, reasoning logic, and data structures Curative treatment of renal osteodystrophy, radiologically evident and/or with elevation of alkaline phosphatase and hypocalcemia (<95 mg/L) in patients with renal insufficiency with a creatinine clearance <30 m. L/min and in hemodialysis patients 2) Semantic normalization treatment 18629005 |Administration of drug or medicament|: curative 363703001 |Has intent| = 373808002 |Curative - procedure intent|, of renal osteodystrophy 363702006 |Has focus | = 16726004 |Renal osteodystrophy|: radiologically evident 363714003 |Interprets| = 424398008|Radiographic imaging of bone|, 363713009 |Has interpretation| = 12010005 |osteodystrophy| elevation of alkaline phosphatase 166627004 |Serum alkaline phosphatase raised| Hypocalcemia (<95 mg/L) 17861 -6 |Calcium [Mass/Volume] Serum/Plasma| < 95 mg/L renal insufficiency SNOMED CT LOINC UCUM 723188008 |Renal insufficiency| creatinine clearance <30 m. L/min 33558 -8|Creatinine renal clearance| < 30 m. L/min in hemodialysis patients 152421000119107 |Hemodialysis procedure done| 3
Complex drug indications articulating semantics, reasoning logic, and data structures 3) Convert logical blocs into Boolean logic trees renal osteodystrophy, radiologically evident and/or with elevation of alkaline phosphatase and hypocalcemia (<95 mg/L) in patients with renal insufficiency with a creatinine clearance <30 m. L/min and in hemodialysis patients Renal osteodystrophy and (with comorbidities) (supported by evidence) or Radiological evidence or (biological and evidence) Alkaline phosphatase raised Serum calcium < 95 mg/L and Renal insufficiency Hemodialysis patient Creatinine clearance < 30 m. L/min 4
Complex drug indications articulating semantics, reasoning logic, and data structures 4) Position the appropriate concepts into Boolean logic trees renal osteodystrophy, radiologically evident and/or with elevation of alkaline phosphatase and hypocalcemia (<95 mg/L) in patients with renal insufficiency with a creatinine clearance <30 m. L/min and in hemodialysis patients Renal osteodystrophy and (supported by evidence) (with comorbidities) or |Interprets| = |Radiographic imaging of bone|, |Has interpretation| = |osteodystrophy| |Serum alkaline phosphatase raised| SNOMED CT LOINC UCUM Radiological evidence Alkaline phosphatase raised or (biological and evidence) Serum calcium < 95 mg/L |Renal insufficiency| |Calcium [Mass/Volume] in Serum/Plasma| and Hemodialysis patient |Hemodialysis procedure done| Renal insufficiency Creatinine clearance < 30 m. L/min |Creatinine renal clearance| 5
Medication. Knowledge/mkx: … administration. Guideline treatment. Intent. coding : { system : http: //snomed. info/sct, code : 373808002, display : curative intent } indication. reference -> Clinical. Use. Issue/os 0 : library [ http: //example. org/fhir/Library/drug-indications ] type: indication, indication [ { disease. Symptom. Procedure. coding { system : http: //snomed. info/sct, code : 16726004, display : renal osteodystrophy } applicability: { description: “radiologically evident or with elevation of alkaline phosphatase and hypocalcemia (<95 mg/L) in patients with renal insufficiency with a creatinine clearance <30 m. L/min and in hemodialysis patients”, language: “text/cql-identifier”, expression: “indication 1531“ } }] 5) Formalization: Populate the FHIR resources and CQL expressions The CQL expression library "Drug. Indications" version '1' using "FHIR" version '4. 0. 1' include "FHIRHelpers" version '4. 0. 1' called FHIRHelpers codesystem "SNOMED": 'http: //snomed. info/sct' codesystem "LOINC": 'http: //loinc. org' code "osteodystrophy code": '12010005' from "SNOMED" code "radiographic imaging of bone": '424398008' from "SNOMED" code "serum alkaline phosphatase raised": '166627004' from "SNOMED" code "hemodialysis procedure done": '152421000119107' from "SNOMED" code "renal insufficiency": '723188008' from "SNOMED" code "calcium on Serum/Plasma": '17861 -6' from "LOINC" code "creatinine clearance on Urine + Serum/Plasma": '33558 -8' from "LOINC" concept "osteodystrophy": { "osteodystrophy code" } context Patient define "indication 1531": ( exists ([Observation: "radiographic imaging of bone"] O where O. interpretation contains "osteodystrophy") or ( exists ([Condition: "serum alkaline phosphatase raised"]) and exists ([Observation: "calcium on Serum/Plasma"] O where O. value < 95 'mg/L') ) ) and ( ( exists ([Condition: "renal insufficiency"]) and exists ([Observation: "creatinine clearance on Urine + Serum/Plasma"] O where O. value < 30 'm. L/min') ) or exists ([Condition: "hemodialysis procedure done"]) )