From ad70936517f66228c703d2869b9a672829b5008e Mon Sep 17 00:00:00 2001 From: Gregor Lichtner Date: Tue, 27 Feb 2024 19:19:15 +0100 Subject: [PATCH 1/4] feat: implemented correct therapeutic dosages --- .../recommendation_17_intervention.fsh | 242 +++++++++++--- .../recommendation_18_intervention.fsh | 300 ++++++++++++++---- 2 files changed, 430 insertions(+), 112 deletions(-) diff --git a/input/fsh/covid19-inpatient-therapy/17-therapeutic-anticoagulation/recommendation_17_intervention.fsh b/input/fsh/covid19-inpatient-therapy/17-therapeutic-anticoagulation/recommendation_17_intervention.fsh index 27df569bc..2f74da10c 100644 --- a/input/fsh/covid19-inpatient-therapy/17-therapeutic-anticoagulation/recommendation_17_intervention.fsh +++ b/input/fsh/covid19-inpatient-therapy/17-therapeutic-anticoagulation/recommendation_17_intervention.fsh @@ -30,16 +30,22 @@ Description: "In hospitalized, non-intensive care patients with COVID-19 and inc * goalId = "aPTT-goal" * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(TherapeuticAnticoagulationNMHDalteparin) + * definitionCanonical = Canonical(TherapeuticAnticoagulationNMHDalteparin1xd) * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(TherapeuticAnticoagulationNMHEnoxaparin) + * definitionCanonical = Canonical(TherapeuticAnticoagulationNMHDalteparin2xd) * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(TherapeuticAnticoagulationNMHNadroparinLowWeight) + * definitionCanonical = Canonical(TherapeuticAnticoagulationNMHDalteparinTable) * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(TherapeuticAnticoagulationNMHNadroparinHighWeight) + * definitionCanonical = Canonical(TherapeuticAnticoagulationNMHNadroparin) + * code = $sct#432102000 "Administration of substance (procedure)" +* action[drugAdministration][+] + * definitionCanonical = Canonical(TherapeuticAnticoagulationNMHEnoxaparin1xd) + * code = $sct#432102000 "Administration of substance (procedure)" +* action[drugAdministration][+] + * definitionCanonical = Canonical(TherapeuticAnticoagulationNMHEnoxaparin2xd) * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] * definitionCanonical = Canonical(TherapeuticAnticoagulationNMHCertoparin) @@ -84,13 +90,36 @@ Description: "Therapeutic Anticoagulation Treatment (UFH) for non-intensive care * doseRange * low = 0 '[iU]' "IU" // any dose of i.v. UFH +Instance: TherapeuticAnticoagulationNMHDalteparin1xd +InstanceOf: drug-administration-action +Usage: #definition +Title: "Therapeutic Anticoagulation Treatment with Dalteparin" +Description: "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care hospitalised COVID-19 patients patients with high risk (D-Dimer >= 2mg/l) with Dalteparin" +* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/therapeutic-anticoagulant-dalteparin-administration-1xd) +* insert publisher-experimental-version(0.1) +* name = "TherapeuticAnticoagulationDalteparinPlan" +* status = #active +* description = "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care hospitalised COVID-19 patients patients with high risk (D-Dimer >= 2mg/l) with Dalteparin" +* code = $sct#432102000 "Administration of substance (procedure)" +* productCodeableConcept + * coding[sct] = $sct#372563008 "Dalteparin (substance)" + * coding[atcde] = $atcde#B01AB04 "Dalteparin" +* dosage[+] + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 200 '[iU]/kg' "IU/kg" -Instance: TherapeuticAnticoagulationNMHDalteparin +Instance: TherapeuticAnticoagulationNMHDalteparin2xd InstanceOf: drug-administration-action Usage: #definition Title: "Therapeutic Anticoagulation Treatment with Dalteparin" Description: "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care hospitalised COVID-19 patients patients with high risk (D-Dimer >= 2mg/l) with Dalteparin" -* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/therapeutic-anticoagulant-dalteparin-administration) +* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/therapeutic-anticoagulant-dalteparin-administration-2xd) * insert publisher-experimental-version(0.1) * name = "TherapeuticAnticoagulationDalteparinPlan" * status = #active @@ -99,23 +128,89 @@ Description: "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care * productCodeableConcept * coding[sct] = $sct#372563008 "Dalteparin (substance)" * coding[atcde] = $atcde#B01AB04 "Dalteparin" -* dosage +* dosage[+] + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * timing + * repeat + * frequency = 2 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 100 '[iU]/kg' "IU/kg" + +Instance: TherapeuticAnticoagulationNMHDalteparinTable +InstanceOf: drug-administration-action +Usage: #definition +Title: "Therapeutic Anticoagulation Treatment with Dalteparin" +Description: "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care hospitalised COVID-19 patients patients with high risk (D-Dimer >= 2mg/l) with Dalteparin" +* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/therapeutic-anticoagulant-dalteparin-administration-table) +* insert publisher-experimental-version(0.1) +* name = "TherapeuticAnticoagulationDalteparinPlan" +* status = #active +* description = "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care hospitalised COVID-19 patients patients with high risk (D-Dimer >= 2mg/l) with Dalteparin" +* code = $sct#432102000 "Administration of substance (procedure)" +* productCodeableConcept + * coding[sct] = $sct#372563008 "Dalteparin (substance)" + * coding[atcde] = $atcde#B01AB04 "Dalteparin" +* dosage[+] * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 46 'kg' "kg" + * extension[value].valueRange.high = 56.999999 'kg' "kg" * timing * repeat * frequency = 1 * period = 1 * periodUnit = $ucum#d "day" * doseAndRate - * doseRange - * low = 5000.0000001 '[iU]' "IU" + * doseQuantity = 10000 '[iU]' "IU" +* dosage[+] + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 57 'kg' "kg" + * extension[value].valueRange.high = 68.999999 'kg' "kg" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 12500 '[iU]' "IU" +* dosage[+] + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 69 'kg' "kg" + * extension[value].valueRange.high = 82.999999 'kg' "kg" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 15000 '[iU]' "IU" +* dosage[+] + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 83 'kg' "kg" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 18000 '[iU]' "IU" + -Instance: TherapeuticAnticoagulationNMHEnoxaparin +Instance: TherapeuticAnticoagulationNMHEnoxaparin1xd InstanceOf: drug-administration-action Usage: #definition Title: "Therapeutic Anticoagulation Treatment with Enoxaparin" Description: "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care hospitalised COVID-19 patients patients with high risk (D-Dimer >= 2mg/l) with Enoxaparin" -* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/therapeutic-anticoagulant-enoxaparin-administration) +* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/therapeutic-anticoagulant-enoxaparin-administration-1xd) * insert publisher-experimental-version(0.1) * name = "TherapeuticAnticoagulationPlanEnoxaparin" * status = #active @@ -124,7 +219,7 @@ Description: "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care * productCodeableConcept * coding[sct] = $sct#372562003 "Enoxaparin (substance)" * coding[atcde] = $atcde#B01AB05 "Enoxaparin" -* dosage +* dosage[+] * route = $sct#34206005 "Subcutaneous route (qualifier value)" * timing * repeat @@ -132,55 +227,57 @@ Description: "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care * period = 1 * periodUnit = $ucum#d "day" * doseAndRate - * doseRange - * low = 40.0000001 'mg' + * doseQuantity = 1.5 'mg/kg' "mg/kg" -Instance: TherapeuticAnticoagulationNMHNadroparinLowWeight +Instance: TherapeuticAnticoagulationNMHEnoxaparin2xd InstanceOf: drug-administration-action Usage: #definition -Title: "Therapeutic Anticoagulation Treatment with Nadroparin Low Weight" -Description: "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care hospitalised COVID-19 patients (low weight) with high risk (D-Dimer >= 2mg/l) with Nadroparin" -* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/therapeutic-anticoagulant-nadroparin-administration-low-weight) +Title: "Therapeutic Anticoagulation Treatment with Enoxaparin" +Description: "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care hospitalised COVID-19 patients patients with high risk (D-Dimer >= 2mg/l) with Enoxaparin" +* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/therapeutic-anticoagulant-enoxaparin-administration-2xd) * insert publisher-experimental-version(0.1) -* name = "TherapeuticAnticoagulationPlanNadroparinLowWeight" +* name = "TherapeuticAnticoagulationPlanEnoxaparin" * status = #active -* description = "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care hospitalised COVID-19 patients (low weight) with high risk (D-Dimer >= 2mg/l) with Nadroparin" +* description = "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care hospitalised COVID-19 patients patients with high risk (D-Dimer >= 2mg/l) with Enoxaparin" * code = $sct#432102000 "Administration of substance (procedure)" * productCodeableConcept - * coding[sct] = $sct#699946002 "Nadroparin (substance)" - * coding[atcde] = $atcde#B01AB06 "Nadroparin" + * coding[sct] = $sct#372562003 "Enoxaparin (substance)" + * coding[atcde] = $atcde#B01AB05 "Enoxaparin" * dosage[+] - * extension[condition] - * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" - * extension[value].valueRange.high = 70 'kg' "kg" * route = $sct#34206005 "Subcutaneous route (qualifier value)" * timing * repeat - * frequency = 1 + * frequency = 2 * period = 1 * periodUnit = $ucum#d "day" * doseAndRate - * doseRange - * low = 3800.0000001 '[iU]' "IU" + * doseQuantity = 1 'mg/kg' "mg/kg" -Instance: TherapeuticAnticoagulationNMHNadroparinHighWeight +Instance: TherapeuticAnticoagulationNMHNadroparin InstanceOf: drug-administration-action Usage: #definition -Title: "Therapeutic Anticoagulation Treatment with Nadroparin High Weight" -Description: "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care hospitalised COVID-19 patients (high weight) with high risk (D-Dimer >= 2mg/l) with Nadroparin" -* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/therapeutic-anticoagulant-nadroparin-administration-high-weight) +Title: "Therapeutic Anticoagulation Treatment with Nadroparin" +Description: "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care hospitalised COVID-19 patientswith high risk (D-Dimer >= 2mg/l) with Nadroparin" +* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/therapeutic-anticoagulant-nadroparin-administration) * insert publisher-experimental-version(0.1) -* name = "TherapeuticAnticoagulationPlanNadroparinHighWeight" +* name = "TherapeuticAnticoagulationPlanNadroparin" * status = #active -* description = "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care hospitalised COVID-19 patients (high weight) with high risk (D-Dimer >= 2mg/l) with Nadroparin" +* description = "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care hospitalised COVID-19 patients with high risk (D-Dimer >= 2mg/l) with Nadroparin" * code = $sct#432102000 "Administration of substance (procedure)" * productCodeableConcept * coding[sct] = $sct#699946002 "Nadroparin (substance)" * coding[atcde] = $atcde#B01AB06 "Nadroparin" +// Weight (kg) Dose s.c. (IE; 2x/d) +// <50 3800 +// 50-59 4750 +// 60-69 5700 +// 70-79 6650 +// 80-89 7600 +// ≥90 8550 * dosage[+] * extension[condition] * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" - * extension[value].valueRange.low = 70.0000001 'kg' "kg" + * extension[value].valueRange.high = 49.999999 'kg' "kg" * route = $sct#34206005 "Subcutaneous route (qualifier value)" * timing * repeat @@ -188,8 +285,71 @@ Description: "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care * period = 1 * periodUnit = $ucum#d "day" * doseAndRate - * doseRange - * low = 5700.0000001 '[iU]' "IU" + * doseQuantity = 3800 '[iU]' "IU" +* dosage[+] + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 50 'kg' "kg" + * extension[value].valueRange.high = 59.999999 'kg' "kg" + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 4750 '[iU]' "IU" +* dosage[+] + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 60 'kg' "kg" + * extension[value].valueRange.high = 69.999999 'kg' "kg" + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 5700 '[iU]' "IU" +* dosage[+] + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 70 'kg' "kg" + * extension[value].valueRange.high = 79.999999 'kg' "kg" + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 6650 '[iU]' "IU" +* dosage[+] + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 80 'kg' "kg" + * extension[value].valueRange.high = 89.999999 'kg' "kg" + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 7600 '[iU]' "IU" +* dosage[+] + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 90 'kg' "kg" + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 8550 '[iU]' "IU" Instance: TherapeuticAnticoagulationNMHCertoparin InstanceOf: drug-administration-action @@ -209,12 +369,11 @@ Description: "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care * route = $sct#34206005 "Subcutaneous route (qualifier value)" * timing * repeat - * frequency = 1 + * frequency = 2 * period = 1 * periodUnit = $ucum#d "day" * doseAndRate - * doseRange - * low = 3000.0000001 '[iU]' "IU" + * doseQuantity = 8000 '[iU]' "IU" Instance: TherapeuticAnticoagulationFondaparinux InstanceOf: drug-administration-action @@ -287,5 +446,4 @@ Description: "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care * period = 1 * periodUnit = $ucum#d "day" * doseAndRate - * doseRange - * low = 4500.0000001 '[iU]' "IU" + * doseQuantity = 175 'IU/kg' "IU/kg" diff --git a/input/fsh/covid19-inpatient-therapy/18-no-therapeutic-anticoagulation/recommendation_18_intervention.fsh b/input/fsh/covid19-inpatient-therapy/18-no-therapeutic-anticoagulation/recommendation_18_intervention.fsh index 5af2ceea5..a24cb4818 100644 --- a/input/fsh/covid19-inpatient-therapy/18-no-therapeutic-anticoagulation/recommendation_18_intervention.fsh +++ b/input/fsh/covid19-inpatient-therapy/18-no-therapeutic-anticoagulation/recommendation_18_intervention.fsh @@ -26,26 +26,32 @@ Description: "In intensive care patients without a specific indication (e.g. pul * low = 50 's' "sec" * insert rs-combination-all * action[drugAdministration][+] - * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWDalteparin) + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWUFH) + * goalId = "aPTT-goal" * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWEnoxaparin) + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWDalteparin1xd) * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWNadroparinLowWeight) + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWDalteparin2xd) * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWNadroparinHighWeight) + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWDalteparinTable) * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWCertoparin) + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWNadroparin) * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWArgatra) - * goalId = "aPTT-goal" + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWEnoxaparin1xd) * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWUFH) + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWEnoxaparin2xd) + * code = $sct#432102000 "Administration of substance (procedure)" +* action[drugAdministration][+] + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWCertoparin) + * code = $sct#432102000 "Administration of substance (procedure)" +* action[drugAdministration][+] + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWArgatra) * goalId = "aPTT-goal" * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] @@ -55,12 +61,38 @@ Description: "In intensive care patients without a specific indication (e.g. pul /*************************/ /* Recommended Actions */ /*************************/ -Instance: NoTherapeuticAnticoagulationWDalteparin +Instance: NoTherapeuticAnticoagulationWUFH +InstanceOf: drug-administration-action +Usage: #definition +Title: "No Therapeutic Anticoagulation Treatment with UFH" +Description: "No Therapeutic Anticoagulation Treatment with UFH for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" +* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/no-therapeutic-anticoagulant-UFH-administration) +* insert publisher-experimental-version(0.1) +* name = "NoTherapeuticAnticoagulationPlanUFH" +* status = #active +* description = "No Therapeutic Anticoagulation Treatment with UFH for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" +* code = $sct#432102000 "Administration of substance (procedure)" +* productCodeableConcept + * coding[sct] = $sct#372877000 "Heparin (substance)" + * coding[atcde] = $atcde#C05BA03 "Heparin" +* dosage + * route = $sct#47625008 "Intravenous route (qualifier value)" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseRange + * low = 0 '[iU]' "IU" // any dose of i.v. Argatroban +* doNotPerform = true + +Instance: NoTherapeuticAnticoagulationWDalteparin1xd InstanceOf: drug-administration-action Usage: #definition Title: "No Therapeutic Anticoagulation Treatment with Dalteparin" Description: "No Therapeutic Anticoagulation Treatment with Dalteparin for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" -* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/no-therapeutic-anticoagulant-dalteparin-administration) +* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/no-therapeutic-anticoagulant-dalteparin-administration-1xd) * insert publisher-experimental-version(0.1) * name = "NoTherapeuticAnticoagulationDalteparinPlan" * status = #active @@ -69,7 +101,7 @@ Description: "No Therapeutic Anticoagulation Treatment with Dalteparin for non-i * productCodeableConcept * coding[sct] = $sct#372563008 "Dalteparin (substance)" * coding[atcde] = $atcde#B01AB04 "Dalteparin" -* dosage +* dosage[+] * route = $sct#34206005 "Subcutaneous route (qualifier value)" * timing * repeat @@ -77,16 +109,107 @@ Description: "No Therapeutic Anticoagulation Treatment with Dalteparin for non-i * period = 1 * periodUnit = $ucum#d "day" * doseAndRate - * doseRange - * low = 5000.0000001 '[iU]' "IU" + * doseQuantity = 200 '[iU]/kg' "IU/kg" * doNotPerform = true -Instance: NoTherapeuticAnticoagulationWEnoxaparin +Instance: NoTherapeuticAnticoagulationWDalteparin2xd +InstanceOf: drug-administration-action +Usage: #definition +Title: "No Therapeutic Anticoagulation Treatment with Dalteparin" +Description: "No Therapeutic Anticoagulation Treatment with Dalteparin for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" +* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/no-therapeutic-anticoagulant-dalteparin-administration-2xd) +* insert publisher-experimental-version(0.1) +* name = "NoTherapeuticAnticoagulationDalteparinPlan" +* status = #active +* description = "No Therapeutic Anticoagulation Treatment with Dalteparin for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" +* code = $sct#432102000 "Administration of substance (procedure)" +* productCodeableConcept + * coding[sct] = $sct#372563008 "Dalteparin (substance)" + * coding[atcde] = $atcde#B01AB04 "Dalteparin" +* dosage[+] + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * timing + * repeat + * frequency = 2 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 100 '[iU]/kg' "IU/kg" +* doNotPerform = true + +Instance: NoTherapeuticAnticoagulationWDalteparinTable +InstanceOf: drug-administration-action +Usage: #definition +Title: "No Therapeutic Anticoagulation Treatment with Dalteparin" +Description: "No Therapeutic Anticoagulation Treatment with Dalteparin for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" +* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/no-therapeutic-anticoagulant-dalteparin-administration-table) +* insert publisher-experimental-version(0.1) +* name = "NoTherapeuticAnticoagulationDalteparinPlan" +* status = #active +* description = "No Therapeutic Anticoagulation Treatment with Dalteparin for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" +* code = $sct#432102000 "Administration of substance (procedure)" +* productCodeableConcept + * coding[sct] = $sct#372563008 "Dalteparin (substance)" + * coding[atcde] = $atcde#B01AB04 "Dalteparin" +* dosage[+] + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 46 'kg' "kg" + * extension[value].valueRange.high = 56.999999 'kg' "kg" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 10000 '[iU]' "IU" +* dosage[+] + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 57 'kg' "kg" + * extension[value].valueRange.high = 68.999999 'kg' "kg" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 12500 '[iU]' "IU" +* dosage[+] + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 69 'kg' "kg" + * extension[value].valueRange.high = 82.999999 'kg' "kg" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 15000 '[iU]' "IU" +* dosage[+] + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 83 'kg' "kg" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 18000 '[iU]' "IU" +* doNotPerform = true + +Instance: NoTherapeuticAnticoagulationWEnoxaparin1xd InstanceOf: drug-administration-action Usage: #definition Title: "No Therapeutic Anticoagulation Treatment with Enoxaparin" Description: "No Therapeutic Anticoagulation Treatment with Enoxaparin for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" -* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/no-therapeutic-anticoagulant-enoxaparin-administration) +* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/no-therapeutic-anticoagulant-enoxaparin-administration-1xd) * insert publisher-experimental-version(0.1) * name = "NoTherapeuticAnticoagulationPlanEnoxaparin" * status = #active @@ -95,7 +218,7 @@ Description: "No Therapeutic Anticoagulation Treatment with Enoxaparin for non-i * productCodeableConcept * coding[sct] = $sct#372562003 "Enoxaparin (substance)" * coding[atcde] = $atcde#B01AB05 "Enoxaparin" -* dosage +* dosage[+] * route = $sct#34206005 "Subcutaneous route (qualifier value)" * timing * repeat @@ -103,57 +226,59 @@ Description: "No Therapeutic Anticoagulation Treatment with Enoxaparin for non-i * period = 1 * periodUnit = $ucum#d "day" * doseAndRate - * doseRange - * low = 40.0000001 'mg' + * doseQuantity = 1.5 'mg/kg' "mg/kg" * doNotPerform = true -Instance: NoTherapeuticAnticoagulationWNadroparinLowWeight +Instance: NoTherapeuticAnticoagulationWEnoxaparin2xd InstanceOf: drug-administration-action Usage: #definition -Title: "No Therapeutic Anticoagulation Treatment with Nadroparin Low Weight" -Description: "No Therapeutic Anticoagulation Treatment with Nadroparin for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" -* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/no-therapeutic-anticoagulant-nadroparin-administration-low-weight) +Title: "No Therapeutic Anticoagulation Treatment with Enoxaparin" +Description: "No Therapeutic Anticoagulation Treatment with Enoxaparin for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" +* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/no-therapeutic-anticoagulant-enoxaparin-administration-2xd) * insert publisher-experimental-version(0.1) -* name = "NoTherapeuticAnticoagulationPlanNadroparinLowWeight" +* name = "NoTherapeuticAnticoagulationPlanEnoxaparin" * status = #active -* description = "No Therapeutic Anticoagulation Treatment with Nadroparin for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" +* description = "No Therapeutic Anticoagulation Treatment with Enoxaparin for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" * code = $sct#432102000 "Administration of substance (procedure)" * productCodeableConcept - * coding[sct] = $sct#699946002 "Nadroparin (substance)" - * coding[atcde] = $atcde#B01AB06 "Nadroparin" + * coding[sct] = $sct#372562003 "Enoxaparin (substance)" + * coding[atcde] = $atcde#B01AB05 "Enoxaparin" * dosage[+] - * extension[condition] - * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" - * extension[value].valueRange.high = 70 'kg' "kg" * route = $sct#34206005 "Subcutaneous route (qualifier value)" * timing * repeat - * frequency = 1 + * frequency = 2 * period = 1 * periodUnit = $ucum#d "day" * doseAndRate - * doseRange - * low = 3800.0000001 '[iU]' "IU" + * doseQuantity = 1 'mg/kg' "mg/kg" * doNotPerform = true -Instance: NoTherapeuticAnticoagulationWNadroparinHighWeight +Instance: NoTherapeuticAnticoagulationWNadroparin InstanceOf: drug-administration-action Usage: #definition -Title: "No Therapeutic Anticoagulation Treatment with Nadroparin High Weight" +Title: "No Therapeutic Anticoagulation Treatment with Nadroparin" Description: "No Therapeutic Anticoagulation Treatment with Nadroparin for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" -* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/no-therapeutic-anticoagulant-nadroparin-administration-high-weight) +* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/no-therapeutic-anticoagulant-nadroparin-administration) * insert publisher-experimental-version(0.1) -* name = "NoTherapeuticAnticoagulationPlanNadroparinHighWeight" +* name = "NoTherapeuticAnticoagulationPlanNadroparin" * status = #active * description = "No Therapeutic Anticoagulation Treatment with Nadroparin for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" * code = $sct#432102000 "Administration of substance (procedure)" * productCodeableConcept * coding[sct] = $sct#699946002 "Nadroparin (substance)" * coding[atcde] = $atcde#B01AB06 "Nadroparin" +// Weight (kg) Dose s.c. (IE; 2x/d) +// <50 3800 +// 50-59 4750 +// 60-69 5700 +// 70-79 6650 +// 80-89 7600 +// ≥90 8550 * dosage[+] * extension[condition] * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" - * extension[value].valueRange.low = 70.0000001 'kg' "kg" + * extension[value].valueRange.high = 49.999999 'kg' "kg" * route = $sct#34206005 "Subcutaneous route (qualifier value)" * timing * repeat @@ -161,8 +286,71 @@ Description: "No Therapeutic Anticoagulation Treatment with Nadroparin for non-i * period = 1 * periodUnit = $ucum#d "day" * doseAndRate - * doseRange - * low = 5700.0000001 '[iU]' "IU" + * doseQuantity = 3800 '[iU]' "IU" +* dosage[+] + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 50 'kg' "kg" + * extension[value].valueRange.high = 59.999999 'kg' "kg" + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 4750 '[iU]' "IU" +* dosage[+] + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 60 'kg' "kg" + * extension[value].valueRange.high = 69.999999 'kg' "kg" + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 5700 '[iU]' "IU" +* dosage[+] + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 70 'kg' "kg" + * extension[value].valueRange.high = 79.999999 'kg' "kg" + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 6650 '[iU]' "IU" +* dosage[+] + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 80 'kg' "kg" + * extension[value].valueRange.high = 89.999999 'kg' "kg" + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 7600 '[iU]' "IU" +* dosage[+] + * extension[condition] + * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight" + * extension[value].valueRange.low = 90 'kg' "kg" + * route = $sct#34206005 "Subcutaneous route (qualifier value)" + * timing + * repeat + * frequency = 1 + * period = 1 + * periodUnit = $ucum#d "day" + * doseAndRate + * doseQuantity = 8550 '[iU]' "IU" * doNotPerform = true Instance: NoTherapeuticAnticoagulationWCertoparin @@ -183,38 +371,11 @@ Description: "No Therapeutic Anticoagulation Treatment with Certoparin for non-i * route = $sct#34206005 "Subcutaneous route (qualifier value)" * timing * repeat - * frequency = 1 + * frequency = 2 * period = 1 * periodUnit = $ucum#d "day" * doseAndRate - * doseRange - * low = 3000.0000001 '[iU]' "IU" -* doNotPerform = true - -Instance: NoTherapeuticAnticoagulationWUFH -InstanceOf: drug-administration-action -Usage: #definition -Title: "No Therapeutic Anticoagulation Treatment with UFH" -Description: "No Therapeutic Anticoagulation Treatment with UFH for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" -* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/no-therapeutic-anticoagulant-UFH-administration) -* insert publisher-experimental-version(0.1) -* name = "NoTherapeuticAnticoagulationPlanUFH" -* status = #active -* description = "No Therapeutic Anticoagulation Treatment with UFH for non-intensive care hospitalised COVID-19 patients patients with no specific indications (i.e., pulmonary embolism)" -* code = $sct#432102000 "Administration of substance (procedure)" -* productCodeableConcept - * coding[sct] = $sct#372877000 "Heparin (substance)" - * coding[atcde] = $atcde#C05BA03 "Heparin" -* dosage - * route = $sct#47625008 "Intravenous route (qualifier value)" - * timing - * repeat - * frequency = 1 - * period = 1 - * periodUnit = $ucum#d "day" - * doseAndRate - * doseRange - * low = 0 '[iU]' "IU" // any dose of i.v. Argatroban + * doseQuantity = 8000 '[iU]' "IU" * doNotPerform = true Instance: NoTherapeuticAnticoagulationWArgatra @@ -265,6 +426,5 @@ Description: "No Therapeutic Anticoagulation Treatment with Tinzaparin for non-i * period = 1 * periodUnit = $ucum#d "day" * doseAndRate - * doseRange - * low = 4500.0000001 '[iU]' "IU" + * doseQuantity = 175 'IU/kg' "IU/kg" * doNotPerform = true From 766dbb715d77e174c72938919ed10c4f311b530f Mon Sep 17 00:00:00 2001 From: Gregor Lichtner Date: Tue, 27 Feb 2024 19:29:30 +0100 Subject: [PATCH 2/4] fix: correct exclusions in rec15 --- .../recommendation_15_intervention.fsh | 23 +++++++++++++------ 1 file changed, 16 insertions(+), 7 deletions(-) diff --git a/input/fsh/covid19-inpatient-therapy/15-prophylactic-anticoagulation/recommendation_15_intervention.fsh b/input/fsh/covid19-inpatient-therapy/15-prophylactic-anticoagulation/recommendation_15_intervention.fsh index 707652ae3..51b29904e 100644 --- a/input/fsh/covid19-inpatient-therapy/15-prophylactic-anticoagulation/recommendation_15_intervention.fsh +++ b/input/fsh/covid19-inpatient-therapy/15-prophylactic-anticoagulation/recommendation_15_intervention.fsh @@ -43,30 +43,39 @@ Description: "Hospitalized patients with COVID-19 should receive standard drug t * action[combination][+] * insert rs-combination-all * action[drugAdministration][+] - * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWDalteparin) + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWUFH) + * goalId = "aPTT-goal" * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWEnoxaparin) + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWDalteparin1xd) * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWNadroparinLowWeight) + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWDalteparin2xd) * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWNadroparinHighWeight) + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWDalteparinTable) * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWCertoparin) + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWNadroparin) * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWArgatra) + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWEnoxaparin1xd) * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] - * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWUFH) + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWEnoxaparin2xd) + * code = $sct#432102000 "Administration of substance (procedure)" + * action[drugAdministration][+] + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWCertoparin) + * code = $sct#432102000 "Administration of substance (procedure)" + * action[drugAdministration][+] + * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWArgatra) + * goalId = "aPTT-goal" * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWTinzaparin) * code = $sct#432102000 "Administration of substance (procedure)" + Instance: AntithrombFondapProphInHospitalisedCOVID19PatientsRecommPlan InstanceOf: recommendation-plan Usage: #definition From e8f1ad1c81e885a4723e1b97615433b4257efa3e Mon Sep 17 00:00:00 2001 From: Gregor Lichtner Date: Tue, 27 Feb 2024 19:46:15 +0100 Subject: [PATCH 3/4] fix: units --- .../recommendation_15_intervention.fsh | 2 -- .../recommendation_17_intervention.fsh | 2 +- .../recommendation_18_intervention.fsh | 2 +- 3 files changed, 2 insertions(+), 4 deletions(-) diff --git a/input/fsh/covid19-inpatient-therapy/15-prophylactic-anticoagulation/recommendation_15_intervention.fsh b/input/fsh/covid19-inpatient-therapy/15-prophylactic-anticoagulation/recommendation_15_intervention.fsh index 51b29904e..06b627f55 100644 --- a/input/fsh/covid19-inpatient-therapy/15-prophylactic-anticoagulation/recommendation_15_intervention.fsh +++ b/input/fsh/covid19-inpatient-therapy/15-prophylactic-anticoagulation/recommendation_15_intervention.fsh @@ -44,7 +44,6 @@ Description: "Hospitalized patients with COVID-19 should receive standard drug t * insert rs-combination-all * action[drugAdministration][+] * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWUFH) - * goalId = "aPTT-goal" * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWDalteparin1xd) @@ -69,7 +68,6 @@ Description: "Hospitalized patients with COVID-19 should receive standard drug t * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWArgatra) - * goalId = "aPTT-goal" * code = $sct#432102000 "Administration of substance (procedure)" * action[drugAdministration][+] * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWTinzaparin) diff --git a/input/fsh/covid19-inpatient-therapy/17-therapeutic-anticoagulation/recommendation_17_intervention.fsh b/input/fsh/covid19-inpatient-therapy/17-therapeutic-anticoagulation/recommendation_17_intervention.fsh index 2f74da10c..489916a41 100644 --- a/input/fsh/covid19-inpatient-therapy/17-therapeutic-anticoagulation/recommendation_17_intervention.fsh +++ b/input/fsh/covid19-inpatient-therapy/17-therapeutic-anticoagulation/recommendation_17_intervention.fsh @@ -446,4 +446,4 @@ Description: "Therapeutic Anticoagulation Treatment (NMH) for non-intensive care * period = 1 * periodUnit = $ucum#d "day" * doseAndRate - * doseQuantity = 175 'IU/kg' "IU/kg" + * doseQuantity = 175 '[iU]/kg' "IU/kg" diff --git a/input/fsh/covid19-inpatient-therapy/18-no-therapeutic-anticoagulation/recommendation_18_intervention.fsh b/input/fsh/covid19-inpatient-therapy/18-no-therapeutic-anticoagulation/recommendation_18_intervention.fsh index a24cb4818..242b754a4 100644 --- a/input/fsh/covid19-inpatient-therapy/18-no-therapeutic-anticoagulation/recommendation_18_intervention.fsh +++ b/input/fsh/covid19-inpatient-therapy/18-no-therapeutic-anticoagulation/recommendation_18_intervention.fsh @@ -426,5 +426,5 @@ Description: "No Therapeutic Anticoagulation Treatment with Tinzaparin for non-i * period = 1 * periodUnit = $ucum#d "day" * doseAndRate - * doseQuantity = 175 'IU/kg' "IU/kg" + * doseQuantity = 175 '[iU]/kg' "IU/kg" * doNotPerform = true From 7731f4e2c9e77e6f771d30570742c025fe2482b9 Mon Sep 17 00:00:00 2001 From: Gregor Lichtner Date: Tue, 27 Feb 2024 19:53:13 +0100 Subject: [PATCH 4/4] =?UTF-8?q?Bump=20version:=201.4.0=20=E2=86=92=201.5.0?= =?UTF-8?q?-snapshot?= MIME-Version: 1.0 Content-Type: text/plain; charset=UTF-8 Content-Transfer-Encoding: 8bit --- .bumpversion.cfg | 2 +- sushi-config.yaml | 2 +- 2 files changed, 2 insertions(+), 2 deletions(-) diff --git a/.bumpversion.cfg b/.bumpversion.cfg index 2f2d8f62b..24a5b6fa2 100644 --- a/.bumpversion.cfg +++ b/.bumpversion.cfg @@ -1,5 +1,5 @@ [bumpversion] -current_version = 1.4.0 +current_version = 1.5.0-snapshot parse = (?P\d+)\.(?P\d+)\.(?P\d+)(\-(?P\S+))? serialize = {major}.{minor}.{patch}-{release} diff --git a/sushi-config.yaml b/sushi-config.yaml index 7f1b7d957..9537a2b86 100644 --- a/sushi-config.yaml +++ b/sushi-config.yaml @@ -3,7 +3,7 @@ canonical: https://www.netzwerk-universitaetsmedizin.de/fhir/codex-celida name: CELIDA Recommendations title: CODEX+ CELIDA Recommendations status: draft -version: 1.4.0 +version: 1.5.0-snapshot fhirVersion: 5.0.0 copyrightYear: 2021+ releaseLabel: ci-build