CH CRL (R4)
0.9.0 - Draft

This page is part of the CH CRL (R4) (v0.9.0: STU Draft) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

Change Log

All significant changes to this FHIR implementation guide will be documented on this page.

Note for implementers:
Necessary changes, e.g. due to specification changes or bugs, to existing FHIR artifacts from the previous version that affect existing implementations are highlighted in bold.

v0.9.0

Added

  • Download link for NPM package, see here.
  • Separate tabs for the use case and the cancer report (logical model) for simpler navigation in the IG.
  • Set the flag mustSupport=true for case-opening criteria, see here.
  • New use case step with example: Follow-up with a gastroenterologist.
  • Constraints in profiles to enhance validation (e.g. ch-crl-obs-1: Observation must have either value[x] or dataAbsentReason).
  • More NKRS variables with profiles, examples and terminology.
    1. Method of first detection (Variable number: 2.6) (Profile, ValueSet)
    2. Associated in situ tumour (Variable number: 3.6.2) (Profile)
    3. ICCC-3 main group (Variable number: 3.9.1) (Profile, ValueSet)
    4. ICCC-3 code (Variable number: 3.9.2) (Profile, ValueSet)
    5. ICCC-3 extended code (Variable number: 3.9.3) (Profile, ValueSet)
    6. Ann Arbor staging (Variable number: 4.18) (Profile, ValueSet)
    7. COG staging (Variable number: 4.19) (Profile, ValueSet)
    8. COG ALL staging (Variable number: 4.20) (Profile, ValueSet)
    9. FIGO staging (Variable number: 4.21) (Profile, ValueSet)
    10. INRGSS staging (Variable number: 4.22) (Profile, ValueSet)
    11. IRSS staging (Variable number: 4.23) (Profile, ValueSet)
    12. Lugano staging (Variable number: 4.24) (Profile, ValueSet)
    13. PRETEXT staging (Variable number: 4.25) (Profile, ValueSet)
    14. Rai staging (Variable number: 4.26) (Profile, ValueSet)
    15. Binet staging (Variable number: 4.27) (Profile, ValueSet)
    16. Rhabdomyosarcoma site staging (Variable number: 4.28) (Profile, ValueSet)
    17. ISS staging (Variable number: 4.29) (Profile, ValueSet)
    18. DSSplus (Variable number: 4.30) (Profile, ValueSet)
    19. SIOP staging (Variable number: 4.31) (Profile, ValueSet)
    20. St. Jude / Murphy staging (Variable number: 4.32) (Profile, ValueSet)
    21. Toronto Tier II (manual) staging (Variable number: 4.33.2) (Profile, ValueSet)
    22. Creasman grading system (Variable number: 4.34) (Profile, ValueSet)
    23. Elston/Ellis grading system (Variable number: 4.35) (Profile, ValueSet)
    24. SalzerKuntschik grading system (Variable number: 4.36) (Profile, ValueSet)
    25. Shimada grading system (Variable number: 4.37) (Profile, ValueSet)
    26. WHO(CNS) grading system (Variable number: 4.38) (Profile, ValueSet)
    27. Clinical tumour size (Variable number: 4.39) (Profile)
    28. Pathological tumour size (Variable number: 4.40) (Profile)
    29. Metastases at diagnosis indicator (Variable number: 4.41) (Profile)
    30. Topography of metastases at diagnosis (Variable number: 4.42) (Profile, ValueSet)
    31. Oestrogen receptor status (Variable number: 5.1.1) (Profile)
    32. Progesterone receptor status (Variable number: 5.1.2) (Profile)
    33. Her2 receptor status (Variable number: 5.1.3) (Profile, ValueSet)
    34. Tumour proliferation labeling (Variable number: 5.1.4) (Profile)
    35. Pretreatment Prostate Specific Antigen (PSA) (Variable number: 5.2.1) (Profile)
    36. Gleason biopsy most common grade (Variable number: 5.2.2) (Profile)
    37. Gleason biopsy second most common or highest grade (Variable number: 5.2.3) (Profile)
    38. Gleason excision most common grade (Variable number: 5.2.4) (Profile)
    39. Gleason excision second most common or highest grade (Variable number: 5.2.5) (Profile)
    40. Gleason score (Variable number: 5.2.6) (Profile)
    41. WHO grade group (Variable number: 5.2.7) (Profile)
    42. Breslow thickness (Variable number: 5.3.1) (Profile)
    43. Circumferential resection margins (Variable number: 5.4.1) (Profile)
    44. Microsatellite instability (Variable number: 5.4.2) (Profile)
    45. α-fetoprotein (Variable number: 5.5.1) (Profile, ValueSet)
    46. β-hCG (Variable number: 5.5.2) (Profile, ValueSet)
    47. LDH (Variable number: 5.5.3) (Profile, ValueSet)
    48. Serum tumour markers (Variable number: 5.5.4) (Profile, ValueSet)
    49. HPV/p16 (Variable number: 5.6.1) (Profile)
    50. EBV (Variable number: 5.6.2) (Profile)
    51. Residual invasive tumour (Variable number: 6.1) (Profile, ValueSet)
    52. Residual in-situ tumour (Variable number: 6.2) (Profile, ValueSet)
    53. Resection margin invasive tumour (Variable number: 6.3) (Profile)
    54. Resection margin in-situ tumour (Variable number: 6.4) (Profile)
    55. Sentinel lymph node assessment (Variable number: 6.5) (Profile, ValueSet)
    56. Number of examined sentinel lymph nodes (Variable number: 6.6) (Profile)
    57. Number of positive sentinel lymph nodes (Variable number: 6.7) (Profile)
    58. Basis of first treatment complex decision (Variable number: 7.1) (Profile, ValueSet)
    59. Date of first treatment complex decision (Variable number: 7.2.1) (Profile)
    60. First treatment complex goal(s) (Variable number: 7.3) (Profile, ValueSet)
    61. First treatment complex code(s) (Variable number: 7.4) (Profile)
    62. First treatment complex start date(s) (Variable number: 7.5.1) (Profile)
    63. First treatment complex institution(s) (Variable number: 7.6) (Profile)
    64. Type of recurrence(s)/transformation(s) (Variable number: 8.1) (Profile, ValueSet)
    65. Date of recurrence(s)/transformation(s) (Variable number: 8.2.1) (Profile)
    66. Morphology term before change of main diagnosis (Variable number: 8.4) (Profile)
    67. Morphology term after Transformation (Variable number: 8.5) (Profile)
    68. Topography(s) of post-diagnosis metastases (Variable number: 8.6) (Profile, ValueSet)
    69. Diabetes mellitus (Variable number: 10.1) (Profile, ValueSet)
    70. Liver Disease (Variable number: 10.2) (Profile, ValueSet)
    71. HIV/AIDS (Variable number: 10.3) (Profile)
    72. Moderate to Severe Chronic Kidney Disease (Variable number: 10.4) (Profile)
    73. Congestive Heart Failure (Variable number: 10.5) (Profile)
    74. Myocardial infarction (Variable number: 10.6) (Profile)
    75. Chronic Pulmonary Disease (Variable number: 10.7) (Profile)
    76. Peripheral Vascular Disease (Variable number: 10.8) (Profile)
    77. Cerebrovascular Accident or Transient Ischemic Attack (Variable number: 10.9) (Profile)
    78. Dementia (Variable number: 10.10) (Profile)
    79. Hemiplegia / Paraplegia (Variable number: 10.11) (Profile)
    80. Connective Tissue Disease - Rheumatic disease (Variable number: 10.12) (Profile)
    81. Peptic Ulcer Disease (Variable number: 10.13) (Profile)
    82. Charlson Index (Variable number: 10.14) (Profile)

Changed / Updated

  • Switch to the new IG template and adaptations to its new requiremenst. This adaptation only slightly changes the appearance of the IG.
  • Transformation of the raw source (IG input) into FHIR Shorthand files (.fsh). This change has no impact on the IG published as a web page, it just makes it easier to author the FHIR artifacts for the IG.
  • Updating the dependency on CH Core IG from current to the currently published version 2.0.0.
  • Structure of the cancer report document, based on the registration application. Implementers need to insert sections (with codings and titles) in the Composition to group the references.
  • There have been changes to the NKRS code lists V1.1. Implementers have to adapt the following codes systems, which were already integrated in the FHIR Implementation Guide:
    • NKRS - Diagnostic Methods Used
      • Additional code 23 “Biopsy locoregional or of metastasis”
      • The numerical code of the following elements increases accordingly by 1
    • NKRS - TNM Stage Group
      • Additional code IIID “Stage IIID”
      • Removed codes A “Stage A”, AP “Stage AP”, B “Stage B”, BP “Stage BP”, C “Stage C”, CP “Stage CP”
  • Enable local codes to be reported as an option (if not otherwise possible):
  • Add the Extension ‘data-absent-reason’ to the Procedure for the diagnostic method(s), to support the representation of the value ‘unknown’. Implementers should now be able to support ‘unknown’ for this Procedure.
  • Mapping CH CRL to mCODE adapted to both new versions.

Fixed

v0.2.1

Final version 0.2.1 of use case 1b.

v0.2.0

Draft version 0.2.0 of use case 1b for public comment.

Added

  • FHIR artifacts for use case 1b (report as structured data).

v0.1.1

Final version 0.1.1 of use case 1a.

v0.1.0

Draft version 0.1.0 of use case 1a for public comment.

Added

  • FHIR artifacts for use case 1a (report as PDF).