CH LAB-Report (R4)
1.0.0 - trial-use
CH LAB-Report (R4)
1.0.0 - trial-use
This page is part of the CH LAB-Report (R4) (v1.0.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
The dependencies between the resources are shown in this diagram: Resource Overview
To provide a better overview, this profiles page is divided into General Profiles and Profiles for specific purposes. The implementation guide offers specific profiles for Panels for automated blood cell count and profiles handling Panels for renal insufficiency and eGFR (estimated Glomerulum Filtration Rate).
In the laboratory field, we often use panels for grouping laboratory analyses that belong together in terms of content, e.g. the group of analyses that quantify cardiovascular risks or that stand for a liver disease. It is the task of the individual medical laboratories to offer the user meaningful panels. Some laboratories also offer their customers the opportunity to create their own panels. All this results in a wide range of panels that serve different purposes and differ from laboratory to laboratory. The implementation guide contains a narrow selection of panels that can be optionally used by laboratories and that can cover common needs.
In FHIR, we have various options for displaying test panels in the laboratory area:
1. sliced component: we use the element component as an array in the Observation resource. The disadvantage is that component cannot be structured.
2. nested profiles: we can use the element hasMember to create test panels with any number of branches, which can be nested. The two profiles CH LAB-Report Observation Results Panel and CH LAB-Report Observation Results Single Test are provided for this purpose.
The profile for estimated GFR is a particular challenge. There are different ways to calculate this GFR based on age, gender, race, creatinine, creatinine combined with cystatin-C. The implementation guide contains 3 profiles for this:
An expert in nephrology says: "Well, the fact is that there is explicitly no standard in Switzerland. The professional association allows both formulas, for various reasons (history, custom, politics (“factor for blacks”)). Likewise the statement of both formulas is virtually identical, they are both equally meaningful. He recommends that we map both formulas and mention that it is decided per institution, which is used. However, the discussion in Switzerland, Europe and worldwide is probably heated and ongoing."
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CH LAB-Report Observation Results: Single Test
This profile constrains the ChLabObservationResultsLaboratory profile to represent single test results for the HL7 Swiss project. The profile enables only value[x] and component elements, hasMember elements are not allowed.
We have two possibilities to structure the data for an automated blood cell count. We can use a profile with contains each cell count in a component. Or we pack the results in a container profile with nested cell count profiles.
The estimated glomerular filtration rate (eGFR) is a critical measure used to assess kidney function. Several formulas and approaches have been developed to calculate eGFR, with variations based on available patient information.