"DLCO (pred adj Hb 13.8 g/dL)" - meaning? #21
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jamais-vu
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Note that the meaning of these Observations is still ambiguous. See: #21
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jdjkelly
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* style: remove line break at end of description * docs: add descriptions for spirometry profiles * fix: typo * docs: add descriptions. add TODOs for expansion * docs: expand description * docs: change parentheses around units to commas This is purely a style judgment. I think it looks better. * fix: typo * fix: DLCO % pred unit DLCO % pred valueQuantity unit and code were `mL/min/mmHg`. Should be `%`. * docs: update descriptions to specify profile type * docs: expand descriptions * fix: build error Mismatched quotes on lines 12 and 38 * refactor: clean up Instances directory structure Create subdirectories for spirometry and diffusing-capacity Instances. * add ids * feat: create Instances for remaining Observations Create an example Instance for each Observation which appears in the example PFT. Note that not all our Profiles have a corresponding measurement in the example PFT. * add new Instances to Bundle and DiagnosticReport * fix: typo in valueQuantity.unit * docs: expand description * remove FVC predicted value instance The ATS states inclusion of the predicted value (aka the reference value) is unnecessary as it does not aid in interpretation of abnormality. Previously I had included it as a demonstration of how a predicted value may be included for completeness if desired, but have decided its inclusion is potentially confusing and beyond the current scope of the IG. * add VA derivedFrom elements * add derivedFrom to KCO_POST instance * fix: change `mmHg` to `mm[Hg]` `mmHg` (millimeters of mercury) is not a valid UCUM unit. The correct expression is `mm[Hg]`. * comment out missing Reference link * fix: remove trailing whitespace IG build warning: value should not start or finish with whitespace * change usage: #inline -> #example IG build information: "The Implementation Guide contains no explicitly linked examples for this profile" Changing this Instance to #example means it is explicitly created as a separate resource. * Revert "comment out missing Reference link" This reverts commit f8b153c. * Revert "comment out missing Reference link" This reverts commit f8b153c. We need to include this element. `Composition.author` has cardinality `1..*`. * fix: change code.text 'pre' to 'post' * add pre/post unspecified spirometry instances Since the example PFT provides only PRE and POST values, I have used the PRE values for pre/post unspecified instances. In addition to changing name, id, and profile, each instance has had its `code` and `derivedFrom` modified correspondingly. * add pre/post unspecified KCO instances Since the example PFT provides only KCO POST values, I have used those values for both KCO PRE and KCO pre/post unspecified instances. I also removed `derivedFrom` for `KCO` and `KCO_PRE`, since those observations of `DLCO_atStandardPB` and `VA` are specifically post-bronchodilator and may not apply elsewhere. * comment out narrative and placeholders Narrative is not being used the way I wanted. TODO. Placeholders are beyond current scope. * add code system and version IG build warning: "A code with no system has no defined meaning. A system should be provided" * fix: add missing author, remove other references `Composition.author` has cardinality `1..*`. To avoid reference not found error, I set our placeholder Practitioner instance to #example and reference that as the composition's author. The other placeholder references are commented out because they are not required and beyond our scope. * fix: remove trailing whitespace IG build warning: "value should not start or finish with whitespace" * add ending period to descriptions * remove line break * fix 'Contents' links and update with new sections IG build raised two errors for markdown links not being resolved: - '#introduction' - '#gaps-in-observation-coding' I renamed 'Introduction' to 'Scope' and corrected 'Gaps in Coding'. I also fixed the subsection indentation for 'Gaps in Coding' and added links for missing sections. * feat: add DLCO (pred adj Hb 13.8 g/dL) instances Note that the meaning of these Observations is still ambiguous. See: #21 * fix: incorrect id * fix: comment out unresolvable references * docs: add definition and narrative These Instances are helpful but non-essential for our example PFT. I add definition and narrative explaining what they are and clarifying they have no relevance on their own and exist only to illustrate what PFT DiagnosticReport and Observations look like.
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In Figure 3 of the ATS's Recommendations for a Standardized Pulmonary Function Report (2017) example PFT, there is a measurement
DLCO (pred adj Hb 13.8 g/dL). In the caption for Figure 3, it is stated:It's unclear to me what this means - is the observed value adjusted for some predicted value of hemoglobin, or is the predicted value adjusted for a hemoglobin value of 13.8 g/dL?
My best guess is it means the predicted value is adjusted for a hemoglobin value of 13.8 g/dL. Note that the provided values for
DLCO (at standard PB)andDLCO (pred adj Hb 13.8 g/dL)have equivalent results but different % pred:DLCO (at standard PB):
DLCO (pred adj Hb 13.8 g/dL):
This leads me to believe the predicted value has been adjusted for hemoglobin, and the result value is maybe even the same measurement (ie a duplicate value of the
DLCO (at standard PB)result is inserted into the table).There's a LOINC code for "Diffusion capacity.carbon monoxide adjusted for hemoglobin" which I thought corresponded to this. But that does not seem to apply here if
DLCO (pred adj Hb 13.8 g/dL)means the predicted value was adjusted and the result value was not adjusted.Implications
If my above guess is correct, then our profiles
DLCOAdjustedForHemoglobinandDLCOAdjustedForHemoglobin_PercentOfPredictedwill need to be updated.The text was updated successfully, but these errors were encountered: