Breast Cancer Screening and Management (BCSM) Clinical Decision Support (CDS) Implementation Guide
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: GeneticRiskReferral_eve-fhxgeneinherited_no_eve-brcageneancestry_no_eve-fhxbrcaovcatubalperit_yes_act-fhxrisktool_act-fhxriskassess - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Bundle ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "GeneticRiskReferral_eve-fhxgeneinherited_no_eve-brcageneancestry_no_eve-fhxbrcaovcatubalperit_yes_act-fhxrisktool_act-fhxriskassess"] ; # 
  fhir:type [ fhir:v "collection"] ; # 
  fhir:entry ( [
fhir:fullUrl [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/CarePlan/395"^^xsd:anyURI ] ;
    ( fhir:resource <http://cancerscreeningcds.github.io/bcsm-cds/CarePlan/395> )
  ] [
fhir:fullUrl [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/RequestGroup/396"^^xsd:anyURI ] ;
    ( fhir:resource <http://cancerscreeningcds.github.io/bcsm-cds/RequestGroup/396> )
  ] [
fhir:fullUrl [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/397"^^xsd:anyURI ] ;
    ( fhir:resource <http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/397> )
  ] [
fhir:fullUrl [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/398"^^xsd:anyURI ] ;
    ( fhir:resource <http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/398> )
  ] ) . # 

<http://cancerscreeningcds.github.io/bcsm-cds/CarePlan/395> a fhir:CarePlan ;
  fhir:id [ fhir:v "395"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"CarePlan_395\"> </a><p class=\"res-header-id\"><b>Generated Narrative: CarePlan 395</b></p><a name=\"395\"> </a><a name=\"hc395\"> </a><a name=\"395-en-US\"> </a><p><b>instantiatesCanonical</b>: <a href=\"PlanDefinition-flow-GeneticRiskReferral.html\">Genetic Risk Referral</a></p><p><b>status</b>: Draft</p><p><b>intent</b>: Proposal</p><p><b>subject</b>: <a href=\"Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient\">Jane Doe</a></p><p><b>created</b>: 2024-12-10 00:00:00+0000</p><h3>Activities</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Reference</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"Bundle-GeneticRiskReferral_eve-fhxgeneinherited_no_eve-brcageneancestry_no_eve-fhxbrcaovcatubalperit_yes_act-fhxrisktool_act-fhxriskassess.html#RequestGroup_396\">Bundle: type = collection</a></td></tr></table></div>"^^rdf:XMLLiteral
  ] ; # 
  fhir:instantiatesCanonical ( [
fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/flow-GeneticRiskReferral"^^xsd:anyURI ;
fhir:link <http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/flow-GeneticRiskReferral>
  ] ) ; # 
  fhir:status [ fhir:v "draft"] ; # 
  fhir:intent [ fhir:v "proposal"] ; # 
  fhir:subject [
fhir:reference [ fhir:v "Patient/defaultPatient" ] ;
fhir:display [ fhir:v "Jane Doe" ]
  ] ; # 
  fhir:created [ fhir:v "2024-12-10T00:00:00.0Z"^^xsd:dateTime] ; # 
  fhir:activity ( [
fhir:reference [
fhir:reference [ fhir:v "RequestGroup/396" ]     ]
  ] ) . # 

<http://cancerscreeningcds.github.io/bcsm-cds/RequestGroup/396> a fhir:RequestGroup ;
  fhir:id [ fhir:v "396"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"RequestGroup_396\"> </a><p class=\"res-header-id\"><b>Generated Narrative: RequestGroup 396</b></p><a name=\"396\"> </a><a name=\"hc396\"> </a><a name=\"396-en-US\"> </a><p><b>instantiatesCanonical</b>: <a href=\"PlanDefinition-flow-GeneticRiskReferral.html\">Genetic Risk Referral</a></p><p><b>status</b>: Draft</p><p><b>intent</b>: Proposal</p><p><b>subject</b>: <a href=\"Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient\">Jane Doe</a></p><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>GeneticRiskAssessment</blockquote><p><b>title</b>: Perform genetic risk assessment</p><p><b>description</b>: A genetic risk assessment, either informal or formal using a validated instrument, will help determine if the patient may benefit from referral for genetic risk counseling and testing.\n\nWomen with a positive result on the risk assessment tool should receive genetic counseling and, if indicated after counseling, genetic testing.</p><h3>Documentations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Label</b></td><td><b>Display</b></td><td><b>Citation</b></td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td>Citation</td><td>USPSTF</td><td>BRCA-Related Cancer: Risk Assessment, Genetic Counseling, and Genetic Testing</td><td><div><p>US Preventive Services Task Force. Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2019;322(7):652–665.</p>\n</div></td><td><a href=\"https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/brca-related-cancer-risk-assessment-genetic-counseling-and-genetic-testing\">https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/brca-related-cancer-risk-assessment-genetic-counseling-and-genetic-testing</a></td></tr></table><p><b>selectionBehavior</b>: Any</p><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>FhxGeneticRiskAssessment</blockquote><p><b>title</b>: Informal genetic risk assessment</p><p><b>description</b>: Perform assessment based on criteria in first- or second-degree blood relatives known to be associated with increased risk of inherited breast cancer susceptibility variant.</p><p><b>resource</b>: <a href=\"Bundle-GeneticRiskReferral_eve-fhxgeneinherited_no_eve-brcageneancestry_no_eve-fhxbrcaovcatubalperit_yes_act-fhxrisktool_act-fhxriskassess.html#ServiceRequest_397\">Bundle: type = collection</a></p></blockquote><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>FhxGeneticRiskAssessmentTool</blockquote><p><b>title</b>: Genetic risk assessment instrument</p><p><b>description</b>: Tools evaluated by the USPSTF include the Ontario Family History Assessment Tool, Manchester Scoring System, Referral Screening Tool, Pedigree Assessment Tool, 7-Question Family History Screening Tool, International Breast Cancer Intervention Study instrument (Tyrer-Cuzick), and brief versions of BRCAPRO. </p><p><b>resource</b>: <a href=\"Bundle-GeneticRiskReferral_eve-fhxgeneinherited_no_eve-brcageneancestry_no_eve-fhxbrcaovcatubalperit_yes_act-fhxrisktool_act-fhxriskassess.html#ServiceRequest_398\">Bundle: type = collection</a></p></blockquote></blockquote></div>"^^rdf:XMLLiteral
  ] ; # 
  fhir:instantiatesCanonical ( [
fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/flow-GeneticRiskReferral"^^xsd:anyURI ;
fhir:link <http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/flow-GeneticRiskReferral>
  ] ) ; # 
  fhir:status [ fhir:v "draft"] ; # 
  fhir:intent [ fhir:v "proposal"] ; # 
  fhir:subject [
fhir:reference [ fhir:v "Patient/defaultPatient" ] ;
fhir:display [ fhir:v "Jane Doe" ]
  ] ; # 
  fhir:action ( [
fhir:id [ fhir:v "GeneticRiskAssessment" ] ;
fhir:title [ fhir:v "Perform genetic risk assessment" ] ;
fhir:description [ fhir:v "A genetic risk assessment, either informal or formal using a validated instrument, will help determine if the patient may benefit from referral for genetic risk counseling and testing.\n\nWomen with a positive result on the risk assessment tool should receive genetic counseling and, if indicated after counseling, genetic testing." ] ;
    ( fhir:documentation [
fhir:type [ fhir:v "citation" ] ;
fhir:label [ fhir:v "USPSTF" ] ;
fhir:display [ fhir:v "BRCA-Related Cancer: Risk Assessment, Genetic Counseling, and Genetic Testing" ] ;
fhir:citation [ fhir:v "US Preventive Services Task Force. Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2019;322(7):652–665." ] ;
fhir:url [ fhir:v "https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/brca-related-cancer-risk-assessment-genetic-counseling-and-genetic-testing"^^xsd:anyURI ]     ] ) ;
fhir:selectionBehavior [ fhir:v "any" ] ;
    ( fhir:action [
fhir:id [ fhir:v "FhxGeneticRiskAssessment" ] ;
fhir:title [ fhir:v "Informal genetic risk assessment" ] ;
fhir:description [ fhir:v "Perform assessment based on criteria in first- or second-degree blood relatives known to be associated with increased risk of inherited breast cancer susceptibility variant." ] ;
fhir:resource [
fhir:reference [ fhir:v "ServiceRequest/397" ]       ]     ] [
fhir:id [ fhir:v "FhxGeneticRiskAssessmentTool" ] ;
fhir:title [ fhir:v "Genetic risk assessment instrument" ] ;
fhir:description [ fhir:v "Tools evaluated by the USPSTF include the Ontario Family History Assessment Tool, Manchester Scoring System, Referral Screening Tool, Pedigree Assessment Tool, 7-Question Family History Screening Tool, International Breast Cancer Intervention Study instrument (Tyrer-Cuzick), and brief versions of BRCAPRO. " ] ;
fhir:resource [
fhir:reference [ fhir:v "ServiceRequest/398" ]       ]     ] )
  ] ) . # 

<http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/397> a fhir:ServiceRequest ;
  fhir:id [ fhir:v "397"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_397\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest 397</b></p><a name=\"397\"> </a><a name=\"hc397\"> </a><a name=\"397-en-US\"> </a><p><b>basedOn</b>: <a href=\"ActivityDefinition-GeneticRiskAssessmentRequest.html\">Genetic Risk Assessment Request</a></p><p><b>status</b>: option</p><p><b>intent</b>: Proposal</p><p><b>code</b>: <span title=\"Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system fhxriskassess}\">Informal familial risk assessment</span></p><p><b>subject</b>: <a href=\"Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient\">Jane Doe</a></p><p><b>reasonCode</b>: <span title=\"Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system fhxbrcaovcatubalperit}\">Family history of breast, ovarian, tubal, or peritoneal cancer</span></p></div>"^^rdf:XMLLiteral
  ] ; # 
  fhir:basedOn ( [
fhir:link <http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/GeneticRiskAssessmentRequest> ;
fhir:reference [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/GeneticRiskAssessmentRequest" ]
  ] ) ; # 
  fhir:status [ fhir:v "option"] ; # 
  fhir:intent [ fhir:v "proposal"] ; # 
  fhir:code [
    ( fhir:coding [
fhir:system [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"^^xsd:anyURI ] ;
fhir:code [ fhir:v "fhxriskassess" ] ;
fhir:display [ fhir:v "Informal familial risk assessment" ]     ] )
  ] ; # 
  fhir:subject [
fhir:reference [ fhir:v "Patient/defaultPatient" ] ;
fhir:display [ fhir:v "Jane Doe" ]
  ] ; # 
  fhir:reasonCode ( [
    ( fhir:coding [
fhir:system [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system"^^xsd:anyURI ] ;
fhir:code [ fhir:v "fhxbrcaovcatubalperit" ] ;
fhir:display [ fhir:v "Family history of breast, ovarian, tubal, or peritoneal cancer" ]     ] )
  ] ) . # 

<http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/398> a fhir:ServiceRequest ;
  fhir:id [ fhir:v "398"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_398\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest 398</b></p><a name=\"398\"> </a><a name=\"hc398\"> </a><a name=\"398-en-US\"> </a><p><b>basedOn</b>: <a href=\"ActivityDefinition-GeneticRiskAssessmentRequest.html\">Genetic Risk Assessment Request</a></p><p><b>status</b>: option</p><p><b>intent</b>: Proposal</p><p><b>code</b>: <span title=\"Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system fhxrisktool}\">Brief familial risk assessment tool</span></p><p><b>subject</b>: <a href=\"Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient\">Jane Doe</a></p><p><b>reasonCode</b>: <span title=\"Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system fhxbrcaovcatubalperit}\">Family history of breast, ovarian, tubal, or peritoneal cancer</span></p></div>"^^rdf:XMLLiteral
  ] ; # 
  fhir:basedOn ( [
fhir:link <http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/GeneticRiskAssessmentRequest> ;
fhir:reference [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/GeneticRiskAssessmentRequest" ]
  ] ) ; # 
  fhir:status [ fhir:v "option"] ; # 
  fhir:intent [ fhir:v "proposal"] ; # 
  fhir:code [
    ( fhir:coding [
fhir:system [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"^^xsd:anyURI ] ;
fhir:code [ fhir:v "fhxrisktool" ] ;
fhir:display [ fhir:v "Brief familial risk assessment tool" ]     ] )
  ] ; # 
  fhir:subject [
fhir:reference [ fhir:v "Patient/defaultPatient" ] ;
fhir:display [ fhir:v "Jane Doe" ]
  ] ; # 
  fhir:reasonCode ( [
    ( fhir:coding [
fhir:system [ fhir:v "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system"^^xsd:anyURI ] ;
fhir:code [ fhir:v "fhxbrcaovcatubalperit" ] ;
fhir:display [ fhir:v "Family history of breast, ovarian, tubal, or peritoneal cancer" ]     ] )
  ] ) . #