<?xml version="1.0" encoding="UTF-8"?>

<Bundle xmlns="http://hl7.org/fhir">
  <id value="SpecialPopulations_eve-fhxbrcarisk_uspstf_only"/>
  <type value="collection"/>
  <entry>
    <fullUrl value="http://cancerscreeningcds.github.io/bcsm-cds/CarePlan/541"/>
    <resource>
      <CarePlan>
        <id value="541"/>
        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="CarePlan_541"> </a><p class="res-header-id"><b>Generated Narrative: CarePlan 541</b></p><a name="541"> </a><a name="hc541"> </a><a name="541-en-US"> </a><p><b>instantiatesCanonical</b>: <a href="PlanDefinition-flow-SpecialPopulations.html">Special Populations</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-SpecialPopulations_eve-fhxbrcarisk_uspstf_only.html#RequestGroup_542">Bundle: type = collection</a></td></tr></table></div>
        </text>
        <instantiatesCanonical value="http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/flow-SpecialPopulations"/>
        <status value="draft"/>
        <intent value="proposal"/>
        <subject>
          <reference value="Patient/defaultPatient"/>
          <display value="Jane Doe"/>
        </subject>
        <created value="2024-12-10T00:00:00.0Z"/>
        <activity>
          <reference>
            <reference value="RequestGroup/542"/>
          </reference>
        </activity>
      </CarePlan>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://cancerscreeningcds.github.io/bcsm-cds/RequestGroup/542"/>
    <resource>
      <RequestGroup>
        <id value="542"/>
        <text>
          <status value="extensions"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="RequestGroup_542"> </a><p class="res-header-id"><b>Generated Narrative: RequestGroup 542</b></p><a name="542"> </a><a name="hc542"> </a><a name="542-en-US"> </a><p><b>instantiatesCanonical</b>: <a href="PlanDefinition-flow-SpecialPopulations.html">Special Populations</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>CompellingFamilyHistory</blockquote><p><b>title</b>: Perform lifetime risk assessment</p><p><b>description</b>: Consider performing assessment of lifetime risk, as defined by models largely dependent on family history.

If estimated lifetime risk is &gt;20%, based on informal assessment or assessment using validated risk model, then patient is eligible for annual screening mammogram starting at age 30 and supplemental screening with annual screening MRI. Otherwise, patient can be offered annual screening mammogram starting at age 40.

Validated tools include BRCAPRO, Claus, BOADICEA [Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm], and Tyrer-Cuzick.</p><p><b>code</b>: <span title="Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system lifetimeriskassessment}">Perform lifetime risk assessment</span></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>Url</b></td></tr><tr><td style="display: none">*</td><td>Citation</td><td>ACS</td><td>American Cancer Society Recommendations for the Early Detection of Breast Cancer</td><td><a href="https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html">https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html</a></td></tr></table><p><b>resource</b>: <a href="Bundle-SpecialPopulations_eve-fhxbrcarisk_uspstf_only.html#ServiceRequest_543">Bundle: type = collection</a></p></blockquote><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>USPSTFRecommendation</blockquote><p><b>Recommendation Flag Extension</b>: <span title="Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/recommendation-flag-code-system overdue}">Overdue</span></p><p><b>title</b>: Biennial screening mammo starting age 40</p><p><b>description</b>: Biennial screening mammogram starting at age 40</p><p><b>code</b>: <span title="Codes:{http://loinc.org 24606-6}">MG Breast Screening</span></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>Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement</td><td><div><p>US Preventive Services Task Force. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. Published online April 30, 2024.</p>
</div></td><td><a href="https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening">https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening</a></td></tr></table><p><b>timing</b>: Events: 2021-01-01 , Once per 2 years</p><p><b>resource</b>: <a href="Bundle-SpecialPopulations_eve-fhxbrcarisk_uspstf_only.html#ServiceRequest_544">Bundle: type = collection</a></p></blockquote></div>
        </text>
        <instantiatesCanonical value="http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/flow-SpecialPopulations"/>
        <status value="draft"/>
        <intent value="proposal"/>
        <subject>
          <reference value="Patient/defaultPatient"/>
          <display value="Jane Doe"/>
        </subject>
        <action id="CompellingFamilyHistory">
          <title value="Perform lifetime risk assessment"/>
          <description value="Consider performing assessment of lifetime risk, as defined by models largely dependent on family history.&#xA;&#xA;If estimated lifetime risk is &gt;20%, based on informal assessment or assessment using validated risk model, then patient is eligible for annual screening mammogram starting at age 30 and supplemental screening with annual screening MRI. Otherwise, patient can be offered annual screening mammogram starting at age 40.&#xA;&#xA;Validated tools include BRCAPRO, Claus, BOADICEA [Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm], and Tyrer-Cuzick."/>
          <code>
            <coding>
              <system value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"/>
              <code value="lifetimeriskassessment"/>
              <display value="Perform lifetime risk assessment"/>
            </coding>
          </code>
          <documentation>
            <type value="citation"/>
            <label value="ACS"/>
            <display value="American Cancer Society Recommendations for the Early Detection of Breast Cancer"/>
            <url value="https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html"/>
          </documentation>
          <resource>
            <reference value="ServiceRequest/543"/>
          </resource>
        </action>
        <action id="USPSTFRecommendation">
          <extension url="http://cancerscreeningcds.github.io/bcsm-cds/StructureDefinition/csm-recommendation-flag">
            <valueCodeableConcept>
              <coding>
                <system value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/recommendation-flag-code-system"/>
                <code value="overdue"/>
                <display value="Overdue"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <title value="Biennial screening mammo starting age 40"/>
          <description value="Biennial screening mammogram starting at age 40"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="24606-6"/>
              <display value="MG Breast Screening"/>
            </coding>
          </code>
          <documentation>
            <type value="citation"/>
            <label value="USPSTF"/>
            <display value="Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement"/>
            <citation value="US Preventive Services Task Force. Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. Published online April 30, 2024."/>
            <url value="https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening"/>
          </documentation>
          <timingTiming>
            <event value="2021-01-01"/>
            <repeat>
              <boundsPeriod>
                <start value="2021-01-01"/>
              </boundsPeriod>
              <frequency value="1"/>
              <period value="2"/>
              <periodUnit value="a"/>
            </repeat>
          </timingTiming>
          <resource>
            <reference value="ServiceRequest/544"/>
          </resource>
        </action>
      </RequestGroup>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/543"/>
    <resource>
      <ServiceRequest>
        <id value="543"/>
        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_543"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest 543</b></p><a name="543"> </a><a name="hc543"> </a><a name="543-en-US"> </a><p><b>basedOn</b>: <a href="ActivityDefinition-BreastCancerScreeningServiceRequest.html">Breast Cancer Screening Service 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 lifetimeriskassessment}">Perform lifetime 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 fhxbreastcarisk}">Compelling family history of breast cancer</span></p></div>
        </text>
        <basedOn>
          <reference value="http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/BreastCancerScreeningServiceRequest"/>
        </basedOn>
        <status value="option"/>
        <intent value="proposal"/>
        <code>
          <coding>
            <system value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"/>
            <code value="lifetimeriskassessment"/>
            <display value="Perform lifetime risk assessment"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/defaultPatient"/>
          <display value="Jane Doe"/>
        </subject>
        <reasonCode>
          <coding>
            <system value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system"/>
            <code value="fhxbreastcarisk"/>
            <display value="Compelling family history of breast cancer"/>
          </coding>
        </reasonCode>
      </ServiceRequest>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/544"/>
    <resource>
      <ServiceRequest>
        <id value="544"/>
        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_544"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest 544</b></p><a name="544"> </a><a name="hc544"> </a><a name="544-en-US"> </a><p><b>basedOn</b>: <a href="ActivityDefinition-BreastCancerScreeningServiceRequest.html">Breast Cancer Screening Service Request</a></p><p><b>status</b>: option</p><p><b>intent</b>: Proposal</p><p><b>code</b>: <span title="Codes:{http://loinc.org 24606-6}">MG Breast Screening</span></p><p><b>subject</b>: <a href="Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient">Jane Doe</a></p><p><b>occurrence</b>: 2021-01-01</p><p><b>reasonCode</b>: <span title="Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system USPSTFaveragerisk}">USPSTF average risk</span></p></div>
        </text>
        <basedOn>
          <reference value="http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/BreastCancerScreeningServiceRequest"/>
        </basedOn>
        <status value="option"/>
        <intent value="proposal"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="24606-6"/>
            <display value="MG Breast Screening"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/defaultPatient"/>
          <display value="Jane Doe"/>
        </subject>
        <occurrenceDateTime value="2021-01-01"/>
        <reasonCode>
          <coding>
            <system value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system"/>
            <code value="USPSTFaveragerisk"/>
            <display value="USPSTF average risk"/>
          </coding>
        </reasonCode>
      </ServiceRequest>
    </resource>
  </entry>
</Bundle>