Breast Cancer Screening and Management (BCSM) Clinical Decision Support (CDS) Implementation Guide
1.0.0 - ci-build
Breast Cancer Screening and Management (BCSM) Clinical Decision Support (CDS) Implementation Guide - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Draft as of 2024-10-22 |
<PlanDefinition xmlns="http://hl7.org/fhir">
<id value="flow-ScreeningEligible"/>
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<div xmlns="http://www.w3.org/1999/xhtml">
<div>
<table class="grid dict">
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">flow-ScreeningEligible</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-flow-ScreeningEligible.html">Screening Eligible</a></td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">1.0.0</td>
</tr>
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">Screening Eligible</td>
</tr>
<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">draft</td>
</tr>
<tr>
<th scope="row"><b>Experimental: </b></th>
<td style="padding-left: 4px;">true</td>
</tr>
<tr>
<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<b>system: </b> <span><a href="http://terminology.hl7.org/6.2.0/CodeSystem-plan-definition-type.html">http://terminology.hl7.org/CodeSystem/plan-definition-type</a></span>
</p>
<p style="margin-bottom: 5px;">
<b>code: </b> <span>eca-rule</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Date: </b></th>
<td style="padding-left: 4px;">2024-10-22</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">MITRE</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;"><div><p>Determines whether a patient is eligible for routine breast cancer screening. This includes absolute exclusion criteria for which routine screening is not indicated in all guidelines and pathways.</p>
<p>Individuals who have certain signs or symptoms concerning for breast cancer or other breast diseases are excluded from routine screening pathways and should have diagnostic testing performed.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Knowledge Capability: </b></th>
<td style="padding-left: 4px;">
executable
</td>
</tr>
<tr>
<th scope="row"><b>Knowledge Representation Level: </b></th>
<td style="padding-left: 4px;">
structured
</td>
</tr>
<tr>
<th scope="row"><b>Copyright: </b></th>
<td style="padding-left: 4px;"><div><p>(C) 2024 The MITRE Corporation. All Rights Reserved. Approved for Public Release: 24-2711. Distribution Unlimited. Unless otherwise noted, this work is available under an Apache 2.0 license. It was produced by the MITRE Corporation for the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention in accordance with the Statement of Work, contract number 75FCMC18D0047, task order number 75D30123F17931.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Approval Date: </b></th>
<td style="padding-left: 4px;">2024-10-22</td>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td><code>Library/ScreeningEligible|1.0.0</code></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Actions: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td>
<b> Screening eligible:</b> Patient is eligible for screening
<br/>
<b>If:</b>
<i>Applicability:</i>
<i>(CheckIsIncludedAndNotExcluded)</i>
<br/>
<i>Applicability:</i>
<i>(IsScreeningEligible)</i>
<br/>
<b>Then:</b> <i>Definition:</i> <code>http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateEligible|1.0.0</code><br/>
</td>
</tr>
<tr>
<td>
<b> Not eligible for screening:</b> This patient is not eligible for screening.
Referenced guidelines apply to individuals assigned female at birth. Routine screening of cis-gender individuals assigned male at birth is not recommended. For transgender women, consider specialist referral.
Additional resources: ACR Appropriateness Criteria® Transgender Breast Cancer Screening; UCSF guidelines 'Screening for breast cancer in transgender women'
<br/>
<b>If:</b>
<i>Applicability:</i>
<i>(CheckIsIncludedAndNotExcluded)</i>
<br/>
<i>Applicability:</i>
<i>(ExistsNotEligibleNotAssignedFemaleAtBirth)</i>
<br/>
<b>Then:</b> <i>Definition:</i> <code>http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0</code><br/>
<i>Dynamic Values:</i><br/>
reasonCode[0].coding[0]: <i>(ScreeningEligibleReason)</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Refer to Oncologic care plan:</b> This patient is not eligible for routine screening and should be referred to a specialist for management.
Breast cancer within 5 years may require enhanced surveillance including diagnostic mammogram. Refer to patient's Oncologic treatment team or Survivorship Care Plan for patient specific guidance.
<br/>
<b>If:</b>
<i>Applicability:</i>
<i>(CheckIsIncludedAndNotExcluded)</i>
<br/>
<i>Applicability:</i>
<i>(ExistsNotEligibleCurrentBreastCancer)</i>
<br/>
<b>Then:</b> <i>Definition:</i> <code>http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0</code><br/>
<i>Dynamic Values:</i><br/>
reasonCode[0].coding[0]: <i>(ScreeningEligibleReason)</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Not eligible for screening:</b> This patient is not eligible for screening.
New breast symptoms or exam findings, or chronic symptoms or findings which have progressively worsened, should undergo diagnostic testing rather than routine screening.
<br/>
<b>If:</b>
<i>Applicability:</i>
<i>(CheckIsIncludedAndNotExcluded)</i>
<br/>
<i>Applicability:</i>
<i>(ExistsNotEligibleBreastSymptomsOrFindings)</i>
<br/>
<b>Then:</b> <i>Definition:</i> <code>http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0</code><br/>
<i>Dynamic Values:</i><br/>
reasonCode[0].coding[0]: <i>(ScreeningEligibleReason)</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Not eligible for screening:</b> This patient is not eligible for screening.
This patient has had bilateral mastectomy and does not meet the eligibility requirements for routine breast cancer screening.
<br/>
<b>If:</b>
<i>Applicability:</i>
<i>(CheckIsIncludedAndNotExcluded)</i>
<br/>
<i>Applicability:</i>
<i>(ExistsNotEligibleBilateralMastectomy)</i>
<br/>
<b>Then:</b> <i>Definition:</i> <code>http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/CommunicateNotEligible|1.0.0</code><br/>
<i>Dynamic Values:</i><br/>
reasonCode[0].coding[0]: <i>(ScreeningEligibleReason)</i>
<br/>
</td>
</tr>
<tr>
<td>
<b> Screening Eligible Missing Data:</b> Error due to missing required data for inclusion and exclusion evaluation.
<br/>
<b>If:</b>
<i>Applicability:</i>
<i>(MissingAgeOrBirthdate)</i>
<br/>
<b>Then:</b> <i>Definition:</i> <a href="Questionnaire-ScreeningEligibleQuestionnaire.html">Screening Eligibleversion: null1.0.0)</a><br/>
</td>
</tr>
</table>
</td>
</tr>
</table>
</div>
</div>
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<name value="flow-ScreeningEligible"/>
<title value="Screening Eligible"/>
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<description
value="Determines whether a patient is eligible for routine breast cancer screening. This includes absolute exclusion criteria for which routine screening is not indicated in all guidelines and pathways.
Individuals who have certain signs or symptoms concerning for breast cancer or other breast diseases are excluded from routine screening pathways and should have diagnostic testing performed."/>
<copyright
value="(C) 2024 The MITRE Corporation. All Rights Reserved. Approved for Public Release: 24-2711. Distribution Unlimited. Unless otherwise noted, this work is available under an Apache 2.0 license. It was produced by the MITRE Corporation for the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention in accordance with the Statement of Work, contract number 75FCMC18D0047, task order number 75D30123F17931."/>
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<name
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</editor>
<reviewer>
<name
value="Division of Cancer Prevention and Control, Centers for Disease Control and Prevention"/>
</reviewer>
<endorser>
<name
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</endorser>
<library value="Library/ScreeningEligible|1.0.0"/>
<action id="IsScreeningEligible">
<title value="Screening eligible"/>
<description value="Patient is eligible for screening"/>
<code>
<coding>
<system
value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"/>
<code value="eligible"/>
<display value="Eligible for 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"/>
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<url
value="https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening"/>
</document>
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<type value="derived-from"/>
<label value="Screening Eligible"/>
<display
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<expression value="IsScreeningEligible"/>
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<definitionCanonical
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</action>
<action id="NotEligibleCurrentBreastCancer">
<title value="Not eligible for screening"/>
<description
value="This patient is not eligible for screening.
Referenced guidelines apply to individuals assigned female at birth. Routine screening of cis-gender individuals assigned male at birth is not recommended. For transgender women, consider specialist referral.
Additional resources: ACR Appropriateness Criteria® Transgender Breast Cancer Screening; UCSF guidelines 'Screening for breast cancer in transgender women'"/>
<code>
<coding>
<system
value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"/>
<code value="noteligible"/>
<display value="Not eligible for screening"/>
</coding>
</code>
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<type value="citation"/>
<label value="USPSTF"/>
<display
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<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"/>
<document>
<url
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<type value="derived-from"/>
<label value="Screening Eligible"/>
<display
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</documentation>
<documentation>
<type value="documentation"/>
<label value="ACR"/>
<display
value="ACR Appropriateness Criteria® Transgender Breast Cancer Screening"/>
<citation
value="Brown, Ann, et al. "ACR appropriateness criteria® transgender breast cancer screening." Journal of the American College of Radiology 18.11 (2021): S502-S515."/>
<url
value="https://www.jacr.org/article/S1546-1440(21)00730-4/fulltext"/>
<document>
<url
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<type value="documentation"/>
<label value="UCSF"/>
<display
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<url value="https://transcare.ucsf.edu/guidelines/breast-cancer-women"/>
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<url
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<language value="text/cql-identifier"/>
<expression value="ExistsNotEligibleNotAssignedFemaleAtBirth"/>
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<path value="reasonCode[0].coding[0]"/>
<expression>
<language value="text/cql-identifier"/>
<expression value="ScreeningEligibleReason"/>
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</dynamicValue>
</action>
<action id="NotEligibleCurrentBreastCancer">
<title value="Refer to Oncologic care plan"/>
<description
value="This patient is not eligible for routine screening and should be referred to a specialist for management.
Breast cancer within 5 years may require enhanced surveillance including diagnostic mammogram. Refer to patient's Oncologic treatment team or Survivorship Care Plan for patient specific guidance."/>
<code>
<coding>
<system
value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"/>
<code value="noteligible"/>
<display value="Not eligible for 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"/>
<document>
<url
value="https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening"/>
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<type value="derived-from"/>
<label value="Screening Eligible"/>
<display
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<action id="NotEligibleBreastSymptomsOrFindings">
<title value="Not eligible for screening"/>
<description
value="This patient is not eligible for screening.
New breast symptoms or exam findings, or chronic symptoms or findings which have progressively worsened, should undergo diagnostic testing rather than routine screening."/>
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<url
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<url
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<action id="NotEligibleBilateralMastectomy">
<title value="Not eligible for screening"/>
<description
value="This patient is not eligible for screening.
This patient has had bilateral mastectomy and does not meet the eligibility requirements for routine breast cancer screening."/>
<code>
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<system
value="http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/plan-definition-action-code-system"/>
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<display value="Not eligible for screening"/>
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<url
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<url
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<label value="Screening Eligible"/>
<display
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<action>
<title value="Screening Eligible Missing Data"/>
<description
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</action>
</PlanDefinition>