Merge pull request #51 from CODEX-CELIDA/fix/rec15/dosages

fix(rec15): dosages
CODEX-CELIDA · May 5, 2024 · b8140fb · b8140fb
2 parents 87d7ae6 + 39f066d
commit b8140fb
Showing 1 changed file with 80 additions and 60 deletions.
diff --git a/...id19-inpatient-therapy/15-prophylactic-anticoagulation/recommendation_15_intervention.fsh b/...id19-inpatient-therapy/15-prophylactic-anticoagulation/recommendation_15_intervention.fsh
@@ -25,10 +25,7 @@ Description: "Hospitalized patients with COVID-19 should receive standard drug t
     * definitionCanonical = Canonical(ProphylacticAnticoagulationWEnoxaparin)
     * code = $sct#432102000 "Administration of substance (procedure)"
   * action[drugAdministration][+]
-    * definitionCanonical = Canonical(ProphylacticAnticoagulationWNadroparinLowWeight)
-    * code = $sct#432102000 "Administration of substance (procedure)"
-  * action[drugAdministration][+]
-    * definitionCanonical = Canonical(ProphylacticAnticoagulationWNadroparinHighWeight)
+    * definitionCanonical = Canonical(ProphylacticAnticoagulationWNadroparin)
     * code = $sct#432102000 "Administration of substance (procedure)"
   * action[drugAdministration][+]
     * definitionCanonical = Canonical(ProphylacticAnticoagulationWCertoparin)
@@ -72,10 +69,6 @@ Description: "Hospitalized patients with COVID-19 should receive standard drug t
   * action[drugAdministration][+]
     * definitionCanonical = Canonical(NoTherapeuticAnticoagulationWTinzaparin)
     * code = $sct#432102000 "Administration of substance (procedure)"
-  * action[drugAdministration][+]
-    * definitionCanonical = Canonical(NoTherapeuticAnticoagulationFondaparinux)
-    * code = $sct#432102000 "Administration of substance (procedure)"
-
 
 Instance: AntithrombFondapProphInHospitalisedCOVID19PatientsRecommPlan
 InstanceOf: recommendation-plan
@@ -91,10 +84,13 @@ Description: "Antithrombotic prophylaxis with Fondaparinux in hospitalised COVID
 * description = "Antithrombotic prophylaxis with Fondaparinux in hospitalised COVID-19 patients"
 * subjectCanonical = Canonical(PopHospitalisedCOVID19PatientsWithContraIndications)
 * extension[partOf].valueCanonical = Canonical(RecCollectionProphAnticoagulationHospitalizedCOVID19Patients)
-* insert rs-combination-at-least(1)
+* insert rs-combination-all
 * action[drugAdministration][+]
   * code = $sct#432102000 "Administration of substance (procedure)"
   * definitionCanonical = Canonical(AntithromboticProphylaxisFondaparinuxSubcutaneous)
+* action[drugAdministration][+]
+  * definitionCanonical = Canonical(NoTherapeuticAnticoagulationFondaparinux)
+  * code = $sct#432102000 "Administration of substance (procedure)"
 
 
 /**********************/
@@ -114,7 +110,16 @@ Description: "Antithrombotic prophylaxis with Dalteparin in hospitalised COVID-1
 * productCodeableConcept
   * coding[atcde] = $atcde#B01AB04 "Dalteparin"
   * coding[sct] = $sct#372563008 "Dalteparin (substance)"
-* dosage
+* dosage[+]
+  * route = $sct#34206005 "Subcutaneous route (qualifier value)"
+  * timing
+    * repeat
+      * frequency = 1
+      * period = 1
+      * periodUnit = $ucum#d "day"
+  * doseAndRate
+    * doseQuantity = 2500 '[iU]' "IU"
+* dosage[+]
   * route = $sct#34206005 "Subcutaneous route (qualifier value)"
   * timing
     * repeat
@@ -138,6 +143,15 @@ Description: "Antithrombotic prophylaxis with Enoxaparin in hospitalised COVID-1
 * productCodeableConcept
   * coding[atcde] = $atcde#B01AB05 "Enoxaparin"
   * coding[sct] = $sct#372562003 "Enoxaparin (substance)"
+* dosage[+]
+  * route = $sct#34206005 "Subcutaneous route (qualifier value)"
+  * timing
+    * repeat
+      * frequency = 1
+      * period = 1
+      * periodUnit = $ucum#d "day"
+  * doseAndRate
+    * doseQuantity = 20 'mg'
 * dosage
   * route = $sct#34206005 "Subcutaneous route (qualifier value)"
   * timing
@@ -148,16 +162,16 @@ Description: "Antithrombotic prophylaxis with Enoxaparin in hospitalised COVID-1
   * doseAndRate
     * doseQuantity = 40 'mg'
 
-Instance: ProphylacticAnticoagulationWNadroparinLowWeight
+Instance: ProphylacticAnticoagulationWNadroparin
 InstanceOf: drug-administration-action
 Usage: #definition
-Title: "Antithrombotic prophylaxis with Nadroparin Low Weight"
-Description: "Antithrombotic prophylaxis with Nadroparin Low Weight in hospitalised COVID-19 patients (in absence of contraindications for LWMH)"
-* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/antithrombotic-prophylaxis-nadroparin-administration-low-weight)
+Title: "Antithrombotic prophylaxis with Nadroparin"
+Description: "Antithrombotic prophylaxis with Nadroparin in hospitalised COVID-19 patients (in absence of contraindications for LWMH)"
+* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/antithrombotic-prophylaxis-nadroparin-administration)
 * insert publisher-experimental-version(0.1)
-* name = "AntithromboticProphylaxisWithPlanNadroparinLowWeight"
+* name = "AntithromboticProphylaxisWithPlanNadroparin"
 * status = #active
-* description = "Antithrombotic prophylaxis with Nadroparin Low Weight in hospitalised COVID-19 patients (in absence of contraindications for LWMH)"
+* description = "Antithrombotic prophylaxis with Nadroparin in hospitalised COVID-19 patients (in absence of contraindications for LWMH)"
 * code = $sct#432102000 "Administration of substance (procedure)"
 * productCodeableConcept
   * coding[atcde] = $atcde#B01AB06 "Nadroparin"
@@ -174,21 +188,6 @@ Description: "Antithrombotic prophylaxis with Nadroparin Low Weight in hospitali
       * periodUnit = $ucum#d "day"
   * doseAndRate
     * doseQuantity = 3800 '[iU]' "IU"
-
-Instance: ProphylacticAnticoagulationWNadroparinHighWeight
-InstanceOf: drug-administration-action
-Usage: #definition
-Title: "Antithrombotic prophylaxis with Nadroparin High Weight"
-Description: "Antithrombotic prophylaxis with Nadroparin High Weight in hospitalised COVID-19 patients (in absence of contraindications for LWMH)"
-* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/antithrombotic-prophylaxis-nadroparin-administration-high-weight)
-* insert publisher-experimental-version(0.1)
-* name = "AntithromboticProphylaxisWithNadroparinHighWeightPlan"
-* status = #active
-* description = "Antithrombotic prophylaxis with Nadroparin High Weight in hospitalised COVID-19 patients (in absence of contraindications for LWMH)"
-* code = $sct#432102000 "Administration of substance (procedure)"
-* productCodeableConcept
-  * coding[atcde] = $atcde#B01AB06 "Nadroparin"
-  * coding[sct] = $sct#699946002 "Nadroparin (substance)"
 * dosage[+]
   * extension[condition]
     * extension[type].valueCodeableConcept = $loinc#29463-7 "Body weight"
@@ -226,30 +225,6 @@ Description: "Antithrombotic prophylaxis with Certoparin in hospitalised COVID-1
   * doseAndRate
     * doseQuantity = 3000 '[iU]' "IU"
 
-Instance: AntithromboticProphylaxisFondaparinuxSubcutaneous
-InstanceOf: drug-administration-action
-Usage: #definition
-Title: "Antithrombotic prophylaxis with Fondaparinux"
-Description: "Antithrombotic prophylaxis with Fondaparinux in hospitalised COVID-19 patients (when contraindications for LWMH exist)"
-* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/antithrombotic-prophylaxis-fondaparinux-administration)
-* insert publisher-experimental-version(0.1)
-* name = "ProphylacticFondaparinuxApplicationActivity"
-* status = #active
-* description = "Antithrombotic prophylaxis with Fondaparinux in hospitalised COVID-19 patients (when contraindications for LWMH exist)"
-* code = $sct#432102000 "Administration of substance (procedure)"
-* productCodeableConcept
-  * coding[atcde] = $atcde#B01AX05 "Fondaparinux"
-  * coding[sct] = $sct#708189008 "Fondaparinux (substance)"
-* dosage
-  * route = $sct#34206005 "Subcutaneous route (qualifier value)"
-  * timing
-    * repeat
-      * frequency = 1
-      * period = 1
-      * periodUnit = $ucum#d "day"
-  * doseAndRate
-    * doseQuantity = 2.5 'mg' "mg"
-
 Instance: ProphylacticAnticoagulationWTinzaparin
 InstanceOf: drug-administration-action
 Usage: #definition
@@ -272,7 +247,7 @@ Description: "Antithrombotic prophylaxis with Tinzaparin in hospitalised COVID-1
       * period = 1
       * periodUnit = $ucum#d "day"
   * doseAndRate
-    * doseQuantity = 4500 '[iU]' "IU"
+    * doseQuantity = 3500 '[iU]' "IU"
 
 Instance: ProphylacticAnticoagulationWHeparinSC
 InstanceOf: drug-administration-action
@@ -288,14 +263,59 @@ Description: "Prophylactic Treatment with UFH subcutaneous for non-intensive car
 * productCodeableConcept
   * coding[sct] = $sct#372877000 "Heparin (substance)"
   * coding[atcde] = $atcde#C05BA03 "Heparin"
-* dosage
+* dosage[+]
   * route = $sct#34206005 "Subcutaneous route (qualifier value)"
   * timing
     * repeat
       * frequency = 2
       * period = 1
       * periodUnit = $ucum#d "day"
   * doseAndRate
-    * doseRange
-      * low = 5000 '[iU]' "IU"
-      * high = 7500 '[iU]' "IU"
+    * doseQuantity = 5000 '[iU]' "IU"
+* dosage[+]
+  * route = $sct#34206005 "Subcutaneous route (qualifier value)"
+  * timing
+    * repeat
+      * frequency = 3
+      * period = 1
+      * periodUnit = $ucum#d "day"
+  * doseAndRate
+    * doseQuantity = 5000 '[iU]' "IU"
+* dosage[+]
+  * route = $sct#34206005 "Subcutaneous route (qualifier value)"
+  * timing
+    * repeat
+      * frequency = 2
+      * period = 1
+      * periodUnit = $ucum#d "day"
+  * doseAndRate
+    * doseQuantity = 7500 '[iU]' "IU"
+
+
+Instance: AntithromboticProphylaxisFondaparinuxSubcutaneous
+InstanceOf: drug-administration-action
+Usage: #definition
+Title: "Antithrombotic prophylaxis with Fondaparinux"
+Description: "Antithrombotic prophylaxis with Fondaparinux in hospitalised COVID-19 patients (when contraindications for LWMH exist)"
+* insert canonical-url(covid19-inpatient-therapy, recommended-action/drug-administration-action/antithrombotic-prophylaxis-fondaparinux-administration)
+* insert publisher-experimental-version(0.1)
+* name = "ProphylacticFondaparinuxApplicationActivity"
+* status = #active
+* description = "Antithrombotic prophylaxis with Fondaparinux in hospitalised COVID-19 patients (when contraindications for LWMH exist)"
+* code = $sct#432102000 "Administration of substance (procedure)"
+* productCodeableConcept
+  * coding[atcde] = $atcde#B01AX05 "Fondaparinux"
+  * coding[sct] = $sct#708189008 "Fondaparinux (substance)"
+* dosage
+  * route = $sct#34206005 "Subcutaneous route (qualifier value)"
+  * timing
+    * repeat
+      * frequency = 1
+      * period = 1
+      * periodUnit = $ucum#d "day"
+  * doseAndRate
+    * doseQuantity = 2.5 'mg' "mg"
+
+
+
+