TEMPLATE test histopathology (test histopathology)

TEMPLATE IDtest histopathology
Concepttest histopathology
DescriptionNot Specified
PurposeNot Specified
References
Other Details (Language Independent)
  • MetaDataSet:Sample Set : Template metadata sample set
Language usednb
Citeable Identifier1078.60.663
Root archetype idopenEHR-EHR-COMPOSITION.report.v1
RapportRapport: Dokument som brukes for å kommunisere informasjon til andre, ofte som svar på en forespørsel.
Other Context
Rapport IDRapport ID: Rapportidentifikator.
StatusStatus: Status for hele rapporten. NB: Dette er ikke status for enkeltkomponentene i rapporten.
Laboratory resultLaboratory result: Funn og tolkning av laboratorieanalyse utført på prøvemateriale fra pasient.
Denne arketypen kan brukes for å registrere en enkeltverdi av en analyse, men vil ofte bli spesialisert eller lagt inn i en templat for å representere flere verdier eller pakker av analyser. Denne arketypen fungerer også som forelder for spesialiserte laboratoresvar-arketyper, for eksempel mikrobiologi eller patologi.
Test nameTest name: Identifikasjon av den utførte analysen, av og til inkludert prøvetype og pasientens tilstand
Et prøveresultat kan gjelde for en enkelt analyse eller en gruppe av analyser, inkludert analysepakker. Koding med en terminologi, eventuelt med en prekoordinert term inkludert prøvetype er å foretrekke, hvis mulig. Kan bli kodet med LOINC eller SNOMED CT eller nasjonale laboratoriekodeverk. Eksempler kan være "Glukose", "Urea og elektrolytter", "Dyrkning", "Kortisol (morgen)" eller "Leverbiopsi".
Standard verdi: Kidney biopsy
Histopathology findingsHistopathology findings: Findings and interpretation of histopathology (anatomic pathology) tests performed on tissues and body fluids.
Microscopic findingsMicroscopic findings: A group of findings within the histopathology examination. The Runtime name constraint allows identification of the type of histopathology examination performed.
Microscopic finding 1Microscopic finding 1: Details of an individual histopathology finding, often related to a specific anatomical location or specimen.
SpecimenSpecimen: To record details of a laboratory specimen.
Specimen typeSpecimen type: The type of specimen to be collected e.g venous blood, prostatic biopsy.
Optional[{fhir_mapping=Specimen.type}]
Standard verdi: Kidney needle biopsy microscopy slide 1
Specimen containerSpecimen container: Details of a specimen container. This is often integral to workflow and reporting of pathology specimens, particularly anatomical and histological pathology specimens.
Container typeContainer type: The type of container.
  • Microscope slide 
Related specimenRelated specimen: Details of a related specimen.
Parent specimen identifierParent specimen identifier: Unique identifier of the parent specimen, where the specimen is split into sub-samples.
Standard verdi: Pathlab:Assigner:B1612345:Specimen
DescriptionDescription: A narrative description of the histopathology finding.
Standard verdi: Description, description, description
Microscopic finding 2Microscopic finding 2: Details of an individual histopathology finding, often related to a specific anatomical location or specimen.
SpecimenSpecimen: To record details of a laboratory specimen.
Specimen typeSpecimen type: The type of specimen to be collected e.g venous blood, prostatic biopsy.
Optional[{fhir_mapping=Specimen.type}]
Standard verdi: Kidney needle biopsy microscopy slide 2
Specimen containerSpecimen container: Details of a specimen container. This is often integral to workflow and reporting of pathology specimens, particularly anatomical and histological pathology specimens.
Container typeContainer type: The type of container.
  • Microscope slide 
Related specimenRelated specimen: Details of a related specimen.
Parent specimen identifierParent specimen identifier: Unique identifier of the parent specimen, where the specimen is split into sub-samples.
Standard verdi: Pathlab:Assigner:B1612345:Specimen
DescriptionDescription: A narrative description of the histopathology finding.
Electron microscopic findingElectron microscopic finding: Details of an individual histopathology finding, often related to a specific anatomical location or specimen.
SpecimenSpecimen: To record details of a laboratory specimen.
Specimen typeSpecimen type: The type of specimen to be collected e.g venous blood, prostatic biopsy.
Optional[{fhir_mapping=Specimen.type}]
Standard verdi: Kidney needle biopsy electron microscopy grid
Specimen containerSpecimen container: Details of a specimen container. This is often integral to workflow and reporting of pathology specimens, particularly anatomical and histological pathology specimens.
Container typeContainer type: The type of container.
  • Electron microscopy grid 
Related specimenRelated specimen: Details of a related specimen.
Parent specimen identifierParent specimen identifier: Unique identifier of the parent specimen, where the specimen is split into sub-samples.
Standard verdi: Pathlab:Assigner:B1612345:Specimen
DescriptionDescription: A narrative description of the histopathology finding.
Test representationTest representation: Rich text or other multimedia representation of this particular result as issued by the diagnostic service.
Multiple formats are allowed but they must be semantically equivalent.
DescriptionDescription: A narrative description of the group of histopathology findings.
Standard verdi: Overall description of microscopic findings, if relevant 
Macroscopic findingsMacroscopic findings: A group of findings within the histopathology examination. The Runtime name constraint allows identification of the type of histopathology examination performed.
Macroscopic findings container 1Macroscopic findings container 1: Details of an individual histopathology finding, often related to a specific anatomical location or specimen.
SpecimenSpecimen: To record details of a laboratory specimen.
Specimen typeSpecimen type: The type of specimen to be collected e.g venous blood, prostatic biopsy.
Optional[{fhir_mapping=Specimen.type}]
Standard verdi: Kidney needle biopsy in formalin
Specimen containerSpecimen container: Details of a specimen container. This is often integral to workflow and reporting of pathology specimens, particularly anatomical and histological pathology specimens.
Container typeContainer type: The type of container.
  • Specimen vial 
Container additiveContainer additive: Any special fixative or transport medium requirements.
Standard verdi: Formalin
Related specimenRelated specimen: Details of a related specimen.
Parent specimen identifierParent specimen identifier: Unique identifier of the parent specimen, where the specimen is split into sub-samples.
Standard verdi: Pathlab:Assigner:B1612345:Specimen
DescriptionDescription: A narrative description of the histopathology finding.
Standard verdi: 2 cores, 20 and 15 mm long
Macroscopic findings container 2Macroscopic findings container 2: Details of an individual histopathology finding, often related to a specific anatomical location or specimen.
SpecimenSpecimen: To record details of a laboratory specimen.
Specimen typeSpecimen type: The type of specimen to be collected e.g venous blood, prostatic biopsy.
Optional[{fhir_mapping=Specimen.type}]
Standard verdi: Kidney needle biopsy in McDowell solution
Specimen containerSpecimen container: Details of a specimen container. This is often integral to workflow and reporting of pathology specimens, particularly anatomical and histological pathology specimens.
Container typeContainer type: The type of container.
  • Specimen vial 
Container additiveContainer additive: Any special fixative or transport medium requirements.
Standard verdi: McDowell solution
Related specimenRelated specimen: Details of a related specimen.
Parent specimen identifierParent specimen identifier: Unique identifier of the parent specimen, where the specimen is split into sub-samples.
Standard verdi: Pathlab:Assigner:B1612345:Specimen
DescriptionDescription: A narrative description of the histopathology finding.
Standard verdi: 1 core, 19 mm long
DescriptionDescription: A narrative description of the group of histopathology findings.
Standard verdi: Overall description of macroscopic findings, if relevant
ConclusionConclusion: Konsis, tekstlig tolkning av laboratoriesvaret, satt i en klinisk sammenheng.
Standard verdi: Conclusion based on all findings. Blablabla.
Diagnosis 1Diagnosis 1: Enkeltord, frase eller kort beskrivelse som beskriver teksten i "Konklusjon".
Koding med en terminologi foretrekkes, der det er mulig.
Diagnosis 2Diagnosis 2: Enkeltord, frase eller kort beskrivelse som beskriver teksten i "Konklusjon".
Koding med en terminologi foretrekkes, der det er mulig.