{ "resourceType" : "Questionnaire", "id" : "HLATestsTransplantAskAtOrderEntry", "meta" : { "profile" : ["https://fhir.nwgenomics.nhs.uk/StructureDefinition/NWQuestionnaire"] }, "language" : "en", "text" : { "status" : "extensions", "div" : "

Generated Narrative: Questionnaire HLATestsTransplantAskAtOrderEntry

Profile: Questionnaire

Structure\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
LinkIDTextCardinalityTypeDescription & Constraints\"doco\"
\".\"\".\" **Ask At Order Entry Questions** used alongside the [common core order\nform](Questionnaire-GenomicTestOrder.html) for the "HLA Tests - Transplant" order\nscreen within Histocompatibility and Immunogenetics orders (SNOMED CT\n`909871000000100`) - see\n[Order Entry Questions](Questionnaire-GenomicTestOrder.html#order-entry-questions) and\n[Histocompatibility and Immunogenetics](HistocompatibilityAndImmunogenetics.html#ask-at-order-entry-questions).\nFor the sibling Chimerism testing order screen, see\n[Chimerism Test Additional Ask At Order Entry Questions](Questionnaire-ChimerismTestAdditionalAskAtOrderQuestions.html).\n\nExtracted from the `NTE` segments (each carrying HL7 v2 Table 0105-style comment type\n`OSQ`) of a live Histotrac `ORM^O01` order - see the worked\n[example](HistocompatibilityAndImmunogenetics.html#ask-at-order-entry-questions) for the\nfull message. Each `NTE-3` value uses a local `Label:->Value` convention (e.g.\n`HLA Type:->Patient`), split below into a question/answer pair.\n\n**Research summary (no NHS England-published order-comms/interoperability standard was\nfound for these fields)**: NHS England's published pathology standards\n([Pathology Test and Results Standard](https://standards.nhs.uk/published-standards/pathology-test-and-results-standard),\n[SNOMED CT for pathology reporting](https://digital.nhs.uk/services/pathology-standards-and-implementation/snomed-ct-for-pathology-reporting))\ndo not cover Histocompatibility and Immunogenetics (H&I) order entry specifically. The\nrelevant national body is **NHS Blood and Transplant (NHSBT)**, not NHS England: its\n[INF136 "User Guide for Histocompatibility and Immunogenetics Diagnostics\nServices"](https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/29939/inf136.pdf)\ndefines six national H&I request forms (Table 2) including `FRM1008` "H&I Organ\nTransplant (Patients and Donors)" and `FRM1010` "H&I Haematopoietic Stem Cell\nTransplantation (Recipients & Donors)", plus a sample-requirements table listing\n"HLA type of **patient, donors or family members**" for Solid Organ Transplantation -\nconfirming HLA Type is a fixed national list, not free text, even though NHSBT does not\npublish a FHIR/LOINC/SNOMED binding for it. NHSBT's Solid Organ Transplantation section\n(4.5.1) also describes 24-hour on-call cover for "**renal** and, where appropriate,\n**cardiothoracic** transplantation", with liver/other transplant types noted separately\nas not having HLA match as a primary factor - consistent with Patient Type being a\nsmall, fixed list. The professional bodies **BSHI** (British Society for\nHistocompatibility and Immunogenetics) and **BTS** (British Transplantation Society)\njointly publish clinical guidelines (e.g. the\n[2015 BTS/BSHI antibody characterisation guideline](https://bts.org.uk/wp-content/uploads/2016/09/06_BTS_BSHI_Antibodies-1.pdf))\nbut not data/interoperability standards. This IG's own dependency,\n[HL7's Genomics Reporting IG - Histocompatibility and Immunogenetic\nReporting](http://hl7.org/fhir/uv/genomics-reporting/histocompatibility.html), profiles\nstructured HLA genotype/haplotype *results* (LOINC `84413-4` Genotype display name,\n`48018-6` Gene studied, `13298-5` HLA-A [Type], the GL String and HGNC systems) but does\nnot address order-entry "ask at order" questions like these. See each item below for\nLOINC panels and UK code lists relevant to that specific question.Questionnairehttps://fhir.nwgenomics.nhs.uk/Questionnaire/HLATestsTransplantAskAtOrderEntry#2.2.0
\".\"\".\"\".\" AskAtOrderEntryAsk At Order Entry Questions0..1group
\".\"\".\"\".\"\".\" HistoIG/patient_testPatient Test(s)0..*choiceDefinition: ServiceRequest.orderDetail
Options: 5 options
\".\"\".\"\".\"\".\"\".\" HistoIG/patient_test-designNoteHistotrac NTE-3 (CommentType=OSQ): restates the OBR-4 test name. Mapped to\n`ServiceRequest.orderDetail` rather than `ServiceRequest.code` - the base\n[Genomic Test Order](Questionnaire-GenomicTestOrder.html)'s own Test Code item\nalready targets `ServiceRequest.code` (single-cardinality), so reusing it here\nwould conflict with no `enableWhen` to say which item wins.\n`ServiceRequest.orderDetail` is repeating and intended for exactly this kind of\nfurther order qualifier, and matches this item's own `repeats = true` (the Hive\nUI presents them as checkboxes - more than one may be selected per order).\nConfirmed as this fixed 5-value checklist from the Hive/Histotrac order-entry UI,\nshown identically regardless of Patient Type (Stem cell or Renal) - coded locally\nagainst the `NWGMSA` CodeSystem.0..1display
\".\"\".\"\".\"\".\"\".\" HistoIG/patient_test-referenceNo MFT/NHS England code set was found for these five specific test names, but\nLOINC has panels the Histotrac test catalogue could map onto if a coded\nalternative to the local `NWGMSA` codes is wanted: 102092-4 (HLA-ABDR typing\npanel), 96615-0/96629-1 (HLA-A/B/C class I typing, high/low resolution), 94492-6\n(HLA-DQA1/DQB1 typing), 72905-3 (Neutrophil Ab and HLA Ab screen panel), 94428-0\n(HLA class I and II IgG panel), and 80737-0 (Calculated panel reactive antibody).\nNot the NHS England Genomic Test Directory (England-GenomicTestDirectory) - H&I is\nnot part of that catalogue.0..1display
\".\"\".\"\".\"\".\" HistoIG/hla_typeHLA Type1..1choiceDefinition: Observation.valueCodeableConcept
Options: 2 options
\".\"\".\"\".\"\".\"\".\" HistoIG/hla_type-designNoteWhose HLA is being typed - carried as an Observation referenced from\nServiceRequest.supportingInfo, the same Ask at Order Entry pattern used by\ndWGS's Family Structure/Participant Type. Confirmed as a 2-value list (Patient,\nDonor) from the Hive/Histotrac order-entry UI screenshots - coded locally\nagainst the `NWGMSA` CodeSystem as no NHSBT/NHS England-published\nFHIR/LOINC/SNOMED binding exists.0..1display
\".\"\".\"\".\"\".\"\".\" HistoIG/hla_type-referenceNHSBT's INF136 (Table 2) names a national request form "H&I Organ Transplant\n(Patients and Donors)" (FRM1008), and its sample-requirements table lists "HLA\ntype of patient, donors or family members" for Solid Organ Transplantation -\nwider than the Patient/Donor pair the Hive UI actually offers. A separate\nnational form, "H&I Haematopoietic Stem Cell Transplantation (Recipients &\nDonors)" (FRM1010), uses Recipient/Donor instead of Patient/Donor for that\ntransplant type. No NHSBT-published FHIR/LOINC/SNOMED binding exists for either,\nand Hive does not appear to expose a Family Member/Recipient option here.0..1display
\".\"\".\"\".\"\".\" HistoIG/patient_typePatient Type0..1choiceDefinition: Observation.valueCodeableConcept
Options: 3 options
\".\"\".\"\".\"\".\"\".\" HistoIG/patient_type-designNoteTransplant context - carried as an Observation referenced from\nServiceRequest.supportingInfo. Confirmed as a 3-value list (Stem cell, Renal,\nThoracic) from the Hive/Histotrac order-entry UI - coded locally against the\n`NWGMSA` CodeSystem. When Patient Type is "Renal" the Hive UI also shows an\nOrgan picker (see `HistoIG/organ` below); no Organ field is shown for Stem\ncell/Thoracic.0..1display
\".\"\".\"\".\"\".\"\".\" HistoIG/patient_type-referenceNHSBT's INF136 (4.5.1) describes 24-hour on-call cover for "renal and, where\nappropriate, cardiothoracic transplantation" as the two Solid Organ\nTransplantation categories with routine H&I on-call support, and the Hive UI's\n"Thoracic" option lines up with that "cardiothoracic" wording (not "Cardiac").\nStem cell is a third category the Hive UI groups here rather than treating as a\nseparate transplant type. No NHSBT/NHS England LOINC/SNOMED binding was found\nfor this field.0..1display
\".\"\".\"\".\"\".\" HistoIG/organOrgan0..1choiceDefinition: Specimen.collection.bodySite
Options: 5 options
\".\"\".\"\".\"\".\"\".\" HistoIG/organ-designNoteThe organ relevant to the transplant - the body site the specimen was collected\nfrom. Confirmed as this 5-value list (plus a free-text\n"Other" box, not modelled here) from the Hive/Histotrac order-entry UI, only shown\nthere when Patient Type is "Renal" - coded locally against the `NWGMSA`\nCodeSystem, since two of the five values (the two "Simultaneous..." combination\ntransplants) are not themselves single SNOMED CT body-site concepts.0..1display
\".\"\".\"\".\"\".\"\".\" HistoIG/organ-referenceFor the three single-organ values (Kidney, Pancreas, Islets), SNOMED CT body-site\ncodes from the FHIR body-site value set (https://hl7.org/fhir/R4/valueset-body-site.html)\nor NHS Digital's UK-specific "Solid organ transplant codes" (ORGTRANSP_COD)\nreference set (part of the NHS Digital Primary Care Domain Refsets, ~364 codes,\nhttps://www.opencodelists.org/codelist/nhsd-primary-care-domain-refsets/orgtransp_cod/)\nremain candidate future bindings if a coded alternative to the local `NWGMSA`\ncodes is wanted. Neither source has a single code for a combination transplant\nsuch as "Simultaneous Pancreas/Kidney", which is why the local coding keeps all\nfive Hive values together as one list rather than splitting by source.0..1display
\".\"\".\"\".\"\".\" HistoIG/specimen_sourceSpecimen Source0..1choiceDefinition: Specimen.type.coding.code
Options: 3 options
\".\"\".\"\".\"\".\"\".\" HistoIG/specimen_source-designNoteConfirmed as this 3-value list (Blood, Buccal, plus a free-text "Other" box, not\nmodelled here) from the Hive/Histotrac order-entry UI's HLA panel - narrower than\nthe EU/UK/NW-compatible [Specimen Type](ValueSet-specimen-type.html) value set\npreviously bound here (`answerValueSet = Canonical(SpecimenType)`), so this item\nnow uses local `NWGMSA` codes to match what Hive actually offers for this\nexchange. The separate [Chimerism Test Additional Ask At Order Entry Questions](Questionnaire-ChimerismTestAdditionalAskAtOrderQuestions.html)\norder screen in Hive instead offers "Blood (PB)"/"Bone Marrow (BM)". Deliberately\ngiven its own `HistoIG/specimen_source` linkId rather than reusing the base\n[Genomic Test Order](Questionnaire-GenomicTestOrder.html)'s own `LN/66746-9`\nSpecimen Type item (same `code`/LOINC `66746-9`, so the semantic link is kept via\n`code`) - the two questions are asked at different points for different purposes\nin Hive, and the IG Publisher's Questionnaire derivation validator does not\nsupport a `derivedFrom`/`extends` item reusing a base item's linkId while also\ndeclaring more than one `answerOption`.0..1display
\".\"\".\"\".\"\".\"\".\" HistoIG/specimen_source-referenceNHSBT's INF136 Table 5 (sample requirements) shows nearly every H&I test uses\nperipheral blood (EDTA and/or clotted, varying by test), with spleen/lymph node\nas the exception for deceased-donor crossmatching - consistent with Hive's Blood\noption. If a coded alternative to the local `NWGMSA` codes is wanted, the\n[Specimen Type](ValueSet-specimen-type.html) value set remains a candidate binding\n(e.g. whole blood, plasma/serum specimen for Blood; a buccal swab specimen code\nfor Buccal). No dedicated NHS-published specimen-type binding specific to H&I was\nfound.0..1display

\"doco\" Documentation for this format

Options Sets

Answer options for HistoIG/patient_test

Answer options for HistoIG/hla_type

Answer options for HistoIG/patient_type

Answer options for HistoIG/organ

Answer options for HistoIG/specimen_source

" }, "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/artifact-versionAlgorithm", "valueCoding" : { "system" : "http://hl7.org/fhir/version-algorithm", "code" : "semver" } }], "url" : "https://fhir.nwgenomics.nhs.uk/Questionnaire/HLATestsTransplantAskAtOrderEntry", "version" : "2.2.0", "title" : "HLA Tests - Transplant Ask At Order Entry", "derivedFrom" : ["https://fhir.nwgenomics.nhs.uk/Questionnaire/GenomicTestOrder|2.2.0"], "_derivedFrom" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-derivationType", "valueCoding" : { "system" : "http://hl7.org/fhir/questionnaire-derivationType", "code" : "extends" } }] }], "status" : "draft", "date" : "2026-09-20T05:53:36+00:00", "publisher" : "NHS North West Genomics", "contact" : [{ "telecom" : [{ "system" : "url", "value" : "https://www.nwgenomics.nhs.uk/contact-us" }] }], "description" : "**Ask At Order Entry Questions** used alongside the [common core order\nform](Questionnaire-GenomicTestOrder.html) for the \"HLA Tests - Transplant\" order\nscreen within Histocompatibility and Immunogenetics orders (SNOMED CT\n`909871000000100`) - see\n[Order Entry Questions](Questionnaire-GenomicTestOrder.html#order-entry-questions) and\n[Histocompatibility and Immunogenetics](HistocompatibilityAndImmunogenetics.html#ask-at-order-entry-questions).\nFor the sibling Chimerism testing order screen, see\n[Chimerism Test Additional Ask At Order Entry Questions](Questionnaire-ChimerismTestAdditionalAskAtOrderQuestions.html).\n\nExtracted from the `NTE` segments (each carrying HL7 v2 Table 0105-style comment type\n`OSQ`) of a live Histotrac `ORM^O01` order - see the worked\n[example](HistocompatibilityAndImmunogenetics.html#ask-at-order-entry-questions) for the\nfull message. Each `NTE-3` value uses a local `Label:->Value` convention (e.g.\n`HLA Type:->Patient`), split below into a question/answer pair.\n\n**Research summary (no NHS England-published order-comms/interoperability standard was\nfound for these fields)**: NHS England's published pathology standards\n([Pathology Test and Results Standard](https://standards.nhs.uk/published-standards/pathology-test-and-results-standard),\n[SNOMED CT for pathology reporting](https://digital.nhs.uk/services/pathology-standards-and-implementation/snomed-ct-for-pathology-reporting))\ndo not cover Histocompatibility and Immunogenetics (H&I) order entry specifically. The\nrelevant national body is **NHS Blood and Transplant (NHSBT)**, not NHS England: its\n[INF136 \"User Guide for Histocompatibility and Immunogenetics Diagnostics\nServices\"](https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/29939/inf136.pdf)\ndefines six national H&I request forms (Table 2) including `FRM1008` \"H&I Organ\nTransplant (Patients and Donors)\" and `FRM1010` \"H&I Haematopoietic Stem Cell\nTransplantation (Recipients & Donors)\", plus a sample-requirements table listing\n\"HLA type of **patient, donors or family members**\" for Solid Organ Transplantation -\nconfirming HLA Type is a fixed national list, not free text, even though NHSBT does not\npublish a FHIR/LOINC/SNOMED binding for it. NHSBT's Solid Organ Transplantation section\n(4.5.1) also describes 24-hour on-call cover for \"**renal** and, where appropriate,\n**cardiothoracic** transplantation\", with liver/other transplant types noted separately\nas not having HLA match as a primary factor - consistent with Patient Type being a\nsmall, fixed list. The professional bodies **BSHI** (British Society for\nHistocompatibility and Immunogenetics) and **BTS** (British Transplantation Society)\njointly publish clinical guidelines (e.g. the\n[2015 BTS/BSHI antibody characterisation guideline](https://bts.org.uk/wp-content/uploads/2016/09/06_BTS_BSHI_Antibodies-1.pdf))\nbut not data/interoperability standards. This IG's own dependency,\n[HL7's Genomics Reporting IG - Histocompatibility and Immunogenetic\nReporting](http://hl7.org/fhir/uv/genomics-reporting/histocompatibility.html), profiles\nstructured HLA genotype/haplotype *results* (LOINC `84413-4` Genotype display name,\n`48018-6` Gene studied, `13298-5` HLA-A [Type], the GL String and HGNC systems) but does\nnot address order-entry \"ask at order\" questions like these. See each item below for\nLOINC panels and UK code lists relevant to that specific question.", "jurisdiction" : [{ "coding" : [{ "system" : "urn:iso:std:iso:3166", "code" : "GB", "display" : "United Kingdom of Great Britain and Northern Ireland" }] }], "item" : [{ "linkId" : "AskAtOrderEntry", "text" : "Ask At Order Entry Questions", "type" : "group", "item" : [{ "linkId" : "HistoIG/patient_test", "definition" : "http://hl7.org/fhir/StructureDefinition/ServiceRequest#ServiceRequest.orderDetail", "text" : "Patient Test(s)", "type" : "choice", "repeats" : true, "answerOption" : [{ "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "HLATypingAntibodyScreening", "display" : "HLA Typing + Antibody Screening" } }, { "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "HLAAntibodyScreening", "display" : "HLA Antibody Screening" } }, { "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "HLATypeRecipient", "display" : "HLA Type Recipient" } }, { "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "DSA", "display" : "DSA" } }, { "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "HLAAutoXM", "display" : "HLA Auto XM" } }], "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "help" }] } }], "linkId" : "HistoIG/patient_test-designNote", "text" : "Histotrac NTE-3 (CommentType=OSQ): restates the OBR-4 test name. Mapped to\n`ServiceRequest.orderDetail` rather than `ServiceRequest.code` - the base\n[Genomic Test Order](Questionnaire-GenomicTestOrder.html)'s own Test Code item\nalready targets `ServiceRequest.code` (single-cardinality), so reusing it here\nwould conflict with no `enableWhen` to say which item wins.\n`ServiceRequest.orderDetail` is repeating and intended for exactly this kind of\nfurther order qualifier, and matches this item's own `repeats = true` (the Hive\nUI presents them as checkboxes - more than one may be selected per order).\nConfirmed as this fixed 5-value checklist from the Hive/Histotrac order-entry UI,\nshown identically regardless of Patient Type (Stem cell or Renal) - coded locally\nagainst the `NWGMSA` CodeSystem.", "type" : "display" }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "help" }] } }], "linkId" : "HistoIG/patient_test-reference", "text" : "No MFT/NHS England code set was found for these five specific test names, but\nLOINC has panels the Histotrac test catalogue could map onto if a coded\nalternative to the local `NWGMSA` codes is wanted: 102092-4 (HLA-ABDR typing\npanel), 96615-0/96629-1 (HLA-A/B/C class I typing, high/low resolution), 94492-6\n(HLA-DQA1/DQB1 typing), 72905-3 (Neutrophil Ab and HLA Ab screen panel), 94428-0\n(HLA class I and II IgG panel), and 80737-0 (Calculated panel reactive antibody).\nNot the NHS England Genomic Test Directory (England-GenomicTestDirectory) - H&I is\nnot part of that catalogue.", "type" : "display" }] }, { "linkId" : "HistoIG/hla_type", "definition" : "http://hl7.org/fhir/StructureDefinition/Observation#Observation.valueCodeableConcept", "text" : "HLA Type", "type" : "choice", "required" : true, "answerOption" : [{ "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "Patient", "display" : "Patient" } }, { "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "Donor", "display" : "Donor" } }], "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "help" }] } }], "linkId" : "HistoIG/hla_type-designNote", "text" : "Whose HLA is being typed - carried as an Observation referenced from\nServiceRequest.supportingInfo, the same Ask at Order Entry pattern used by\ndWGS's Family Structure/Participant Type. Confirmed as a 2-value list (Patient,\nDonor) from the Hive/Histotrac order-entry UI screenshots - coded locally\nagainst the `NWGMSA` CodeSystem as no NHSBT/NHS England-published\nFHIR/LOINC/SNOMED binding exists.", "type" : "display" }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "help" }] } }], "linkId" : "HistoIG/hla_type-reference", "text" : "NHSBT's INF136 (Table 2) names a national request form \"H&I Organ Transplant\n(Patients and Donors)\" (FRM1008), and its sample-requirements table lists \"HLA\ntype of patient, donors or family members\" for Solid Organ Transplantation -\nwider than the Patient/Donor pair the Hive UI actually offers. A separate\nnational form, \"H&I Haematopoietic Stem Cell Transplantation (Recipients &\nDonors)\" (FRM1010), uses Recipient/Donor instead of Patient/Donor for that\ntransplant type. No NHSBT-published FHIR/LOINC/SNOMED binding exists for either,\nand Hive does not appear to expose a Family Member/Recipient option here.", "type" : "display" }] }, { "linkId" : "HistoIG/patient_type", "definition" : "http://hl7.org/fhir/StructureDefinition/Observation#Observation.valueCodeableConcept", "text" : "Patient Type", "type" : "choice", "answerOption" : [{ "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "StemCell", "display" : "Stem cell" } }, { "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "Renal", "display" : "Renal" } }, { "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "Thoracic", "display" : "Thoracic" } }], "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "help" }] } }], "linkId" : "HistoIG/patient_type-designNote", "text" : "Transplant context - carried as an Observation referenced from\nServiceRequest.supportingInfo. Confirmed as a 3-value list (Stem cell, Renal,\nThoracic) from the Hive/Histotrac order-entry UI - coded locally against the\n`NWGMSA` CodeSystem. When Patient Type is \"Renal\" the Hive UI also shows an\nOrgan picker (see `HistoIG/organ` below); no Organ field is shown for Stem\ncell/Thoracic.", "type" : "display" }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "help" }] } }], "linkId" : "HistoIG/patient_type-reference", "text" : "NHSBT's INF136 (4.5.1) describes 24-hour on-call cover for \"renal and, where\nappropriate, cardiothoracic transplantation\" as the two Solid Organ\nTransplantation categories with routine H&I on-call support, and the Hive UI's\n\"Thoracic\" option lines up with that \"cardiothoracic\" wording (not \"Cardiac\").\nStem cell is a third category the Hive UI groups here rather than treating as a\nseparate transplant type. No NHSBT/NHS England LOINC/SNOMED binding was found\nfor this field.", "type" : "display" }] }, { "linkId" : "HistoIG/organ", "definition" : "http://hl7.org/fhir/StructureDefinition/Specimen#Specimen.collection.bodySite", "text" : "Organ", "type" : "choice", "answerOption" : [{ "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "Kidney", "display" : "Kidney" } }, { "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "Pancreas", "display" : "Pancreas" } }, { "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "Islets", "display" : "Islets" } }, { "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "SimultaneousPancreasKidney", "display" : "Simultaneous Pancreas/Kidney" } }, { "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "SimultaneousIsletKidney", "display" : "Simultaneous Islet/Kidney" } }], "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "help" }] } }], "linkId" : "HistoIG/organ-designNote", "text" : "The organ relevant to the transplant - the body site the specimen was collected\nfrom. Confirmed as this 5-value list (plus a free-text\n\"Other\" box, not modelled here) from the Hive/Histotrac order-entry UI, only shown\nthere when Patient Type is \"Renal\" - coded locally against the `NWGMSA`\nCodeSystem, since two of the five values (the two \"Simultaneous...\" combination\ntransplants) are not themselves single SNOMED CT body-site concepts.", "type" : "display" }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "help" }] } }], "linkId" : "HistoIG/organ-reference", "text" : "For the three single-organ values (Kidney, Pancreas, Islets), SNOMED CT body-site\ncodes from the FHIR body-site value set (https://hl7.org/fhir/R4/valueset-body-site.html)\nor NHS Digital's UK-specific \"Solid organ transplant codes\" (ORGTRANSP_COD)\nreference set (part of the NHS Digital Primary Care Domain Refsets, ~364 codes,\nhttps://www.opencodelists.org/codelist/nhsd-primary-care-domain-refsets/orgtransp_cod/)\nremain candidate future bindings if a coded alternative to the local `NWGMSA`\ncodes is wanted. Neither source has a single code for a combination transplant\nsuch as \"Simultaneous Pancreas/Kidney\", which is why the local coding keeps all\nfive Hive values together as one list rather than splitting by source.", "type" : "display" }] }, { "linkId" : "HistoIG/specimen_source", "definition" : "http://hl7.org/fhir/StructureDefinition/Specimen#Specimen.type.coding.code", "code" : [{ "system" : "http://loinc.org", "code" : "66746-9", "display" : "Specimen Type" }, { "system" : "http://snomed.info/sct", "code" : "123038009", "display" : "Specimen" }], "text" : "Specimen Source", "type" : "choice", "answerOption" : [{ "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "HistoBlood", "display" : "Blood" } }, { "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "HistoBuccal", "display" : "Buccal" } }, { "valueCoding" : { "system" : "https://fhir.nwgenomics.nhs.uk/CodeSystem/NWGMSA", "code" : "HistoOther", "display" : "Other" } }], "item" : [{ "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "help" }] } }], "linkId" : "HistoIG/specimen_source-designNote", "text" : "Confirmed as this 3-value list (Blood, Buccal, plus a free-text \"Other\" box, not\nmodelled here) from the Hive/Histotrac order-entry UI's HLA panel - narrower than\nthe EU/UK/NW-compatible [Specimen Type](ValueSet-specimen-type.html) value set\npreviously bound here (`answerValueSet = Canonical(SpecimenType)`), so this item\nnow uses local `NWGMSA` codes to match what Hive actually offers for this\nexchange. The separate [Chimerism Test Additional Ask At Order Entry Questions](Questionnaire-ChimerismTestAdditionalAskAtOrderQuestions.html)\norder screen in Hive instead offers \"Blood (PB)\"/\"Bone Marrow (BM)\". Deliberately\ngiven its own `HistoIG/specimen_source` linkId rather than reusing the base\n[Genomic Test Order](Questionnaire-GenomicTestOrder.html)'s own `LN/66746-9`\nSpecimen Type item (same `code`/LOINC `66746-9`, so the semantic link is kept via\n`code`) - the two questions are asked at different points for different purposes\nin Hive, and the IG Publisher's Questionnaire derivation validator does not\nsupport a `derivedFrom`/`extends` item reusing a base item's linkId while also\ndeclaring more than one `answerOption`.", "type" : "display" }, { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl", "valueCodeableConcept" : { "coding" : [{ "system" : "http://hl7.org/fhir/questionnaire-item-control", "code" : "help" }] } }], "linkId" : "HistoIG/specimen_source-reference", "text" : "NHSBT's INF136 Table 5 (sample requirements) shows nearly every H&I test uses\nperipheral blood (EDTA and/or clotted, varying by test), with spleen/lymph node\nas the exception for deceased-donor crossmatching - consistent with Hive's Blood\noption. If a coded alternative to the local `NWGMSA` codes is wanted, the\n[Specimen Type](ValueSet-specimen-type.html) value set remains a candidate binding\n(e.g. whole blood, plasma/serum specimen for Blood; a buccal swab specimen code\nfor Buccal). No dedicated NHS-published specimen-type binding specific to H&I was\nfound.", "type" : "display" }] }] }] }