Stress Testing Report Templates 

TID 3300 Stress Testing Report

The Stress Testing Report template is the root structure for the representation of measurements and findings of a stress testing procedure.

Type:

Extensible

Order:

Significant

Root:

Yes

Table TID 3300. Stress Testing Report

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CONTAINER

DT (18752-6, LN, "Stress Testing Report")

1

M

Root node

2

>

HAS CONCEPT MOD

CODE

EV (121058, DCM, "Procedure reported")

1

M

DCID 3200 “Stress Test Procedure”

3

>

HAS CONCEPT MOD

INCLUDE

DTID 1204 “Language of Content Item and Descendants”

1

M

4

>

HAS OBS CONTEXT

INCLUDE

DTID 1002 “Observer Context”

1-n

M

5

>

CONTAINS

CONTAINER

EV (121109, DCM, "Indications for Procedure")

1

U

6

>>

CONTAINS

CODE

EV (121071, DCM, "Finding")

1-n

U

DCID 3201 “Indications for Stress Test”

7

>>

CONTAINS

TEXT

EV (121071, DCM, "Finding")

1

U

8

>

CONTAINS

INCLUDE

DTID 3602 “Cardiovascular Patient Characteristics”

1

M

9

>

CONTAINS

INCLUDE

DTID 3802 “Cardiovascular Patient History”

1

U

10

>

CONTAINS

INCLUDE

DTID 3301 “Stress Test Procedure Description”

1

M

11

>

CONTAINS

INCLUDE

DTID 3303 “Stress Test Phase Data”

1-n

M

12

>

CONTAINS

INCLUDE

DTID 3311 “Stress Test Summary”

1

U

13

>

CONTAINS

INCLUDE

DTID 3318 “Comparison to Prior Stress Exam”

1

U

14

>

CONTAINS

INCLUDE

DTID 3320 “Conclusions and Recommendations”

1

U


TID 3301 Stress Test Procedure Description

Type:

Extensible

Order:

Significant

Table TID 3301. Stress Test Procedure Description

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CONTAINER

DT (121064, DCM, "Current Procedure Descriptions")

1

M

2

>

CONTAINS

CODE

DT (109056, DCM, "Stress Protocol")

1

U

BCID 3261 “Stress Protocols”

3

>

CONTAINS

TEXT

DT (109056, DCM, "Stress Protocol")

1

U

4

>

CONTAINS

CODE

DT (10:11345, MDC, "Lead System")

1

U

BCID 3263 “Electrode Placement Values”

5

>

CONTAINS

CODE

DT (A-17200, SRT, "Exerciser Device")

1

U

BCID 3203 “Exerciser Device”

6

>

CONTAINS

CODE

DT (G-C11C, SRT, "Pharmacological Stress Agent")

1

MC

IFF Pharmacological Stress used

BCID 3204 “Stress Agents”

7

>

CONTAINS

CONTAINER

EV (122700, DCM, "Indications for Pharmacological Stress")

1

MC

IFF Pharmacological Stress used

8

>>

CONTAINS

CODE

EV (121071, DCM, "Finding")

1-n

U

DCID 3205 “Indications for Pharmacological Stress Test”

9

>

CONTAINS

CODE

DT (P0-0099A, SRT, "Imaging procedure")

1

MC

IFF imaging used in procedure

DCID 3206 “Non-invasive Cardiac Imaging Procedures”

10

>

CONTAINS

CODE

DT (125203, DCM, "Acquisition Protocol")

1

UC

IFF Nuclear imaging

DCID 3110 “Nuclear Cardiology Protocols”

11

>

CONTAINS

CODE

DT (125203, DCM, "Acquisition Protocol")

1

UC

IFF PET imaging

DCID 3106 “PET Cardiology Protocols”

12

>

CONTAINS

TEXT

DT (121141, DCM, "Image Type")

1

UC

IFF Nuclear or PET imaging

STATIC, DYNAMIC, or GATED.

See note.

13

>

CONTAINS

CODE

DT (RID11248, RADLEX, "Cardiac Gating")

1

U

DCID 3104 “Cardiac Synchronization Technique”

14

>

CONTAINS

CODE

DT (125203, DCM, "Acquisition Protocol")

1

UC

IFF Contrast echocardiography

DT (P5-B3008, SRT, "Contrast echocardiography")

15

>

CONTAINS

CODE

DT (113743, DCM, "Patient Orientation")

1

U

DCID 19 “Patient Orientation”

16

>>

HAS CONCEPT MOD

CODE

EV (113744, DCM, "Patient Orientation Modifier")

1

U

DCID 20 “Patient Orientation Modifier”

17

>

CONTAINS

TEXT

DT (121065, DCM, "Procedure Description")

1

U

18

>

CONTAINS

DATETIME

DT (122701, DCM, "Procedure Time Base")

1

U

See note.


Content Item Descriptions

Row 12

Image Type may be copied from the NM Image SOP Instance attribute Image Type (0008,0008) value 3, or from the PET Image SOP Instance attribute Series Type (0054,1000).

Row 18

The Procedure Time Base is the time from which elapsed times are measured. The Study Time (0008,0030) may include the patient prep period, while this Procedure Time Base is typically established when baseline data collection begins.

TID 3303 Stress Test Phase Data

The Stress Test Phase Data template provides a structure for measurements acquired during a single procedure phase.

Type:

Extensible

Order:

Significant

Table TID 3303. Stress Test Phase Data

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CONTAINER

DT (121070, DCM, "Findings")

1

M

See note.

2

>

HAS ACQ CONTEXT

CODE

EV (G-7292, SRT, "Procedure phase")

1

MC

XOR row 3

BCID 3207 “Stress Test Procedure Phases”

3

>

HAS ACQ CONTEXT

CODE

EV (G-7292, SRT, "Procedure phase")

1

MC

IFF Nuclear Imaging; XOR row 2

DCID 3101 “Cardiac Procedural State Values”

4

>

HAS ACQ CONTEXT

TEXT

EV (G-7292, SRT, "Procedure phase")

1

U

5

>

CONTAINS

INCLUDE

DTID 3301 “Stress Test Procedure Description”

1

MC

IFF protocol changed from initial specification

6

>

HAS ACQ CONTEXT

NUM

EV (109055, DCM, "Protocol Stage")

1

U

UNITS = DT ({stage}, UCUM, "stage")

7

>

CONTAINS

INCLUDE

DTID 3304 “Stress Test Measurement Group”

1-n

U

8

>

CONTAINS

INCLUDE

DTID 3307 “NM/PET Perfusion Measurement Group”

1

MC

IFF Nuclear or PET Imaging

9

>

CONTAINS

INCLUDE

DTID 3309 “Stress Echo Measurement Group”

1

UC

IFF Echocardiography Imaging


Content Item Descriptions

Row 1

The Container shall have a specific Content Item Observation DateTime (0040,A032) attribute to indicate the time at which the phase began.

TID 3304 Stress Test Measurement Group

Each instance of the Stress Test Measurement Group represents a group of data elements acquired at approximately the same instant, and conventionally rendered as row in a tabular presentation. It is typically generated during the Stress exam whenever a time interval elapses (for example, every minute of the phase), when a technician observes data worth capturing, or when measurements exceed a given range.

Type:

Extensible

Order:

Significant

Table TID 3304. Stress Test Measurement Group

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CONTAINER

DT (121070, DCM, "Findings")

1

M

See note.

2

>

CONTAINS

NUM

DT (F-031F9, SRT, "Time since start of exam")

1

M

UNITS = DT (min, UCUM, "min")

3

>

CONTAINS

NUM

DT (122710, DCM, "Time since start of stage")

1

M

UNITS = DT (min, UCUM, "min")

4

>

CONTAINS

NUM

DT (122702, DCM, "Treadmill speed")

1

U

UNITS = DCID 3212 “Treadmill Speed”

5

>

CONTAINS

NUM

DT (122703, DCM, "Treadmill gradient")

1

U

UNITS = EV (%, UCUM, "%")

6

>

CONTAINS

NUM

DT (122704, DCM, "Ergometer power")

1

U

UNITS = EV (W, UCUM, "Watts")

7

>

CONTAINS

NUM

DT (122709, DCM, "Activity workload")

1

U

UNITS = DT ([MET], UCUM, "METS")

8

>

CONTAINS

INCLUDE

DTID 300 “Measurement”

1

U

$Measurement = DT (122706, DCM, "Rating of Perceived Exertion")

$Method = BCID 3239 “Perceived Exertion Scales”

9

>

CONTAINS

NUM

DT (122705, DCM, "Pharmacological Stress Agent Dose Rate")

1

MC

IFF Pharmacological Stress used

UNITS = EV (ug/kg/min, UCUM, "ug/kg/min")

10

>

CONTAINS

INCLUDE

DTID 3106 “Drugs/Contrast Administered”

1

U

See note.

11

>

CONTAINS

NUM

EV (8867-4, LN, "Heart Rate")

1

U

UNITS = EV ({H.B.}/min, UCUM, "BPM")

12

>

CONTAINS

NUM

EV (F-008EC, SRT, "Systolic Blood Pressure")

1

U

UNITS = DCID 3500 “Pressure Units”

13

>

CONTAINS

NUM

EV (F-008ED, SRT, "Diastolic Blood Pressure")

1

U

UNITS = DCID 3500 “Pressure Units”

14

>

CONTAINS

NUM

DT (122707, DCM, "Number of Ectopic Beats")

1

U

UNITS = EV ({beats}, UCUM, "beats")

15

>>

HAS PROPERTIES

NUM

DT (R-40861, SRT, "Period of collection")

1

M

UNITS = DT (min, UCUM, "min")

16

>>

HAS PROPERTIES

CODE

EV (G-C504, SRT, "Associated Morphology")

1-n

U

BCID 3234 “Ectopic Beat Morphology”

17

>

CONTAINS

INCLUDE

DTID 300 “Measurement”

1-n

U

$Measurement = DT (F-03204, SRT, "ST Elevation")

$Units = DT (mV, UCUM, "mV")

$TargetSite = DCID 3001 “ECG Leads”

18

>

CONTAINS

INCLUDE

DTID 300 “Measurement”

1-n

U

$Measurement = DT (F-38279, SRT, "ST Depression")

$Units = DT (mV, UCUM, "mV")

$TargetSite = DCID 3001 “ECG Leads”

19

>

CONTAINS

INCLUDE

DTID 300 “Measurement”

1-n

U

$Measurement = DCID 3228 “ECG Timing Measurements”

$Units = DT (ms, UCUM, "ms")

$TargetSite = DCID 3001 “ECG Leads”

See note.

20

>

CONTAINS

INCLUDE

DTID 300 “Measurement”

1-n

U

$Measurement = DCID 3227 “QTc Measurements”

$Units = DT (ms, UCUM, "ms")

$TargetSite = DCID 3001 “ECG Leads”

$Equation = DCID 3678 “Qt Correction Algorithms”

See note.

21

>>

INFERRED FROM

NUM

DT (2:16000, MDC, "RR Interval for QTc")

1

U

UNITS = DT (ms, UCUM, "ms")

See note.

22

>

CONTAINS

INCLUDE

DTID 300 “Measurement”

1-n

U

$Measurement = DCID 3229 “ECG Axis Measurements”

$Units = DT (deg, UCUM, "deg")

See note.

23

>

CONTAINS

INCLUDE

DTID 300 “Measurement”

1

U

$Measurement = DCID 3526 “Blood Gas Saturation”

$Units = EV (%, UCUM, "%")

24

>

CONTAINS

NUM

DT (122708, DCM, "Double Product")

1

U

UNITS = DT (mm[Hg].{H.B.}/min, UCUM, "mmHg.BPM")

25

>

CONTAINS

CODE

EV (121071, DCM, "Finding")

1-n

U

DCID 3220 “Stress Symptoms”

26

>

CONTAINS

CODE

EV (F-00033, SRT, "ECG Finding")

1-n

U

DCID 3230 “ECG Findings”

27

>

CONTAINS

TEXT

EV (121106, DCM, "Comment")

1

U


Content Item Descriptions

Row 1

The Container shall have a specific Content Item Observation DateTime (0040,A032) attribute to indicate the time at which the measurements were made.

Row 10

Included TID 3106 “Drugs/Contrast Administered” allows the recording of test medications other than the Pharmacological Stress Agent identified in TID 3301 “Stress Test Procedure Description”.

Rows 17, 18

ECG ST elevation/depression is measured in units of mV, but is conventionally reported in units of mm, based on strip recordings with scaling of 100 uV/mm. The display application should render these measurements in units meaningful to the user.

Row 19

Note that the MDC codes for "per lead" measurements specified in CID 3228 “ECG Timing Measurements” are base codes for post-coordination with lead identifiers conveyed in the Target Site modifier in TID 300 “Measurement”. MDC also defines pre-coordinated codes that include both the measurement and the lead, which may be used in this row.

Row 20

Note that the MDC code for "QTc interval per lead" specified in CID 3227 “QTc Measurements” is a base code for post-coordination with lead identifiers conveyed in the Target Site modifier in TID 300 “Measurement”. MDC also defines pre-coordinated codes that include both the measurement and the lead, which may be used in this row.

Note that TID 300 “Measurement” enables the encoding of a non-standard correction algorithm, either as a local code, or as a TEXT Method Citation (see TID 300 “Measurement” row 12).

Row 21

R-R interval used for QT correction algorithm

Row 22

Recommended range for ECG axis measurements is -90° to +270°

TID 3307 NM/PET Perfusion Measurement Group

Type:

Extensible

Order:

Significant

Table TID 3307. NM/PET Perfusion Measurement Group

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CONTAINER

DT (121070, DCM, "Findings")

1

M

2

>

HAS CONCEPT MOD

CODE

EV (121058, DCM, "Procedure reported")

1

M

DCID 3108 “NM/PET Procedures”

3

>

CONTAINS

CODE

EV (F-61FDB, SRT, "Radiopharmaceutical agent")

1

M

DCID 3111 “Nuclear Cardiology Radiopharmaceuticals”

4

>

CONTAINS

NUM

EV (123006, DCM, "Radionuclide Total Dose")

1

M

DCID 3083 “Units of Radioactivity”

5

>

CONTAINS

DATETIME

EV (123003, DCM, "Radiopharmaceutical Start Time")

1

M

6

>

CONTAINS

NUM

DT (122711, DCM, "Exercise duration after stress agent injection")

1

U

UNITS = DT (min, UCUM, "min")

7

>

CONTAINS

DATETIME

EV (122712, DCM, "Imaging Start Time")

1

M

8

>

CONTAINS

CODE

EV (122713, DCM, "Attenuation correction")

1

U

BCID 3112 “Attenuation Correction”

9

>>

HAS PROPERTIES

CODE

EV (111001, DCM, "Algorithm Name")

1

U

BCID 3117 “Attenuation Correction Methods”

10

>

CONTAINS

CODE

EV (121071, DCM, "Finding")

1-n

U

BCID 3113 “Types of Perfusion Defects”

11

>>

HAS PROPERTIES

CODE

EV (G-C0E3, SRT, "Finding Site")

1

M

BCID 3717 “Myocardial Wall Segments”

12

>>

HAS PROPERTIES

CODE

EV (112025, DCM, "Size Descriptor")

1

M

BCID 252 “S-M-L Size Descriptor”

13

>>

HAS PROPERTIES

CODE

EV (G-C197, SRT, "Severity")

1

M

BCID 3716 “Severity”

14

>

CONTAINS

CODE

EV (F-02220, SRT, "Left Ventricular Function")

1

U

BCID 3119 “LV Function”

15

>>

HAS PROPERTIES

CODE

EV (G-C197, SRT, "Severity")

1

U

BCID 3716 “Severity”

16

>

CONTAINS

INCLUDE

DTID 300 “Measurement”

1

U

$Measurement = EV (10230-1, LN, "LV Ejection Fraction")

$Units = EV (%, UCUM, "%")

$Derivation = DT (R-41D2D, SRT, "Calculated")

17

>

CONTAINS

CODE

EV (F-02236, SRT, "Left Ventricular Size")

1

U

BCID 3122 “Ventricular Enlargement”

18

>

CONTAINS

INCLUDE

DTID 300 “Measurement”

1

U

$Measurement = EV (8821-1, LN, "Left Ventricular ED Volume")

$Units = EV (ml, UCUM, "ml")

19

>

CONTAINS

INCLUDE

DTID 300 “Measurement”

1

U

$Measurement = EV (8823-7, LN, "Left Ventricular ES Volume")

$Units = EV (ml, UCUM, "ml")

20

>

CONTAINS

INCLUDE

DTID 5204 “Wall Motion Analysis”

1

U

$Procedure = DCID 3108 “NM/PET Procedures”


TID 3309 Stress Echo Measurement Group

Type:

Extensible

Order:

Significant

Table TID 3309. Stress Echo Measurement Group

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CONTAINER

DT (121070, DCM, "Findings")

1

M

2

>

HAS CONCEPT MOD

CODE

EV (121058, DCM, "Procedure reported")

1

M

DT (P5-B3000, SRT, "Echocardiography")

3

>

CONTAINS

INCLUDE

DTID 5203 “Echo Measurement”

1-n

U

$Measurement = DCID 12200 “Echocardiography Left Ventricle”

$Method = CID 12227 “Echocardiography Measurement Method”

4

>>

HAS CONCEPT MOD

CODE

EV (G-C0E3, SRT, "Finding Site")

1

MC

IF Row 3 measurement concept is in CID 12222 “Orifice Flow Properties”

EV (T-32600, SRT, "Left Ventricle")

5

>

CONTAINS

INCLUDE

DTID 5203 “Echo Measurement”

1-n

U

$Measurement = DCID 12211 “Echocardiography Aortic Valve”

$Method = CID 12227 “Echocardiography Measurement Method”

6

>>

HAS CONCEPT MOD

CODE

EV (G-C0E3, SRT, "Finding Site")

1

MC

IF Row 5 measurement concept is in CID 12222 “Orifice Flow Properties”

EV (T-35400, SRT, "Aortic Valve")

7

>

CONTAINS

INCLUDE

DTID 5203 “Echo Measurement”

1-n

U

$Measurement = DCID 12207 “Echocardiography Mitral Valve”

$Method = CID 12227 “Echocardiography Measurement Method”

8

>>

HAS CONCEPT MOD

CODE

EV (G-C0E3, SRT, "Finding Site")

1

MC

IF Row 7 measurement concept is in CID 12222 “Orifice Flow Properties”

EV (T-35300, SRT, "Mitral Valve")

9

>

CONTAINS

INCLUDE

DTID 5203 “Echo Measurement”

1-n

U

$Measurement = DCID 12208 “Echocardiography Tricuspid Valve”

$Method = CID 12227 “Echocardiography Measurement Method”

10

>>

HAS CONCEPT MOD

CODE

EV (G-C0E3, SRT, "Finding Site")

1

MC

IF Row 9 measurement concept is in CID 12222 “Orifice Flow Properties”

EV (T-35100, SRT, "Tricuspid Valve")

11

>

CONTAINS

INCLUDE

DTID 5204 “Wall Motion Analysis”

1

U

$Procedure = DT (P5-B3121, SRT, "Echocardiography for Determining Ventricular Contraction")


Content Item Descriptions

Rows 3-10

These invocations of TID 5203 “Echo Measurement” do not include an inherited Findings Site concept, for example as in the invocations of TID 5203 “Echo Measurement” from TID 5202 “Echo Section”. Echo measurements that do not have the associated Finding Site pre-coordinated in the measurement concept (i.e., the orifice flow measurements of CID 12222 “Orifice Flow Properties”), shall have the Finding Site explicitly post-coordinated with a Concept Modifier (Rows 4, 6, 8, and 10).

This template does not include the concept of an Image Library, for example as used in TID 5200 “Echocardiography Procedure Report”. Image Content Items in the Echo Measurement template shall be included with by-value relationships, not with by-reference relationships.

TID 3311 Stress Test Summary

Type:

Extensible

Order:

Significant

Table TID 3311. Stress Test Summary

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CONTAINER

EV (121111, DCM, "Summary")

1

M

2

>

CONTAINS

TEXT

EV (121111, DCM, "Summary")

1

U

3

>

CONTAINS

INCLUDE

DTID 3312 “Physiological Summary”

1

U

4

>

CONTAINS

INCLUDE

DTID 3313 “Stress ECG Summary”

1

U

5

>

CONTAINS

INCLUDE

DTID 3317 “Stress Imaging Summary”

1

U

6

>

CONTAINS

CODE

EV (121071, DCM, "Finding")

1

U

EV (D3-13025, SRT, "Exercise-induced angina")

See note.

7

>>

INCLUDE

DTID 1350 “Negation Modifier, Presence of Finding”

1

M

8

>

CONTAINS

CODE

EV (121071, DCM, "Finding")

1-n

U

DCID 3220 “Stress Symptoms”

9

>

CONTAINS

TEXT

EV (121071, DCM, "Finding")

1

U

10

>

CONTAINS

CODE

DT (G-0180, SRT, "Reason for stopping test")

1

U

DCID 3221 “Stress Test Termination Reasons”

11

>

CONTAINS

NUM

DT (122715, DCM, "Pharmacological Stress Agent Dose")

1

U

DT (mg/kg, UCUM, "mg/kg")


Content Item Descriptions

Rows 6-7

These rows allow an explicit finding of presence or absence of exercise-induced angina through the TID 1350 “Negation Modifier, Presence of Finding” Concept Modifier "Presence of property"

TID 3312 Physiological Summary

Type:

Extensible

Order:

Significant

Table TID 3312. Physiological Summary

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

NUM

DT (40443-4, LN, "Resting Heart Rate")

1

M

UNITS = DT ({H.B.}/min, UCUM, "BPM")

2

NUM

EV (F-008EC, SRT, "Systolic Blood Pressure")

1

M

UNITS = DCID 3500 “Pressure Units”

3

>

HAS CONCEPT MOD

CODE

EV (109054, DCM, "Patient State")

1

M

DT (F-01604, SRT, "Resting State")

4

NUM

EV (F-008ED, SRT, "Diastolic Blood Pressure")

1

M

UNITS = DCID 3500 “Pressure Units”

5

>

HAS CONCEPT MOD

CODE

EV (109054, DCM, "Patient State")

1

M

DT (F-01604, SRT, "Resting State")

6

NUM

DT (F-04F92, SRT, "Target HR")

1

M

UNITS = DT ({H.B.}/min, UCUM, "BPM")

7

NUM

DT (F-04FA6, SRT, "Maximum HR Achieved")

1

M

UNITS = DT ({H.B.}/min, UCUM, "BPM")

8

NUM

DT (F-04FA6, SRT, "Maximum HR Achieved")

1

M

UNITS = EV (%, UCUM, "%")

9

>

HAS CONCEPT MOD

CODE

EV (121425, DCM, "Index")

1

M

DT (F-04F92, SRT, "Target HR")

10

NUM

DT (122716, DCM, "Maximum Power Output Achieved")

1

U

UNITS = DT (W, UCUM, "Watts")

11

NUM

DT (122717, DCM, "Peak activity workload")

1

U

UNITS = DT ([MET], UCUM, "METS")

12

CODE

DT (F-04F9F, SRT, "HR Response")

1

U

DCID 3210 “Speed of Response”

13

NUM

DT (F-00E11, SRT, "Maximum systolic blood pressure")

1

U

UNITS = DCID 3500 “Pressure Units”

14

NUM

DT (F-00E21, SRT, "Maximum diastolic blood pressure")

1

U

UNITS = DCID 3500 “Pressure Units”

15

CODE

DT (F-04F74, SRT, "BP Response")

1

U

DCID 3210 “Speed of Response”

16

NUM

DT (122718, DCM, "Peak Double Product")

1

U

UNITS = DT (mm[Hg].{H.B.}/min, UCUM, "mmHg.BPM")

17

NUM

DT (F-031F8, SRT, "Total Exercise duration")

1

U

UNITS = DT (min, UCUM, "min")

18

NUM

DT (F-031F7, SRT, "Total test duration")

1

U

UNITS = DT (min, UCUM, "min")

19

INCLUDE

DTID 300 “Measurement”

1

U

$Measurement = DT (F-04FCC, SRT, "Functional capacity")

See note.

20

TEXT

DT (F-04FCC, SRT, "Functional capacity")

1

U

21

INCLUDE

DTID 300 “Measurement”

1-n

U

$Measurement = EV (122760, DCM, "Stress test score")

$Method = BCID 3238 “Stress Scoring Scales”

22

NUM

DT (F-04FCA, SRT, "Heart rate recovery time")

1

U

UNITS = DT (s, UCUM, "s")

23

CODE

EV (121071, DCM, "Finding")

1-n

U

BCID 3213 “Stress Hemodynamic Findings”

24

CODE

EV (F-00F4E, SRT, "Cardiovascular event risk")

1

U

BCID 3118 “Level of Risk”


Content Item Descriptions

Row 22

Numerical scoring of a patient's functional capacity shall include the range of the scoring system in the Units of Measurement (see Section 7.2.2), and may include a coded identifier for the scoring system in the Method concept modifier of TID 300 “Measurement”.

TID 3313 Stress ECG Summary

Type:

Extensible

Order:

Significant

Table TID 3313. Stress ECG Summary

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

TEXT

EV (F-00033, SRT, "ECG Finding")

1

U

Device Generated Test Summary

2

>

HAS OBS CONTEXT

CODE

EV (121005, DCM, "Observer Type")

1

M

EV (121007, DCM, "Device")

3

>

HAS OBS CONTEXT

INCLUDE

DTID 1004 “Device Observer Identifying Attributes”

1

M

4

INCLUDE

DTID 300 “Measurement”

1-n

U

$Measurement = EV (F-03204, SRT, "ST Elevation")

$Units = DT (mV, UCUM, "mV")

$Derivation = EV (G-A437, SRT, "Maximum")

$TargetSite = DCID 3001 “ECG Leads”

5

INCLUDE

DTID 300 “Measurement”

1-n

U

$Measurement = EV (F-38279, SRT, "ST Depression")

$Units = DT (mV, UCUM, "mV")

$Derivation = EV (G-A437, SRT, "Maximum")

$TargetSite = DCID 3001 “ECG Leads”

6

INCLUDE

DTID 300 “Measurement”

1-n

U

$Measurement = EV (F-38287, SRT, "T wave alternans")

$Units = DT (uV, UCUM, "uV")

$Derivation = EV (G-A437, SRT, "Maximum")

$TargetSite = DCID 3001 “ECG Leads”

7

CODE

EV (F-38035, SRT, "ST Segment Finding")

1

U

BCID 3231 “ST Segment Findings”

8

>

HAS PROPERTIES

CODE

EV (G-C0E3, SRT, "Finding Site")

1-n

U

BCID 3232 “ST Segment Location”

9

>

HAS PROPERTIES

CODE

EV (G-C504, SRT, "Associated Morphology")

1

U

BCID 3233 “ST Segment Morphology”

10

NUM

DT (122707, DCM, "Number of Ectopic Beats")

1

U

UNITS = EV ({beats}, UCUM, "beats")

11

>

HAS PROPERTIES

CODE

EV (G-C504, SRT, "Associated Morphology")

1-n

U

BCID 3234 “Ectopic Beat Morphology”

12

CODE

DT (8884-9, LN, "Cardiac Rhythm")

1-2

U

BCID 3415 “Cardiac Rhythms”

See note.

13

>

HAS CONCEPT MOD

CODE

EV (109054, DCM, "Patient State")

1

M

DCID 3102 “Rest-Stress”

14

CODE

EV (F-00033, SRT, "ECG Finding")

1-n

U

BCID 3230 “ECG Findings”

15

>

HAS CONCEPT MOD

CODE

EV (109054, DCM, "Patient State")

1

U

BCID 3262 “ECG Patient State Values”


Content Item Descriptions

Rows 4-14

Each observation (measurement or finding) may have a specific Content Item Observation DateTime attribute to indicate the time in the procedure at which the observation was made (e.g., time of maximum heart rate, or time of occurrence of an arrhythmia).

Row 12-13

This Concept and the associated Concept Modifier may be instantiated twice, once for resting state measurements, once for stress.

TID 3317 Stress Imaging Summary

Type:

Extensible

Order:

Significant

Table TID 3317. Stress Imaging Summary

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CODE

DT (122739, DCM, "Overall study quality")

1

M

BCID 3114 “Study Quality”

2

CODE

DT (113010, DCM, "Quality Issue")

1

U

BCID 3115 “Stress Imaging Quality Issues”

3

CODE

EV (121071, DCM, "Finding")

1

U

BCID 3116 “NM Extracardiac Findings”

4

INCLUDE

DTID 300 “Measurement”

1-2

U

$Measurement = DT (F-04F76, SRT, "Perfusion defect extent")

$ModType = EV (109054, DCM, "Patient State")

$ModValue = DCID 3102 “Rest-Stress”

$Units = EV (%, UCUM, "%")

See note.

5

INCLUDE

DTID 300 “Measurement”

1

U

$Measurement = DT (F-04FCD, SRT, "Stress ischemia extent")

$Units = EV (%, UCUM, "%")

6

INCLUDE

DTID 300 “Measurement”

1

U

$Measurement = DT (122762, DCM, "Number of diseased vessel territories")

$Units = EV ({territories}, UCUM, "territories")

7

CODE

EV (121071, DCM, "Finding")

1

U

EV (D3-13040, SRT, "Coronary artery disease")

8

>

HAS PROPERTIES

CODE

EV (G-C0E3, SRT, "Finding Site")

1-n

M

BCID 3016 “Major Coronary Arteries”

9

CODE

EV (F-0238D, SRT, "Myocardial perfusion")

1-2

U

BCID 3120 “Perfusion Findings”

10

>

HAS CONCEPT MOD

CODE

EV (G-C0E3, SRT, "Finding Site")

1

M

BCID 3463 “Ventricle Identification”

11

>

HAS PROPERTIES

CODE

EV (G-C504, SRT, "Associated Morphology")

1

U

BCID 3121 “Perfusion Morphology”

12

CODE

EV (121071, DCM, "Finding")

1

U

DT (D4-31124, SRT, "Transient cavitary dilatation")

13

>

INCLUDE

DTID 1350 “Negation Modifier, Presence of Finding”

1

U

14

INCLUDE

DTID 300 “Measurement”

1

U

$Measurement = DT (F-04FB4, SRT, "Transient cavitary dilatation ratio")

$Units = EV ({ratio}, UCUM, "ratio")

15

INCLUDE

DTID 300 “Measurement”

1-2

U

$Measurement = EV (10230-1, LN, "LV Ejection Fraction")

$ModType = EV (109054, DCM, "Patient State")

$ModValue = DCID 3102 “Rest-Stress”

$Units = EV (%, UCUM, "%")

See note.


Content Item Descriptions

Row 4

This row may be instantiated twice, once for resting state measurements, once for stress.

Row 15

The LVEF code specified in this row is defined in LOINC with method "imaging". LVEF measurement by ultrasound may also be encoded elsewhere in the Content Tree (e.g., in TID 3309 “Stress Echo Measurement Group”) with LOINC code 18043-0, which has method "ultrasound". It is recommended that such findings from the per-phase measurements be summarized here with the generic "LVEF by Imaging" concept code.

TID 3318 Comparison to Prior Stress Exam

This template describes changes in findings from a prior stress exam. Comparison is to only one prior exam, even though the generic concept name for the template uses the plural "exams".

Type:

Extensible

Order:

Significant

Table TID 3318. Comparison to Prior Stress Exam

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CONTAINER

EV (111424, DCM, "Comparison to previous exams")

1

M

2

>

CONTAINS

CODE

DT (121058, DCM, "Procedure Reported")

1

U

DCID 3200 “Stress Test Procedure”

3

>>

HAS PROPERTIES

DATETIME

EV (122146, DCM, "Procedure DateTime")

1

U

4

>>

HAS PROPERTIES

UIDREF

EV (121018, DCM, "Procedure Study Instance UID")

1

U

5

>>

HAS PROPERTIES

COMPOSITE

EV (122075, DCM, "Prior report for current patient")

1-n

U

6

>

CONTAINS

CODE

DT (F-03D1D, SRT, "Exercise tolerance")

1

U

BCID 3236 “Tolerance Comparison Findings”

7

>

CONTAINS

CODE

DT (F-0238D, SRT, "Myocardial Perfusion")

1

U

BCID 3235 “Perfusion Comparison Findings”

8

>>

HAS CONCEPT MOD

CODE

EV (G-C036, SRT, "Measurement Method")

1-n

U

BCID 3215 “Perfusion Finding Method”

9

>

CONTAINS

CODE

DT (F-02225, SRT, "LV Wall motion")

1-n

U

BCID 3237 “Wall Motion Comparison Findings”

10

>>

HAS CONCEPT MOD

CODE

EV (109054, DCM, "Patient State")

1

M

DCID 3102 “Rest-Stress”

11

>

CONTAINS

CODE

EV (111424, DCM, "Comparison to previous exams")

1

U

BCID 3217 “Comparison Finding”

12

>

CONTAINS

NUM

DT (122768, DCM, "Difference in Ejection Fraction")

1

U

UNITS = EV (%, UCUM, "%")

13

>

CONTAINS

NUM

DT (122769, DCM, "Difference in ED LV Volume")

1

U

UNITS = EV (ml, UCUM, "ml")

14

>

CONTAINS

NUM

DT (122769, DCM, "Difference in ED LV Volume")

1

U

UNITS = EV (ml/m2, UCUM, "ml/m2")

15

>>

HAS CONCEPT MOD

CODE

EV (121425, DCM, "Index")

1

M

DT (8277-6, LN, "BSA")


TID 3320 Conclusions and Recommendations

Type:

Extensible

Order:

Non-Significant

Table TID 3320. Conclusions and Recommendations

NL

Rel with Parent

VT

Concept Name

VM

Req Type

Condition

Value Set Constraint

1

CONTAINER

EV (121076, DCM, "Conclusions")

1

MC

IF Completion Flag (0040,A491) = COMPLETE

2

>

CONTAINS

TEXT

EV (121077, DCM, "Conclusion")

1

U

3

>

CONTAINS

CODE

EV (F-00033, SRT, "ECG Finding")

1

M

DCID 3208 “Summary Codes Exercise ECG”

4

>

CONTAINS

CODE

EV (F-01969, SRT, "Imaging Finding")

1

M

DCID 3209 “Summary Codes Stress Imaging”

5

CONTAINER

EV (121074, DCM, "Recommendations")

1

U

6

>

CONTAINS

TEXT

EV (121075, DCM, "Recommendation")

1

U