FHIR IG analytics| Package | fhir.nwgenomics.nhs.uk |
| Resource Type | Questionnaire |
| Id | Questionnaire-HLATestsTransplantAskAtOrderEntry.json |
| FHIR Version | R4 |
| Source | https://build.fhir.org/ig/nw-gmsa/nw-gmsa.github.com/Questionnaire-HLATestsTransplantAskAtOrderEntry.html |
| URL | https://fhir.nwgenomics.nhs.uk/Questionnaire/HLATestsTransplantAskAtOrderEntry |
| Version | 2.2.0 |
| Status | draft |
| Date | 2026-09-27T08:17:18+00:00 |
| Title | HLA Tests - Transplant Ask At Order Entry |
| Realm | us |
| Authority | hl7 |
| Description | **Ask At Order Entry Questions** used alongside the [common core order form](Questionnaire-GenomicTestOrder.html) for the "HLA Tests - Transplant" order screen within Histocompatibility and Immunogenetics orders (SNOMED CT `909871000000100`) - see [Order Entry Questions](Questionnaire-GenomicTestOrder.html#order-entry-questions) and [Histocompatibility and Immunogenetics](HistocompatibilityAndImmunogenetics.html#ask-at-order-entry-questions). For the sibling Chimerism testing order screen, see [Chimerism Test Additional Ask At Order Entry Questions](Questionnaire-ChimerismTestAdditionalAskAtOrderQuestions.html). Extracted from the `NTE` segments (each carrying HL7 v2 Table 0105-style comment type `OSQ`) of a live Histotrac `ORM^O01` order - see the worked [example](HistocompatibilityAndImmunogenetics.html#ask-at-order-entry-questions) for the full message. Each `NTE-3` value uses a local `Label:->Value` convention (e.g. `HLA Type:->Patient`), split below into a question/answer pair. **Research summary (no NHS England-published order-comms/interoperability standard was found for these fields)**: NHS England's published pathology standards ([Pathology Test and Results Standard](https://standards.nhs.uk/published-standards/pathology-test-and-results-standard), [SNOMED CT for pathology reporting](https://digital.nhs.uk/services/pathology-standards-and-implementation/snomed-ct-for-pathology-reporting)) do not cover Histocompatibility and Immunogenetics (H&I) order entry specifically. The relevant national body is **NHS Blood and Transplant (NHSBT)**, not NHS England: its [INF136 "User Guide for Histocompatibility and Immunogenetics Diagnostics Services"](https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/29939/inf136.pdf) defines six national H&I request forms (Table 2) including `FRM1008` "H&I Organ Transplant (Patients and Donors)" and `FRM1010` "H&I Haematopoietic Stem Cell Transplantation (Recipients & Donors)", plus a sample-requirements table listing "HLA type of **patient, donors or family members**" for Solid Organ Transplantation - confirming HLA Type is a fixed national list, not free text, even though NHSBT does not publish a FHIR/LOINC/SNOMED binding for it. NHSBT's Solid Organ Transplantation section (4.5.1) also describes 24-hour on-call cover for "**renal** and, where appropriate, **cardiothoracic** transplantation", with liver/other transplant types noted separately as not having HLA match as a primary factor - consistent with Patient Type being a small, fixed list. The professional bodies **BSHI** (British Society for Histocompatibility and Immunogenetics) and **BTS** (British Transplantation Society) jointly publish clinical guidelines (e.g. the [2015 BTS/BSHI antibody characterisation guideline](https://bts.org.uk/wp-content/uploads/2016/09/06_BTS_BSHI_Antibodies-1.pdf)) but not data/interoperability standards. This IG's own dependency, [HL7's Genomics Reporting IG - Histocompatibility and Immunogenetic Reporting](http://hl7.org/fhir/uv/genomics-reporting/histocompatibility.html), profiles structured HLA genotype/haplotype *results* (LOINC `84413-4` Genotype display name, `48018-6` Gene studied, `13298-5` HLA-A [Type], the GL String and HGNC systems) but does not address order-entry "ask at order" questions like these. See each item below for LOINC panels and UK code lists relevant to that specific question. |
No resources found
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Note: links and images are rebased to the (stated) source
Generated Narrative: Questionnaire HLATestsTransplantAskAtOrderEntry
Profile: Questionnaire
| LinkID | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  | **Ask At Order Entry Questions** used alongside the [common core order form](Questionnaire-GenomicTestOrder.html) for the "HLA Tests - Transplant" order screen within Histocompatibility and Immunogenetics orders (SNOMED CT `909871000000100`) - see [Order Entry Questions](Questionnaire-GenomicTestOrder.html#order-entry-questions) and [Histocompatibility and Immunogenetics](HistocompatibilityAndImmunogenetics.html#ask-at-order-entry-questions). For the sibling Chimerism testing order screen, see [Chimerism Test Additional Ask At Order Entry Questions](Questionnaire-ChimerismTestAdditionalAskAtOrderQuestions.html). Extracted from the `NTE` segments (each carrying HL7 v2 Table 0105-style comment type `OSQ`) of a live Histotrac `ORM^O01` order - see the worked [example](HistocompatibilityAndImmunogenetics.html#ask-at-order-entry-questions) for the full message. Each `NTE-3` value uses a local `Label:->Value` convention (e.g. `HLA Type:->Patient`), split below into a question/answer pair. **Research summary (no NHS England-published order-comms/interoperability standard was found for these fields)**: NHS England's published pathology standards ([Pathology Test and Results Standard](https://standards.nhs.uk/published-standards/pathology-test-and-results-standard), [SNOMED CT for pathology reporting](https://digital.nhs.uk/services/pathology-standards-and-implementation/snomed-ct-for-pathology-reporting)) do not cover Histocompatibility and Immunogenetics (H&I) order entry specifically. The relevant national body is **NHS Blood and Transplant (NHSBT)**, not NHS England: its [INF136 "User Guide for Histocompatibility and Immunogenetics Diagnostics Services"](https://nhsbtdbe.blob.core.windows.net/umbraco-assets-corp/29939/inf136.pdf) defines six national H&I request forms (Table 2) including `FRM1008` "H&I Organ Transplant (Patients and Donors)" and `FRM1010` "H&I Haematopoietic Stem Cell Transplantation (Recipients & Donors)", plus a sample-requirements table listing "HLA type of **patient, donors or family members**" for Solid Organ Transplantation - confirming HLA Type is a fixed national list, not free text, even though NHSBT does not publish a FHIR/LOINC/SNOMED binding for it. NHSBT's Solid Organ Transplantation section (4.5.1) also describes 24-hour on-call cover for "**renal** and, where appropriate, **cardiothoracic** transplantation", with liver/other transplant types noted separately as not having HLA match as a primary factor - consistent with Patient Type being a small, fixed list. The professional bodies **BSHI** (British Society for Histocompatibility and Immunogenetics) and **BTS** (British Transplantation Society) jointly publish clinical guidelines (e.g. the [2015 BTS/BSHI antibody characterisation guideline](https://bts.org.uk/wp-content/uploads/2016/09/06_BTS_BSHI_Antibodies-1.pdf)) but not data/interoperability standards. This IG's own dependency, [HL7's Genomics Reporting IG - Histocompatibility and Immunogenetic Reporting](http://hl7.org/fhir/uv/genomics-reporting/histocompatibility.html), profiles structured HLA genotype/haplotype *results* (LOINC `84413-4` Genotype display name, `48018-6` Gene studied, `13298-5` HLA-A [Type], the GL String and HGNC systems) but does not address order-entry "ask at order" questions like these. See each item below for LOINC panels and UK code lists relevant to that specific question. | Questionnaire | https://fhir.nwgenomics.nhs.uk/Questionnaire/HLATestsTransplantAskAtOrderEntry#2.2.0 | |
  AskAtOrderEntry | Ask At Order Entry Questions | 0..1 | group | |
   HistoIG/patient_test | Patient Test(s) | 0..* | choice | Definition: ServiceRequest.orderDetail Options: 5 options |
  HistoIG/patient_test-designNote | Histotrac NTE-3 (CommentType=OSQ): restates the OBR-4 test name. Mapped to `ServiceRequest.orderDetail` rather than `ServiceRequest.code` - the base [Genomic Test Order](Questionnaire-GenomicTestOrder.html)'s own Test Code item already targets `ServiceRequest.code` (single-cardinality), so reusing it here would conflict with no `enableWhen` to say which item wins. `ServiceRequest.orderDetail` is repeating and intended for exactly this kind of further order qualifier, and matches this item's own `repeats = true` (the Hive UI presents them as checkboxes - more than one may be selected per order). Confirmed as this fixed 5-value checklist from the Hive/Histotrac order-entry UI, shown identically regardless of Patient Type (Stem cell or Renal) - coded against the [Histotrac](CodeSystem-Histotrac.html) CodeSystem (the order-detail restatement codes Histotrac itself uses alongside its Test Code, bound via [HistotracOrderDetail](ValueSet-HistotracOrderDetail.html)), the same pattern as [Chimerism Test Additional Ask At Order Entry Questions](Questionnaire-ChimerismTestAdditionalAskAtOrderQuestions.html#ChimIG/patient_test)'s own `patient_test` item - rather than the local `NWGMSA` codes the Hive order-entry UI's own checkboxes use for the order-entry *selection* itself. | 0..1 | display | |
| HistoIG/patient_test-reference | No MFT/NHS England code set was found for these five specific test names, but LOINC has panels the Histotrac test catalogue could map onto if a coded alternative to the `Histotrac` codes is wanted: 102092-4 (HLA-ABDR typing panel), 96615-0/96629-1 (HLA-A/B/C class I typing, high/low resolution), 94492-6 (HLA-DQA1/DQB1 typing), 72905-3 (Neutrophil Ab and HLA Ab screen panel), 94428-0 (HLA class I and II IgG panel), and 80737-0 (Calculated panel reactive antibody). Not the NHS England Genomic Test Directory (England-GenomicTestDirectory) - H&I is not part of that catalogue. | 0..1 | display | |
| HistoIG/hla_type | HLA Type | 1..1 | choice | Definition: Observation.valueCodeableConcept Options: 2 options |
| HistoIG/hla_type-designNote | Whose HLA is being typed - carried as an Observation referenced from ServiceRequest.supportingInfo, the same Ask at Order Entry pattern used by dWGS's Family Structure/Participant Type. Confirmed as a 2-value list (Patient, Donor) from the Hive/Histotrac order-entry UI screenshots - coded locally against the `NWGMSA` CodeSystem as no NHSBT/NHS England-published FHIR/LOINC/SNOMED binding exists. | 0..1 | display | |
| HistoIG/hla_type-reference | NHSBT's INF136 (Table 2) names a national request form "H&I Organ Transplant (Patients and Donors)" (FRM1008), and its sample-requirements table lists "HLA type of patient, donors or family members" for Solid Organ Transplantation - wider than the Patient/Donor pair the Hive UI actually offers. A separate national form, "H&I Haematopoietic Stem Cell Transplantation (Recipients & Donors)" (FRM1010), uses Recipient/Donor instead of Patient/Donor for that transplant type. No NHSBT-published FHIR/LOINC/SNOMED binding exists for either, and Hive does not appear to expose a Family Member/Recipient option here. | 0..1 | display | |
| HistoIG/patient_type | Patient Type | 0..1 | choice | Definition: Observation.valueCodeableConcept Options: 3 options |
| HistoIG/patient_type-designNote | Transplant context - carried as an Observation referenced from ServiceRequest.supportingInfo. Confirmed as a 3-value list (Stem cell, Renal, Thoracic) from the Hive/Histotrac order-entry UI - coded locally against the `NWGMSA` CodeSystem. When Patient Type is "Renal" the Hive UI also shows an Organ picker (see `HistoIG/organ` below); no Organ field is shown for Stem cell/Thoracic. | 0..1 | display | |
| HistoIG/patient_type-reference | NHSBT's INF136 (4.5.1) describes 24-hour on-call cover for "renal and, where appropriate, cardiothoracic transplantation" as the two Solid Organ Transplantation categories with routine H&I on-call support, and the Hive UI's "Thoracic" option lines up with that "cardiothoracic" wording (not "Cardiac"). Stem cell is a third category the Hive UI groups here rather than treating as a separate transplant type. No NHSBT/NHS England LOINC/SNOMED binding was found for this field. | 0..1 | display | |
| HistoIG/organ | Organ | 0..1 | choice | Definition: Specimen.collection.bodySite Options: 5 options |
| HistoIG/organ-designNote | The organ relevant to the transplant - the body site the specimen was collected from. Confirmed as this 5-value list (plus a free-text "Other" box, not modelled here) from the Hive/Histotrac order-entry UI, only shown there when Patient Type is "Renal". The three single-organ values (Kidney, Pancreas, Islets) are now coded against SNOMED CT from the FHIR [body-site value set](https://hl7.org/fhir/R4/valueset-body-site.html) - `64033007` "Kidney structure", `15776009` "Pancreatic structure", and `78696007` "Endocrine pancreatic structure" for Islets (the closest single body-structure concept to "Islets of Langerhans" available - islet tissue is the endocrine pancreas, there is no separate discrete "Islet of Langerhans structure" concept). The two "Simultaneous..." combination transplants remain coded against `NWGMSA`, since neither is itself a single SNOMED CT body-site concept. | 0..1 | display | |
| HistoIG/organ-reference | NHS Digital's UK-specific "Solid organ transplant codes" (ORGTRANSP_COD) reference set (part of the NHS Digital Primary Care Domain Refsets, ~364 codes, https://www.opencodelists.org/codelist/nhsd-primary-care-domain-refsets/orgtransp_cod/) remains a candidate alternative binding, not adopted here since it is a UK reference set rather than the FHIR body-site value set the SNOMED CT codes above are drawn from. Neither source has a single code for a combination transplant such as "Simultaneous Pancreas/Kidney", which is why those two remain local `NWGMSA` codes rather than SNOMED CT. | 0..1 | display | |
| HistoIG/specimen_source | Specimen Source | 0..1 | choice | Definition: Specimen.type.coding.code Options: 3 options |
| HistoIG/specimen_source-designNote | Confirmed as this 3-value list (Blood, Buccal, plus a free-text "Other" box, not modelled here) from the Hive/Histotrac order-entry UI's HLA panel - narrower than the EU/UK/NW-compatible [Specimen Type](ValueSet-specimen-type.html) value set previously bound here (`answerValueSet = Canonical(SpecimenType)`). Blood and Buccal are now coded against SNOMED CT codes drawn from that same [Specimen Type](ValueSet-specimen-type.html) value set - `119297000` "Blood specimen" and `733104004` "Swab from buccal mucosa" - the same `119297000` code [Chimerism Test Additional Ask At Order Entry Questions](Questionnaire-ChimerismTestAdditionalAskAtOrderQuestions.html)'s own `ChimIG/specimen_source` item uses for its "Blood (PB)" option. Other remains a local `NWGMSA` code, since [Specimen Type](ValueSet-specimen-type.html) has no single generic "other/unspecified" concept to match Hive's free-text catch-all. Deliberately given its own `HistoIG/specimen_source` linkId rather than reusing the base [Genomic Test Order](Questionnaire-GenomicTestOrder.html)'s own `LN/66746-9` Specimen Type item (same `code`/LOINC `66746-9`, so the semantic link is kept via `code`) - the two questions are asked at different points for different purposes in Hive, and the IG Publisher's Questionnaire derivation validator does not support a `derivedFrom`/`extends` item reusing a base item's linkId while also declaring more than one `answerOption`. | 0..1 | display | |
| HistoIG/specimen_source-reference | NHSBT's INF136 Table 5 (sample requirements) shows nearly every H&I test uses peripheral blood (EDTA and/or clotted, varying by test), with spleen/lymph node as the exception for deceased-donor crossmatching - consistent with Hive's Blood option. No dedicated NHS-published specimen-type binding specific to H&I was found; the generic [Specimen Type](ValueSet-specimen-type.html) SNOMED CT codes above are used instead for Blood/Buccal. | 0..1 | display | |
| 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
FHIR
FHIRsmith{
"resourceType": "Questionnaire",
"id": "HLATestsTransplantAskAtOrderEntry",
"meta": {
"profile": [
"https://fhir.nwgenomics.nhs.uk/StructureDefinition/NWQuestionnaire"
]
},
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"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": "2026-09-27T08:17:18+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/Histotrac",
"code": "HLATypingAntibodyScreening",
"display": "HLA Typing + Antibody Screening"
}
},
{
"valueCoding": {
"system": "https://fhir.nwgenomics.nhs.uk/CodeSystem/Histotrac",
"code": "HLAAntibodyScreening",
"display": "HLA Antibody Screening"
}
},
{
"valueCoding": {
"system": "https://fhir.nwgenomics.nhs.uk/CodeSystem/Histotrac",
"code": "HLATypeRecipient",
"display": "HLA Type Recipient"
}
},
{
"valueCoding": {
"system": "https://fhir.nwgenomics.nhs.uk/CodeSystem/Histotrac",
"code": "DSA",
"display": "DSA"
}
},
{
"valueCoding": {
"system": "https://fhir.nwgenomics.nhs.uk/CodeSystem/Histotrac",
"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 against\nthe [Histotrac](CodeSystem-Histotrac.html) CodeSystem (the order-detail\nrestatement codes Histotrac itself uses alongside its Test Code, bound via\n[HistotracOrderDetail](ValueSet-HistotracOrderDetail.html)), the same pattern as\n[Chimerism Test Additional Ask At Order Entry\nQuestions](Questionnaire-ChimerismTestAdditionalAskAtOrderQuestions.html#ChimIG/patient_test)'s\nown `patient_test` item - rather than the local `NWGMSA` codes the Hive\norder-entry UI's own checkboxes use for the order-entry *selection* itself.",
"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 `Histotrac` 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": "http://snomed.info/sct",
"code": "64033007",
"display": "Kidney structure"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "15776009",
"display": "Pancreatic structure"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "78696007",
"display": "Endocrine pancreatic structure"
}
},
{
"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\". The three single-organ values (Kidney,\nPancreas, Islets) are now coded against SNOMED CT from the FHIR [body-site value\nset](https://hl7.org/fhir/R4/valueset-body-site.html) - `64033007` \"Kidney\nstructure\", `15776009` \"Pancreatic structure\", and `78696007` \"Endocrine\npancreatic structure\" for Islets (the closest single body-structure concept to\n\"Islets of Langerhans\" available - islet tissue is the endocrine pancreas, there\nis no separate discrete \"Islet of Langerhans structure\" concept). The two\n\"Simultaneous...\" combination transplants remain coded against `NWGMSA`, since\nneither is itself a single SNOMED CT body-site concept.",
"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": "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/)\nremains a candidate alternative binding, not adopted here since it is a UK\nreference set rather than the FHIR body-site value set the SNOMED CT codes above\nare drawn from. Neither source has a single code for a combination transplant\nsuch as \"Simultaneous Pancreas/Kidney\", which is why those two remain local\n`NWGMSA` codes rather than SNOMED CT.",
"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": "http://snomed.info/sct",
"code": "119297000",
"display": "Blood specimen"
}
},
{
"valueCoding": {
"system": "http://snomed.info/sct",
"code": "733104004",
"display": "Swab from buccal mucosa"
}
},
{
"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)`). Blood and\nBuccal are now coded against SNOMED CT codes drawn from that same [Specimen\nType](ValueSet-specimen-type.html) value set - `119297000` \"Blood specimen\" and\n`733104004` \"Swab from buccal mucosa\" - the same `119297000` code [Chimerism Test\nAdditional Ask At Order Entry\nQuestions](Questionnaire-ChimerismTestAdditionalAskAtOrderQuestions.html)'s own\n`ChimIG/specimen_source` item uses for its \"Blood (PB)\" option. Other remains a\nlocal `NWGMSA` code, since [Specimen Type](ValueSet-specimen-type.html) has no\nsingle generic \"other/unspecified\" concept to match Hive's free-text catch-all.\nDeliberately given its own `HistoIG/specimen_source` linkId rather than reusing\nthe base [Genomic Test Order](Questionnaire-GenomicTestOrder.html)'s own\n`LN/66746-9` Specimen Type item (same `code`/LOINC `66746-9`, so the semantic link\nis kept via `code`) - the two questions are asked at different points for\ndifferent purposes in Hive, and the IG Publisher's Questionnaire derivation\nvalidator does not support a `derivedFrom`/`extends` item reusing a base item's\nlinkId while also declaring 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. No dedicated NHS-published specimen-type binding specific to H&I was\nfound; the generic [Specimen Type](ValueSet-specimen-type.html) SNOMED CT codes\nabove are used instead for Blood/Buccal.",
"type": "display"
}
]
}
]
}
]
}