Inference information
This document describes the details of all inferences generated by application of RI to a radiology document.
The Radiology Insights feature of Azure Health Insights uses natural language processing techniques to process unstructured medical radiology documents. It adds several types of inferences that help the user to effectively monitor, understand, and improve financial and clinical outcomes in a radiology workflow context.
The types of inferences currently supported by the system are: AgeMismatch, SexMismatch, LateralityDiscrepancy, CompleteOrderDiscrepancy, LimitedOrderDiscrepancy, Finding, CriticalResult, FollowupRecommendation, RadiologyProcedure, Communication.
List of inferences in scope of RI
- Age Mismatch
- Laterality Discrepancy
- Sex Mismatch
- Complete Order Discrepancy
- Limited Order Discrepancy
- Finding
- Critical Result
- follow-up Recommendation
- Communication
- Radiology Procedure
To interact with the Radiology-Insights model, you can provide several model configuration parameters that modify the outcome of the responses. One of the configurations is "inferenceTypes", which can be used if only part of the Radiology Insights inferences is required. If this list is omitted or empty, the model returns all the inference types.
Possible inference types:
"finding", "ageMismatch", "lateralityDiscrepancy", "sexMismatch", "completeOrderDiscrepancy", "limitedOrderDiscrepancy", "criticalResult", "followupRecommendation", "followupCommunication", "radiologyProcedure".
"configuration" : {
"inferenceOptions" : {
"followupRecommendationOptions" : {
"includeRecommendationsWithNoSpecifiedModality" : false,
"includeRecommendationsInReferences" : false,
"provideFocusedSentenceEvidence" : false
},
"findingOptions" : {
"provideFocusedSentenceEvidence" : false
}
},
"inferenceTypes" : [ "finding", "ageMismatch", "lateralityDiscrepancy", "sexMismatch", "completeOrderDiscrepancy", "limitedOrderDiscrepancy", "criticalResult", "followupRecommendation", "followupCommunication", "radiologyProcedure" ],
"locale" : "en-US",
"verbose" : false,
"includeEvidence" : true
}
Age Mismatch
An age mismatch occurs when the document gives a certain age for the patient, which differs from the age that is calculated based on the patient’s birthdate in info/details and the date of creation or the encounter period in the request.
- kind: RadiologyInsightsInferenceType.AgeMismatch;
Examples request/response json:
{
"jobData": {
"configuration": {
"inferenceOptions": {
"followupRecommendationOptions": {
"includeRecommendationsWithNoSpecifiedModality": false,
"includeRecommendationsInReferences": false,
"provideFocusedSentenceEvidence": false
},
"findingOptions": {
"provideFocusedSentenceEvidence": false
}
},
"inferenceTypes": ["ageMismatch"],
"locale": "en-US",
"verbose": false,
"includeEvidence": false
},
"patients": [
{
"id": "111111",
"details": {
"sex": "female",
"birthDate" : "1986-07-01T21:00:00+00:00",
"clinicalInfo": [
{
"resourceType": "Observation",
"status": "unknown",
"code": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls",
"code": "C0018802",
"display": "MalignantNeoplasms"
}
]
},
"valueBoolean": "true"
}
]
},
"encounters": [
{
"id": "encounterid1",
"period": {
"start": "2021-8-28T00:00:00",
"end": "2021-8-28T00:00:00"
},
"class": "inpatient"
}
],
"patientDocuments": [
{
"type": "note",
"clinicalType": "radiologyReport",
"id": "docid1",
"language": "en",
"authors": [
{
"id": "authorid1",
"fullName": "authorname1"
}
],
"specialtyType": "radiology",
"createdAt": "2021-8-28T00:00:00",
"administrativeMetadata": {
"orderedProcedures": [
{
"code": {
"coding": [
{
"system": "Https://loinc.org",
"code": "41806-1",
"display": "CT ABDOMEN"
}
]
},
"description": "CT ABDOMEN"
}
],
"encounterId": "encounterid1"
},
"content": {
"sourceType": "inline",
"value" : "CT ABDOMEN AND PELVIS\n\nProvided history: \n78 years old Female\nAbnormal weight loss\n\nTechnique: Routine protocol helical CT of the abdomen and pelvis were performed after the injection of intravenous nonionic iodinated contrast. Axial, Sagittal and coronal 2-D reformats were obtained. Oral contrast was also administered.\n\nFindings:\nLimited evaluation of the included lung bases demonstrates no evidence of abnormality. \n\nGallbladder is absent. "
}
}
]
}
]
}
}
{
"result": {
"patientResults": [
{
"patientId": "111111",
"inferences": [
{
"kind": "ageMismatch"
}
]
}
],
"modelVersion": "2024-01-10-Preview"
},
"id": "7fc4bd1a-9321-45ea-845e-158a3ab222de",
"createdDateTime": "2024-01-12T07:08:21.109402Z",
"expirationDateTime": "2024-01-12T07:25:01.109402Z",
"lastUpdateDateTime": "2024-01-12T07:08:26.8320889Z",
"status": "succeeded"
}
Laterality Discrepancy
A laterality mismatch is flagged when the orderedProcedure is for a body part with a laterality and the text refers to the opposite laterality or doesn't contain a laterality. Example: "x-ray right foot", "left foot is normal" A laterality mismatch is also flagged when there's a body part with left or right in the finding section, and the same body part occurs with the opposite laterality in the impression section.
- kind: RadiologyInsightsInferenceType.LateralityDiscrepancy
- LateralityIndication: FHIR.R4.CodeableConcept
- DiscrepancyType: LateralityDiscrepancyType
There are three possible discrepancy types:
- "orderLateralityMismatch" means that the laterality in the text conflicts with the one in the order.
- "textLateralityContradiction" means that there's a body part with left or right in the finding section, and the same body part occurs with the opposite laterality in the impression section.
- "textLateralityMissing" means that the laterality mentioned in the order never occurs in the text.
The lateralityIndication is a FHIR.R4.CodeableConcept. There are two possible values (SNOMED codes):
- 20028007: RIGHT (QUALIFIER VALUE)
- 7771000: LEFT (QUALIFIER VALUE)
The meaning of this field is as follows:
- For orderLateralityMismatch: concept in the text that the laterality was flagged for.
- For textLateralityContradiction: concept in the impression section that the laterality was flagged for.
- For "textLateralityMissing", this field isn't filled in.
For a mismatch with discrepancy type "textLaterityMissing", no evidence is returned.
Examples request/response json:
{
"jobData": {
"configuration": {
"inferenceOptions": {
"followupRecommendationOptions": {
"includeRecommendationsWithNoSpecifiedModality": false,
"includeRecommendationsInReferences": false,
"provideFocusedSentenceEvidence": false
},
"findingOptions": {
"provideFocusedSentenceEvidence": false
}
},
"inferenceTypes": ["lateralityDiscrepancy"],
"locale": "en-US",
"verbose": false,
"includeEvidence": false
},
"patients": [
{
"id": "111111",
"details": {
"sex": "female",
"birthDate" : "1986-07-01T21:00:00+00:00",
"clinicalInfo": [
{
"resourceType": "Observation",
"status": "unknown",
"code": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls",
"code": "C0018802",
"display": "MalignantNeoplasms"
}
]
},
"valueBoolean": "true"
}
]
},
"encounters": [
{
"id": "encounterid1",
"period": {
"start": "2021-8-28T00:00:00",
"end": "2021-8-28T00:00:00"
},
"class": "inpatient"
}
],
"patientDocuments": [
{
"type": "note",
"clinicalType": "radiologyReport",
"id": "docid1",
"language": "en",
"authors": [
{
"id": "authorid1",
"fullName": "authorname1"
}
],
"specialtyType": "radiology",
"createdAt": "2021-8-28T00:00:00",
"administrativeMetadata": {
"orderedProcedures": [
{
"code": {
"coding": [
{
"system": "Https://loinc.org",
"code": "26688-1",
"display": "US BREAST - LEFT LIMITED"
}
]
},
"description": "US BREAST - LEFT LIMITED"
}
],
"encounterId": "encounterid1"
},
"content": {
"sourceType": "inline",
"value" : "Exam: US LT BREAST TARGETED\r\n\r\nTechnique: Targeted imaging of the right breast is performed.\r\n\r\nFindings:\r\n\r\nTargeted imaging of the left breast is performed from the 6:00 to the 9:00 position. \r\n\r\nAt the 6:00 position, 5 cm from the nipple, there is a 3 x 2 x 4 mm minimally hypoechoic mass with a peripheral calcification. This may correspond to the mammographic finding. No other cystic or solid masses visualized.\r\n"
}
}
]
}
]
}
}
{
"result": {
"patientResults": [
{
"patientId": "11111",
"inferences": [
{
"kind": "lateralityDiscrepancy",
"lateralityIndication": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "24028007",
"display": "RIGHT (QUALIFIER VALUE)"
}
]
},
"discrepancyType": "orderLateralityMismatch"
}
]
}
],
"modelVersion": "2024-01-10-Preview"
},
"id": "c09cbea6-cc13-486d-9238-1b0f98598375",
"createdDateTime": "2024-01-12T07:28:41.1288573Z",
"expirationDateTime": "2024-01-12T07:45:21.1288573Z",
"lastUpdateDateTime": "2024-01-12T07:28:46.7075373Z",
"status": "succeeded"
}
Sex Mismatch This mismatch occurs when the document gives a different sex for the patient than stated in the patient’s info/details in the request. If the patient info contains no sex, then the mismatch can also be flagged when there's contradictory language about the patient’s sex in the text.
- kind: RadiologyInsightsInferenceType.SexMismatch
- sexIndication: FHIR.R4.CodeableConcept
Field "sexIndication" contains one coding with a SNOMED concept for either MALE (FINDING) if the document refers to a male or FEMALE (FINDING) if the document refers to a female: - 248153007: MALE (FINDING)
- 248152002: FEMALE (FINDING)
Examples request/response json:
{
"jobData": {
"configuration": {
"inferenceOptions": {
"followupRecommendationOptions": {
"includeRecommendationsWithNoSpecifiedModality": false,
"includeRecommendationsInReferences": false,
"provideFocusedSentenceEvidence": false
},
"findingOptions": {
"provideFocusedSentenceEvidence": false
}
},
"inferenceTypes": ["sexMismatch"],
"locale": "en-US",
"verbose": false,
"includeEvidence": false
},
"patients": [
{
"id": "111111",
"details": {
"sex": "female",
"birthDate" : "2011-08-31T18:00:00+00:00",
"clinicalInfo": [
{
"resourceType": "Observation",
"status": "unknown",
"code": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls",
"code": "C0018802",
"display": "MalignantNeoplasms"
}
]
},
"valueBoolean": "true"
}
]
},
"encounters": [
{
"id": "encounterid1",
"period": {
"start": "2017-10-21T00:00:00",
"end": "2017-10-21T00:00:00"
},
"class": "inpatient"
}
],
"patientDocuments": [
{
"type": "note",
"clinicalType": "radiologyReport",
"id": "docid1",
"language": "en",
"authors": [
{
"id": "authorid1",
"fullName": "authorname1"
}
],
"specialtyType": "radiology",
"createdAt": "2017-10-21T00:00:00",
"administrativeMetadata": {
"orderedProcedures": [
{
"code": {
"coding": [
{
"system": "Https://loinc.org",
"code": "37006-4",
"display": "MG BREAST - BILATERAL MLO"
}
]
},
"description": "MG BREAST - BILATERAL MLO"
}
],
"encounterId": "encounterid1"
},
"content": {
"sourceType": "inline",
"value" : "Clinical indication: Screening mammogram on a 43 year old man.\r\n\r\nTechnique: Bilateral screening digital mammographic views with tomosynthesis.\n\r\n\r\nFindings:\nThe breast demonstrate scattered fibroglandular densities. There is a nodular density 2-3 o'clock posterior left breast. There are no suspicious masses, microcalcifications or areas of architectural distortion suggestive of malignancy. Both visualized axillae are unremarkable.\n\r\n\r\nImpression:\nNodularity 2-3 o'clock posterior left breast. Recommend left mammography in 6 months.\r\n\nFindings were discussed with Jane Doe, MD at 3:15 pm on 2023/09/05.\n \n \n \r\n\r\nRadiology Insights service surfaces insights documented by the radiologist in a radiology report. No new medical conclusions are drawn from it."
}
}
]
}
]
}
}
{
"result": {
"patientResults": [
{
"patientId": "11111",
"inferences": [
{
"kind": "sexMismatch",
"sexIndication": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "248153007",
"display": "MALE (FINDING)"
}
]
}
}
]
}
],
"modelVersion": "2024-01-10-Preview"
},
"id": "9ac3de47-c163-4838-bfe8-c27f127123ae",
"createdDateTime": "2024-01-12T07:33:22.787062Z",
"expirationDateTime": "2024-01-12T07:50:02.787062Z",
"lastUpdateDateTime": "2024-01-12T07:33:29.786962Z",
"status": "succeeded"
}
Complete Order Discrepancy A CompleteOrderDiscrepancy is created if there's a complete orderedProcedure for a body region and not all the body parts for this body region or their measurements are in the text.
- kind: RadiologyInsightsInferenceType.CompleteOrderDiscrepancy
- orderType: FHIR.R4.CodeableConcept
- MissingBodyParts: Array FHIR.R4.CodeableConcept
- missingBodyPartMeasurements: Array FHIR.R4.CodeableConcept
Field "ordertype" contains one Coding, with one of the following Loinc codes:
- 24558-9: US Abdomen
- 24869-0: US Pelvis
- 24531-6: US Retroperitoneum
- 24601-7: US breast
Fields "missingBodyParts" and/or "missingBodyPartsMeasurements" contain body parts (radlex codes) that are missing or whose measurements are missing. The provided evidence for this inference refers to body parts or measurements that are present (or words that imply them).
Example: A report with "ULTRASOUND, PELVIC (NONOBSTETRIC), REAL TIME WITH IMAGE DOCUMENTATION; COMPLETE" as orderedProcedure needs to mention the body parts uterus, left ovary, right ovary, endometrium and their measurements.
Examples request/response json:
{
"jobData": {
"configuration": {
"inferenceOptions": {
"followupRecommendationOptions": {
"includeRecommendationsWithNoSpecifiedModality": false,
"includeRecommendationsInReferences": false,
"provideFocusedSentenceEvidence": false
},
"findingOptions": {
"provideFocusedSentenceEvidence": false
}
},
"inferenceTypes": ["completeOrderDiscrepancy"],
"locale": "en-US",
"verbose": false,
"includeEvidence": false
},
"patients": [
{
"id": "111111",
"details": {
"sex": "female",
"birthDate" : "1959-11-11T19:00:00+00:00",
"clinicalInfo": [
{
"resourceType": "Observation",
"status": "unknown",
"code": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls",
"code": "C0018802",
"display": "MalignantNeoplasms"
}
]
},
"valueBoolean": "true"
}
]
},
"encounters": [
{
"id": "encounterid1",
"period": {
"start": "2021-8-28T00:00:00",
"end": "2021-8-28T00:00:00"
},
"class": "inpatient"
}
],
"patientDocuments": [
{
"type": "note",
"clinicalType": "radiologyReport",
"id": "docid1",
"language": "en",
"authors": [
{
"id": "authorid1",
"fullName": "authorname1"
}
],
"specialtyType": "radiology",
"createdAt": "2021-8-28T00:00:00",
"administrativeMetadata": {
"orderedProcedures": [
{
"code": {
"coding": [
{
"system": "Http://hl7.org/fhir/ValueSet/cpt-all",
"code": "76856",
"display": "USPELVIS - US PELVIS COMPLETE"
}
]
},
"description": "USPELVIS - US PELVIS COMPLETE"
}
],
"encounterId": "encounterid1"
},
"content": {
"sourceType": "inline",
"value" : "\r\n\r\n\r\nCLINICAL HISTORY: \r\n20-year-old female presenting with abdominal pain. Surgical history \r\nsignificant for appendectomy.\r\n \r\nCOMPARISON: \r\nRight upper quadrant sonographic performed 1 day prior.\r\n \r\nTECHNIQUE: \r\nTransabdominal grayscale pelvic sonography with duplex color Doppler \r\nand spectral waveform analysis of the ovaries.\r\n \r\nFINDINGS: \r\nThe uterus is unremarkable given the transabdominal technique with \r\nendometrial echo complex within physiologic normal limits. The \r\novaries are symmetric in size. The right ovary measures 2.5 x 1.2 x 3.0 cm. The \r\nleft ovary measures 2.8 x 1.5 x 1.9 cm.\n \r\nOn duplex imaging, symmetrical signal.\r\n \r\nIMPRESSION: \r\n1. Normal pelvic sonography. Findings of testicular torsion.\r\n\nA new US pelvis within the next 6 months is recommended.\n\nRecommend clinical follow up in 1-2 weeks.\n\nThese results have been discussed with Dr. Doe at 3 PM on November 1 2020.\n \r\n"
}
}
]
}
]
}
}
{
"result": {
"patientResults": [
{
"patientId": "11111",
"inferences": [
{
"kind": "completeOrderDiscrepancy",
"orderType": {
"coding": [
{
"system": "http://loinc.org",
"code": "24869-0",
"display": "US Pelvis"
}
]
},
"missingBodyParts": [],
"missingBodyPartMeasurements": [
{
"coding": [
{
"system": "http://radlex.org",
"code": "RID302",
"display": "UTERUS"
}
]
},
{
"coding": [
{
"system": "http://radlex.org",
"code": "RID30958",
"display": "ENDOMETRIUM"
}
]
}
]
}
]
}
],
"modelVersion": "2024-01-10-Preview"
},
"id": "debe34dc-2c52-49d0-aac3-0ab4630b460d",
"createdDateTime": "2024-01-12T07:16:59.2847076Z",
"expirationDateTime": "2024-01-12T07:33:39.2847076Z",
"lastUpdateDateTime": "2024-01-12T07:17:07.153749Z",
"status": "succeeded"
}
Limited Order Discrepancy
This inference is created if there's a limited orderedProcedure, meaning that not all body parts and measurements for a corresponding complete order should be in the text.
- kind: RadiologyInsightsInferenceType.LimitedOrderDiscrepancy
- orderType: FHIR.R4.CodeableConcept
- PresentBodyParts: Array FHIR.R4.CodeableConcept
- PresentBodyPartMeasurements: Array FHIR.R4.CodeableConcept
Field "ordertype" contains one Coding, with one of the following Loinc codes:
- 24558-9: US Abdomen
- 24869-0: US Pelvis
- 24531-6: US Retroperitoneum
- 24601-7: US breast
Fields "presentBodyParts" and/or "presentBodyPartsMeasurements" contain body parts (radlex codes) that are present or whose measurements are present. The provided evidence for this inference refers to body parts or measurements that are present (or words that imply them). Example: A report with "US ABDOMEN LIMITED" as orderedProcedure shouldn't mention all body parts corresponding to a complete order.
Examples request/response json:
{
"jobData": {
"configuration": {
"inferenceOptions": {
"followupRecommendationOptions": {
"includeRecommendationsWithNoSpecifiedModality": false,
"includeRecommendationsInReferences": false,
"provideFocusedSentenceEvidence": false
},
"findingOptions": {
"provideFocusedSentenceEvidence": false
}
},
"inferenceTypes": ["limitedOrderDiscrepancy"],
"locale": "en-US",
"verbose": false,
"includeEvidence": false
},
"patients": [
{
"id": "111111",
"details": {
"sex": "male",
"birthDate" : "1959-11-11T19:00:00+00:00",
"clinicalInfo": [
{
"resourceType": "Observation",
"status": "unknown",
"code": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls",
"code": "C0018802",
"display": "MalignantNeoplasms"
}
]
},
"valueBoolean": "true"
}
]
},
"encounters": [
{
"id": "encounterid1",
"period": {
"start": "2021-8-28T00:00:00",
"end": "2021-8-28T00:00:00"
},
"class": "inpatient"
}
],
"patientDocuments": [
{
"type": "note",
"clinicalType": "radiologyReport",
"id": "docid1",
"language": "en",
"authors": [
{
"id": "authorid1",
"fullName": "authorname1"
}
],
"specialtyType": "radiology",
"createdAt": "2021-8-28T00:00:00",
"administrativeMetadata": {
"orderedProcedures": [
{
"code": {
"coding": [
{
"system": "Https://loinc.org",
"code": "30704-1",
"display": "US ABDOMEN LIMITED"
}
]
},
"description": "US ABDOMEN LIMITED"
}
],
"encounterId": "encounterid1"
},
"content": {
"sourceType": "inline",
"value" : "\nHISTORY: 49-year-old male with a history of tuberous sclerosis presenting with epigastric pain and diffuse tenderness. The patient was found to have pericholecystic haziness on CT; evaluation for acute cholecystitis.\n\nTECHNIQUE: Ultrasound evaluation of the abdomen was performed. Comparison is made to the prior abdominal ultrasound (2004) and to the enhanced CT of the abdomen and pelvis (2014).\n\nFINDINGS:\n\nThe liver is elongated, measuring 19.3 cm craniocaudally, and is homogeneous in echotexture without evidence of focal mass lesion. The liver contour is smooth on high resolution images. There is no appreciable intra- or extrahepatic biliary ductal dilatation, with the visualized extrahepatic bile duct measuring up to 6 mm. There are multiple shadowing gallstones, including within the gallbladder neck, which do not appear particularly mobile. In addition, there is thickening of the gallbladder wall up to approximately 7 mm with probable mild mural edema. There is no pericholecystic fluid. No sonographic Murphy's sign was elicited; however the patient reportedly received pain medications in the emergency department.\n\nThe pancreatic head, body and visualized portions of the tail are unremarkable. The spleen is normal in size, measuring 9.9 cm in length.\n\nThe kidneys are normal in size. The right kidney measures 11.5 x 5.2 x 4.3 cm and the left kidney measuring 11.8 x 5.3 x 5.1 cm. There are again multiple bilateral echogenic renal masses consistent with angiomyolipomas, in keeping with the patient's history of tuberous sclerosis. The largest echogenic mass on the right is located in the upper pole and measures 1.2 x 1.3 x 1.3 cm. The largest echogenic mass on the left is located within the renal sinus and measures approximately 2.6 x 2.7 x 4.6 cm. Additional indeterminate renal lesions are present bilaterally and are better characterized on CT. There is no hydronephrosis.\n\nNo ascites is identified within the upper abdomen.\n\nThe visualized portions of the upper abdominal aorta and IVC are normal in caliber.\n\nIMPRESSION:\n\n1. Numerous gallstones associated with gallbladder wall thickening and probable gallbladder mural edema, highly suspicious for acute cholecystitis in this patient presenting with epigastric pain and pericholecystic hazy density identified on CT. Although no sonographic Murphy sign was elicited, evaluation is limited secondary to reported prior administration of pain medication. Thus, clinical correlation is required. No evidence of biliary ductal dilation.\n\n2. There are again multiple bilateral echogenic renal masses consistent with angiomyolipomas, in keeping with the patient's history of tuberous sclerosis. Additional indeterminate renal lesions are present bilaterally and are better characterized on CT and MR.\n\nThese findings were discussed with Dr. Doe at 5:05 p.m. on 1/1/15."
}
}
]
}
]
}
}
{
"result": {
"patientResults": [
{
"patientId": "11111",
"inferences": [
{
"kind": "limitedOrderDiscrepancy",
"orderType": {
"coding": [
{
"system": "http://loinc.org",
"code": "24558-9",
"display": "US Abdomen"
}
]
},
"presentBodyParts": [
{
"coding": [
{
"system": "http://radlex.org",
"code": "RID58",
"display": "Liver"
}
]
},
{
"coding": [
{
"system": "http://radlex.org",
"code": "RID187",
"display": "GALLBLADDER"
}
]
},
{
"coding": [
{
"system": "http://radlex.org",
"code": "RID199",
"display": "COMMON BILE DUCT"
}
]
},
{
"coding": [
{
"system": "http://radlex.org",
"code": "RID170",
"display": "PANCREAS"
}
]
},
{
"coding": [
{
"system": "http://radlex.org",
"code": "RID86",
"display": "SPLEEN"
}
]
},
{
"coding": [
{
"system": "http://radlex.org",
"code": "RID29663",
"display": "LEFT KIDNEY"
}
]
},
{
"coding": [
{
"system": "http://radlex.org",
"code": "RID29662",
"display": "RIGHT KIDNEY"
}
]
},
{
"coding": [
{
"system": "http://radlex.org",
"code": "RID905",
"display": "ABDOMINAL AORTA"
}
]
},
{
"coding": [
{
"system": "http://radlex.org",
"code": "RID1178",
"display": "INFERIOR VENA CAVA"
}
]
}
],
"presentBodyPartMeasurements": []
}
]
}
],
"modelVersion": "2024-01-10-Preview"
},
"id": "6d836504-f884-428d-b823-752947387b4a",
"createdDateTime": "2024-01-12T07:13:58.7944605Z",
"expirationDateTime": "2024-01-12T07:30:38.7944605Z",
"lastUpdateDateTime": "2024-01-12T07:14:11.9375243Z",
"status": "succeeded"
}
Finding
This inference is created for a medical problem (for example "acute infection of the lungs") or for a characteristic or a nonpathologic finding of a body part (for example "stomach normal").
- kind: RadiologyInsightsInferenceType.finding
- finding: FHIR.R4.Observation
Finding: Section Next to the provided evidence for this inference, there can be an extension with "url" : "section". This extension has an inner extension with a display name that describes the section, the inner extension contains a LOINC code.
When the findingOptions provideFocusedSentenceEvidence is on true, there can also be an extension with url "ci_sentence". This extension refers to the sentence containing the first word of the clinical indicator (that is, the medical problem), if any. The generation of such a sentence is switchable using the model configuration.
Additional info can be found in the document Model Configuration.
Finding: status and resourceType:
- status: is always set to "unknown"
- resourceType: is always set to "Observation"
Finding: interpretation: contains a sublist of the following SNOMED codes:
- 7147002: NEW (QUALIFIER VALUE)
- 36692007: KNOWN (QUALIFIER VALUE)
- 260413007: NONE (QUALIFIER VALUE)
- 260385009: NEGATIVE (QUALIFIER VALUE)
- 723506003: RESOLVED (QUALIFIER VALUE)
- 64957009: UNCERTAIN (QUALIFIER VALUE)
- 385434005: IMPROBABLE DIAGNOSIS (CONTEXTUAL QUALIFIER) (QUALIFIER VALUE)
- 60022001: POSSIBLE DIAGNOSIS (CONTEXTUAL QUALIFIER) (QUALIFIER VALUE)
- 2931005: PROBABLE DIAGNOSIS (CONTEXTUAL QUALIFIER) (QUALIFIER VALUE)
- 15841000000104: CANNOT BE EXCLUDED (QUALIFIER VALUE)
- 260905004: CONDITION (ATTRIBUTE)
- 441889009: DENIED (QUALIFIER VALUE)
- 722291000000108: HISTORY (QUALIFIER VALUE)
- 6493001: RECENT (QUALIFIER VALUE)
- 2667000: ABSENT (QUALIFIER VALUE)
- 17621005: NORMAL (QUALIFIER VALUE)
- 263730007: CONTINUAL (QUALIFIER VALUE)
In this list, the string before the colon is the code, and the string after the colon is the display name. If the value is "NONE (QUALIFIER VALUE)", the finding is absent. This value is, for example, "no sepsis".
code:
- SNOMED code 404684003: CLINICAL FINDING (FINDING) (meaning that the finding has a clinical indicator) or
- SNOMED code 123037004: BODY STRUCTURE (BODY STRUCTURE) (no clinical indicator.)
Finding: field "component" Much relevant information is in the components. The component’s "code" field contains one CodeableConcept with one SNOMED code.
Component description: For this inference some of the components are optional.
Finding: component "subject of information" This component has SNOMED code 131195008: SUBJECT OF INFORMATION (ATTRIBUTE). It also has the "valueCodeableConcept" field filled. The value is a SNOMED code describing the medical problem that the finding pertains to. At least one "subject of information" component is present if and only if the "finding.code" field has 404684003: CLINICAL FINDING (FINDING). There can be several "subject of information" components, with different concepts in the "valueCodeableConcept" field.
Finding: component "anatomy" Zero or more components with SNOMED code "722871000000108: ANATOMY (QUALIFIER VALUE)". This component has field "valueCodeConcept" filled with a SNOMED or radlex code. For example, for "lung infection" this component contains a code for the lungs.
Finding: component "region" Zero or more components with SNOMED code 45851105: REGION (ATTRIBUTE). Like anatomy, this component has field "valueCodeableConcept" filled with a SNOMED or radlex code. Such a concept refers to the body region of the anatomy. For example, if the anatomy is a code for the vagina, the region may be a code for the female reproductive system.
Finding: component "laterality" Zero or more components with code 45651917: LATERALITY (ATTRIBUTE). Each has field "valueCodeableConcept" set to a SNOMED concept pertaining to the laterality of the finding. For example, this component is filled for a finding pertaining to the right arm.
Finding: component "change values" Zero or more components with code 288533004: CHANGE VALUES (QUALIFIER VALUE). Each has field "valueCodeableConcept" set to a SNOMED concept pertaining to a size change in the finding (for example, a nodule that is growing or decreasing).
Finding: component "percentage" At most one component with code 45606679: PERCENT (PROPERTY) (QUALIFIER VALUE). It has field "valueString" set with either a value or a range consisting of a lower and upper value, separated by "-".
Finding: component "severity" At most one component with code 272141005: SEVERITIES (QUALIFIER VALUE), indicating how severe the medical problem is. It has field "valueCodeableConcept" set with a SNOMED code from the following list:
- 255604002: MILD (QUALIFIER VALUE)
- 6736007: MODERATE (SEVERITY MODIFIER) (QUALIFIER VALUE)
- 24484000: SEVERE (SEVERITY MODIFIER) (QUALIFIER VALUE)
- 371923003: MILD TO MODERATE (QUALIFIER VALUE)
- 371924009: MODERATE TO SEVERE (QUALIFIER VALUE)
Finding: component "chronicity" At most one component with code 246452003: CHRONICITY (ATTRIBUTE), indicating whether the medical problem is chronic or acute. It has field "valueCodeableConcept" set with a SNOMED code from the following list:
- 255363002: SUDDEN (QUALIFIER VALUE)
- 90734009: CHRONIC (QUALIFIER VALUE)
- 19939008: SUBACUTE (QUALIFIER VALUE)
- 255212004: ACUTE-ON-CHRONIC (QUALIFIER VALUE)
Finding: component "cause" At most one component with code 135650694: CAUSES OF HARM (QUALIFIER VALUE), indicating what the cause is of the medical problem. It has field "valueString" set to the strings of one or more tokens from the text, separated by ";;".
Finding: component "qualifier value" Zero or more components with code 362981000: QUALIFIER VALUE (QUALIFIER VALUE). This component refers to a feature of the medical problem. Every component has either:
- Field "valueString" set with token strings from the text, separated by ";;"
- Or field "valueCodeableConcept" set to a SNOMED code
- Or no field set (then the meaning can be retrieved from the token extensions (rare occurrence))
Finding: component "multiple" Exactly one component with code 46150521: MULTIPLE (QUALIFIER VALUE). It has field "valueBoolean" set to true or false. This component indicates the difference between, for example, one nodule (multiple is false) or several nodules (multiple is true). This component has no token extensions.
Finding: component "size" Zero or more components with code 246115007, "SIZE (ATTRIBUTE)". Even if there's just one size for a finding, there are several components if the size has two or three dimensions, for example, "2.1 x 3.3 cm" or "1.2 x 2.2 x 1.5 cm". There's a size component for every dimension. Every component has field "interpretation" set to either SNOMED code 15240007: CURRENT or 9130008: PREVIOUS, depending on whether the size was measured during this visit or in the past. Every component has either field "valueQuantity" or "valueRange" set. If "valueQuantity" is set, then "valueQuantity.value" is always set. In most cases, "valueQuantity.unit" is set. It's possible that "valueQuantity.comparator" is also set, to either ">", "<", ">=" or "<=". For example, the component is set to "<=" for "the tumor is up to 2 cm". If "valueRange" is set, then "valueRange.low" and "valueRange.high" are set to quantities with the same data as described in the previous paragraph. This field contains, for example, "The tumor is between 2.5 cm and 2.6 cm in size".
Examples request/response json:
{
"jobData": {
"configuration": {
"inferenceOptions": {
"followupRecommendationOptions": {
"includeRecommendationsWithNoSpecifiedModality": false,
"includeRecommendationsInReferences": false,
"provideFocusedSentenceEvidence": false
},
"findingOptions": {
"provideFocusedSentenceEvidence": false
}
},
"inferenceTypes": ["finding"],
"locale": "en-US",
"verbose": false,
"includeEvidence": false
},
"patients": [
{
"id": "111111",
"details": {
"sex": "female",
"birthDate" : "2011-08-31T18:00:00+00:00",
"clinicalInfo": [
{
"resourceType": "Observation",
"status": "unknown",
"code": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls",
"code": "C0018802",
"display": "MalignantNeoplasms"
}
]
},
"valueBoolean": "true"
}
]
},
"encounters": [
{
"id": "encounterid1",
"period": {
"start": "2021-8-28T00:00:00",
"end": "2021-8-28T00:00:00"
},
"class": "inpatient"
}
],
"patientDocuments": [
{
"type": "note",
"clinicalType": "radiologyReport",
"id": "docid1",
"language": "en",
"authors": [
{
"id": "authorid1",
"fullName": "authorname1"
}
],
"specialtyType": "radiology",
"createdAt": "2021-8-28T00:00:00",
"administrativeMetadata": {
"orderedProcedures": [
{
"code": {
"coding": [
{
"system": "Https://loinc.org",
"code": "24627-2",
"display": "CT CHEST"
}
]
},
"description": "CT CHEST"
}
],
"encounterId": "encounterid1"
},
"content": {
"sourceType": "inline",
"value": "\n\n\nFINDINGS:\nIn the right upper lobe, there is a new mass measuring 5.6 x 4.5 x 3.4 cm.\nA lobulated soft tissue mass is identified in the superior right lower lobe abutting the major fissure measuring 5.4 x 4.3 x 3.7 cm (series 3 image 94, coronal image 110).\nA 4 mm nodule in the right lower lobe (series 3, image 72) is increased dating back to 6/29/2012. This may represent lower lobe metastasis.\n\nIMPRESSION: 4 cm pulmonary nodule posterior aspect of the right upper lobe necessitating additional imaging as described.\n\t\t"
}
}
]
}
]
}
}
{
"result": {
"patientResults": [
{
"patientId": "11111",
"inferences": [
{
"kind": "finding",
"finding": {
"resourceType": "Observation",
"id": "943",
"status": "unknown",
"category": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "439401001",
"display": "DIAGNOSIS (OBSERVABLE ENTITY)"
}
]
}
],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "404684003",
"display": "CLINICAL FINDING (FINDING)"
}
]
},
"interpretation": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "60022001",
"display": "POSSIBLE DIAGNOSIS (CONTEXTUAL QUALIFIER) (QUALIFIER VALUE)"
}
]
}
],
"component": [
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "131195008",
"display": "SUBJECT OF INFORMATION (ATTRIBUTE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "128462008",
"display": "SECONDARY MALIGNANT NEOPLASTIC DISEASE (DISORDER)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "39607008",
"display": "LUNG STRUCTURE (BODY STRUCTURE)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID13406",
"display": "ANATOMICAL LOBE"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID1301",
"display": "LUNG"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID13437",
"display": "LUNGS"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "46150521",
"display": "MULTIPLE (QUALIFIER VALUE)"
}
]
},
"valueBoolean": false
}
]
},
"extension": [
{
"extension": [
{
"url": "code",
"valueString": "18782-3"
},
{
"url": "codingSystem",
"valueString": "2.16.840.1.113883.6.1"
},
{
"url": "codingSystemName",
"valueString": "http://loinc.org"
},
{
"url": "displayName",
"valueString": "Findings"
}
],
"url": "section"
}
]
},
{
"kind": "finding",
"finding": {
"resourceType": "Observation",
"id": "944",
"status": "unknown",
"category": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "439401001",
"display": "DIAGNOSIS (OBSERVABLE ENTITY)"
}
]
}
],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "404684003",
"display": "CLINICAL FINDING (FINDING)"
}
]
},
"interpretation": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "7147002",
"display": "NEW (QUALIFIER VALUE)"
}
]
}
],
"component": [
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "131195008",
"display": "SUBJECT OF INFORMATION (ATTRIBUTE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "4147007",
"display": "MASS (MORPHOLOGIC ABNORMALITY)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "39607008",
"display": "LUNG STRUCTURE (BODY STRUCTURE)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID13406",
"display": "ANATOMICAL LOBE"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID1301",
"display": "LUNG"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID13437",
"display": "LUNGS"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "45651917",
"display": "LATERALITY (ATTRIBUTE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "24028007",
"display": "RIGHT (QUALIFIER VALUE)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "46150521",
"display": "MULTIPLE (QUALIFIER VALUE)"
}
]
},
"valueBoolean": false
},
{
"code": {
"coding": [
{
"system": "http://radlex.org",
"code": "246115007",
"display": "SIZE (ATTRIBUTE)"
}
]
},
"valueQuantity": {
"value": 5.6,
"unit": "CENTIMETER"
},
"interpretation": [
{
"coding": [
{
"code": "15240007",
"display": "CURRENT"
}
]
}
]
},
{
"code": {
"coding": [
{
"system": "http://radlex.org",
"code": "246115007",
"display": "SIZE (ATTRIBUTE)"
}
]
},
"valueQuantity": {
"value": 4.5,
"unit": "CENTIMETER"
},
"interpretation": [
{
"coding": [
{
"code": "15240007",
"display": "CURRENT"
}
]
}
]
},
{
"code": {
"coding": [
{
"system": "http://radlex.org",
"code": "246115007",
"display": "SIZE (ATTRIBUTE)"
}
]
},
"valueQuantity": {
"value": 3.4,
"unit": "CENTIMETER"
},
"interpretation": [
{
"coding": [
{
"code": "15240007",
"display": "CURRENT"
}
]
}
]
}
]
},
"extension": [
{
"extension": [
{
"url": "code",
"valueString": "18782-3"
},
{
"url": "codingSystem",
"valueString": "2.16.840.1.113883.6.1"
},
{
"url": "codingSystemName",
"valueString": "http://loinc.org"
},
{
"url": "displayName",
"valueString": "Findings"
}
],
"url": "section"
}
]
},
{
"kind": "finding",
"finding": {
"resourceType": "Observation",
"id": "945",
"status": "unknown",
"category": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "439401001",
"display": "DIAGNOSIS (OBSERVABLE ENTITY)"
}
]
}
],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "404684003",
"display": "CLINICAL FINDING (FINDING)"
}
]
},
"component": [
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "131195008",
"display": "SUBJECT OF INFORMATION (ATTRIBUTE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "4147007",
"display": "MASS (MORPHOLOGIC ABNORMALITY)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "39607008",
"display": "LUNG STRUCTURE (BODY STRUCTURE)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID13406",
"display": "ANATOMICAL LOBE"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID1301",
"display": "LUNG"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID13437",
"display": "LUNGS"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "45651917",
"display": "LATERALITY (ATTRIBUTE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "24028007",
"display": "RIGHT (QUALIFIER VALUE)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "362981000",
"display": "QUALIFIER VALUE (QUALIFIER VALUE)"
}
]
},
"valueString": "lobulated"
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "46150521",
"display": "MULTIPLE (QUALIFIER VALUE)"
}
]
},
"valueBoolean": false
},
{
"code": {
"coding": [
{
"system": "http://radlex.org",
"code": "246115007",
"display": "SIZE (ATTRIBUTE)"
}
]
},
"valueQuantity": {
"value": 5.4,
"unit": "CENTIMETER"
},
"interpretation": [
{
"coding": [
{
"code": "15240007",
"display": "CURRENT"
}
]
}
]
},
{
"code": {
"coding": [
{
"system": "http://radlex.org",
"code": "246115007",
"display": "SIZE (ATTRIBUTE)"
}
]
},
"valueQuantity": {
"value": 4.3,
"unit": "CENTIMETER"
},
"interpretation": [
{
"coding": [
{
"code": "15240007",
"display": "CURRENT"
}
]
}
]
},
{
"code": {
"coding": [
{
"system": "http://radlex.org",
"code": "246115007",
"display": "SIZE (ATTRIBUTE)"
}
]
},
"valueQuantity": {
"value": 3.7,
"unit": "CENTIMETER"
},
"interpretation": [
{
"coding": [
{
"code": "15240007",
"display": "CURRENT"
}
]
}
]
}
]
},
"extension": [
{
"extension": [
{
"url": "code",
"valueString": "18782-3"
},
{
"url": "codingSystem",
"valueString": "2.16.840.1.113883.6.1"
},
{
"url": "codingSystemName",
"valueString": "http://loinc.org"
},
{
"url": "displayName",
"valueString": "Findings"
}
],
"url": "section"
}
]
},
{
"kind": "finding",
"finding": {
"resourceType": "Observation",
"id": "946",
"status": "unknown",
"category": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "439401001",
"display": "DIAGNOSIS (OBSERVABLE ENTITY)"
}
]
}
],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "404684003",
"display": "CLINICAL FINDING (FINDING)"
}
]
},
"interpretation": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "36692007",
"display": "KNOWN (QUALIFIER VALUE)"
}
]
}
],
"component": [
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "131195008",
"display": "SUBJECT OF INFORMATION (ATTRIBUTE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "27925004",
"display": "NODULE (MORPHOLOGIC ABNORMALITY)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "39607008",
"display": "LUNG STRUCTURE (BODY STRUCTURE)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID13406",
"display": "ANATOMICAL LOBE"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID1301",
"display": "LUNG"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID13437",
"display": "LUNGS"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "45651917",
"display": "LATERALITY (ATTRIBUTE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "24028007",
"display": "RIGHT (QUALIFIER VALUE)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "288533004",
"display": "CHANGE VALUES (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "35105006",
"display": "INCREASED (QUALIFIER VALUE)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "46150521",
"display": "MULTIPLE (QUALIFIER VALUE)"
}
]
},
"valueBoolean": false
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "46083823",
"display": "DATE AND TIME OF DAY (PROPERTY) (QUALIFIER VALUE)"
}
]
},
"valueDateTime": "2012-06-29"
},
{
"code": {
"coding": [
{
"system": "http://radlex.org",
"code": "246115007",
"display": "SIZE (ATTRIBUTE)"
}
]
},
"valueQuantity": {
"value": 4,
"unit": "MILLIMETER"
},
"interpretation": [
{
"coding": [
{
"code": "15240007",
"display": "CURRENT"
}
]
}
]
}
]
},
"extension": [
{
"extension": [
{
"url": "code",
"valueString": "18782-3"
},
{
"url": "codingSystem",
"valueString": "2.16.840.1.113883.6.1"
},
{
"url": "codingSystemName",
"valueString": "http://loinc.org"
},
{
"url": "displayName",
"valueString": "Findings"
}
],
"url": "section"
}
]
},
{
"kind": "finding",
"finding": {
"resourceType": "Observation",
"id": "947",
"status": "unknown",
"category": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "439401001",
"display": "DIAGNOSIS (OBSERVABLE ENTITY)"
}
]
}
],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "404684003",
"display": "CLINICAL FINDING (FINDING)"
}
]
},
"component": [
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "131195008",
"display": "SUBJECT OF INFORMATION (ATTRIBUTE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "27925004",
"display": "NODULE (MORPHOLOGIC ABNORMALITY)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "39607008",
"display": "LUNG STRUCTURE (BODY STRUCTURE)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID1303",
"display": "UPPER LOBE OF RIGHT LUNG"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID13406",
"display": "ANATOMICAL LOBE"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "45651917",
"display": "LATERALITY (ATTRIBUTE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "24028007",
"display": "RIGHT (QUALIFIER VALUE)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "46150521",
"display": "MULTIPLE (QUALIFIER VALUE)"
}
]
},
"valueBoolean": false
},
{
"code": {
"coding": [
{
"system": "http://radlex.org",
"code": "246115007",
"display": "SIZE (ATTRIBUTE)"
}
]
},
"valueQuantity": {
"value": 4,
"unit": "CENTIMETER"
},
"interpretation": [
{
"coding": [
{
"code": "15240007",
"display": "CURRENT"
}
]
}
]
}
]
},
"extension": [
{
"extension": [
{
"url": "code",
"valueString": "19005-8"
},
{
"url": "codingSystem",
"valueString": "2.16.840.1.113883.6.1"
},
{
"url": "codingSystemName",
"valueString": "http://loinc.org"
},
{
"url": "displayName",
"valueString": "Impresssions"
}
],
"url": "section"
}
]
}
]
}
],
"modelVersion": "2024-01-10-Preview"
},
"id": "dbff77ce-e28f-4c24-a298-53db82c2e37c",
"createdDateTime": "2024-01-12T07:24:44.9837229Z",
"expirationDateTime": "2024-01-12T07:41:24.9837229Z",
"lastUpdateDateTime": "2024-01-12T07:24:52.5370766Z",
"status": "succeeded"
}
Critical Result This inference is made for a new medical problem that requires attention within a specific time frame, possibly urgent.
- kind: RadiologyInsightsInferenceType.criticalResult
- result: CriticalResult
Field "result.description" gives a description of the medical problem, for example "MALIGNANCY". Field "result.finding", if set, contains the same information as the "finding" field in a finding inference.
Next to provided evidence for this inference, there can be an extension for a section. This field contains the most specific section that the first token of the critical result is in (or to be precise, the first token that is in a section). This section is in the same format as a section for a finding. This extension has an inner extension with a display name that describes the section. When a Loinc code is known for this section, the inner extension will also have a code.
Examples request/response json:
{
"jobData": {
"configuration": {
"inferenceOptions": {
"followupRecommendationOptions": {
"includeRecommendationsWithNoSpecifiedModality": false,
"includeRecommendationsInReferences": false,
"provideFocusedSentenceEvidence": false
},
"findingOptions": {
"provideFocusedSentenceEvidence": false
}
},
"inferenceTypes": ["criticalResult"],
"locale": "en-US",
"verbose": false,
"includeEvidence": false
},
"patients": [
{
"id": "111111",
"details": {
"sex": "female",
"birthDate" : "1986-07-01T21:00:00+00:00",
"clinicalInfo": [
{
"resourceType": "Observation",
"status": "unknown",
"code": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls",
"code": "C0018802",
"display": "MalignantNeoplasms"
}
]
},
"valueBoolean": "true"
}
]
},
"encounters": [
{
"id": "encounterid1",
"period": {
"start": "2021-8-28T00:00:00",
"end": "2021-8-28T00:00:00"
},
"class": "inpatient"
}
],
"patientDocuments": [
{
"type": "note",
"clinicalType": "radiologyReport",
"id": "docid1",
"language": "en",
"authors": [
{
"id": "authorid1",
"fullName": "authorname1"
}
],
"specialtyType": "radiology",
"createdAt": "2021-8-28T00:00:00",
"administrativeMetadata": {
"orderedProcedures": [
{
"code": {
"coding": [
{
"system": "Https://loinc.org",
"code": "26086-9",
"display": "XR KNEE - LEFT 2 VIEWS"
}
]
},
"description": "XR KNEE - LEFT 2 VIEWS"
}
],
"encounterId": "encounterid1"
},
"content": {
"sourceType": "inline",
"value" : "Indication: Pain.\n\nComparison: None available.\n\nTechnique: knee routine right\n\nFindings: \nMinimally displaced fibular head fracture, best seen on lateral view. No additional acute fracture is detected. The visualized joint spaces appear maintained. No evidence of joint effusion.\n\nImpression:\nMinimally displaced fracture of the fibular head, best seen on lateral view. Suggest MRI of the left knee for further evaluation.\n\n"
}
}
]
}
]
}
}
{
"result": {
"patientResults": [
{
"patientId": "11111",
"inferences": [
{
"kind": "criticalResult",
"result": {
"description": "NEW FRACTURE",
"finding": {
"resourceType": "Observation",
"id": "722",
"status": "unknown",
"category": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "439401001",
"display": "DIAGNOSIS (OBSERVABLE ENTITY)"
}
]
}
],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "404684003",
"display": "CLINICAL FINDING (FINDING)"
}
]
},
"component": [
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "131195008",
"display": "SUBJECT OF INFORMATION (ATTRIBUTE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "72704001",
"display": "FRACTURE (MORPHOLOGIC ABNORMALITY)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "131195008",
"display": "SUBJECT OF INFORMATION (ATTRIBUTE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "417163006",
"display": "TRAUMATIC AND/OR NON-TRAUMATIC INJURY (DISORDER)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "30021000",
"display": "LOWER LEG STRUCTURE (BODY STRUCTURE)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID2871",
"display": "FIBULA"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID28569",
"display": "SET OF BONE ORGANS"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID13197",
"display": "BONE ORGAN"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "362981000",
"display": "QUALIFIER VALUE (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "112638000",
"display": "DISPLACEMENT (MORPHOLOGIC ABNORMALITY)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "46150521",
"display": "MULTIPLE (QUALIFIER VALUE)"
}
]
},
"valueBoolean": false
}
]
}
}
},
{
"kind": "criticalResult",
"result": {
"description": "NEW FRACTURE",
"finding": {
"resourceType": "Observation",
"id": "724",
"status": "unknown",
"category": [
{
"coding": [
{
"system": "http://snomed.info/sct",
"code": "439401001",
"display": "DIAGNOSIS (OBSERVABLE ENTITY)"
}
]
}
],
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "404684003",
"display": "CLINICAL FINDING (FINDING)"
}
]
},
"component": [
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "131195008",
"display": "SUBJECT OF INFORMATION (ATTRIBUTE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "72704001",
"display": "FRACTURE (MORPHOLOGIC ABNORMALITY)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "131195008",
"display": "SUBJECT OF INFORMATION (ATTRIBUTE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "417163006",
"display": "TRAUMATIC AND/OR NON-TRAUMATIC INJURY (DISORDER)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "30021000",
"display": "LOWER LEG STRUCTURE (BODY STRUCTURE)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID2871",
"display": "FIBULA"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID28569",
"display": "SET OF BONE ORGANS"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "722871000000108",
"display": "ANATOMY (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://radlex.org",
"code": "RID13197",
"display": "BONE ORGAN"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "362981000",
"display": "QUALIFIER VALUE (QUALIFIER VALUE)"
}
]
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "112638000",
"display": "DISPLACEMENT (MORPHOLOGIC ABNORMALITY)"
}
]
}
},
{
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "46150521",
"display": "MULTIPLE (QUALIFIER VALUE)"
}
]
},
"valueBoolean": false
}
]
}
}
}
]
}
],
"modelVersion": "2024-01-10-Preview"
},
"id": "780e4802-2a64-44d9-a108-bda47f477198",
"createdDateTime": "2024-01-12T07:35:57.9734608Z",
"expirationDateTime": "2024-01-12T07:52:37.9734608Z",
"lastUpdateDateTime": "2024-01-12T07:36:04.755901Z",
"status": "succeeded"
}
Follow-up Recommendation
This inference is created when the text recommends a specific medical procedure or follow-up for the patient.
- kind: RadiologyInsightsInferenceType.FollowupRecommendation
- effectiveDateTime/effectiveAt: utcDateTime
- effectivePeriod: FHIR.R4.Period
- findings: Array RecommendationFinding
- isConditional: boolean
- isOption: boolean
- isGuideline: boolean
- isHedging: boolean
- recommendedProcedure: ProcedureRecommendation.
Explanation of the different fields:
- follow-up Recommendation: sentences Next to the provided evidence for this inference, there can be an extension containing sentences. When the followupRecommendationOptions provideFocusedSentenceEvidence is on true, there can also be an extension with url "modality_sentences". This extension refers to the sentence containing the first word of the modality (that is, the procedure). The generation of such a sentence is switchable using the model configuration.
Check Model Configuration for more info.
recommendedProcedure: ProcedureRecommendation
- follow-up Recommendation: sentences Next to the token extensions, there can be an extension containing sentences. This behavior is switchable.
- follow-up Recommendation: boolean fields "isHedging" mean that the recommendation is uncertain, for example, "a follow-up could be done". "isConditional" is for input like "If the patient continues having pain, Magnetic Resonance Imaging should be performed." "isOptions": is also for conditional input. "isGuideline" means that the recommendation is in a general guideline:
BI-RADS CATEGORIES:
Incomplete: Needs more imaging evaluation
Negative
Benign
Probably benign - Short interval follow-up suggested
Suspicious abnormality - Biopsy should be considered
Highly suggestive of malignancy - Appropriate action should be taken.
Known biopsy-proven malignancy
follow-up Recommendation: effectiveDateTime/effectiveAt and effectivePeriod. Field "effectiveDateTime" or "effectiveAt" will be set when the procedure needs to be done (recommended) at a specific point in time. For example, "next Wednesday". Field "effectivePeriod" will be set if a specific period is mentioned, with a start and end datetime. For example, for "within six months", the start datetime will be the date of service, and the end datetime will be the day six months after that.
follow-up Recommendation: findings If set, field "findings" contains one or more findings that have to do with the recommendation. For example, a leg scan (procedure) can be recommended because of leg pain (finding). Every array element of field "findings" is a RecommendationFinding. Field RecommendationFinding.finding has the same information as a FindingInference.finding field. For field "RecommendationFinding.RecommendationFindingStatus", see the OpenAPI specification for the possible values. Field "RecommendationFinding.criticalFinding" is set if a critical result is associated with the finding. It then contains the same information as described for a critical result inference.
follow-up Recommendation: recommended procedure Field "recommendedProcedure" is either a GenericProcedureRecommendation, or an ImagingProcedureRecommendation. (Type "procedureRecommendation" is a supertype for these two types.) A GenericProcedureRecommendation has the following:
Field "kind" has value "genericProcedureRecommendation"
Field "description" has either value "MANAGEMENT PROCEDURE (PROCEDURE)" or "CONSULTATION (PROCEDURE)"
Field "code" only contains an extension with tokens An ImagingProcedureRecommendation has the following:
Field "kind" has value "imagingProcedureRecommendation"
Field "imagingProcedures" contains an array with one element of type ImagingProcedure.
This type has the following fields, the first 2 of which are always filled:
- "modality": a CodeableConcept containing at most one coding with a SNOMED code.
- "anatomy": a CodeableConcept containing at most one coding with a SNOMED code.
- "laterality: a CodeableConcept containing at most one coding with a SNOMED code.
- "contrast": not set.
- "view": not set.
Examples request/response json:
{
"jobData": {
"configuration": {
"inferenceOptions": {
"followupRecommendationOptions": {
"includeRecommendationsWithNoSpecifiedModality": true,
"includeRecommendationsInReferences": false,
"provideFocusedSentenceEvidence": false
},
"findingOptions": {
"provideFocusedSentenceEvidence": true
}
},
"inferenceTypes": ["finding", "followupRecommendation"],
"locale": "en-US",
"verbose": false,
"includeEvidence": true
},
"patients": [
{
"id": "111111",
"details": {
"sex": "female",
"birthDate" : "2011-08-31T18:00:00+00:00",
"clinicalInfo": [
{
"resourceType": "Observation",
"status": "unknown",
"code": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls",
"code": "C0018802",
"display": "MalignantNeoplasms"
}
]
},
"valueBoolean": "true"
}
]
},
"encounters": [
{
"id": "encounterid1",
"period": {
"start": "2014-2-20T00:00:00",
"end": "2014-2-20T00:00:00"
},
"class": "inpatient"
}
],
"patientDocuments": [
{
"type": "note",
"clinicalType": "radiologyReport",
"id": "docid1",
"language": "en",
"authors": [
{
"id": "authorid1",
"fullName": "authorname1"
}
],
"specialtyType": "radiology",
"createdAt": "2014-2-20T00:00:00",
"administrativeMetadata": {
"orderedProcedures": [
{
"code": {
"coding": [
{
"system": "Https://loinc.org",
"code": "LP207608-3",
"display": "ULTRASOUND"
}
]
},
"description": "ULTRASOUND"
}
],
"encounterId": "encounterid1"
},
"content": {
"sourceType": "inline",
"value" : " \n\nIMPRESSION: \n \n1. Given its size, surgical \nconsultation is recommended.\n2. Recommend ultrasound.\n3. Recommend screening.\n\nRECOMMENDATION:\n\nTHIS IS A (AAA) CASE. An aneurysm follow up program has been developed to facilitate the monitoring of your patient and the next ultrasound will be arranged based on approved guidelines. \nKP NW Practice Guidelines for Surveillance of a AAA: Recommended Imaging Intervals \n<3cm No need for followup \n3-3.9cm Every 3 years \n4-4.4cm Every 2 years \n4.5-4.9cm Female every 6 months, Male every year \n5.0-5.5cm Male every 6 months \nReferral to Vascular Surgery: \nFemale >5cm \nMale <60 years of age; >5cm \nMale >61 years of age; >5.5cm.\nIf infrarenal aorta not well seen on US, repeat in 1 month with 24 hour liquid diet. If still not well seen, CT non-contrast abd/pelvis.\n"
}
}
]
}
]
}
}
{
"result": {
"patientResults": [
{
"patientId": "11111",
"inferences": [
{
"kind": "followupRecommendation",
"findings": [],
"isConditional": false,
"isOption": false,
"isGuideline": false,
"isHedging": false,
"recommendedProcedure": {
"kind": "imagingProcedureRecommendation",
"procedureCodes": [
{
"coding": [
{
"system": "http://loinc.org",
"code": "25061-3",
"display": "US UNSPECIFIED BODY REGION"
}
]
}
],
"imagingProcedures": [
{
"modality": {
"extension": [
{
"extension": [
{
"url": "reference",
"valueReference": {
"reference": "docid1"
}
},
{
"url": "offset",
"valueInteger": 91
},
{
"url": "length",
"valueInteger": 10
}
],
"url": "http://hl7.org/fhir/StructureDefinition/derivation-reference"
}
],
"coding": [
{
"system": "http://snomed.info/sct",
"code": "16310003",
"display": "DIAGNOSTIC ULTRASONOGRAPHY (PROCEDURE)"
}
]
},
"anatomy": {
"extension": [
{
"extension": [
{
"url": "reference",
"valueReference": {
"reference": "docid1"
}
},
{
"url": "offset",
"valueInteger": 91
},
{
"url": "length",
"valueInteger": 10
}
],
"url": "http://hl7.org/fhir/StructureDefinition/derivation-reference"
}
],
"coding": [
{
"system": "http://snomed.info/sct",
"code": "279495008",
"display": "HUMAN BODY STRUCTURE (BODY STRUCTURE)"
}
]
}
}
]
},
"extension": [
{
"extension": [
{
"url": "reference",
"valueReference": {
"reference": "docid1"
}
},
{
"url": "offset",
"valueInteger": 91
},
{
"url": "length",
"valueInteger": 10
}
],
"url": "http://hl7.org/fhir/StructureDefinition/derivation-reference"
}
]
},
{
"kind": "followupRecommendation",
"findings": [],
"isConditional": false,
"isOption": false,
"isGuideline": false,
"isHedging": false,
"recommendedProcedure": {
"kind": "imagingProcedureRecommendation",
"imagingProcedures": [
{
"modality": {
"extension": [
{
"extension": [
{
"url": "reference",
"valueReference": {
"reference": "docid1"
}
},
{
"url": "offset",
"valueInteger": 116
},
{
"url": "length",
"valueInteger": 9
}
],
"url": "http://hl7.org/fhir/StructureDefinition/derivation-reference"
}
],
"coding": [
{
"system": "http://snomed.info/sct",
"code": "363680008",
"display": "RADIOGRAPHIC IMAGING PROCEDURE (PROCEDURE)"
}
]
},
"anatomy": {
"extension": [
{
"extension": [
{
"url": "reference",
"valueReference": {
"reference": "docid1"
}
},
{
"url": "offset",
"valueInteger": 116
},
{
"url": "length",
"valueInteger": 9
}
],
"url": "http://hl7.org/fhir/StructureDefinition/derivation-reference"
}
],
"coding": [
{
"system": "http://snomed.info/sct",
"code": "279495008",
"display": "HUMAN BODY STRUCTURE (BODY STRUCTURE)"
}
]
}
}
]
},
"extension": [
{
"extension": [
{
"url": "reference",
"valueReference": {
"reference": "docid1"
}
},
{
"url": "offset",
"valueInteger": 116
},
{
"url": "length",
"valueInteger": 9
}
],
"url": "http://hl7.org/fhir/StructureDefinition/derivation-reference"
}
]
},
{
"kind": "followupRecommendation",
"findings": [],
"isConditional": false,
"isOption": false,
"isGuideline": false,
"isHedging": false,
"recommendedProcedure": {
"kind": "genericProcedureRecommendation",
"code": {
"extension": [
{
"extension": [
{
"url": "reference",
"valueReference": {
"reference": "docid1"
}
},
{
"url": "offset",
"valueInteger": 39
},
{
"url": "length",
"valueInteger": 8
}
],
"url": "http://hl7.org/fhir/StructureDefinition/derivation-reference"
},
{
"extension": [
{
"url": "reference",
"valueReference": {
"reference": "docid1"
}
},
{
"url": "offset",
"valueInteger": 49
},
{
"url": "length",
"valueInteger": 12
}
],
"url": "http://hl7.org/fhir/StructureDefinition/derivation-reference"
}
],
"coding": [
{
"system": "http://snomed.info/sct",
"code": "11429006",
"display": "CONSULTATION (PROCEDURE)"
}
]
},
"description": "CONSULTATION (PROCEDURE)"
},
"extension": [
{
"extension": [
{
"url": "reference",
"valueReference": {
"reference": "docid1"
}
},
{
"url": "offset",
"valueInteger": 39
},
{
"url": "length",
"valueInteger": 8
}
],
"url": "http://hl7.org/fhir/StructureDefinition/derivation-reference"
},
{
"extension": [
{
"url": "reference",
"valueReference": {
"reference": "docid1"
}
},
{
"url": "offset",
"valueInteger": 49
},
{
"url": "length",
"valueInteger": 12
}
],
"url": "http://hl7.org/fhir/StructureDefinition/derivation-reference"
}
]
}
]
}
],
"modelVersion": "2024-01-10-Preview"
},
"id": "555fe1b1-6d60-4ec3-b784-7056128139b9",
"createdDateTime": "2024-01-12T07:10:40.1744625Z",
"expirationDateTime": "2024-01-12T07:27:20.1744625Z",
"lastUpdateDateTime": "2024-01-12T07:10:48.1815422Z",
"status": "succeeded"
}
Follow-up Communication
This inference is created when findings or test results were communicated to a medical professional.
- kind: RadiologyInsightsInferenceType.FollowupCommunication
- dateTime/communicatedAt: Array utcDateTime
- recipient: Array MedicalProfessionalType
- wasAcknowledged: boolean
Field "wasAcknowledged" is set to true if the communication was verbal (nonverbal communication might not have reached the recipient yet and can't be considered acknowledged). Field "dateTime/communicatedAt" is set if the date-time of the communication is known. Field "recipient" is set if the recipients are known. See the OpenAPI spec for its possible values.
Examples request/response json:
{
"jobData": {
"configuration": {
"inferenceOptions": {
"followupRecommendationOptions": {
"includeRecommendationsWithNoSpecifiedModality": false,
"includeRecommendationsInReferences": false,
"provideFocusedSentenceEvidence": false
},
"findingOptions": {
"provideFocusedSentenceEvidence": false
}
},
"inferenceTypes": ["followupCommunication"],
"locale": "en-US",
"verbose": false,
"includeEvidence": false
},
"patients": [
{
"id": "111111",
"details": {
"sex": "female",
"birthDate" : "1959-11-11T19:00:00+00:00",
"clinicalInfo": [
{
"resourceType": "Observation",
"status": "unknown",
"code": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls",
"code": "C0018802",
"display": "MalignantNeoplasms"
}
]
},
"valueBoolean": "true"
}
]
},
"encounters": [
{
"id": "encounterid1",
"period": {
"start": "2021-8-28T00:00:00",
"end": "2021-8-28T00:00:00"
},
"class": "inpatient"
}
],
"patientDocuments": [
{
"type": "note",
"clinicalType": "radiologyReport",
"id": "docid1",
"language": "en",
"authors": [
{
"id": "authorid1",
"fullName": "authorname1"
}
],
"specialtyType": "radiology",
"createdAt": "2021-8-28T00:00:00",
"administrativeMetadata": {
"orderedProcedures": [
{
"code": {
"coding": [
{
"system": "Https://loinc.org",
"code": "36572-6",
"display": "XR CHEST AP"
}
]
},
"description": "XR CHEST AP"
}
],
"encounterId": "encounterid1"
},
"content": {
"sourceType": "inline",
"value" : "\r\n\r\n\r\n\nThe results were faxed to Julie Carter on July 6 2016 at 3 PM.\n\nThe results were sent via Powerscribe to George Brown, PA.\n\n\t\t"
}
}
]
}
]
}
}
{
"result": {
"patientResults": [
{
"patientId": "11111",
"inferences": [
{
"kind": "followupCommunication",
"dateTime": [
"2016-07-06T15:00:00"
],
"recipient": [
"unknown"
],
"wasAcknowledged": false
},
{
"kind": "followupCommunication",
"recipient": [
"physicianAssistant"
],
"wasAcknowledged": false
}
]
}
],
"modelVersion": "2024-01-10-Preview"
},
"id": "8c13627c-759c-4753-8aaf-2f021b9587ea",
"createdDateTime": "2024-01-12T07:13:03.6054891Z",
"expirationDateTime": "2024-01-12T07:29:43.6054891Z",
"lastUpdateDateTime": "2024-01-12T07:13:08.9740608Z",
"status": "succeeded"
}
Radiology Procedure
This inference is for the ordered radiology procedures.
- kind: RadiologyInsightsInferenceType.RadiologyProcedure
- procedureCodes: Array FHIR.R4.CodeableConcept
- imagingProcedures: Array ImagingProcedure
- orderedProcedure: OrderedProcedure
Field "imagingProcedures" contains one or more instances of an imaging procedure, as documented for the follow-up recommendations. Field "procedureCodes", if set, contains LOINC codes. Field "orderedProcedure" contains (one or more) the descriptions and the codes of the ordered procedures as given by the client. The descriptions are in field "orderedProcedure.description", separated by ";;". The codes are in "orderedProcedure.code.coding". In every coding in the array, only field "coding" is set.
Examples request/response json:
{
"jobData": {
"configuration": {
"inferenceOptions": {
"followupRecommendationOptions": {
"includeRecommendationsWithNoSpecifiedModality": false,
"includeRecommendationsInReferences": false,
"provideFocusedSentenceEvidence": false
},
"findingOptions": {
"provideFocusedSentenceEvidence": false
}
},
"inferenceTypes": ["radiologyProcedure"],
"locale": "en-US",
"verbose": false,
"includeEvidence": false
},
"patients": [
{
"id": "111111",
"details": {
"sex": "female",
"birthDate" : "1959-11-11T19:00:00+00:00",
"clinicalInfo": [
{
"resourceType": "Observation",
"status": "unknown",
"code": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls",
"code": "C0018802",
"display": "MalignantNeoplasms"
}
]
},
"valueBoolean": "true"
}
]
},
"encounters": [
{
"id": "encounterid1",
"period": {
"start": "2021-8-28T00:00:00",
"end": "2021-8-28T00:00:00"
},
"class": "inpatient"
}
],
"patientDocuments": [
{
"type": "note",
"clinicalType": "radiologyReport",
"id": "docid1",
"language": "en",
"authors": [
{
"id": "authorid1",
"fullName": "authorname1"
}
],
"specialtyType": "radiology",
"createdAt": "2021-8-28T00:00:00",
"administrativeMetadata": {
"orderedProcedures": [
{
"code": {
"coding": [
{
"system": "Http://hl7.org/fhir/ValueSet/cpt-all",
"code": "70460",
"display": "Ct head/brain w/dye"
}
]
},
"description": "Ct head/brain w/dye"
}
],
"encounterId": "encounterid1"
},
"content": {
"sourceType": "inline",
"value" : "\nExam: Head CT with Contrast\r\n\r\nHistory: Headaches for 2 months\r\n\r\nTechnique: Axial, sagittal, and coronal images were reconstructed from helical CT through the head without IV contrast.\r\n\r\nIV contrast: 100 mL IV Omnipaque 300.\r\n\r\nFindings: There is no mass effect. There is no abnormal enhancement of the brain or within injuries with IV contrast.\nHowever, there is no evidence of enhancing lesion in either internal auditory canal.\n\r\nImpression: Negative CT of the brain without IV contrast.\r I recommend a new brain CT within nine months.\n"
}
}
]
}
]
}
}
{
"result": {
"patientResults": [
{
"patientId": "11111",
"inferences": [
{
"procedureCodes": [
{
"coding": [
{
"system": "http://loinc.org",
"code": "24727-0",
"display": "CT HEAD W CONTRAST IV"
}
]
},
{
"coding": [
{
"system": "http://loinc.org",
"code": "24727-0",
"display": "CT HEAD W CONTRAST IV"
}
]
}
],
"imagingProcedures": [
{
"modality": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "77477000",
"display": "COMPUTERIZED AXIAL TOMOGRAPHY (PROCEDURE)"
}
]
},
"anatomy": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "69536005",
"display": "HEAD STRUCTURE (BODY STRUCTURE)"
}
]
}
},
{
"modality": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "77477000",
"display": "COMPUTERIZED AXIAL TOMOGRAPHY (PROCEDURE)"
}
]
},
"anatomy": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "69536005",
"display": "HEAD STRUCTURE (BODY STRUCTURE)"
}
]
}
},
{
"modality": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "77477000",
"display": "COMPUTERIZED AXIAL TOMOGRAPHY (PROCEDURE)"
}
]
},
"anatomy": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "12738006",
"display": "BRAIN STRUCTURE (BODY STRUCTURE)"
}
]
}
}
],
"orderedProcedure": {
"code": {
"coding": [
{
"code": "24727-0"
},
{
"code": "70460"
}
]
},
"description": "CT HEAD W CONTRAST IV.;;Ct head/brain w/dye."
},
"kind": "radiologyProcedure"
}
]
}
],
"modelVersion": "2024-01-10-Preview"
},
"id": "89d4d36c-a8ce-444d-807b-333f3b7c08ec",
"createdDateTime": "2024-01-12T07:22:56.1444627Z",
"expirationDateTime": "2024-01-12T07:39:36.1444627Z",
"lastUpdateDateTime": "2024-01-12T07:23:04.9333715Z",
"status": "succeeded"
}
Next steps
To get better insights into the request and responses, read more on following page:
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