archetype (adl_version=1.4; uid=406da867-ee6b-4e1b-8765-009a2ef7f74b)
	openEHR-EHR-OBSERVATION.crusade_bleeding.v0

concept
	[at0000]	-- CRUSADE bleeding score
language
	original_language = <[ISO_639-1::en]>
description
	original_author = <
		["name"] = <"John Meredith">
		["organisation"] = <"NHS Wales Informatics Service">
		["email"] = <"john.meredith@wales.nhs.uk">
		["date"] = <"2019-04-03">
	>
	details = <
		["en"] = <
			language = <[ISO_639-1::en]>
			purpose = <"To record the results for each component parameter, the total sum and grade for the CRUSADE bleeding score.">
			use = <"Use to record the results for each component parameter, the total sum and grade for the CRUSADE bleeding score.">
			keywords = <"ACS, Acute coronary syndrome, Bleeding, CBRS, CRUSADE bleeding risk score, NSTEMI, Non-ST segment elevation myocardial infarction, PCI, percutaneous coronary intervention, prognosis, ST segment elevation myocardial infarction, STEMI, ischaemic heart disease, myocardial infarction, primary percutaneous coronary intervention, risk score", ...>
			misuse = <"">
			copyright = <"© Apperta Foundation, openEHR Foundation">
		>
	>
	lifecycle_state = <"in_development">
	other_contributors = <"Heather Leslie, Atomica Informatics, Australia", ...>
	other_details = <
		["licence"] = <"This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/.">
		["custodian_organisation"] = <"openEHR Foundation">
		["references"] = <"Abu-Assi E, Gracía-Acuña JM, Ferreira-González I, Peña-Gil C, Gayoso-Diz P, González-Juanatey JR. Evaluating the Performance of the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines (CRUSADE) bleeding score in a contemporary Spanish cohort of patients with non-ST-segment elevation acute myocardial infarction. Circulation. 2010;121(22):2419–2426. doi:10.1161/CIRCULATIONAHA.109.925594.

Abu-Assi E, Raposeiras-Roubin S, Lear P, et al. Comparing the predictive validity of three contemporary bleeding risk scores in acute coronary syndrome. Eur Heart J Acute Cardiovasc Care. 2012;1(3):222–231. doi:10.1177/2048872612453924.

Ariza-Solé A, Sánchez-Elvira G, Sánchez-Salado JC, et al. CRUSADE bleeding risk score validation for ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Thromb Res. 2013;132(6):652–658. doi:10.1016/j.thromres.2013.09.019.

Flores-Ríos X, Couto-Mallón D, Rodríguez-Garrido J, et al. Comparison of the performance of the CRUSADE, ACUITY-HORIZONS, and ACTION bleeding risk scores in STEMI undergoing primary PCI: insights from a cohort of 1391 patients. Eur Heart J Acute Cardiovasc Care. 2013;2(1):19–26. doi:10.1177/2048872612469885.

Subherwal S, Bach RG, Chen AY, et al. Baseline risk of major bleeding in non-ST-segment-elevation myocardial infarction: the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) Bleeding Score. Circulation. 2009;119(14):1873–1882. doi:10.1161/CIRCULATIONAHA.108.828541.">
		["original_namespace"] = <"org.openehr">
		["original_publisher"] = <"openEHR Foundation">
		["custodian_namespace"] = <"org.openehr">
		["MD5-CAM-1.0.1"] = <"C406593C95354B2A415574B61DF67F98">
		["build_uid"] = <"042cd698-77ba-4be5-9157-9f8ca71ca78a">
		["revision"] = <"0.0.1-alpha">
	>

definition
	OBSERVATION[at0000] matches {    -- CRUSADE bleeding score
		data matches {
			HISTORY[at0001] matches {    -- History
				events cardinality matches {1..*; unordered} matches {
					POINT_EVENT[at0002] occurrences matches {0..*} matches {    -- Any point in time event
						data matches {
							ITEM_TREE[at0003] matches {    -- ItemTree
								items cardinality matches {0..*; unordered} matches {
									ELEMENT[at0004] occurrences matches {0..1} matches {    -- Baseline haematocrit
										value matches {
											0|[local::at0009],
											2|[local::at0008],
											3|[local::at0007],
											7|[local::at0006],
											9|[local::at0005]
										}
									}
									ELEMENT[at0010] occurrences matches {0..1} matches {    -- Creatinine clearance
										value matches {
											0|[local::at0016],
											7|[local::at0015],
											17|[local::at0014],
											28|[local::at0013],
											35|[local::at0012],
											39|[local::at0011]
										}
									}
									ELEMENT[at0017] occurrences matches {0..1} matches {    -- Heart rate
										value matches {
											0|[local::at0018],
											1|[local::at0019],
											3|[local::at0020],
											6|[local::at0021],
											8|[local::at0022],
											10|[local::at0023],
											11|[local::at0024]
										}
									}
									ELEMENT[at0025] occurrences matches {0..1} matches {    -- Sex
										value matches {
											0|[local::at0027],
											8|[local::at0026]
										}
									}
									ELEMENT[at0028] occurrences matches {0..1} matches {    -- Signs of heart failure
										value matches {
											0|[local::at0029],
											7|[local::at0030]
										}
									}
									ELEMENT[at0031] occurrences matches {0..1} matches {    -- Prior vascular disease
										value matches {
											0|[local::at0032],
											7|[local::at0033]
										}
									}
									ELEMENT[at0034] occurrences matches {0..1} matches {    -- Diabetes mellitus
										value matches {
											0|[local::at0035],
											6|[local::at0036]
										}
									}
									ELEMENT[at0073] occurrences matches {0..1} matches {    -- Systolic blood pressure
										value matches {
											1|[local::at0077],
											3|[local::at0078],
											5|[local::at0076],
											8|[local::at0075],
											10|[local::at0074]
										}
									}
									ELEMENT[at0064] occurrences matches {0..1} matches {    -- Total score
										value matches {
											DV_COUNT matches {
												magnitude matches {|0..91|}
											}
										}
									}
									ELEMENT[at0063] occurrences matches {0..1} matches {    -- Risk grade
										value matches {
											1|[local::at0065],
											21|[local::at0066],
											31|[local::at0067],
											41|[local::at0068],
											51|[local::at0069]
										}
									}
								}
							}
						}
					}
				}
			}
		}
		protocol matches {
			ITEM_TREE[at0044] matches {    -- ItemTree
				items cardinality matches {0..*; unordered} matches {
					ELEMENT[at0046] occurrences matches {0..1} matches {    -- Score version
						value matches {
							DV_TEXT matches {*}
						}
					}
					allow_archetype CLUSTER[at0071] occurrences matches {0..*} matches {    -- Extension
						include
							archetype_id/value matches {/.*/}
					}
				}
			}
		}
	}



ontology
	term_definitions = <
		["en"] = <
			items = <
				["at0000"] = <
					text = <"CRUSADE bleeding score">
					description = <"An assessment tool used to stratify risk for major bleeding in patients presenting with NSTEMI or STEMI prior to initiation of treatment.">
					comment = <"CRUSADE is an acronym from the original study title: \"Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines\".">
				>
				["at0001"] = <
					text = <"History">
					description = <"@ internal @">
				>
				["at0002"] = <
					text = <"Any point in time event">
					description = <"Default, unspecified point in time event which may be explicitly defined in a template or at run-time.">
				>
				["at0003"] = <
					text = <"ItemTree">
					description = <"@ internal @">
				>
				["at0004"] = <
					text = <"Baseline haematocrit">
					description = <"Haematocrit measured in %.">
				>
				["at0005"] = <
					text = <"<31">
					description = <"Less than 31%.">
				>
				["at0006"] = <
					text = <"31-33.9">
					description = <"Between 31 and 33.9%.">
				>
				["at0007"] = <
					text = <"34-36.9">
					description = <"Between 34 and 36.9%.">
				>
				["at0008"] = <
					text = <"37-39.9">
					description = <"Between 37 and 39.9%.">
				>
				["at0009"] = <
					text = <">=40">
					description = <"Greater than or equal to 40%.">
				>
				["at0010"] = <
					text = <"Creatinine clearance">
					description = <"Creatinine clearance estimated using the Cockcroft-Gault equation.">
				>
				["at0011"] = <
					text = <"<=15">
					description = <"Less than or equal to 15 mL/min.">
				>
				["at0012"] = <
					text = <">15-30">
					description = <"Greater than 15 to 30 mL/min.">
				>
				["at0013"] = <
					text = <">30-60">
					description = <"Greater than 30 to 60 mL/min.">
				>
				["at0014"] = <
					text = <">60-90">
					description = <"Greater than 60 to 90 mL/min.">
				>
				["at0015"] = <
					text = <">90-120">
					description = <"Greater than 90 to 120 mL/min.">
				>
				["at0016"] = <
					text = <">120">
					description = <"Greater than 120 mL/min.">
				>
				["at0017"] = <
					text = <"Heart rate">
					description = <"Heart rate measured in beats/min.">
				>
				["at0018"] = <
					text = <"<=70">
					description = <"Less than or equal to 70 bpm.">
				>
				["at0019"] = <
					text = <"71-80">
					description = <"Between 71 and 80 bpm.">
				>
				["at0020"] = <
					text = <"81-90">
					description = <"Between 81 and 90 bpm.">
				>
				["at0021"] = <
					text = <"91-100">
					description = <"Between 91 and 100 bpm.">
				>
				["at0022"] = <
					text = <"101-110">
					description = <"Between 101 and 110 bpm.">
				>
				["at0023"] = <
					text = <"111-120">
					description = <"Between 111 and 120 bpm.">
				>
				["at0024"] = <
					text = <">=121">
					description = <"Greater than or equal to 121.">
				>
				["at0025"] = <
					text = <"Sex">
					description = <"Patient sex.">
				>
				["at0026"] = <
					text = <"Female">
					description = <"Patient sex is female.">
				>
				["at0027"] = <
					text = <"Male">
					description = <"Patient sex is male.">
				>
				["at0028"] = <
					text = <"Signs of heart failure">
					description = <"Signs of congestive heart failure at presentation?">
				>
				["at0029"] = <
					text = <"No">
					description = <"No signs of congestive heart failure at presentation.">
				>
				["at0030"] = <
					text = <"Yes">
					description = <"Signs of Congestive Heart Failure at presentation.">
				>
				["at0031"] = <
					text = <"Prior vascular disease">
					description = <"History of vascular disease?">
					comment = <"Prior vascular disease defined as peripheral artery disease or prior stroke.">
				>
				["at0032"] = <
					text = <"No">
					description = <"No history of vascular disease.">
				>
				["at0033"] = <
					text = <"Yes">
					description = <"Patient has history of vascular disease.">
				>
				["at0034"] = <
					text = <"Diabetes mellitus">
					description = <"History of diabetes mellitus?">
				>
				["at0035"] = <
					text = <"No">
					description = <"No history of diabetes mellitus.">
				>
				["at0036"] = <
					text = <"Yes">
					description = <"Patient has history of diabetes mellitus.">
				>
				["at0044"] = <
					text = <"ItemTree">
					description = <"@ internal @">
				>
				["at0046"] = <
					text = <"Score version">
					description = <"The version of the score used, normally recorded as the year.">
				>
				["at0063"] = <
					text = <"Risk grade">
					description = <"Overall CRUSADE risk score.">
					comment = <"Relative % calculated by risk score quintiles">
				>
				["at0064"] = <
					text = <"Total score">
					description = <"Sum of the individual scores assigned for each of the contributing variables.">
				>
				["at0065"] = <
					text = <"<=20">
					description = <"Very low risk.">
				>
				["at0066"] = <
					text = <"21-30">
					description = <"Low risk.">
				>
				["at0067"] = <
					text = <"31-40">
					description = <"Moderate risk.">
				>
				["at0068"] = <
					text = <"41-50">
					description = <"High risk.">
				>
				["at0069"] = <
					text = <">=51">
					description = <"Very high risk.">
				>
				["at0071"] = <
					text = <"Extension">
					description = <"Additional information required to extend the model with local content or to align with other reference models/formalisms.">
					comment = <"For example: local information requirements; or additional metadata to align with FHIR.">
				>
				["at0073"] = <
					text = <"Systolic blood pressure">
					description = <"Systolic blood pressure measured in mm Hg.">
					comment = <"Systolic blood pressure ordinal scores are duplicated between 101 and 120 mm Hg or greater than or equal to 201.">
				>
				["at0074"] = <
					text = <"<=90">
					description = <"Systolic blood pressure is less than or equal to 90 mm Hg.">
				>
				["at0075"] = <
					text = <"91-100">
					description = <"Between 91 and 100 mm Hg.">
				>
				["at0076"] = <
					text = <"101-120 or >=201">
					description = <"Between 101 and 120 mm Hg or greater than or equal to 201.">
				>
				["at0077"] = <
					text = <"121-180">
					description = <"Between 121 and 180 mm Hg.">
				>
				["at0078"] = <
					text = <"181-200">
					description = <"Between 181 and 200 mm Hg.">
				>
			>
		>
	>