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synthea-alldiseases/src/main/resources/modules/allergies/immunotherapy.json

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{
"name": "Allergy Immunotherapy",
"remarks": [
"This submodule is called by 'allergies.json'. This models a series of ",
"immunotherapy treatments designed to lessen the severity of allergy ",
"symptoms, or even eliminate the sensitivity altogether. ",
"Immunotherapy is most effective against outdoor allergens (trees, grass), ",
"and common indoor allergens (mold, mites, pet dander). Immunotherapy is ",
"minimally effective against food allergens."
],
"states": {
"Initial": {
"type": "Initial",
"direct_transition": "Immunotherapy_Consultation"
},
"Immunotherapy_Consultation": {
"type": "Encounter",
"remarks": [
"======================================================================",
" IMMUNOTHERAPY ",
"======================================================================",
"Allergen immunotherapy for hay fever has been common practice since the ",
"1930's. It was first proven by scientists in the UK in 1911. It has since ",
"been expanded to include additional environmental and food allergens."
],
"encounter_class": "ambulatory",
"codes": [
{
"system": "SNOMED-CT",
"code": "170837001",
"display": "Allergic disorder initial assessment (regime/therapy)"
}
],
"distributed_transition": [
{
"distribution": 0.75,
"transition": "Immunotherapy_Given"
},
{
"distribution": 0.25,
"transition": "Immunotherapy_Not_Given",
"remarks": [
"The distribution here is somewhat arbitrary. I could not find reasonable stats for",
"what percentage of people are given immunotherapy but it's not everyone.",
"I went with a 75/25 split. Reasons to not give immunotherapy include fear of needles,",
"pre-existing immune conditions (like AIDS), and prohibitive cost."
]
}
],
"reason": "allergy_unspecified"
},
"Immunotherapy_Given": {
"type": "SetAttribute",
"attribute": "immunotherapy_status",
"value": "given",
"direct_transition": "Immunotherapy_CarePlan"
},
"Immunotherapy_Not_Given": {
"type": "SetAttribute",
"attribute": "immunotherapy_status",
"value": "not-given",
"direct_transition": "End_Consultation"
},
"Immunotherapy_CarePlan": {
"type": "CarePlanStart",
"codes": [
{
"system": "SNOMED-CT",
"code": "170836005",
"display": "Allergic disorder monitoring (regime/therapy)"
}
],
"activities": [
{
"system": "SNOMED-CT",
"code": "182678001",
"display": "Allergen immunotherapy (regime/therapy)"
}
],
"direct_transition": "Benchmark_Allergy_Test"
},
"Benchmark_Allergy_Test": {
"type": "Procedure",
"duration": {
"low": 20,
"high": 40,
"unit": "minutes"
},
"codes": [
{
"system": "SNOMED-CT",
"code": "395142003",
"display": "Allergy screening test (procedure)"
}
],
"direct_transition": "Benchmark_Allergy_Panel"
},
"Benchmark_Allergy_Panel": {
"type": "CallSubmodule",
"submodule": "allergies/allergy_panel",
"direct_transition": "End_Consultation"
},
"End_Consultation": {
"type": "EncounterEnd",
"conditional_transition": [
{
"condition": {
"condition_type": "Attribute",
"attribute": "immunotherapy_status",
"operator": "==",
"value": "not-given"
},
"transition": "Terminal"
},
{
"transition": "Initialize_Immunotherapy_Counter"
}
]
},
"Initialize_Immunotherapy_Counter": {
"type": "SetAttribute",
"attribute": "immunotherapy_counter",
"value": 0,
"direct_transition": "Undergoing_Immunotherapy_Treatment"
},
"Undergoing_Immunotherapy_Treatment": {
"type": "Delay",
"remarks": [
"Patients get immunotherapy treatments for an average of 5 years.",
"Given monthly appointments we count a total of 60 appointments before ",
"ending the immunotherapy."
],
"range": {
"low": 3,
"high": 4,
"unit": "weeks"
},
"conditional_transition": [
{
"condition": {
"condition_type": "Attribute",
"attribute": "immunotherapy_counter",
"operator": "<",
"value": 60
},
"transition": "Immunotherapy_Treatment"
},
{
"transition": "Immunotherapy_Treatment_Complete"
}
]
},
"Immunotherapy_Treatment": {
"type": "Encounter",
"encounter_class": "ambulatory",
"codes": [
{
"system": "SNOMED-CT",
"code": "371883000",
"display": "Outpatient procedure (procedure)"
}
],
"direct_transition": "Immunotherapy_Procedure",
"reason": "allergy_unspecified"
},
"Immunotherapy_Procedure": {
"type": "Procedure",
"codes": [
{
"system": "SNOMED-CT",
"code": "180256009",
"display": "Subcutaneous immunotherapy (procedure)"
}
],
"duration": {
"low": 15,
"high": 60,
"unit": "minutes"
},
"direct_transition": "End_Treatment_Session"
},
"End_Treatment_Session": {
"type": "EncounterEnd",
"direct_transition": "Count_A_Treatment"
},
"Count_A_Treatment": {
"type": "Counter",
"action": "increment",
"attribute": "immunotherapy_counter",
"direct_transition": "Undergoing_Immunotherapy_Treatment"
},
"Immunotherapy_Treatment_Complete": {
"type": "Simple",
"direct_transition": "Immunotherapy_Followup"
},
"Immunotherapy_Followup": {
"type": "Encounter",
"encounter_class": "ambulatory",
"codes": [
{
"system": "SNOMED-CT",
"code": "170838006",
"display": "Allergic disorder follow-up assessment (regime/therapy)"
}
],
"direct_transition": "Immunotherapy_CarePlan_Ends",
"reason": "allergy_unspecified"
},
"Immunotherapy_CarePlan_Ends": {
"type": "CarePlanEnd",
"careplan": "Immunotherapy_CarePlan",
"direct_transition": "Immunotherapy_Success_Rate"
},
"Immunotherapy_Success_Rate": {
"type": "Simple",
"remarks": [
"My research has shown up to 85% of people respond positively to ",
"immunotherapy treatment. This allows patients to 'outgrow' their ",
"environmental allergies."
],
"distributed_transition": [
{
"distribution": 0.8,
"transition": "Outgrown_Environmental_Allergies"
},
{
"distribution": 0.2,
"transition": "Followup_Test"
}
]
},
"Outgrown_Environmental_Allergies": {
"type": "CallSubmodule",
"submodule": "allergies/outgrow_env_allergies",
"direct_transition": "Followup_Test"
},
"Followup_Test": {
"type": "Procedure",
"duration": {
"low": 20,
"high": 40,
"unit": "minutes"
},
"codes": [
{
"system": "SNOMED-CT",
"code": "395142003",
"display": "Allergy screening test (procedure)"
}
],
"direct_transition": "Followup_Allergy_Panel"
},
"Followup_Allergy_Panel": {
"type": "CallSubmodule",
"submodule": "allergies/allergy_panel",
"direct_transition": "Followup_End"
},
"Followup_End": {
"type": "EncounterEnd",
"direct_transition": "Terminal"
},
"Terminal": {
"type": "Terminal"
}
},
"gmf_version": 1
}