541 lines
14 KiB
JSON
541 lines
14 KiB
JSON
{
|
|
"name": "Bronchitis",
|
|
"remarks": [
|
|
"For now this covers only acute bronchitis. Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD).",
|
|
"Acute bronchitis is the fifth most common reason why adults see their GP; 5% of the adult population seeks medical advice for bronchitis each year.",
|
|
"Most of the data here comes from the following sources: ",
|
|
"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2278319/",
|
|
"http://www.aafp.org/afp/1998/0315/p1270.html"
|
|
],
|
|
"states": {
|
|
"Initial": {
|
|
"type": "Initial",
|
|
"direct_transition": "Potential_Infection"
|
|
},
|
|
"Potential_Infection": {
|
|
"type": "Delay",
|
|
"exact": {
|
|
"quantity": 1,
|
|
"unit": "months"
|
|
},
|
|
"complex_transition": [
|
|
{
|
|
"condition": {
|
|
"condition_type": "Age",
|
|
"operator": "<",
|
|
"quantity": 18,
|
|
"unit": "years"
|
|
},
|
|
"distributions": [
|
|
{
|
|
"distribution": 0.005,
|
|
"transition": "Bronchitis_Infection",
|
|
"remarks": [
|
|
"6% of children get bronchitis each year.",
|
|
"6% / year == ~ .5% per month?"
|
|
]
|
|
},
|
|
{
|
|
"distribution": 0.995,
|
|
"transition": "Potential_Infection"
|
|
}
|
|
]
|
|
},
|
|
{
|
|
"distributions": [
|
|
{
|
|
"distribution": 0.00416,
|
|
"transition": "Bronchitis_Infection",
|
|
"remarks": [
|
|
"5% of the adult population seeks medical advice for bronchitis each year.",
|
|
"5% / year == ~ .42% per month?"
|
|
]
|
|
},
|
|
{
|
|
"distribution": 0.99584,
|
|
"transition": "Potential_Infection"
|
|
}
|
|
]
|
|
}
|
|
]
|
|
},
|
|
"Bronchitis_Infection": {
|
|
"type": "ConditionOnset",
|
|
"target_encounter": "Doctor_Visit",
|
|
"codes": [
|
|
{
|
|
"system": "SNOMED-CT",
|
|
"code": "10509002",
|
|
"display": "Acute bronchitis (disorder)"
|
|
}
|
|
],
|
|
"direct_transition": "Bronchitis_Symptom1"
|
|
},
|
|
"Bronchitis_Symptom1": {
|
|
"type": "Symptom",
|
|
"symptom": "Cough",
|
|
"range": {
|
|
"low": 25,
|
|
"high": 75
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom2"
|
|
},
|
|
"Bronchitis_Symptom2": {
|
|
"type": "Symptom",
|
|
"symptom": "Mucus",
|
|
"range": {
|
|
"low": 25,
|
|
"high": 50
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom3"
|
|
},
|
|
"Bronchitis_Symptom3": {
|
|
"type": "Symptom",
|
|
"symptom": "Shortness of Breath",
|
|
"range": {
|
|
"low": 25,
|
|
"high": 75
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom4"
|
|
},
|
|
"Bronchitis_Symptom4": {
|
|
"type": "Symptom",
|
|
"symptom": "Sore Throat",
|
|
"range": {
|
|
"low": 25,
|
|
"high": 50
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom5"
|
|
},
|
|
"Bronchitis_Symptom5": {
|
|
"type": "Symptom",
|
|
"symptom": "Fatigue",
|
|
"range": {
|
|
"low": 25,
|
|
"high": 75
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom6"
|
|
},
|
|
"Bronchitis_Symptom6": {
|
|
"type": "Symptom",
|
|
"symptom": "Fever",
|
|
"range": {
|
|
"low": 25,
|
|
"high": 50
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom7"
|
|
},
|
|
"Bronchitis_Symptom7": {
|
|
"type": "Symptom",
|
|
"symptom": "Body Aches",
|
|
"range": {
|
|
"low": 0,
|
|
"high": 25
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom8"
|
|
},
|
|
"Bronchitis_Symptom8": {
|
|
"type": "Symptom",
|
|
"symptom": "Nasal Congestion",
|
|
"range": {
|
|
"low": 25,
|
|
"high": 50
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom9"
|
|
},
|
|
"Bronchitis_Symptom9": {
|
|
"type": "Symptom",
|
|
"symptom": "Nausea/Vomiting",
|
|
"range": {
|
|
"low": 0,
|
|
"high": 25
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom10"
|
|
},
|
|
"Bronchitis_Symptom10": {
|
|
"type": "Symptom",
|
|
"symptom": "Diarrhea",
|
|
"range": {
|
|
"low": 0,
|
|
"high": 25
|
|
},
|
|
"direct_transition": "Symptoms_Dont_improve"
|
|
},
|
|
"Symptoms_Dont_improve": {
|
|
"type": "Delay",
|
|
"range": {
|
|
"low": 1,
|
|
"high": 3,
|
|
"unit": "days"
|
|
},
|
|
"direct_transition": "Doctor_Visit"
|
|
},
|
|
"Doctor_Visit": {
|
|
"type": "Encounter",
|
|
"encounter_class": "ambulatory",
|
|
"reason": "Bronchitis_Infection",
|
|
"remarks": [
|
|
"There are no reliable diagnostic signs or laboratory tests, so the diagnosis of acute bronchitis is essentially a clinical one. ",
|
|
"The most important condition to rule out is acute pneumonia. "
|
|
],
|
|
"codes": [
|
|
{
|
|
"system": "SNOMED-CT",
|
|
"code": "185345009",
|
|
"display": "Encounter for symptom (procedure)"
|
|
}
|
|
],
|
|
"distributed_transition": [
|
|
{
|
|
"distribution": 0.05,
|
|
"transition": "Chest_Xray"
|
|
},
|
|
{
|
|
"distribution": 0.2,
|
|
"transition": "Sputum_Test"
|
|
},
|
|
{
|
|
"distribution": 0.5,
|
|
"transition": "Lung_Function_Test"
|
|
},
|
|
{
|
|
"distribution": 0.2,
|
|
"transition": "Bronchitis_CarePlan_Selector"
|
|
}
|
|
]
|
|
},
|
|
"Chest_Xray": {
|
|
"type": "Procedure",
|
|
"reason": "Bronchitis_Infection",
|
|
"codes": [
|
|
{
|
|
"system": "SNOMED-CT",
|
|
"code": "399208008",
|
|
"display": "Plain X-ray of chest (procedure)"
|
|
}
|
|
],
|
|
"duration": {
|
|
"low": 10,
|
|
"high": 25,
|
|
"unit": "minutes"
|
|
},
|
|
"direct_transition": "Bronchitis_CarePlan_Selector"
|
|
},
|
|
"Sputum_Test": {
|
|
"type": "Procedure",
|
|
"reason": "Bronchitis_Infection",
|
|
"codes": [
|
|
{
|
|
"system": "SNOMED-CT",
|
|
"code": "269911007",
|
|
"display": "Sputum examination (procedure)"
|
|
}
|
|
],
|
|
"duration": {
|
|
"low": 3,
|
|
"high": 15,
|
|
"unit": "minutes"
|
|
},
|
|
"direct_transition": "Bronchitis_CarePlan_Selector"
|
|
},
|
|
"Lung_Function_Test": {
|
|
"type": "Procedure",
|
|
"reason": "Bronchitis_Infection",
|
|
"codes": [
|
|
{
|
|
"system": "SNOMED-CT",
|
|
"code": "23426006",
|
|
"display": "Measurement of respiratory function (procedure)"
|
|
}
|
|
],
|
|
"duration": {
|
|
"low": 10,
|
|
"high": 25,
|
|
"unit": "minutes"
|
|
},
|
|
"direct_transition": "Bronchitis_CarePlan_Selector"
|
|
},
|
|
"Bronchitis_CarePlan_Selector": {
|
|
"type": "Simple",
|
|
"conditional_transition": [
|
|
{
|
|
"condition": {
|
|
"condition_type": "And",
|
|
"conditions": [
|
|
{
|
|
"condition_type": "Age",
|
|
"operator": ">=",
|
|
"quantity": 18,
|
|
"unit": "years"
|
|
},
|
|
{
|
|
"condition_type": "Attribute",
|
|
"attribute": "smoker",
|
|
"operator": "==",
|
|
"value": true
|
|
}
|
|
]
|
|
},
|
|
"transition": "Smoker_CarePlan"
|
|
},
|
|
{
|
|
"transition": "Nonsmoker_CarePlan"
|
|
}
|
|
]
|
|
},
|
|
"Smoker_CarePlan": {
|
|
"type": "CarePlanStart",
|
|
"assign_to_attribute": "bronchitis_careplan",
|
|
"reason": "Bronchitis_Infection",
|
|
"codes": [
|
|
{
|
|
"system": "SNOMED-CT",
|
|
"code": "53950000",
|
|
"display": "Respiratory therapy (procedure)"
|
|
}
|
|
],
|
|
"activities": [
|
|
{
|
|
"system": "SNOMED-CT",
|
|
"code": "710081004",
|
|
"display": "Smoking cessation therapy (regime/therapy)"
|
|
},
|
|
{
|
|
"system": "SNOMED-CT",
|
|
"code": "304510005",
|
|
"display": "Recommendation to avoid exercise (procedure)"
|
|
},
|
|
{
|
|
"system": "SNOMED-CT",
|
|
"code": "371605008",
|
|
"display": "Deep breathing and coughing exercises (regime/therapy)"
|
|
}
|
|
],
|
|
"direct_transition": "OTC_Medicine"
|
|
},
|
|
"Nonsmoker_CarePlan": {
|
|
"type": "CarePlanStart",
|
|
"assign_to_attribute": "bronchitis_careplan",
|
|
"reason": "Bronchitis_Infection",
|
|
"codes": [
|
|
{
|
|
"system": "SNOMED-CT",
|
|
"code": "53950000",
|
|
"display": "Respiratory therapy (procedure)"
|
|
}
|
|
],
|
|
"activities": [
|
|
{
|
|
"system": "SNOMED-CT",
|
|
"code": "304510005",
|
|
"display": "Recommendation to avoid exercise (procedure)"
|
|
},
|
|
{
|
|
"system": "SNOMED-CT",
|
|
"code": "371605008",
|
|
"display": "Deep breathing and coughing exercises (regime/therapy)"
|
|
}
|
|
],
|
|
"direct_transition": "OTC_Medicine"
|
|
},
|
|
"OTC_Medicine": {
|
|
"type": "Simple",
|
|
"remarks": [
|
|
"Up to 95% of bronchitis cases are viral so antibiotics are rarely prescribed",
|
|
"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2278319/"
|
|
],
|
|
"complex_transition": [
|
|
{
|
|
"condition": {
|
|
"condition_type": "Symptom",
|
|
"symptom": "Mucus",
|
|
"operator": "<",
|
|
"value": 30
|
|
},
|
|
"distributions": [
|
|
{
|
|
"distribution": 0.8,
|
|
"transition": "Cough_suppressant"
|
|
},
|
|
{
|
|
"distribution": 0.2,
|
|
"transition": "Acetaminophen"
|
|
}
|
|
],
|
|
"remarks": [
|
|
"cough suppressants shouldn't be given if the cough brings up mucus"
|
|
]
|
|
},
|
|
{
|
|
"distributions": [
|
|
{
|
|
"distribution": 0.1,
|
|
"transition": "Cough_suppressant"
|
|
},
|
|
{
|
|
"distribution": 0.9,
|
|
"transition": "Acetaminophen"
|
|
}
|
|
]
|
|
}
|
|
]
|
|
},
|
|
"Cough_suppressant": {
|
|
"type": "MedicationOrder",
|
|
"assign_to_attribute": "OTC_Bronchitis_Med",
|
|
"reason": "Bronchitis_Infection",
|
|
"codes": [
|
|
{
|
|
"system": "RxNorm",
|
|
"code": "1043400",
|
|
"display": "Acetaminophen 21.7 MG/ML / Dextromethorphan Hydrobromide 1 MG/ML / doxylamine succinate 0.417 MG/ML Oral Solution"
|
|
}
|
|
],
|
|
"direct_transition": "End_Doctor_Visit"
|
|
},
|
|
"Acetaminophen": {
|
|
"type": "MedicationOrder",
|
|
"assign_to_attribute": "OTC_Bronchitis_Med",
|
|
"reason": "Bronchitis_Infection",
|
|
"codes": [
|
|
{
|
|
"system": "RxNorm",
|
|
"code": "313782",
|
|
"display": "Acetaminophen 325 MG Oral Tablet"
|
|
}
|
|
],
|
|
"direct_transition": "End_Doctor_Visit"
|
|
},
|
|
"End_Doctor_Visit": {
|
|
"type": "EncounterEnd",
|
|
"direct_transition": "Wait_for_condition_to_resolve"
|
|
},
|
|
"Wait_for_condition_to_resolve": {
|
|
"type": "Delay",
|
|
"range": {
|
|
"low": 1,
|
|
"high": 3,
|
|
"unit": "weeks"
|
|
},
|
|
"direct_transition": "Bronchitis_Subsides"
|
|
},
|
|
"Bronchitis_Subsides": {
|
|
"type": "ConditionEnd",
|
|
"condition_onset": "Bronchitis_Infection",
|
|
"direct_transition": "Bronchitis_Symptom1_Subsides"
|
|
},
|
|
"Bronchitis_Symptom1_Subsides": {
|
|
"type": "Symptom",
|
|
"symptom": "Cough",
|
|
"exact": {
|
|
"quantity": 0
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom2_Subsides"
|
|
},
|
|
"Bronchitis_Symptom2_Subsides": {
|
|
"type": "Symptom",
|
|
"symptom": "Mucus",
|
|
"exact": {
|
|
"quantity": 0
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom4_Subsides"
|
|
},
|
|
"Bronchitis_Symptom4_Subsides": {
|
|
"type": "Symptom",
|
|
"symptom": "Sore Throat",
|
|
"exact": {
|
|
"quantity": 0
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom5_Subsides"
|
|
},
|
|
"Bronchitis_Symptom5_Subsides": {
|
|
"type": "Symptom",
|
|
"symptom": "Fatigue",
|
|
"exact": {
|
|
"quantity": 0
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom6_Subsides"
|
|
},
|
|
"Bronchitis_Symptom6_Subsides": {
|
|
"type": "Symptom",
|
|
"symptom": "Fever",
|
|
"exact": {
|
|
"quantity": 0
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom7_Subsides"
|
|
},
|
|
"Bronchitis_Symptom7_Subsides": {
|
|
"type": "Symptom",
|
|
"symptom": "Body Aches",
|
|
"exact": {
|
|
"quantity": 0
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom8_Subsides"
|
|
},
|
|
"Bronchitis_Symptom8_Subsides": {
|
|
"type": "Symptom",
|
|
"symptom": "Nasal Congestion",
|
|
"exact": {
|
|
"quantity": 0
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom9_Subsides"
|
|
},
|
|
"Bronchitis_Symptom9_Subsides": {
|
|
"type": "Symptom",
|
|
"symptom": "Nausea/Vomiting",
|
|
"exact": {
|
|
"quantity": 0
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom10_Subsides"
|
|
},
|
|
"Bronchitis_Symptom10_Subsides": {
|
|
"type": "Symptom",
|
|
"symptom": "Diarrhea",
|
|
"exact": {
|
|
"quantity": 0
|
|
},
|
|
"direct_transition": "Bronchitis_Symptom3_Subsides"
|
|
},
|
|
"Bronchitis_Symptom3_Subsides": {
|
|
"type": "Symptom",
|
|
"symptom": "Shortness of Breath",
|
|
"exact": {
|
|
"quantity": 0
|
|
},
|
|
"conditional_transition": [
|
|
{
|
|
"condition": {
|
|
"condition_type": "Attribute",
|
|
"attribute": "OTC_Bronchitis_Med",
|
|
"operator": "is not nil"
|
|
},
|
|
"transition": "End_OTC_Medication"
|
|
},
|
|
{
|
|
"transition": "Next_Well_Visit"
|
|
}
|
|
]
|
|
},
|
|
"End_OTC_Medication": {
|
|
"type": "MedicationEnd",
|
|
"referenced_by_attribute": "OTC_Bronchitis_Med",
|
|
"direct_transition": "Next_Well_Visit"
|
|
},
|
|
"Next_Well_Visit": {
|
|
"type": "Encounter",
|
|
"wellness": true,
|
|
"direct_transition": "End_Bronchitis_CarePlan",
|
|
"reason": "Bronchitis_Infection"
|
|
},
|
|
"End_Bronchitis_CarePlan": {
|
|
"type": "CarePlanEnd",
|
|
"referenced_by_attribute": "bronchitis_careplan",
|
|
"direct_transition": "End_Wellness_Visit"
|
|
},
|
|
"End_Wellness_Visit": {
|
|
"type": "EncounterEnd",
|
|
"direct_transition": "Potential_Infection"
|
|
}
|
|
},
|
|
"gmf_version": 1
|
|
} |