Are are interpretations applied to observations where fasting vs. non-fasting is a factor


#1

Hi, I’m new to the FHIR world but excited to leverage it.

One use case I have is to display a set of health measures like Total Cholesterol, HDL, LDL, Triglycerides, and related measures. When observations are collected it matters if the patient was fasting or not in the context of the interpretation. And different reference ranges can be applied based on fasting vs. non-fasting. e.g.

  • Non Fasting Levels: 175mg/dl or higher: abnormal result: should be followed up with a fasting test
  • Fasting Levels: 500 mg/dL or higher: significant and severe hypertriglyceridemia

How can the observation and related resources be used to handle know the context of fasting vs. non-fasting and applying (if appropriate) a reference range that is different.

I hope I’m using the right lingo here as I’m new to this. Thank you


#2

The patient’s fasting/non-fasting status should be captured as a component of each observation (i.e. Observation.component) given that it needs to be seen as part of the observation in order to make an accurate interpretation of the result. This means that you’ll be capturing the fasting status separately for the HDL, LDL, etc. However, that’s necessary in order to allow each Observation to be subsequently interpreted on its own.


#3

Thanks lloyd. That’s very helpful!


#4

I have also seen a precoordinated Observation.code used, such as:
3048-6 = Triglyceride [Mass/volume] in Serum or Plasma --fasting
2571-8 = Triglyceride [Mass/volume] in Serum or Plasma