ARCHETYPE Family history (openEHR-EHR-EVALUATION.family_history.v2)

Name: Family history
License: http://creativecommons.org/licenses/by-sa/4.0/

ARCHETYPE ID	openEHR-EHR-EVALUATION.family_history.v2
Concept	Family history
Description	Summary information about the significant health-related problems found in family members.
Use	Use to record a summary of information about problems or diagnoses found in family members. This information may be used to contribute to the identification of a current health problem, assessment of future risk from familial problems or conditions, or to initiate preventive health activities. Traditionally the scope of family history has been focused on genetic factors or biomarkers as indicators of risk or potential risk. The scope of this archetype includes both recording of problems or diagnoses that have an inheritable origin as well as those that are not directly inheritable but influenced by the domestic setting, including psychosocial or environmental factors. Examples include exposure to toxins in the family environment, domestic violence, sexual abuse, alcoholism and other addictions. Non-genetic family members can include adopted or long term fostered children, those related by marriage, or other unrelated individuals who participate in the regular life and influence of the family. This archetype has been designed to include: - a narrative overview as free text. This will allow family history details from existing systems to be incorporated as non-structured text; and - a detailed area focusing on relevant health details about specific family members, including their medical history and biomarkers. This archetype can be used within many contexts. For example, recording a family history entry within a clinical consultation; populating a Family History List; or to provide a summary statement within a Discharge Summary document. Additional detail about a family member's specific problem, diagnosis or past procedures can be captured using the EVALUATION.problem_diagnosis or the ACTION.procedure archetype and specifying the 'Subject of Care' as the family member, rather than the subject of the health record. This archetype can be used as the basis for a Family Pedigree chart of health problems/diagnoses or to support estimations of risk of a condition based on prevalence in the family history or known biomarkers. It may be necessary to identify each family member specifically and not just by the relationship to the patient. For example, while there will be only one maternal grandmother, there may be many female maternal cousins. This may be required to ensure that a pedigree chart is accurate. It will also enable accurate amendments to the record for each identified family member. If the record is private and will not be shared, for reasons of clarity it may be preferable to record the relative's actual name. If the record, or part of the record, is to be shared, it may be more appropriate for the family member to be identified by a unique label or alias.
Misuse	Not to be used to record information about the relative or absolute risk of developing a condition due to family history - use the EVALUATION.health_risk archetype, including the CLUSTER.family_prevalence for details about the affected ratio of family members. Not to be used for contact tracing for infectious diseases requiring immediate action. Use specific archetypes for this purpose. Not to be used to record an exclusion of Family History - use the EVALUATION.exclusion-family_history archetype for this purpose.
Purpose	To record information about the occurrence of significant health-related problems in genetic and non-genetic family members - both alive and deceased. The intended scope of this archetype is deliberately kept loose to include the broadest range of problems or issues that might be found within families. It specifically includes known problems and diagnoses, identified biological markers, plus any relevant psychosocial factors and environmental factors.
References	Family History, draft archetype [Internet]. Australia, National eHealth Transition Authority, NEHTA Clinical Knowledge Manager. Authored: 2010 12 15. Available at: http://dcm.nehta.org.au/ckm/#showArchetype_1013.1.927 (last accessed 2015 03 05). Risk of condition based on family history, rejected archetype, openEHR Clinical Knowledge Manager [Internet]. openEHR Foundation. Authored: 2006 04 23. Available at: http://www.openehr.org/ckm/#showArchetype_1013.1.125 (last accessed 2015 03 05). HL7 Version 3 Standard: Clinical Genomics; Pedigree, Release 1. ANSI/HL7 V3 CGPED, R1-2007. Published 2007 05 07. Available at: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=8 (last accessed 2015 03 05).
Copyright	© openEHR Foundation
Authors	Author name: Sam Heard Organisation: Ocean Informatics Email: sam.heard@oceaninformatics.com Date originally authored: 2010-12-15
Other Details Language	Author name: Sam Heard Organisation: Ocean Informatics Email: sam.heard@oceaninformatics.com Date originally authored: 2010-12-15
OtherDetails Language Independent	{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=Family History, draft archetype [Internet]. Australia, National eHealth Transition Authority, NEHTA Clinical Knowledge Manager. Authored: 2010 12 15. Available at: http://dcm.nehta.org.au/ckm/#showArchetype_1013.1.927 (last accessed 2015 03 05). Risk of condition based on family history, rejected archetype, openEHR Clinical Knowledge Manager [Internet]. openEHR Foundation. Authored: 2006 04 23. Available at: http://www.openehr.org/ckm/#showArchetype_1013.1.125 (last accessed 2015 03 05). HL7 Version 3 Standard: Clinical Genomics; Pedigree, Release 1. ANSI/HL7 V3 CGPED, R1-2007. Published 2007 05 07. Available at: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=8 (last accessed 2015 03 05)., current_contact=Heather Leslie, Ocean Informatics, heather.leslie@oceaninformatics.com, original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=E03E502D87EF6E96482A385C0989ECFD, build_uid=b6538ffe-b16e-4b06-8e26-43758f9fc501, ip_acknowledgements=This artefact includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyrighted material of the International Health Terminology Standards Development Organisation (IHTSDO). Where an implementation of this artefact makes use of SNOMED CT content, the implementer must have the appropriate SNOMED CT Affiliate license - for more information contact http://www.snomed.org/snomed-ct/get-snomedct or info@snomed.org., revision=2.0.5-alpha}
Keywords	family, history, health, condition, problem, diagnosis, genetic, pedigree, genealogy, family history, relative, hereditary, inherited, familial, heredity
Lifecycle	in_development
UID	12e8fcc3-a17b-45ad-a7dd-6e8ec78d60a4
Language used	en
Citeable Identifier	1013.1.2469
Revision Number	2.0.5-alpha
All	Archetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=[SNOMED-CT(20160131)::57177007 \| Family history with explicit context], archetypeConceptDescription=Summary information about the significant health-related problems found in family members., archetypeConceptComment=null, otherContributors=Tomas Alme, DIPS ASA, Norway Ole Andreas Bjordal, Webmed, Norway Gunn Anita Skjulhaug, Helse-Bergen HF, Norway Rita Apelt, Department of Health,NT, Australia Vebjørn Arntzen, Oslo universitetssykehus HF, Norway (Nasjonal IKT redaktør) Koray Atalag, University of Auckland, New Zealand Silje Ljosland Bakke, Helse Vest IKT AS, Norway (openEHR Editor) John Bennett, NEHTA, Australia Kristian Berg, Universitetssykehuset Nord Norge, Norway Lars Bitsch-Larsen, Haukeland University Hospital, Bergen, Norway Anita Bjørnnes, Helse Bergen, Norway Terje Bless, Helse Nord FIKS, Norway Diego Bosca, IBIME group, Spain Mauricio Botero, Universidad de Caldas, Colombia Rong Chen, Cambio Healthcare Systems, Sweden Bjørn Christensen, HUS, Norway Stephen Chu, Queensland Health, Australia Lisbeth Dahlhaug, Helse Midt - Norge IT, Norway Eva Dybvik, Nasjonal kompetansetjeneste for leddproteser og hoftebrudd, Haukeland Universitetssjukehus, Norway David Evans, Queensland Health, Australia Shahla Foozonkhah, Ocean Informatics, Australia Einar Fosse, UNN HF, Norwegian Centre for Integrated Care and Telemedicine, Norway Samuel Frade, Marand, Portugal Hildegard Franke, freshEHR Clinical Informatics Ltd., United Kingdom Tim Garden, NTG Department of Health, Australia Sebastian Garde, Ocean Informatics, Germany Jacquie Garton-Smith, Royal Perth Hospital and DoHWA, Australia Andrew Goodchild, NEHTA, Australia Gyri Gradek, Senter for medisinsk genetikk og molekylærmedisin, Haukeland Universitetssykehus, Norway Heather Grain, Llewelyn Grain Informatics, Australia Elisabeth Gudmestad, Helse Bergen HF, Haukeland Universitetssykehus, Dokumentasjonsavdelingen, Norway Daniel Habashi, PasientSky AS, Norway Dag Hanoa, Oslo universitetssykehus, Norway Sam Heard, Ocean Informatics, Australia (Editor) Kristian Heldal, Telemark Hospital Trust, Norway Anca Heyd, DIPS ASA, Norway Nils-Harald Holsen, Nasjonal IKT HF, Norway Evelyn Hovenga, EJSH Consulting, Australia Ann Iren Tellnes Moe, Helse Vest IKT, Norway Leif Ivar Havelin, Helse Bergen, Norway Lars Ivar Mehlum, Helse Bergen HF, Norway Hans Johan Breidablik, Helse Førde HF, Norway Lars Karlsen, DIPS ASA, Norway Goran Karlstrom, County Of Värmland, Sweden Mary Kelaher, NEHTA, Australia Shinji Kobayashi, Kyoto University, Japan Nils Kolstrup, Skansen Legekontor og Nasjonalt Senter for samhandling og telemedisin, Norway Robert L'egan, NEHTA, Australia Sabine Leh, Helse-Bergen, Norway Heather Leslie, Atomica Informatics, Australia (openEHR Editor) Hugh Leslie, Ocean Informatics, Australia Hallvard Lærum, Oslo Universitetssykehus HF, Norway Mike Martyn, The Hobart Anaesthetic Group, Australia Shane McKee, Belfast Health & Social Care Trust, United Kingdom Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (openEHR Editor) Chris Mitchell, RACGP, Australia Lars Morgan Karlsen, DIPS ASA, Norway Stewart Morrison, NEHTA, Australia Bengt Nilssen, Sykehuset Innlandet HFq, Norway Bjørn Næss, DIPS ASA, Norway Jeremy Oats, NT Health, Australia Andrej Orel, Marand d.o.o., Slovenia Lynne Parsons, Primary and Community Health Services, Australia Anne Pauline Anderssen, Helse Nord RHF, Norway Vladimir Pizzo, Hospital Sírio Libanês, Brazil Jodie Pycroft, Adelaide Northern Division of General Practice Ltd, Australia Norwegian Review Summary, National ICT Norway, Norway Robyn Richards, NEHTA - Clinical Terminology, Australia Tanja Riise, Nasjonal IKT HF, Norway Jussara Rotzsch, UNB, Brazil Anoop Shah, University College London, United Kingdom Elizabeth Stanick, Hobart Anaesthetic Group, Australia Kirsten Steen Kyrkjebø, Helse Vest IKT AS, Norway Møyfrid Stokke, Helse Vest IKT, Norway Line Sæle, Nasjonal IKT HF, Norway John Taylor, NEHTA, Australia Micaela Thierley, Helse Bergen, Norway Gordon Tomes, Australian Institute of Health and Welfare, Australia John Tore Valand, Haukeland Universitetssjukehus, Norway (Nasjonal IKT redaktør, Nasjonal IKT oversettelsesredaktør) Richard Townley-O'Neill, NEHTA, Australia Donna Truran, ACCTI-UoW, Australia Jon Tysdahl, Furst medlab AS, Norway Ørjan Vermeer, Haukeland Universitetssjukehus, Kvinneklinikken, Norway Jo Wright, NT Dept of Health, Australia (Editor) Natalia Strauch, Medizinische Hochschule Hannover, Germany, originalLanguage=en, translators= German: Sarah Ballout, Natalia Strauch, Medizinische Hochschule Hannover, ballout.sarah@mh-hannover.de, Strauch.Natalia@mh-hannover.de Swedish: Emma Malm, Karolinska Universitetssjukhuset, emma.malm@cambio.se Norwegian Bokmål: Micaela Thierley, Einar Fosse, John Tore Valand, Silje Ljosland Bakke, Liv Laugen, Oslo University Hospital, Norway, liv.laugen@ous-hf.no Portuguese (Brazil): Vladimir Pizzo, Hospital Sirio Libanes - Brazil, vladimir.pizzo@hsl.org.br French: Vanessa Pereira, Better - Pathfinder, vanessapereira@protonmail.com Chinese (PRC): Lin Zhang, Taikang Insurance Group, linforest@163.com, TBD , subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={identities=[], other_participations=[], events=[], details=[], provider=[], items=[], description=[], protocol=[ResourceSimplifiedHierarchyItem [path=/protocol[at0025]/items[at0026], code=at0026, itemType=ELEMENT, level=2, text=Last Updated, description=The date this family history summary was last updated., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0025]/items[at0045], code=at0045, itemType=SLOT, level=2, text=Extension, description=Additional information required to capture local content or to align with other reference models/formalisms., comment=For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:* All not explicitly excluded archetypes, extendedValues=null]], ism_transition=[], context=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0002], code=at0002, itemType=ELEMENT, level=2, text=Summary, description=Narrative overview about problems, diagnoses, psychosocial, environmental and genetic markers that have been identified in family members., comment=This field can be used to record a summary or the conclusion of all the findings, for unstructured family history information recorded in clinical records, or to import textual data from existing/legacy clinical systems., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0028], code=at0028, itemType=CLUSTER, level=2, text=Per problem, description=Details about the presence of a specific problem or diagnosis in family members., comment=If the problem has a genetic predisposition within families, then only genetic relatives should be considered as part of this data. If the problem has psychosocial or environmental effects then non-genetic family members may also be included., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0028]/items[at0029], code=at0029, itemType=ELEMENT, level=3, text=Problem/diagnosis name, description=Identification of the significant problem or diagnosis in the family overall., comment=This is the problem for which aggregated data involving all family members will be collected. Coding of the index problem with a terminology is preferred, where possible., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0028]/items[at0030], code=at0030, itemType=ELEMENT, level=3, text=Description, description=Narrative description about occurrence of the problem or diagnosis in family members., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0028]/items[at0059], code=at0059, itemType=SLOT, level=3, text=Problem details, description=Structured details about the identified problem or diagnosis., comment=For example: prevalence of the problem/diagnosis in the family., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include: openEHR-EHR-CLUSTER.family_prevalence.v1 and specialisations, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003], code=at0003, itemType=CLUSTER, level=2, text=Per family member, description=Details about a specific family member., comment=The data elements in this cluster will relate to the individual identified either by name or by alias. Repeat the use of the cluster for other family members., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0004], code=at0004, itemType=ELEMENT, level=3, text=Family member name, description=Name of family member., comment=For example: 'Aunt Susan' or 'Susan Smith'. However, for privacy reasons this may not be appropriate for recording, sharing or public display and in this situation the 'Alias' should be used., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0020], code=at0020, itemType=ELEMENT, level=3, text=Alias, description=An alternative name or label to uniquely identify a family member, without using a personal name which might publicly identify the individual., comment=To be used to assist in distinguishing one individual from multiple family members with identical relationships. For example, the label to distinguish one specific sister from three known sisters might be 'eldest sister' 'sister with the red hair' or 'sister #1'., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0048], code=at0048, itemType=SLOT, level=3, text=Family member details, description=Structured detail about the identified family member., comment=May include structured detail that identifies the family member more specifically or other details relevant to the family history of the family member., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include: openEHR-EHR-CLUSTER.person.v1, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0060], code=at0060, itemType=ELEMENT, level=3, text=Biological sex, description=The family member's biological sex., comment=Coding of the sex with a terminology is preferred, where possible., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0016], code=at0016, itemType=ELEMENT, level=3, text=Relationship, description=The relationship of the family member to the subject of care., comment=For example: mother, step-father, maternal grandmother, or paternal uncle. Coding of the relationship with a terminology is preferred, where possible and including specification of maternal and paternal as required., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0064], code=at0064, itemType=ELEMENT, level=3, text=Relationship degree, description=The degree of relationship between the subject of care and the family member., comment=If the 'Relationship' data element uses pre-coordinated terms that include the degree of relationship, then this data element is redundant., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0065::First degree relative [50% genetic share with the subject - for example, parent, sibling or child.] at0066::Second degree relative [25% genetic share with the subject - for example, grandparent, aunt, uncle, niece, nephew, grandchildren and half siblings.] at0067::Third degree relative [12.5% genetic share with the subject - for example, great grandparent, great aunt, great uncle, first cousin, children of nieces and nephews, and great grandchildren.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0068], code=at0068, itemType=ELEMENT, level=3, text=Family line, description=Identification of the maternal or paternal family line in the relationship., comment=If the 'Relationship' data element uses pre-coordinated terms that include the family line, then this data element is redundant., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0069::Maternal line [Related through the subject's mother.] at0070::Paternal line [Related through the subject's father.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0005], code=at0005, itemType=ELEMENT, level=3, text=Date of birth, description=Full or partial date of birth of the family member., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0023], code=at0023, itemType=ELEMENT, level=3, text=Deceased?, description=Is the family member deceased?, comment=Record as 'True' if family member is deceased., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=Allowed values: {true}, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0011], code=at0011, itemType=ELEMENT, level=3, text=Age at death, description=Exact or estimated age of the family member at death., comment=Age of death can be useful if the problem/diagnosis which caused their death is being considered as a risk factor for the subject of the health record. For example: death of mother from breast cancer at young age significally increases the risk of breast cancer in a daughter., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DURATION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0058], code=at0058, itemType=ELEMENT, level=3, text=Date of death, description=Full or partial date of death of the family member., comment=Date of death may be useful in some situations in which the month of death may trigger decision support or identify groupings of disease. For example: environmental allergens triggering respiratory exaccerbations; or events such as Christmas., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0008], code=at0008, itemType=CLUSTER, level=3, text=Clinical history, description=Detail about problems or diagnoses for the family member., comment=If more detail is required, suggest using EVALUATION.problem_diagnosis or the ACTION.procedure archetype and specifying the 'Subject of Care' as the family member, rather than the subject of the health record., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0008]/items[at0009], code=at0009, itemType=ELEMENT, level=4, text=Problem/diagnosis name, description=Identification of the significant problem or diagnosis in the identified family member., comment=Coding of the family member's problem or diagnosis with a terminology is preferred, where possible. May link from this data element to a detailed record of a Problem/Diagnosis using the EVALUATION.problem_diagnosis archetype with the Subject of Care set to the family member, not to the patient., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0008]/items[at0012], code=at0012, itemType=ELEMENT, level=4, text=Clinical description, description=Narrative description or comments about clinical aspects of the family member's problem/diagnosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0008]/items[at0010], code=at0010, itemType=ELEMENT, level=4, text=Age at onset, description=Estimated or actual age of the family member when the problem/diagnosis was clinically recognised., comment=For health problems with multiple occurrences, this describes the first nown occurrence., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DURATION, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0008]/items[at0014], code=at0014, itemType=ELEMENT, level=4, text=Cause of death?, description=Relationship of the problem/diagnosis to the death of this family member., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:* Coded Text at0061::Direct cause or closely related [The problem or diagnosis was a direct cause or closely related to the direct cause of death.] at0062::Unrelated [The problem or diagnosis was unrelated to the cause of death.] at0063::Indeterminate [It is impossible to determine whether the problem or diagnosis was closely related to the direct cause of death.] Text , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0046], code=at0046, itemType=ELEMENT, level=3, text=Comment, description=Additional narrative about the family member not captured in other fields., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0024], code=at0024, itemType=CLUSTER, level=3, text=Biomarkers, description=Detailed information about measurable indicators of a biological state or condition of the family member., comment=For example: detailed information on BRCA mutations in family members. Note: More data elements will be needed in future to record detailed genetic marker information., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0024]/items[at0022], code=at0022, itemType=ELEMENT, level=4, text=Biomarker description, description=Description of risk-related biological markers identified in this family member., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0003]/items[at0024]/items[at0027], code=at0027, itemType=SLOT, level=4, text=Biomarker details, description=Structured details about biological markers., comment=null, uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:* All not explicitly excluded archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0053], code=at0053, itemType=SLOT, level=2, text=Multimedia, description=Multimedia representation of the family history., comment=For example: a pedigree chart., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:* openEHR-EHR-CLUSTER.media_file.v1 and specialisations, extendedValues=null]], activities=[], relationships=[], credentials=[], target=[], source=[], state=[], content=[], contacts=[], capabilities=[]}, topLevelItems={protocol=ResourceSimplifiedHierarchyItem [path=ROOT_/protocol[at0025], code=at0025, itemType=ITEM_TREE, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0.., subCardinalityText=Minimum of 0 items (Cardinality: 0.., unordered), dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null], data=ResourceSimplifiedHierarchyItem [path=ROOT_/data[at0001], code=at0001, itemType=ITEM_TREE, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0.., subCardinalityText=Minimum of 0 items (Cardinality: 0.., unordered), dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=protocol, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/protocol[at0025]/items[at0026], code=at0026, itemType=ELEMENT, level=2, text=Last Updated, description=The date this family history summary was last updated., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0025]/items[at0045], code=at0045, itemType=SLOT, level=2, text=Extension, description=Additional information required to capture local content or to align with other reference models/formalisms., comment=For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:* All not explicitly excluded archetypes, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null]