ARCHETYPE Spirometry result (openEHR-EHR-OBSERVATION.spirometry_result.v2)

Name: Spirometry result
License: http://creativecommons.org/licenses/by-sa/4.0/

ARCHETYPE ID	openEHR-EHR-OBSERVATION.spirometry_result.v2
Concept	Spirometry result
Description	Pulmonary function test results using a spirometer or peak flow meter.
Use	Use to record the results of a pulmonary function test performed using a spirometer or peak flow meter. This archetype is intended to be used to record the results from: - electronic or mechanical measurement devices. Use the 'Type of measurement' element in Protocol to record how the result was measured; - oral, nasal or tracheostomy tests. Use the 'Method' element in Protocol to record the type of breathing equipment used to perform the test. For example: mouth piece or face mask. Measurements with different 'Method' will have to be recorded using separate instances of the archetype. - inspiratory and expiratory tests. The name of each test will indicate whether the test records an inspiratory or expiratory result. If the spirometry test is performed in association with the administration of bronchodilators or challenge substances, this can be recorded using the 'Challenge/reversibility' element. Details of what was administered should be recorded using an instance of the ACTION.medication archetype committed within the same COMPOSITION. If additional information about body temperature, ambient pressure or humidity is required, this can be recorded using additional archetypes. Body temperature can be recorded using an instance of the OBSERVATION.body_temperature archetype committed within the same COMPOSITION. Ambient pressure or humidity can be recorded using the CLUSTER.environmental_conditions in the 'Enviromental conditions' slot. The 'Any event' can be cloned and constrained to support the representation of: - Multiple measurements and their average - clone the 'Any event' as many times as needed, plus an additional event set to 'Interval' and selecting the 'Mean' attribute; - Pre- and post bronchial challenge or bronchodilator results - clone the 'Any event' and rename as 'Baseline' and 'Post challenge/bronchodilator', associated with a time offset if required.
Misuse	Not to be used to record the results of other types of lung function tests, for example body plethysmography or lung diffusion tests. Use specific archetypes for these purposes. Not to be used to record details about incentive spirometry. Use specific archetypes for these purposes. Not to be used to record the results of blood gas tests. Use the OBSERVATION.laboratory_test_result for this purpose. Not to be used to record measurements about pulse oximetry. Use the OBSERVATION.pulse_oximetry for this purpose.
Purpose	To record the results of a pulmonary function test performed using a spirometer or peak flow meter.
References	Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J. Standardisation of spirometry. Eur Respir J. 2005 Aug;26(2):319-38. doi: 10.1183/09031936.05.00034805. PubMed PMID: 16055882. Available from: https://erj.ersjournals.com/content/26/2/319.long Johns DP, Pierce R. Pocket guide to spirometry. McGraw-Hill Medical; 2011. Pingul EM, de Guia TS, Ayuyao FG. FEV1/FEV6 vs FEV1/FVC in the spirometric diagnosis of airways obstruction among Asians [cited 2019 03 12]. Chest. 2007; 132 (4_MeetingAbstracts): 491c-492. Available from https://doi.org/10.1378/chest.132.4_MeetingAbstracts.491c TIFFENEAU R, PINELLI. Air circulant et air captif dans l'exploration de la fonction ventilatrice pulmonaire [Circulating air and captive air in the exploration of the pulmonary ventilator function]. Paris Med. 1947 Dec 27;37(52):624-8. French. PMID: 18909782. Sheshadri A, Keus L, Blanco D, Lei X, Kellner C, Shannon VR, Balachandran DD, Jimenez CA, Bashoura L, Faiz SA. Pulmonary Function Testing in Patients with Tracheostomies: Feasibility and Technical Considerations. Lung. 2021 Jun;199(3):307-310. doi: 10.1007/s00408-021-00441-x. Epub 2021 Mar 29. PMID: 33779802; PMCID: PMC9275556.
Copyright	© openEHR Foundation
Authors	Author name: Ian McNicoll Organisation: freshEHR Informatics, UK Email: ian.mcnicoll@freshEHR.com Date originally authored: 2013-03-08
Other Details Language	Author name: Ian McNicoll Organisation: freshEHR Informatics, UK Email: ian.mcnicoll@freshEHR.com Date originally authored: 2013-03-08
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=Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J. Standardisation of spirometry. Eur Respir J. 2005 Aug;26(2):319-38. doi: 10.1183/09031936.05.00034805. PubMed PMID: 16055882. Available from: https://erj.ersjournals.com/content/26/2/319.long Johns DP, Pierce R. Pocket guide to spirometry. McGraw-Hill Medical; 2011. Pingul EM, de Guia TS, Ayuyao FG. FEV1/FEV6 vs FEV1/FVC in the spirometric diagnosis of airways obstruction among Asians [cited 2019 03 12]. Chest. 2007; 132 (4_MeetingAbstracts): 491c-492. Available from https://doi.org/10.1378/chest.132.4_MeetingAbstracts.491c TIFFENEAU R, PINELLI. Air circulant et air captif dans l'exploration de la fonction ventilatrice pulmonaire [Circulating air and captive air in the exploration of the pulmonary ventilator function]. Paris Med. 1947 Dec 27;37(52):624-8. French. PMID: 18909782. Sheshadri A, Keus L, Blanco D, Lei X, Kellner C, Shannon VR, Balachandran DD, Jimenez CA, Bashoura L, Faiz SA. Pulmonary Function Testing in Patients with Tracheostomies: Feasibility and Technical Considerations. Lung. 2021 Jun;199(3):307-310. doi: 10.1007/s00408-021-00441-x. Epub 2021 Mar 29. PMID: 33779802; PMCID: PMC9275556., original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=7C30237E2A5AD7DAEC81DB4EB35BDB77, build_uid=c92d5ec3-921f-4162-8bc8-4ba4ff57b49a, 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 https://www.snomed.org/snomed-ct/get-snomed or info@snomed.org., revision=2.0.1}
Keywords	respiratory, pulmonary, spirometry, peak flow, lung, bronchial, airway, pef, pefr
Lifecycle	published
UID	80bc786e-3275-4790-9fcf-4e595e6c021c
Language used	en
Citeable Identifier	1013.1.6655
Revision Number	2.0.1
All	Archetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Pulmonary function test results using a spirometer or peak flow meter., archetypeConceptComment=null, otherContributors=Dag Aarhus, Vestre Viken HF, Norway Håvard Andreassen Sæverud, Oslo universitetssykehus, Norway Vebjørn Arntzen, Oslo University Hospital, Norway (openEHR Editor) Astrid Askeland, Dips AS, Norway Silje Ljosland Bakke, Helse Vest IKT AS, Norway (openEHR Editor) SB Bhattacharyya, Bhattacharyyas Clinical Records Research & Informatics LLP, India Hanne Marte Bårholm, Helse Vest IKT, Norway (openEHR Editor) Derek Corrigan, Royal College of Surgeons in Ireland, Ireland Manuela Domingo, hospital general universitario dr. balmis, Spain Ola Drange Røksund, Helse Bergen, Norway Kåre Flø, DIPS ASA, Norway Heather Grain, Llewelyn Grain Informatics, Australia Mikkel Johan Gaup Grønmo, Regional forvaltning EPJ, Helse Nord, Norway (openEHR Editor) Merete Havn Torland, Helse Vest IKT, Norway Sam Heard, Ocean Informatics, Australia Evelyn Hovenga, EJSH Consulting, Australia Tiago Jacinto, CINTESIS - FMUP, Portugal Lars Morgan Karlsen, DIPS ASA, Norway Agathe Krekvik Govertsen, Helse Bergen, Norway Kanika Kuwelker, Helse Vest IKT, Norway (openEHR Editor) Liv Laugen, Oslo University Hospital, Norway, Norway (openEHR Editor) Valeria Lecca, Sardegna Ricerche, Italia Heather Leslie, Atomica Informatics, Australia (openEHR Editor) Anne M Gromsrud, DIPS AS, Norway Ian McNicoll, freshEHR Clinical Informatics, United Kingdom Svenne Naumann, Finnmarkssykehuset, Norway Mikael Nyström, Cambio Healthcare Systems AB, Sweden Bjørn Næss, DIPS ASA, Norway Andrej Orel, Marand d.o.o., Slovenia Ana Pereira, CINTESIS, CUF-Porto, Portugal Francisco Sanchez Laguna, Ministry of Health, Spain Norwegian Review Summary, Norwegian Public Hospitals, Norway Nina Særvold, Helse Bergen, Norway Nyree Taylor, Ocean Health Systems, Australia Anders Thurin, VGR, Sweden John Tore Valand, Helse Bergen, Norway (openEHR Editor) Marit Alice Venheim, Helse Vest IKT, Norway (openEHR Editor) Ina Wille, Helse-Vest RHF, Norway, originalLanguage=en, translators= German: Alina Rehberg, Medizinische Hochschule Hannover, rehberg.alina@mh-hannover.de Finnish: Vesa Peltola, Tieto Finland Oy, vesa.peltola@tieto.com Norwegian Bokmål: Mikkel Johan Gaup Grønmo, Silje Ljosland Bakke, Marit Alice Venheim, Hanne Marte Bårholm, Helse-Nord, Forvaltningssenter EPJ, Helse Vest IKT AS, mikkel.johan.gaup.gronmo@helse-nord.no, silje.ljosland.bakke@helse-vest-ikt.no, marit.alice.venheim@helse-vest-ikt.no, hanne.marte.sandal.barholm@helse-vest-ikt.no, Nasjonal IKT HF Slovenian: ? , subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={protocol=[ResourceSimplifiedHierarchyItem [path=/protocol[at0029]/items[at0196], code=at0196, itemType=ELEMENT, level=2, text=Type of measurement, description=Type of measurement of spirometry., comment=This is particularly relevant for PEFR and PIFR tests., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0197::Mechanical [Measurement using a purely mechanical device.] at0198::Electronic [Measurement using an electronic device.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0029]/items[at0199], code=at0199, itemType=ELEMENT, level=2, text=Method, description=Method used to perform the test., comment=For example: measurements performed orally using a mouth piece and nose clip, or nasally using a face mask with the mouth firmly closed. Measurements with different methods will have to be recorded using separate instances of the archetype., 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=/protocol[at0029]/items[at0192], code=at0192, itemType=ELEMENT, level=2, text=Challenge/reversibility, description=Statement about whether the spirometry test was performed as a reversibility test or a bronchial challenge test., comment=A reversibility test is usually performed using an inhaled bronchodilator such as salbutamol, and is sometimes known as a post bronchodilator test. A bronchial challenge test is usually performed using an inhaled bronchoconstrictor such as methacholine, vigorous exercise, or inhalation of cold/dry air., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0193::None [The spirometry test was performed neither as a reversibility test nor a bronchial challenge test.] at0194::Bronchial challenge test [The spirometry test was performed as a bronchial challenge test.] at0195::Reversibility test [The spirometry test was performed as a reversibility test.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0029]/items[at0030], code=at0030, itemType=SLOT, level=2, text=Device, description=Details of the device used to measure spirometry., comment=null, uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:* openEHR-EHR-CLUSTER.device.v1 and specialisations, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0029]/items[at0185], code=at0185, itemType=SLOT, level=2, text=Predicted results source, description=The knowledge base used for the predicted results., comment=For example: GLI 2012., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:* openEHR-EHR-CLUSTER.knowledge_base_reference.v1 and specialisations, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0029]/items[at0132], code=at0132, 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 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]], credentials=[], description=[], ism_transition=[], provider=[], content=[], activities=[], relationships=[], contacts=[], details=[], capabilities=[], context=[], other_participations=[], state=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/state[at0031]/items[at0115], code=at0115, itemType=ELEMENT, level=4, text=Position, description=The body position of the individual at the time of measurement., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0116::Standing [Standing at the time of measurement.] [SNOMED-CT::10904000 \| Orthostatic body position] at0117::Sitting [Sitting (for example on a bed or chair) at the time of measurement.] [SNOMED-CT::33586001 \| Sitting position] at0118::Reclining [Reclining at the time of measurement.] [SNOMED-CT::272580008 \| Semi-recumbent position] at0119::Lying [Lying flat at the time of measurement.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/state[at0031]/items[at0098], code=at0098, itemType=ELEMENT, level=4, text=Confounding factors, description=Record any issues or factors that may impact on the spirometry test., comment=For example: known COPD., 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]/events[at0002]/state[at0031]/items[at0191], code=at0191, itemType=SLOT, level=4, text=Level of exertion, description=Details about physical activity undertaken at the time of spirometry recording., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include: openEHR-EHR-CLUSTER.level_of_exertion.v0 and specialisations or openEHR-EHR-CLUSTER.level_of_exertion.v1 and specialisations, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/state[at0031]/items[at0209], code=at0209, itemType=SLOT, level=4, text=Environmental conditions, description=Details about environmental conditions undertaken at the time of spirometry recording., comment=null, uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:* openEHR-EHR-CLUSTER.environmental_conditions.v0 and specialisations or openEHR-EHR-CLUSTER.environmental_conditions.v1 and specialisations, extendedValues=null]], events=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002], code=at0002, itemType=EVENT, level=2, text=Any event, description=Default, unspecified point in time or interval which may be explicitly defined in a template or at run-time., comment=null, uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=EVENT, bindings=null, values=null, extendedValues=null]], source=[], items=[], identities=[], target=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0052], code=at0052, itemType=CLUSTER, level=4, text=(Volume), description=Test result represented as a measured volume or calculated capacity., comment=Each test result is recorded using a separate instance of this cluster., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Runtime name constraint: at0065::FVC [Forced vital capacity (FVC) is the maximal volume of air that can be forcibly exhaled from a position of full inspiration.] [SNOMED-CT::50834005 \| Forced vital capacity] at0064::SVC [Slow vital capacity (SVC) is the maximal volume of air that can be slowly exhaled from a position of full inspiration. Also known as Expiratory vital capacity (EVC). Equal to IRV + TV + ERV.] [SNOMED-CT::83411002 \| Slow vital capacity] at0172::FIVC [Forced inspiratory vital capacity (FIVC) is the maximal volume of air that can be forcibly inhaled from a position of full expiration.] at0174::IVC [Inspiratory vital capacity (IVC) is the maximal volume of air that can be slowly inhaled from a position of full expiration. Equal to ERV + TV + IRV.] [SNOMED-CT::251913009 \| Inspiratory vital capacity] at0076::IC [Inspiratory capacity (IC) is the maximal volume of air that can be inhaled after exhalation of normal tidal volume. Equal to TV + IRV.] [SNOMED-CT::29533001 \| Inspiratory capacity] at0145::FEV0.5 [Forced expiratory volume at 0.5 seconds (FEV0.5) is the volume of air that has been exhaled during the first half second of forced exhalation, during the performance of FVC.] at0070::FEV0.75 [Forced expiratory volume at 0.75 seconds (FEV0.75) is the volume of air that has been exhaled during the first three quarters of a second of forced exhalation, during the performance of FVC.] [SNOMED-CT::251910007 \| Forced expired volume in 0.75 seconds] at0067::FEV1 [Forced expiratory volume at 1 second (FEV1) is the volume of air that has been exhaled during the first second of forced exhalation, during the performance of FVC.] [SNOMED-CT::59328004 \| Forced expired volume in 1 second] at0146::FEV2 [Forced expiratory volume at 2 seconds (FEV2) is the volume of air that has been exhaled during the first two seconds of forced exhalation, during the performance of FVC.] at0068::FEV3 [Forced expiratory volume at 3 seconds (FEV3) is the volume of air that has been exhaled during the first three seconds of forced exhalation, during the performance of FVC.] at0069::FEV6 [Forced expiratory volume at 6 seconds (FEV6) is the volume of air that has been exhaled during the first six seconds of forced exhalation, during the performance of FVC.] [SNOMED-CT::878869001 \| Forced expired volume in six seconds] at0171::FIV1 [Forced inspiratory volume at 1 second (FIV1) is the volume of air that has been inhaled during the first second of forced inhalation, during the performance of FIVC.] [SNOMED-CT::251912004 \| Forced inspired volume in 1 second] at0082::TV [Tidal volume (TV) is the normal volume of air that can be inhaled or exhaled during one respiratory cycle when no extra effort is applied. Also known as Vᴛ.] [SNOMED-CT::13621006 \| Tidal volume] at0077::ERV [Expiratory reserve volume (ERV) is the maximal volume of air that can be forcibly exhaled after exhalation of normal tidal volume.] [SNOMED-CT::55532004 \| Expiratory reserve volume] at0078::IRV [Inspiratory reserve volume (IRV) is the maximal volume of air that can be forcibly inhaled after a inhalation of normal tidal volume.] [SNOMED-CT::55562005 \| Inspiratory reserve volume] at0176::MVV [Maximum voluntary ventilation (MVV) is the maximum volume of air the individual can breathe during a period of time specified by an interval event.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0052]/items[at0053], code=at0053, itemType=ELEMENT, level=5, text=Result, description=Measured volume., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Volume Units: >=0.0 l Limit decimal places: 3 >=0.0 ml Limit decimal places: 1 , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0052]/items[at0054], code=at0054, itemType=ELEMENT, level=5, text=Predicted result, description=Predicted volume., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Volume Units: >=0.0 l Limit decimal places: 3 >=0.0 ml Limit decimal places: 1 , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0052]/items[at0044], code=at0044, itemType=ELEMENT, level=5, text=Measured/predicted ratio, description=The ratio of the measured to predicted test results., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_PROPORTION, bindings=null, values= Percent Numerator: >=0.0 , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0057], code=at0057, itemType=CLUSTER, level=4, text=(Flow rate), description=Test result represented as a measured flow rate., comment=Each test result is recorded using a separate instance of this cluster., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Runtime name constraint: at0152::PEFR [Peak expiratory flow rate (PEFR) is the peak flow rate during a forced vital capacity (FVC) maneuver. Also known as forced expiratory flow at maximum effort (FEFmax).] [SNOMED-CT::18491006 \| Peak expiratory flow rate] at0205::PIFR [Peak inspiratory flow rate (PIFR) is the peak flow rate during a forced inspiratory vital capacity (FIVC) maneuver.] [SNOMED-CT::251923000 \| Maximum inspiratory flow rate] at0072::FEF25-75% [Forced expiratory flow 25-75 % (FEF25-75%) is the mean forced expiratory flow of air measured during the expiration of 25-75 % of the volume of the forced vital capacity (FVC).] [SNOMED-CT::251932003 \| Forced expiratory flow rate between 25+75% of vital capacity] at0073::FEF25-50% [Forced expiratory flow 25-50 % (FEF25-50%) is the mean forced expiratory flow of air measured during the expiration of 25-50 % of the volume of the forced vital capacity (FVC).] at0074::FIF25-75% [Forced inspiratory flow 25-75 % (FIF25-75%) is the mean forced inspiratory flow of air measured during the inspiration of 25-75 % of the volume of the forced inspiratory vital capacity (FIVC).] at0075::FIF25-50% [Forced inspiratory flow 25-50 % (FIF25-50%) is the mean forced inspiratory flow of air measured during the inspiration of 25-50 % of the volume of the forced inspiratory vital capacity (FIVC).] at0177::FEF25% [Forced expiratory flow 25 % (FEF25%) is the maximal instantaneous expiratory flow when 25 % of the of the volume of the forced vital capacity (FVC) has been expired. Also known as maximal voluntary flow 75% (MEF75%).] [SNOMED-CT::251921003 \| Maximum expiratory flow rate at 75% of vital capacity] at0178::FEF50% [Forced expiratory flow 50 % (FEF50%) is the maximal instantaneous expiratory flow when 50 % of the of the volume of the forced vital capacity (FVC) has been expired. Also known as maximal voluntary flow 50 % (MEF50%).] [SNOMED-CT::251920002 \| Maximum expiratory flow rate at 50% of vital capacity] at0179::FEF75% [Forced expiratory flow 75 % (FEF75%) is the maximal instantaneous expiratory flow when 75 % of the of the volume of the forced vital capacity (FVC) has been expired. Also known as maximal voluntary flow 25 % (MEF25%).] [SNOMED-CT::251919008 \| Maximum expiratory flow rate at 25% of vital capacity] at0186::FIF25% [Forced inspiratory flow 25 % (FIF25%) is the maximal instantaneous inspiratory flow when 25 % of the of the volume of the forced inspiratory vital capacity (FIVC) has been inspired. Also known as maximum inspiratory flow 75% (MIF75%).] [SNOMED-CT::251927004 \| Maximum inspiratory flow rate at 75% of vital capacity] at0187::FIF50% [Forced inspiratory flow 50 % (FIF50%) is the maximal instantaneous inspiratory flow when 50 % of the of the volume of the forced inspiratory vital capacity (FIVC) has been inspired. Also known as maximum inspiratory flow 50% (MIF50%).] [SNOMED-CT::251926008 \| Maximum inspiratory flow rate at 50% of vital capacity] at0188::FIF75% [Forced inspiratory flow 75 % (FIF75%) is the maximal instantaneous inspiratory flow when 75 % of the of the volume of the forced inspiratory vital capacity (FIVC) has been inspired. Also known as maximum inspiratory flow 25% (MIF25%).] [SNOMED-CT::251924006 \| Maximum inspiratory flow rate at 25% of vital capacity] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0057]/items[at0058], code=at0058, itemType=ELEMENT, level=5, text=Result, description=Measured flow rate., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Flow rate, volume Units: >=0.0 L/s Limit decimal places: 3 >=0.0 mL/s Limit decimal places: 1 >=0.0 L/min Limit decimal places: 1 , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0057]/items[at0008], code=at0008, itemType=ELEMENT, level=5, text=Predicted result, description=Predicted flow rate., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Flow rate, volume Units: >=0.0 L/s Limit decimal places: 3 >=0.0 mL/s Limit decimal places: 1 >=0.0 L/min Limit decimal places: 1 , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0057]/items[at0122], code=at0122, itemType=ELEMENT, level=5, text=Measured/predicted ratio, description=The ratio of measured to predicted test results., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_PROPORTION, bindings=null, values= Percent Numerator: >=0.0 , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0156], code=at0156, itemType=CLUSTER, level=4, text=(Pressure), description=Test result represented as a measured pressure., comment=Each test result is recorded using a separate instance of this cluster., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Runtime name constraint: at0170::MEP [Maximal expiratory pressure (MEP) is the maximal expiratory pressure during a forced vital capacity (FVC) maneuver.] [SNOMED-CT::17202005 \| Peak expiratory pressure] at0181::MIP [Maximal inspiratory pressure (MIP) is the maximal inspiratory pressure during a forced inspiratory vital capacity (FIVC) maneuver.] [SNOMED-CT::27913002 \| Peak inspiratory pressure] at0182::SNIP [Sniff nasal inspiratory pressure (SNIP) is the maximal inspiratory pressure in one occluded nostril during a maximal sniff performed from relaxed end-expiration through the other patent nostril.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0156]/items[at0165], code=at0165, itemType=ELEMENT, level=5, text=Result, description=Measured pressure., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Pressure Units: >=0.0 cmH₂O Limit decimal places: 1 >=0.0 mmHg Limit decimal places: 0 , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0156]/items[at0166], code=at0166, itemType=ELEMENT, level=5, text=Predicted result, description=Predicted pressure., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Pressure Units: >=0.0 cmH₂O Limit decimal places: 1 >=0.0 mmHg Limit decimal places: 0 , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0156]/items[at0167], code=at0167, itemType=ELEMENT, level=5, text=Measured/predicted ratio, description=The ratio of measured to predicted test results., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_PROPORTION, bindings=null, values= Percent Numerator: >=0.0 , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0055], code=at0055, itemType=CLUSTER, level=4, text=(Ratio), description=A calculated test result expressed as a ratio., comment=Each ratio is recorded using a separate instance of this cluster., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=1.., cardinalityText= (Cardinality: 1.., unordered), subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Runtime name constraint: at0081::FEV1/FVC ratio [The ratio of 'Forced expiratory volume in 1 second (FEV1)' to 'Forced vital capacity (FVC)'. Also known as FEV1%FVC or FEV1%F.] [SNOMED-CT::251944000 \| Forced expired volume in one second/forced vital capacity ratio] at0080::FEV1/SVC ratio [The ratio of 'Forced expiratory volume in 1 second (FEV1)' to 'Slow vital capacity (SVC)'.] at0189::FEV1/FEV6 ratio [The ratio of 'Forced expiratory volume in 1 second (FEV1)' to 'Forced expiratory volume in 6 seconds (FEV6)'.] [SNOMED-CT::702534005 \| Forced expiratory volume in one second/Forced expiratory volume in six seconds ratio] at0190::FEV1/IVC ratio [The ratio of 'Forced expiratory volume in 1 second (FEV1)' to 'Inspired vital capacity (IVC)'.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0055]/items[at0056], code=at0056, itemType=ELEMENT, level=5, text=Result, description=Calculated ratio., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_PROPORTION, bindings=null, values= Percent Numerator: >=0.0 , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0055]/items[at0018], code=at0018, itemType=ELEMENT, level=5, text=Predicted result, description=Predicted ratio., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_PROPORTION, bindings=null, values= Percent Numerator: >=0.0 , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0013], code=at0013, itemType=ELEMENT, level=4, text=Forced expiratory time (FET), description=The time taken to complete a forced expiration., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DURATION, bindings=null, values=Allowed values:* seconds >=0 seconds , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0131], code=at0131, itemType=SLOT, level=4, text=Multimedia representation, description=Digital representation of the test results., comment=For example: Flow volume loop; or volume-time tracing., 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], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0130], code=at0130, itemType=ELEMENT, level=4, text=Clinical interpretation, description=Overall clinical interpretation about all of the measurements and calculated ratios., 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]/events[at0002]/data[at0003]/items[at0101], code=at0101, itemType=ELEMENT, level=4, text=Comment, description=Additional narrative about the test results and intepretation 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]]}, topLevelItems={protocol=ResourceSimplifiedHierarchyItem [path=ROOT_/protocol[at0029], code=at0029, 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], state=ResourceSimplifiedHierarchyItem [path=ROOT_/data[at0001]/events[at0002]/state[at0031], code=at0031, itemType=ITEM_TREE, level=2, 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]/events[at0002]/data[at0003], code=at0003, itemType=ITEM_TREE, level=2, 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[at0029]/items[at0196], code=at0196, itemType=ELEMENT, level=2, text=Type of measurement, description=Type of measurement of spirometry., comment=This is particularly relevant for PEFR and PIFR tests., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0197::Mechanical [Measurement using a purely mechanical device.] at0198::Electronic [Measurement using an electronic device.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0029]/items[at0199], code=at0199, itemType=ELEMENT, level=2, text=Method, description=Method used to perform the test., comment=For example: measurements performed orally using a mouth piece and nose clip, or nasally using a face mask with the mouth firmly closed. Measurements with different methods will have to be recorded using separate instances of the archetype., 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=/protocol[at0029]/items[at0192], code=at0192, itemType=ELEMENT, level=2, text=Challenge/reversibility, description=Statement about whether the spirometry test was performed as a reversibility test or a bronchial challenge test., comment=A reversibility test is usually performed using an inhaled bronchodilator such as salbutamol, and is sometimes known as a post bronchodilator test. A bronchial challenge test is usually performed using an inhaled bronchoconstrictor such as methacholine, vigorous exercise, or inhalation of cold/dry air., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values= at0193::None [The spirometry test was performed neither as a reversibility test nor a bronchial challenge test.] at0194::Bronchial challenge test [The spirometry test was performed as a bronchial challenge test.] at0195::Reversibility test [The spirometry test was performed as a reversibility test.] , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0029]/items[at0030], code=at0030, itemType=SLOT, level=2, text=Device, description=Details of the device used to measure spirometry., comment=null, uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:* openEHR-EHR-CLUSTER.device.v1 and specialisations, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0029]/items[at0185], code=at0185, itemType=SLOT, level=2, text=Predicted results source, description=The knowledge base used for the predicted results., comment=For example: GLI 2012., uncommonOntologyItems=null, occurencesFormal=0.., occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:* openEHR-EHR-CLUSTER.knowledge_base_reference.v1 and specialisations, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0029]/items[at0132], code=at0132, 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 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]