MII IG Kerndatensatz-Modul Lungenfunktion
2027.0.0-ballot.1 -
Germany
MII IG Kerndatensatz-Modul Lungenfunktion
2027.0.0-ballot.1 -
Germany
MII IG Kerndatensatz-Modul Lungenfunktion - Downloaded Version 2027.0.0-ballot.1 See the Directory of published versions
This page is aimed at Data Integration Centers and implementers. It describes how the Pulmonary Function module fits into the Core Dataset as a whole, which content it deliberately reuses from other modules, and which standards it is based on.
Pulmonary function examinations are among the most frequently performed functional diagnostic procedures and form an essential basis for diagnosis, treatment decisions and follow-up in pulmonary diseases, as well as for research purposes. The measured values themselves are largely harmonized by international standards (ATS/ERS); the way they are stored is not. At the sites, the data are typically held in the proprietary formats of the respective measuring workstations, in downstream report documents, or exclusively as PDF. A comprehensive overview of the availability of structured pulmonary function data at the consortium sites does not currently exist. The module accounts for this by allowing the individual function tests to be implemented independently of one another, enabling a staged provision according to the data actually available.
A particular characteristic of this module is that the interpretability of the measured values depends directly on data managed outside the module: predicted values and z-scores are calculated from age, sex, height and ethnicity, and the diffusing capacity is corrected using the haemoglobin value. The relationships to the base modules are therefore not merely organizational but clinically mandatory.
The module deliberately defines no profiles of its own for content already specified elsewhere, but reuses it:
| Content | Resource | Origin |
|---|---|---|
| Demographic data | Patient | Person module, extended by ethnicity |
| Vital signs / body measurements | Observation | ISiK or ICU module |
| Blood gases, arterial (capillary) | Observation | Laboratory module |
| Risk factor smoking behaviour | Observation | — |
| Risk factor allergy | AllergyIntolerance | — |
These data are not incidental: body measurements, age, sex and ethnicity feed directly into the calculation of the predicted values and are therefore a prerequisite for a reliable interpretation of the measured values.
Pulmonary function tests are assigned to a patient via references from the pulmonary function test (DiagnosticReport), from the pulmonary function measurement (Procedure) and from the measurement results (Observation) to the PERSON module. In addition, the PERSON module supplies two of the input variables for the calculation of predicted values through date of birth and sex. For ethnicity, which is required for determining reference values (e.g. according to GLI) but is not represented in the base module, the Pulmonary Function module provides an extension of the Patient resource.
A pulmonary function test is assigned to an encounter via references from the pulmonary function test (DiagnosticReport) and from the pulmonary function measurement (Procedure) to the FALL module. A reference to the respective encounter should always be carried along in order to establish the context of the examination — for instance outpatient follow-up, preoperative diagnostics or inpatient work-up.
Arterial and capillary blood gas analysis is not profiled independently but represented through the Observation profiles of the LABOR module and referenced from the pulmonary function test. The same applies to the haemoglobin value used to correct the diffusing capacity (DLCOcSB, KCOcSB). This ensures that values collected on the laboratory side are represented only once and according to the rules applying there.
Vital signs and body measurements — in particular height and weight as input variables for the calculation of predicted values — are taken from the existing Observation profiles of ISiK or the INTENSIVMEDIZIN module and referenced from the pulmonary function test.
Pulmonary function tests serve to confirm, classify and monitor pulmonary diagnoses. A reference to the DIAGNOSE module links the examination to the underlying clinical question or the resulting diagnosis — for instance in the severity classification of COPD based on the FEV 1 value, or in asthma diagnostics via reversibility testing.
The performance of the examination is represented within the module by the pulmonary function measurement (Procedure). It is kept compatible with the PROZEDUR module so that the examination also remains discoverable in the cross-cutting procedure context through the coding provided there (OPS, SNOMED CT).
In bronchial provocation testing and reversibility testing, the substance administered is a constitutive part of the test. Through a reference to the MEDIKATION module, the provocation substance and the bronchodilator including dosage can be represented as a medication administration (MedicationAdministration). In addition, existing long-term medication is relevant, since inhaled therapies influence the measurement results and should be carried along for their assessment.
Subjectively perceived limitations of breathing (PROMs) and sleep medicine aspects are not the subject of this module but are located in separate modules currently under development. The integration of existing data follows the rules of the responsible module in each case and is reviewed for suitability and completeness for the pulmonary function domain.
The Core Dataset module Pulmonary Function follows the established technical standards of medical pulmonary function measurement. It refers to measurement procedures whose values are recognized by the European Respiratory Society and the German Airway League.
The code systems, terminologies and references used for procedures, diagnoses, medication and related clinical questions are:
The HL7 FHIR core specification was also used — in particular the resources DiagnosticReport, Procedure and Observation.
This specification was designed on the basis of the description of the MII Core Dataset in the version of 2017-03-10 (PDF).
The MII-wide naming conventions for FHIR resources are maintained centrally in the Core Dataset wiki and are not repeated here.