DAS-v1.1(2023EN)

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General information

Name: nl.zorg.DAS
Version: 1.1
HCIM Status:Final
Release: 2023
Release status: Prepublished
Release date: 15-10-2023

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Metadata

DCM::CoderList	*
DCM::ContactInformation.Address	*
DCM::ContactInformation.Name	*
DCM::ContactInformation.Telecom	*
DCM::ContentAuthorList	*
DCM::CreationDate	26-03-2020
DCM::DeprecatedDate
DCM::DescriptionLanguage	nl
DCM::EndorsingAuthority.Address
DCM::EndorsingAuthority.Name	*
DCM::EndorsingAuthority.Telecom
DCM::Id	2.16.840.1.113883.2.4.3.11.60.40.3.12.18
DCM::KeywordList
DCM::LifecycleStatus	Final
DCM::ModelerList	Linda Mook
DCM::Name	nl.zorg.DAS
DCM::PublicationDate	15-10-2023
DCM::PublicationStatus	Prepublished
DCM::ReviewerList
DCM::RevisionDate	28-07-2021
DCM::Supersedes	nl.zorg.DAS-v1.0
DCM::Version	1.1
HCIM::PublicationLanguage	EN

Revision History

Only available in Dutch

Publicatieversie 1.0 (01-09-2020)

Publicatieversie 1.1 (01-12-2021)

ZIB-1248	DAS NL-CM:12.18.18 Locatie lijkt verkeerde omschrijvingen te hebben
ZIB-1404	DASMethodeCodelijst verwisselt termen
ZIB-1508	Het element 'Locatie' heeft een foutief DCM::ConceptId. Het id moet overgenomen worden uit de zib waar naar verwezen wordt.
ZIB-1567	Element naam aanpassen

Concept

The Disease Activity Score (DAS) is a combined index developed in Nijmegen around 1990 to measure disease activity in patients with rheumatoid arthritis (RA). It concerns a formula with 28 or 44 painful and swollen joints, a blood value for inflammation (BSE or CRP) and the overall experience of disease activity by the patient. The DAS results in a number between 0 and 10, which indicates how active rheumatoid arthritis is at present. The score has been validated for use in clinical trials in combination with the EULAR response criteria.

Purpose

In addition to frequent use in trials, the DAS is used to measure the disease activity of RA patients in daily clinical practice, supporting the "treat-to-target" strategy recommended in guidelines. The DAS is also used as an outcome measure for the care of RA patients in a national quality registration.

Patient Population

Adult patients with rheumatoid arthritis (RA).

Information Model

Type	Id	Concept						Card.	Definition	DefinitionCode	Reference
	NL-CM:12.18.1	DAS							Root concept of the information model.This root concept contains all data elements of the information model DAS.	443349002 Disease activity score in rheumatoid arthritis
	NL-CM:12.18.15		DASValue					0..1	The result (value).	763259004 DAS - Disease Activity Score
	NL-CM:12.18.14		DASMethod					1	The specification of the DAS method used. There are different DAS scores. Each type has a different formula. DAS-28 or DAS-44 stands for 28 or 44 painful and swollen joints. One blood value for inflammation (a ESR or a CRP laboratory result) and the overall experience of disease activity by the patient via a Visual Analog Scale (VAS).	443349002 Disease activity score in rheumatoid arthritis	DASMethodCodelist
	NL-CM:12.18.21		DASFormula					0..1	The specification of the type of DAS. There are different DAS scores. Each type has a different formula.
	NL-CM:12.18.2		AffectedJoint					0..*	Container of the AffectedJoint concept.This container contains all data elements of the AffectedJoint concept.	118952005 Joint finding
	NL-CM:12.18.16			AnatomicalLocation				0..1	Joints that are tender and/or swollen.		AnatomicalLocation
	NL-CM:20.7.4					Location			The location and laterality of joints in the body.	363698007 Finding site	LocationCodelist
	NL-CM:12.18.4			Swollen				0..1	Swolen joint indicator.	271771009 Joint swelling
	NL-CM:12.18.3			Tender				0..1	Tender joint indicator.	110288007 Tenderness of joint
	NL-CM:12.18.11		CountOfTenderJoints					0..1	Count of tender joints as reported by the patient.	442521001 Tender joint count for rheumatoid arthritis assessment
	NL-CM:12.18.12		CountOfSwolenJoints					0..1	Count of swollen joints.	442194005 Swollen joint count for rheumatoid arthritis assessment
	NL-CM:12.18.22		InflammationIndicator					0..1	Container of the InflammationIndicator concept.This container contains all data elements of the InflammationIndicator concept.
	NL-CM:12.18.20			ESR::LaboratoryResult				(0..1)	The C-reactive protein (CRP) is a laboratory measurment valuable for determining the presence of inflammation or to monitor the effect of a medical treatment on the inflammation. The erythrocyte sedimentation rate (ESR or sed rate) is the rate at which red blood cells in anticoagulated whole blood descend in a standardized tube over a period of one hour. Both test results can be used to calculate the DAS.	4537-7 Erythrocyte sedimentation rate by Westergren method 4539-3 Erythrocyte sedimentation rate Zeta by Zetafuge	LaboratoryTestResult
	NL-CM:12.18.19			CRP::LaboratoryResult				(0..1)	The C-reactive protein (CRP) is a laboratory measurment valuable for determining the presence of inflammation or to monitor the effect of a medical treatment on the inflammation. The erythrocyte sedimentation rate (ESR or sed rate) is the rate at which red blood cells in anticoagulated whole blood descend in a standardized tube over a period of one hour. Both test results can be used to calculate the DAS.	1988-5 C reactive protein [Mass/volume] in Serum or Plasma 30522-7 C reactive protein [Mass/volume] in Serum or Plasma by High sensitivity method	LaboratoryTestResult
	NL-CM:12.18.17		DASDateTime					0..1	The date and possibly time when the DAS score measurement was carried out.	439771001 Date of event
	NL-CM:12.18.8		VASGeneralHealth					0..1	The VAS score for general health as experienced by the patient on a scale of 1 to 100	446661009 Visual analog scale score

Columns Concept and DefinitionCode: hover over the values for more information
For explanation of the symbols, please see the legend page

Example Instances

Only available in Dutch

DAS
DatumTijd	Methode	Waarde	Aantal gewrichten		OntstekingIndicator
			Pijnlijk	Gezwollen	BSE (mm/hr)	CRP (mg/l)
01/08/2020	DAS 28-CRP	5,34	8	2	20
01/08/2020	DAS28-BSE	4,78	8	2		4

Aangedaan Gewricht
	Pijnlijk		Gezwollen
	L	R	L	R
Schoudergewricht
Ellebooggewricht
Polsgewricht
Metacarpofalangeaal gewricht van:
duim
wijsvinger
middelvinger
ringvinger
pink		x
duim		x
wijsvinger	x	x		x
middelvinger		x
ringvinger	x	x		x
pink		x
Kniegewricht
Aantal pijnlijk	8
Aantal gezwollen			2

References

Informatie over het DAS instrument [Online] Beschikbaar op: https://www.das-score.nl/das28/en/ [Geraadpleegd: 8 oktober 2019]

Valuesets

DASMethodCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.12.18.2

Binding: Extensible

Conceptname	Conceptcode	Codesystem name	Codesystem OID	Description
DAS28 - CRP	117651000146103	SNOMED CT	2.16.840.1.113883.6.96	DAS 28-CRP
DAS28 - ESR	117661000146100	SNOMED CT	2.16.840.1.113883.6.96	DAS28-BSE
DAS44 - CRP	117681000146108	SNOMED CT	2.16.840.1.113883.6.96	DAS44-CRP
DAS44 - ESR	117691000146105	SNOMED CT	2.16.840.1.113883.6.96	DAS44-BSE

LocationCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.12.18.1

Binding: Extensible

Conceptname	Conceptcode	Codesystem name	Codesystem OID	Description
Temporomandibular joint structure	53620006	SNOMED CT	2.16.840.1.113883.6.96	Kaakgewricht
Sternoclavicular joint structure	7844006	SNOMED CT	2.16.840.1.113883.6.96	Sternoclaviculair gewricht
Acromioclavicular joint structure	85856004	SNOMED CT	2.16.840.1.113883.6.96	Acromioclaviculair gewricht
Glenohumeral joint structure	85537004	SNOMED CT	2.16.840.1.113883.6.96	Schoudergewricht
Elbow joint structure	16953009	SNOMED CT	2.16.840.1.113883.6.96	Ellebooggewricht
Wrist joint structure	74670003	SNOMED CT	2.16.840.1.113883.6.96	Polsgewricht
Carpometacarpal joint structure of thumb	30099006	SNOMED CT	2.16.840.1.113883.6.96	Carpometacarpaal gewricht van duim
Metacarpophalangeal joint structure of thumb	56310002	SNOMED CT	2.16.840.1.113883.6.96	Metacarpofalangeaal gewricht van duim
Metacarpophalangeal joint structure of index finger	289002	SNOMED CT	2.16.840.1.113883.6.96	Metacarpofalangeaal gewricht van wijsvinger
Metacarpophalangeal joint structure of middle finger	6059006	SNOMED CT	2.16.840.1.113883.6.96	Metacarpofalangeaal gewricht van middelvinger
Metacarpophalangeal joint structure of ring finger	13822002	SNOMED CT	2.16.840.1.113883.6.96	Metacarpofalangeaal gewricht van ringvinger
Metacarpophalangeal joint structure of little finger	5493005	SNOMED CT	2.16.840.1.113883.6.96	Metacarpofalangeaal gewricht van pink
Structure of interphalangeal joint of thumb	115955008	SNOMED CT	2.16.840.1.113883.6.96	Interfalangeaal gewricht van duim
Structure of proximal interphalangeal joint of index finger	371270005	SNOMED CT	2.16.840.1.113883.6.96	Proximaal interfalangeaal gewricht van wijsvinger
Structure of proximal interphalangeal joint of middle finger	371263005	SNOMED CT	2.16.840.1.113883.6.96	Proximaal interfalangeaal gewricht van middelvinger
Structure of proximal interphalangeal joint of ring finger	371267006	SNOMED CT	2.16.840.1.113883.6.96	Proximaal interfalangeaal gewricht van ringvinger
Structure of proximal interphalangeal joint of little finger	371233001	SNOMED CT	2.16.840.1.113883.6.96	Proximaal interfalangeaal gewricht van pink
Structure of distal interphalangeal joint of index finger	371210002	SNOMED CT	2.16.840.1.113883.6.96	Distaal interfalangeaal gewricht van wijsvinger
Structure of distal interphalangeal joint of middle finger	371218009	SNOMED CT	2.16.840.1.113883.6.96	Distaal interfalangeaal gewricht van middelvinger
Structure of distal interphalangeal joint of ring finger	371204002	SNOMED CT	2.16.840.1.113883.6.96	Distaal interfalangeaal gewricht van ringvinger
Structure of distal interphalangeal joint of little finger	371202003	SNOMED CT	2.16.840.1.113883.6.96	Distaal interfalangeaal gewricht van pink
Sacroiliac joint structure	39723000	SNOMED CT	2.16.840.1.113883.6.96	Sacroiliacaal gewricht
Hip joint structure	24136001	SNOMED CT	2.16.840.1.113883.6.96	Heupgewricht
Knee joint structure	49076000	SNOMED CT	2.16.840.1.113883.6.96	Kniegewricht
Ankle joint structure	70258002	SNOMED CT	2.16.840.1.113883.6.96	Enkelgewricht
Intertarsal joint structure	27949001	SNOMED CT	2.16.840.1.113883.6.96	structuur van articulatio intertarsalis
First metatarsophalangeal joint structure	27824001	SNOMED CT	2.16.840.1.113883.6.96	Metatarsofalangeaal gewricht van grote teen
Metatarsophalangeal joint structure of second toe	71721008	SNOMED CT	2.16.840.1.113883.6.96	Metatarsofalangeaal gewricht van tweede teen
Metatarsophalangeal joint structure of third toe	81247008	SNOMED CT	2.16.840.1.113883.6.96	Metatarsofalangeaal gewricht van derde teen
Metatarsophalangeal joint structure of fourth toe	45230000	SNOMED CT	2.16.840.1.113883.6.96	Metatarsofalangeaal gewricht van vierde teen
Metatarsophalangeal joint structure of fifth toe	50133002	SNOMED CT	2.16.840.1.113883.6.96	Metatarsofalangeaal gewricht van kleine teen
Interphalangeal joint structure of great toe	363670009	SNOMED CT	2.16.840.1.113883.6.96	Interfalangeaal gewricht van grote teen
Proximal interphalangeal joint structure of second toe	371292009	SNOMED CT	2.16.840.1.113883.6.96	Proximaal interfalangeaal gewricht van tweede teen
Proximal interphalangeal joint structure of third toe	371255009	SNOMED CT	2.16.840.1.113883.6.96	Proximaal interfalangeaal gewricht van derde teen
Proximal interphalangeal joint structure of fourth toe	371288002	SNOMED CT	2.16.840.1.113883.6.96	Proximaal interfalangeaal gewricht van vierde teen
Proximal interphalangeal joint structure of fifth toe	371284000	SNOMED CT	2.16.840.1.113883.6.96	Proximaal interfalangeaal gewricht van kleine (vijfde) teen
Distal interphalangeal joint structure of second toe	371216008	SNOMED CT	2.16.840.1.113883.6.96	Distaal interfalangeaal gewricht van tweede teen
Distal interphalangeal joint structure of third toe	371219001	SNOMED CT	2.16.840.1.113883.6.96	Distaal interfalangeaal gewricht van derde teen
Distal interphalangeal joint structure of fourth toe	371205001	SNOMED CT	2.16.840.1.113883.6.96	Distaal interfalangeaal gewricht van vierde teen
Distal interphalangeal joint structure of fifth toe	371203008	SNOMED CT	2.16.840.1.113883.6.96	Distaal interfalangeaal gewricht van kleine (vijfde) teen

This information model in other releases

• Release 2020, (Version 1.0)
• Prerelease 2021-2, (Version 1.1)
• Prerelease 2022-1, (Version 1.1)
• Prerelease 2024-1, (Version 1.1)

Information model references

This information model refers to

• AnatomicalLocation-v1.0.3
• LaboratoryTestResult-v6.0

This information model is used in

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Technical specifications in HL7v3 CDA and HL7 FHIR

To exchange information based on health and care information models, additional, more technical specifications are required.
Not every environment can handle the same technical specifications. For this reason, there are several types of technical specifications:

• HL7® version 3 CDA compatible specifications, available through the Nictiz ART-DECOR® environment
• HL7® FHIR® compatible specifications, available through the Nictiz environment on the Simplifier FHIR

Downloads

This information model is also available as pdf file or as spreadsheet

About this information

The information in this wikipage is based on Prerelease 2023-1
SNOMED CT and LOINC codes are based on:

• SNOMED Clinical Terms versie: 20230930 [R] (september 2023-editie)
• LOINC version 2.76

Conditions for use are located on the mainpage
This page is generated on 31/10/2023 18:33:51 with ZibExtraction v. 9.3.8704.31782

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