001package org.hl7.fhir.dstu2016may.model.codesystems;
002
003
004
005
006/*
007  Copyright (c) 2011+, HL7, Inc.
008  All rights reserved.
009  
010  Redistribution and use in source and binary forms, with or without modification, 
011  are permitted provided that the following conditions are met:
012  
013   * Redistributions of source code must retain the above copyright notice, this 
014     list of conditions and the following disclaimer.
015   * Redistributions in binary form must reproduce the above copyright notice, 
016     this list of conditions and the following disclaimer in the documentation 
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020     prior written permission.
021  
022  THIS SOFTWARE IS PROVIDED BY THE COPYRIGHT HOLDERS AND CONTRIBUTORS "AS IS" AND 
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032  
033*/
034
035// Generated on Sun, May 8, 2016 03:05+1000 for FHIR v1.4.0
036
037
038import org.hl7.fhir.exceptions.FHIRException;
039
040public enum V3ObservationInterpretation {
041
042        /**
043         * Codes that specify interpretation of genetic analysis, such as "positive", "negative", "carrier", "responsive", etc.
044         */
045        _GENETICOBSERVATIONINTERPRETATION, 
046        /**
047         * The patient is considered as carrier based on the testing results. A carrier is an individual who carries an altered form of a gene which can lead to having a child or offspring in future generations with a genetic disorder.
048         */
049        CAR, 
050        /**
051         * The patient is considered as carrier based on the testing results. A carrier is an individual who carries an altered form of a gene which can lead to having a child or offspring in future generations with a genetic disorder.
052
053                        
054                           
055                              Deprecation Comment: 
056                           This code is currently the same string as the print name for this concept and is inconsistent with the conventions being used for the other codes in the coding system, as it is a full word with initial capitalization, rather than an all upper case mnemonic.  The recommendation from OO is to deprecate the code "Carrier" and to add "CAR" as the new active code representation for this concept.
057         */
058        CARRIER, 
059        /**
060         * Interpretations of change of quantity and/or severity. At most one of B or W and one of U or D allowed.
061         */
062        _OBSERVATIONINTERPRETATIONCHANGE, 
063        /**
064         * The current result or observation value has improved compared to the previous result or observation value (the change is significant as defined in the respective test procedure).
065
066                        [Note: This can be applied to quantitative or qualitative observations.]
067         */
068        B, 
069        /**
070         * The current result has decreased from the previous result for a quantitative observation (the change is significant as defined in the respective test procedure).
071         */
072        D, 
073        /**
074         * The current result has increased from the previous result for a quantitative observation (the change is significant as defined in the respective test procedure).
075         */
076        U, 
077        /**
078         * The current result or observation value has degraded compared to the previous result or observation value (the change is significant as defined in the respective test procedure).
079
080                        [Note: This can be applied to quantitative or qualitative observations.]
081         */
082        W, 
083        /**
084         * Technical exceptions resulting in the inability to provide an interpretation. At most one allowed. Does not imply normality or severity.
085         */
086        _OBSERVATIONINTERPRETATIONEXCEPTIONS, 
087        /**
088         * The result is below the minimum detection limit (the test procedure or equipment is the limiting factor).
089
090                        Synonyms: Below analytical limit, low off scale.
091         */
092        LESS_THAN, 
093        /**
094         * The result is above the maximum quantifiable limit (the test procedure or equipment is the limiting factor).
095
096                        Synonyms: Above analytical limit, high off scale.
097         */
098        GREATER_THAN, 
099        /**
100         * A valid result cannot be obtained for the specified component / analyte due to the presence of anti-complementary substances in the sample.
101         */
102        AC, 
103        /**
104         * There is insufficient evidence that the species in question is a good target for therapy with the drug.  A categorical interpretation is not possible.
105
106                        [Note: A MIC with "IE" and/or a comment may be reported (without an accompanying S, I or R-categorization).]
107         */
108        IE, 
109        /**
110         * A result cannot be considered valid for the specified component / analyte or organism due to failure in the quality control testing component.
111         */
112        QCF, 
113        /**
114         * A valid result cannot be obtained for the specified organism or cell line due to the presence of cytotoxic substances in the sample or culture.
115         */
116        TOX, 
117        /**
118         * Interpretation of normality or degree of abnormality (including critical or "alert" level). Concepts in this category are mutually exclusive, i.e., at most one is allowed.
119         */
120        _OBSERVATIONINTERPRETATIONNORMALITY, 
121        /**
122         * The result or observation value is outside the reference range or expected norm (as defined for the respective test procedure).
123
124                        [Note: Typically applies to non-numeric results.]
125         */
126        A, 
127        /**
128         * The result or observation value is outside a reference range or expected norm at a level at which immediate action should be considered for patient safety (as defined for the respective test procedure).
129
130                        [Note: Typically applies to non-numeric results.  Analogous to critical/panic limits for numeric results.]
131         */
132        AA, 
133        /**
134         * The result for a quantitative observation is above a reference level at which immediate action should be considered for patient safety (as defined for the respective test procedure).
135
136                        Synonym: Above upper panic limits.
137         */
138        HH, 
139        /**
140         * The result for a quantitative observation is below a reference level at which immediate action should be considered for patient safety (as defined for the respective test procedure).
141
142                        Synonym: Below lower panic limits.
143         */
144        LL, 
145        /**
146         * The result for a quantitative observation is above the upper limit of the reference range (as defined for the respective test procedure).
147
148                        Synonym: Above high normal
149         */
150        H, 
151        /**
152         * A test result that is significantly higher than the reference (normal) or therapeutic interval, but has not reached the critically high value and might need special attention, as defined by the laboratory or the clinician.[Note: This level is situated between 'H' and 'HH'.]
153
154                        
155                           Deprecation Comment: The code 'H>' is being deprecated in order to align with the use of the code 'HU' for "Very high" in V2 Table 0078 "Interpretation Codes".
156
157                        [Note: The use of code 'H>' is non-preferred, as this code is deprecated and on track to be retired; use code 'HU' instead.
158         */
159        H_, 
160        /**
161         * A test result that is significantly higher than the reference (normal) or therapeutic interval, but has not reached the critically high value and might need special attention, as defined by the laboratory or the clinician.
162         */
163        HU, 
164        /**
165         * The result for a quantitative observation is below the lower limit of the reference range (as defined for the respective test procedure).
166
167                        Synonym: Below low normal
168         */
169        L, 
170        /**
171         * A test result that is significantly lower than the reference (normal) or therapeutic interval, but has not reached the critically low value and might need special attention, as defined by the laboratory or the clinician.[Note: This level is situated between 'L' and 'LL'.]
172
173                        
174                           Deprecation Comment: The code 'L<' is being deprecated in order to align with the use of the code 'LU' for "Very low" in V2 Table 0078 "Interpretation Codes".
175
176                        [Note: The use of code 'L<' is non-preferred, as this code is deprecated and on track to be retired; use code 'LU' instead.
177         */
178        L_, 
179        /**
180         * A test result that is significantly lower than the reference (normal) or therapeutic interval, but has not reached the critically low value and might need special attention, as defined by the laboratory or the clinician.
181         */
182        LU, 
183        /**
184         * The result or observation value is within the reference range or expected norm (as defined for the respective test procedure).
185
186                        [Note: Applies to numeric or non-numeric results.]
187         */
188        N, 
189        /**
190         * Interpretations of anti-microbial susceptibility testing results (microbiology). At most one allowed.
191         */
192        _OBSERVATIONINTERPRETATIONSUSCEPTIBILITY, 
193        /**
194         * Bacterial strain inhibited in vitro by a concentration of an antimicrobial agent that is associated with uncertain therapeutic effect. Reference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized_Terminolo.htm)
195Projects: ISO 20776-1, ISO 20776-2
196
197                        [Note 1: Bacterial strains are categorized as intermediate by applying the appropriate breakpoints in a defined phenotypic test system.]
198
199                        [Note 2: This class of susceptibility implies that an infection due to the isolate can be appropriately treated in body sites where the drugs are physiologically concentrated or when a high dosage of drug can be used.]
200
201                        [Note 3: This class also indicates a "buffer zone," to prevent small, uncontrolled, technical factors from causing major discrepancies in interpretations.]
202
203                        [Note 4: These breakpoints can be altered due to changes in circumstances (e.g., changes in commonly used drug dosages, emergence of new resistance mechanisms).]
204         */
205        I, 
206        /**
207         * The patient is considered as carrier based on the testing results. A carrier is an individual who carries an altered form of a gene which can lead to having a child or offspring in future generations with a genetic disorder.
208
209                        
210                           
211                              Deprecation Comment: 
212                           This antimicrobial susceptibility test interpretation concept is recommended by OO to be deprecated as it is no longer recommended for use in susceptibility testing by CLSI (reference CLSI document M100-S22; Vol. 32 No.3; CLSI Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement. Jan 2012).
213         */
214        MS, 
215        /**
216         * A category used for isolates for which only a susceptible interpretive criterion has been designated because of the absence or rare occurrence of resistant strains. Isolates that have MICs above or zone diameters below the value indicated for the susceptible breakpoint should be reported as non-susceptible.
217
218                        NOTE 1: An isolate that is interpreted as non-susceptible does not necessarily mean that the isolate has a resistance mechanism. It is possible that isolates with MICs above the susceptible breakpoint that lack resistance mechanisms may be encountered within the wild-type distribution subsequent to the time the susceptible-only breakpoint is set. 
219
220                        NOTE 2: For strains yielding results in the "nonsusceptible" category, organism identification and antimicrobial susceptibility test results should be confirmed.
221
222                        Synonym: decreased susceptibility.
223         */
224        NS, 
225        /**
226         * Bacterial strain inhibited in vitro by a concentration of an antimicrobial agent that is associated with a high likelihood of therapeutic failure.
227Reference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized_Terminolo.htm)  
228Projects: ISO 20776-1, ISO 20776-2
229
230                        [Note 1: Bacterial strains are categorized as resistant by applying the appropriate breakpoints in a defined phenotypic test system.]
231
232                        [Note 2: This breakpoint can be altered due to changes in circumstances (e.g., changes in commonly used drug dosages, emergence of new resistance mechanisms).]
233         */
234        R, 
235        /**
236         * A category for isolates where the bacteria (e.g. enterococci) are not susceptible in vitro to a combination therapy (e.g., high-level aminoglycoside and cell wall active agent).  This is predictive that this combination therapy will not be effective. 
237
238                        
239                           Usage Note: Since the use of penicillin or ampicillin alone often results in treatment failure of serious enterococcal or other bacterial infections, combination therapy is usually indicated to enhance bactericidal activity. The synergy between a cell wall active agent (such as penicillin, ampicillin, or vancomycin) and an aminoglycoside (such as gentamicin, kanamycin or streptomycin) is best predicted by screening for high-level bacterial resistance to the aminoglycoside.
240
241                        
242                           Open Issue: The print name of the code is very general and the description is very specific to a pair of classes of agents, which may lead to confusion of these concepts in the future should other synergies be found.
243         */
244        SYNR, 
245        /**
246         * Bacterial strain inhibited by in vitro concentration of an antimicrobial agent that is associated with a high likelihood of therapeutic success.
247Reference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized_Terminolo.htm)
248Synonym (earlier term): Sensitive Projects: ISO 20776-1, ISO 20776-2
249
250                        [Note 1: Bacterial strains are categorized as susceptible by applying the appropriate breakpoints in a defined phenotypic system.]
251
252                        [Note 2: This breakpoint can be altered due to changes in circumstances (e.g., changes in commonly used drug dosages, emergence of new resistance mechanisms).]
253         */
254        S, 
255        /**
256         * A category that includes isolates with antimicrobial agent minimum inhibitory concentrations (MICs) that approach usually attainable blood and tissue levels and for which response rates may be lower than for susceptible isolates.
257
258                        Reference: CLSI document M44-A2 2009 "Method for antifungal disk diffusion susceptibility testing of yeasts; approved guideline - second edition" - page 2.
259         */
260        SDD, 
261        /**
262         * A category for isolates where the bacteria (e.g. enterococci) are susceptible in vitro to a combination therapy (e.g., high-level aminoglycoside and cell wall active agent).  This is predictive that this combination therapy will be effective. 
263
264                        
265                           Usage Note: Since the use of penicillin or ampicillin alone often results in treatment failure of serious enterococcal or other bacterial infections, combination therapy is usually indicated to enhance bactericidal activity. The synergy between a cell wall active agent (such as penicillin, ampicillin, or vancomycin) and an aminoglycoside (such as gentamicin, kanamycin or streptomycin) is best predicted by screening for high-level bacterial resistance to the aminoglycoside.
266
267                        
268                           Open Issue: The print name of the code is very general and the description is very specific to a pair of classes of agents, which may lead to confusion of these concepts in the future should other synergies be found.
269         */
270        SYNS, 
271        /**
272         * The patient is considered as carrier based on the testing results. A carrier is an individual who carries an altered form of a gene which can lead to having a child or offspring in future generations with a genetic disorder.
273
274                        
275                           
276                              Deprecation Comment: 
277                           This antimicrobial susceptibility test interpretation concept is recommended by OO to be deprecated as it is no longer recommended for use in susceptibility testing by CLSI (reference CLSI document M100-S22; Vol. 32 No.3; CLSI Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement. Jan 2012).
278         */
279        VS, 
280        /**
281         * The observation/test result is interpreted as being outside the inclusion range for a particular protocol within which the result is being reported.
282
283
284                        Example: A positive result on a Hepatitis screening test.
285                           Open Issue: EX, HX, LX: These three concepts do not seem to meet a clear need in the vocabulary, and their use in observation interpretation appears likely to be covered by other existing concepts (e.g., A, H, L).  The only apparent significant difference is their reference to use in protocols for exclusion of study subjects.
286These concepts/codes were proposed by RCRIM for use in the CTLaboratory message.  They were submitted and approved in the November 2005 Harmonization cycle in proposal "030103C_VOCAB_RCRIM_l_quade_RCRIM Obs Interp_20051028154455".  However, this proposal was not fully implemented in the vocabulary.  The proposal recommended creation of the x_ClinicalResearchExclusion domain in ObservationInterpretation with a value set including those three concepts/codes, but there is no subdomain of that name or equivalent with a binding to either of the value sets that contain these concepts/codes.
287Members of the OO WG have recently attempted to contact members of RCRIM regarding these concepts, both by email and at the recent WGM in Atlanta, without response.  It is felt by OO that the best course of action to take at this time is to add this comprehensive Open Issue rather than deprecate these three concepts at this time, until further discussion is held.
288         */
289        EX, 
290        /**
291         * The observation/test result is interpreted as being outside the inclusion range for a particular protocol within which the result is being reported.
292
293
294                        Example: A positive result on a Hepatitis screening test.
295                           Open Issue: EX, HX, LX: These three concepts do not seem to meet a clear need in the vocabulary, and their use in observation interpretation appears likely to be covered by other existing concepts (e.g., A, H, L).  The only apparent significant difference is their reference to use in protocols for exclusion of study subjects.  These concepts/codes were proposed by RCRIM for use in the CTLaboratory message.  They were submitted and approved in the November 2005 Harmonization cycle in proposal "030103C_VOCAB_RCRIM_l_quade_RCRIM Obs Interp_20051028154455". However, this proposal was not fully implemented in the vocabulary.  The proposal recommended creation of the x_ClinicalResearchExclusion domain in ObservationInterpretation with a value set including those three concepts/codes, but there is no subdomain of that name or equivalent with a binding to either of the value sets that contain these concepts/codes.  Members of the OO WG have recently attempted to contact members of RCRIM regarding these concepts, both by email and at the recent WGM in Atlanta, without response.  It is felt by OO that the best course of action to take at this time is to add this comprehensive Open Issue rather than deprecate these three concepts at this time, until further discussion is held.
296         */
297        HX, 
298        /**
299         * The numeric observation/test result is interpreted as being below the low threshold value for a particular protocol within which the result is being reported.
300
301                        Example: A Total White Blood Cell Count falling below a protocol-defined threshold value of 3000/mm^3
302                           Open Issue: EX, HX, LX: These three concepts do not seem to meet a clear need in the vocabulary, and their use in observation interpretation appears likely to be covered by other existing concepts (e.g., A, H, L).  The only apparent significant difference is their reference to use in protocols for exclusion of study subjects.  These concepts/codes were proposed by RCRIM for use in the CTLaboratory message.  They were submitted and approved in the November 2005 Harmonization cycle in proposal "030103C_VOCAB_RCRIM_l_quade_RCRIM Obs Interp_20051028154455".  However, this proposal was not fully implemented in the vocabulary.  The proposal recommended creation of the x_ClinicalResearchExclusion domain in ObservationInterpretation with a value set including those three concepts/codes, but there is no subdomain of that name or equivalent with a binding to either of the value sets that contain these concepts/codes.  Members of the OO WG have recently attempted to contact members of RCRIM regarding these concepts, both by email and at the recent WGM in Atlanta, without response.  It is felt by OO that the best course of action to take at this time is to add this comprehensive Open Issue rather than deprecate these three concepts at this time, until further discussion is held.
303         */
304        LX, 
305        /**
306         * Interpretations of the presence or absence of a component / analyte or organism in a test or of a sign in a clinical observation. In keeping with laboratory data processing practice, these concepts provide a categorical interpretation of the "meaning" of the quantitative value for the same observation.
307         */
308        OBSERVATIONINTERPRETATIONDETECTION, 
309        /**
310         * The specified component / analyte, organism or clinical sign could neither be declared positive / negative nor detected / not detected by the performed test or procedure.
311
312                        
313                           Usage Note: For example, if the specimen was degraded, poorly processed, or was missing the required anatomic structures, then "indeterminate" (i.e. "cannot be determined") is the appropriate response, not "equivocal".
314         */
315        IND, 
316        /**
317         * The test or procedure was successfully performed, but the results are borderline and can neither be declared positive / negative nor detected / not detected according to the current established criteria.
318         */
319        E, 
320        /**
321         * An absence finding of the specified component / analyte, organism or clinical sign based on the established threshold of the performed test or procedure.
322
323                        [Note: Negative does not necessarily imply the complete absence of the specified item.]
324         */
325        NEG, 
326        /**
327         * The presence of the specified component / analyte, organism or clinical sign could not be determined within the limit of detection of the performed test or procedure.
328         */
329        ND, 
330        /**
331         * A presence finding of the specified component / analyte, organism or clinical sign based on the established threshold of the performed test or procedure.
332         */
333        POS, 
334        /**
335         * The measurement of the specified component / analyte, organism or clinical sign above the limit of detection of the performed test or procedure.
336         */
337        DET, 
338        /**
339         * Interpretation of the observed result taking into account additional information (contraindicators) about the patient's situation. Concepts in this category are mutually exclusive, i.e., at most one is allowed.
340         */
341        OBSERVATIONINTERPRETATIONEXPECTATION, 
342        /**
343         * This result has been evaluated in light of known contraindicators.  Once those contraindicators have been taken into account the result is determined to be "Expected"  (e.g., presence of drugs in a patient that is taking prescription medication for pain management).
344         */
345        EXP, 
346        /**
347         * This result has been evaluated in light of known contraindicators.  Once those contraindicators have been taken into account the result is determined to be "Unexpected" (e.g., presence of non-prescribed drugs in a patient that is taking prescription medication for pain management).
348         */
349        UNE, 
350        /**
351         * Interpretations of the presence and level of reactivity of the specified component / analyte with the reagent in the performed laboratory test.
352         */
353        REACTIVITYOBSERVATIONINTERPRETATION, 
354        /**
355         * An absence finding used to indicate that the specified component / analyte did not react measurably with the reagent.
356         */
357        NR, 
358        /**
359         * A presence finding used to indicate that the specified component / analyte reacted with the reagent above the reliably measurable limit of the performed test.
360         */
361        RR, 
362        /**
363         * A weighted presence finding used to indicate that the specified component / analyte reacted with the reagent, but below the reliably measurable limit of the performed test.
364         */
365        WR, 
366        /**
367         * added to help the parsers
368         */
369        NULL;
370        public static V3ObservationInterpretation fromCode(String codeString) throws FHIRException {
371            if (codeString == null || "".equals(codeString))
372                return null;
373        if ("_GeneticObservationInterpretation".equals(codeString))
374          return _GENETICOBSERVATIONINTERPRETATION;
375        if ("CAR".equals(codeString))
376          return CAR;
377        if ("Carrier".equals(codeString))
378          return CARRIER;
379        if ("_ObservationInterpretationChange".equals(codeString))
380          return _OBSERVATIONINTERPRETATIONCHANGE;
381        if ("B".equals(codeString))
382          return B;
383        if ("D".equals(codeString))
384          return D;
385        if ("U".equals(codeString))
386          return U;
387        if ("W".equals(codeString))
388          return W;
389        if ("_ObservationInterpretationExceptions".equals(codeString))
390          return _OBSERVATIONINTERPRETATIONEXCEPTIONS;
391        if ("<".equals(codeString))
392          return LESS_THAN;
393        if (">".equals(codeString))
394          return GREATER_THAN;
395        if ("AC".equals(codeString))
396          return AC;
397        if ("IE".equals(codeString))
398          return IE;
399        if ("QCF".equals(codeString))
400          return QCF;
401        if ("TOX".equals(codeString))
402          return TOX;
403        if ("_ObservationInterpretationNormality".equals(codeString))
404          return _OBSERVATIONINTERPRETATIONNORMALITY;
405        if ("A".equals(codeString))
406          return A;
407        if ("AA".equals(codeString))
408          return AA;
409        if ("HH".equals(codeString))
410          return HH;
411        if ("LL".equals(codeString))
412          return LL;
413        if ("H".equals(codeString))
414          return H;
415        if ("H>".equals(codeString))
416          return H_;
417        if ("HU".equals(codeString))
418          return HU;
419        if ("L".equals(codeString))
420          return L;
421        if ("L<".equals(codeString))
422          return L_;
423        if ("LU".equals(codeString))
424          return LU;
425        if ("N".equals(codeString))
426          return N;
427        if ("_ObservationInterpretationSusceptibility".equals(codeString))
428          return _OBSERVATIONINTERPRETATIONSUSCEPTIBILITY;
429        if ("I".equals(codeString))
430          return I;
431        if ("MS".equals(codeString))
432          return MS;
433        if ("NS".equals(codeString))
434          return NS;
435        if ("R".equals(codeString))
436          return R;
437        if ("SYN-R".equals(codeString))
438          return SYNR;
439        if ("S".equals(codeString))
440          return S;
441        if ("SDD".equals(codeString))
442          return SDD;
443        if ("SYN-S".equals(codeString))
444          return SYNS;
445        if ("VS".equals(codeString))
446          return VS;
447        if ("EX".equals(codeString))
448          return EX;
449        if ("HX".equals(codeString))
450          return HX;
451        if ("LX".equals(codeString))
452          return LX;
453        if ("ObservationInterpretationDetection".equals(codeString))
454          return OBSERVATIONINTERPRETATIONDETECTION;
455        if ("IND".equals(codeString))
456          return IND;
457        if ("E".equals(codeString))
458          return E;
459        if ("NEG".equals(codeString))
460          return NEG;
461        if ("ND".equals(codeString))
462          return ND;
463        if ("POS".equals(codeString))
464          return POS;
465        if ("DET".equals(codeString))
466          return DET;
467        if ("ObservationInterpretationExpectation".equals(codeString))
468          return OBSERVATIONINTERPRETATIONEXPECTATION;
469        if ("EXP".equals(codeString))
470          return EXP;
471        if ("UNE".equals(codeString))
472          return UNE;
473        if ("ReactivityObservationInterpretation".equals(codeString))
474          return REACTIVITYOBSERVATIONINTERPRETATION;
475        if ("NR".equals(codeString))
476          return NR;
477        if ("RR".equals(codeString))
478          return RR;
479        if ("WR".equals(codeString))
480          return WR;
481        throw new FHIRException("Unknown V3ObservationInterpretation code '"+codeString+"'");
482        }
483        public String toCode() {
484          switch (this) {
485            case _GENETICOBSERVATIONINTERPRETATION: return "_GeneticObservationInterpretation";
486            case CAR: return "CAR";
487            case CARRIER: return "Carrier";
488            case _OBSERVATIONINTERPRETATIONCHANGE: return "_ObservationInterpretationChange";
489            case B: return "B";
490            case D: return "D";
491            case U: return "U";
492            case W: return "W";
493            case _OBSERVATIONINTERPRETATIONEXCEPTIONS: return "_ObservationInterpretationExceptions";
494            case LESS_THAN: return "<";
495            case GREATER_THAN: return ">";
496            case AC: return "AC";
497            case IE: return "IE";
498            case QCF: return "QCF";
499            case TOX: return "TOX";
500            case _OBSERVATIONINTERPRETATIONNORMALITY: return "_ObservationInterpretationNormality";
501            case A: return "A";
502            case AA: return "AA";
503            case HH: return "HH";
504            case LL: return "LL";
505            case H: return "H";
506            case H_: return "H>";
507            case HU: return "HU";
508            case L: return "L";
509            case L_: return "L<";
510            case LU: return "LU";
511            case N: return "N";
512            case _OBSERVATIONINTERPRETATIONSUSCEPTIBILITY: return "_ObservationInterpretationSusceptibility";
513            case I: return "I";
514            case MS: return "MS";
515            case NS: return "NS";
516            case R: return "R";
517            case SYNR: return "SYN-R";
518            case S: return "S";
519            case SDD: return "SDD";
520            case SYNS: return "SYN-S";
521            case VS: return "VS";
522            case EX: return "EX";
523            case HX: return "HX";
524            case LX: return "LX";
525            case OBSERVATIONINTERPRETATIONDETECTION: return "ObservationInterpretationDetection";
526            case IND: return "IND";
527            case E: return "E";
528            case NEG: return "NEG";
529            case ND: return "ND";
530            case POS: return "POS";
531            case DET: return "DET";
532            case OBSERVATIONINTERPRETATIONEXPECTATION: return "ObservationInterpretationExpectation";
533            case EXP: return "EXP";
534            case UNE: return "UNE";
535            case REACTIVITYOBSERVATIONINTERPRETATION: return "ReactivityObservationInterpretation";
536            case NR: return "NR";
537            case RR: return "RR";
538            case WR: return "WR";
539            case NULL: return null;
540            default: return "?";
541          }
542        }
543        public String getSystem() {
544          return "http://hl7.org/fhir/v3/ObservationInterpretation";
545        }
546        public String getDefinition() {
547          switch (this) {
548            case _GENETICOBSERVATIONINTERPRETATION: return "Codes that specify interpretation of genetic analysis, such as \"positive\", \"negative\", \"carrier\", \"responsive\", etc.";
549            case CAR: return "The patient is considered as carrier based on the testing results. A carrier is an individual who carries an altered form of a gene which can lead to having a child or offspring in future generations with a genetic disorder.";
550            case CARRIER: return "The patient is considered as carrier based on the testing results. A carrier is an individual who carries an altered form of a gene which can lead to having a child or offspring in future generations with a genetic disorder.\r\n\n                        \n                           \n                              Deprecation Comment: \n                           This code is currently the same string as the print name for this concept and is inconsistent with the conventions being used for the other codes in the coding system, as it is a full word with initial capitalization, rather than an all upper case mnemonic.  The recommendation from OO is to deprecate the code \"Carrier\" and to add \"CAR\" as the new active code representation for this concept.";
551            case _OBSERVATIONINTERPRETATIONCHANGE: return "Interpretations of change of quantity and/or severity. At most one of B or W and one of U or D allowed.";
552            case B: return "The current result or observation value has improved compared to the previous result or observation value (the change is significant as defined in the respective test procedure).\r\n\n                        [Note: This can be applied to quantitative or qualitative observations.]";
553            case D: return "The current result has decreased from the previous result for a quantitative observation (the change is significant as defined in the respective test procedure).";
554            case U: return "The current result has increased from the previous result for a quantitative observation (the change is significant as defined in the respective test procedure).";
555            case W: return "The current result or observation value has degraded compared to the previous result or observation value (the change is significant as defined in the respective test procedure).\r\n\n                        [Note: This can be applied to quantitative or qualitative observations.]";
556            case _OBSERVATIONINTERPRETATIONEXCEPTIONS: return "Technical exceptions resulting in the inability to provide an interpretation. At most one allowed. Does not imply normality or severity.";
557            case LESS_THAN: return "The result is below the minimum detection limit (the test procedure or equipment is the limiting factor).\r\n\n                        Synonyms: Below analytical limit, low off scale.";
558            case GREATER_THAN: return "The result is above the maximum quantifiable limit (the test procedure or equipment is the limiting factor).\r\n\n                        Synonyms: Above analytical limit, high off scale.";
559            case AC: return "A valid result cannot be obtained for the specified component / analyte due to the presence of anti-complementary substances in the sample.";
560            case IE: return "There is insufficient evidence that the species in question is a good target for therapy with the drug.  A categorical interpretation is not possible.\r\n\n                        [Note: A MIC with \"IE\" and/or a comment may be reported (without an accompanying S, I or R-categorization).]";
561            case QCF: return "A result cannot be considered valid for the specified component / analyte or organism due to failure in the quality control testing component.";
562            case TOX: return "A valid result cannot be obtained for the specified organism or cell line due to the presence of cytotoxic substances in the sample or culture.";
563            case _OBSERVATIONINTERPRETATIONNORMALITY: return "Interpretation of normality or degree of abnormality (including critical or \"alert\" level). Concepts in this category are mutually exclusive, i.e., at most one is allowed.";
564            case A: return "The result or observation value is outside the reference range or expected norm (as defined for the respective test procedure).\r\n\n                        [Note: Typically applies to non-numeric results.]";
565            case AA: return "The result or observation value is outside a reference range or expected norm at a level at which immediate action should be considered for patient safety (as defined for the respective test procedure).\r\n\n                        [Note: Typically applies to non-numeric results.  Analogous to critical/panic limits for numeric results.]";
566            case HH: return "The result for a quantitative observation is above a reference level at which immediate action should be considered for patient safety (as defined for the respective test procedure).\r\n\n                        Synonym: Above upper panic limits.";
567            case LL: return "The result for a quantitative observation is below a reference level at which immediate action should be considered for patient safety (as defined for the respective test procedure).\r\n\n                        Synonym: Below lower panic limits.";
568            case H: return "The result for a quantitative observation is above the upper limit of the reference range (as defined for the respective test procedure).\r\n\n                        Synonym: Above high normal";
569            case H_: return "A test result that is significantly higher than the reference (normal) or therapeutic interval, but has not reached the critically high value and might need special attention, as defined by the laboratory or the clinician.[Note: This level is situated between 'H' and 'HH'.]\r\n\n                        \n                           Deprecation Comment: The code 'H>' is being deprecated in order to align with the use of the code 'HU' for \"Very high\" in V2 Table 0078 \"Interpretation Codes\".\r\n\n                        [Note: The use of code 'H>' is non-preferred, as this code is deprecated and on track to be retired; use code 'HU' instead.";
570            case HU: return "A test result that is significantly higher than the reference (normal) or therapeutic interval, but has not reached the critically high value and might need special attention, as defined by the laboratory or the clinician.";
571            case L: return "The result for a quantitative observation is below the lower limit of the reference range (as defined for the respective test procedure).\r\n\n                        Synonym: Below low normal";
572            case L_: return "A test result that is significantly lower than the reference (normal) or therapeutic interval, but has not reached the critically low value and might need special attention, as defined by the laboratory or the clinician.[Note: This level is situated between 'L' and 'LL'.]\r\n\n                        \n                           Deprecation Comment: The code 'L<' is being deprecated in order to align with the use of the code 'LU' for \"Very low\" in V2 Table 0078 \"Interpretation Codes\".\r\n\n                        [Note: The use of code 'L<' is non-preferred, as this code is deprecated and on track to be retired; use code 'LU' instead.";
573            case LU: return "A test result that is significantly lower than the reference (normal) or therapeutic interval, but has not reached the critically low value and might need special attention, as defined by the laboratory or the clinician.";
574            case N: return "The result or observation value is within the reference range or expected norm (as defined for the respective test procedure).\r\n\n                        [Note: Applies to numeric or non-numeric results.]";
575            case _OBSERVATIONINTERPRETATIONSUSCEPTIBILITY: return "Interpretations of anti-microbial susceptibility testing results (microbiology). At most one allowed.";
576            case I: return "Bacterial strain inhibited in vitro by a concentration of an antimicrobial agent that is associated with uncertain therapeutic effect. Reference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized_Terminolo.htm)\nProjects: ISO 20776-1, ISO 20776-2\r\n\n                        [Note 1: Bacterial strains are categorized as intermediate by applying the appropriate breakpoints in a defined phenotypic test system.]\r\n\n                        [Note 2: This class of susceptibility implies that an infection due to the isolate can be appropriately treated in body sites where the drugs are physiologically concentrated or when a high dosage of drug can be used.]\r\n\n                        [Note 3: This class also indicates a \"buffer zone,\" to prevent small, uncontrolled, technical factors from causing major discrepancies in interpretations.]\r\n\n                        [Note 4: These breakpoints can be altered due to changes in circumstances (e.g., changes in commonly used drug dosages, emergence of new resistance mechanisms).]";
577            case MS: return "The patient is considered as carrier based on the testing results. A carrier is an individual who carries an altered form of a gene which can lead to having a child or offspring in future generations with a genetic disorder.\r\n\n                        \n                           \n                              Deprecation Comment: \n                           This antimicrobial susceptibility test interpretation concept is recommended by OO to be deprecated as it is no longer recommended for use in susceptibility testing by CLSI (reference CLSI document M100-S22; Vol. 32 No.3; CLSI Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement. Jan 2012).";
578            case NS: return "A category used for isolates for which only a susceptible interpretive criterion has been designated because of the absence or rare occurrence of resistant strains. Isolates that have MICs above or zone diameters below the value indicated for the susceptible breakpoint should be reported as non-susceptible.\r\n\n                        NOTE 1: An isolate that is interpreted as non-susceptible does not necessarily mean that the isolate has a resistance mechanism. It is possible that isolates with MICs above the susceptible breakpoint that lack resistance mechanisms may be encountered within the wild-type distribution subsequent to the time the susceptible-only breakpoint is set. \r\n\n                        NOTE 2: For strains yielding results in the \"nonsusceptible\" category, organism identification and antimicrobial susceptibility test results should be confirmed.\r\n\n                        Synonym: decreased susceptibility.";
579            case R: return "Bacterial strain inhibited in vitro by a concentration of an antimicrobial agent that is associated with a high likelihood of therapeutic failure.\nReference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized_Terminolo.htm)  \nProjects: ISO 20776-1, ISO 20776-2\r\n\n                        [Note 1: Bacterial strains are categorized as resistant by applying the appropriate breakpoints in a defined phenotypic test system.]\r\n\n                        [Note 2: This breakpoint can be altered due to changes in circumstances (e.g., changes in commonly used drug dosages, emergence of new resistance mechanisms).]";
580            case SYNR: return "A category for isolates where the bacteria (e.g. enterococci) are not susceptible in vitro to a combination therapy (e.g., high-level aminoglycoside and cell wall active agent).  This is predictive that this combination therapy will not be effective. \r\n\n                        \n                           Usage Note: Since the use of penicillin or ampicillin alone often results in treatment failure of serious enterococcal or other bacterial infections, combination therapy is usually indicated to enhance bactericidal activity. The synergy between a cell wall active agent (such as penicillin, ampicillin, or vancomycin) and an aminoglycoside (such as gentamicin, kanamycin or streptomycin) is best predicted by screening for high-level bacterial resistance to the aminoglycoside.\r\n\n                        \n                           Open Issue: The print name of the code is very general and the description is very specific to a pair of classes of agents, which may lead to confusion of these concepts in the future should other synergies be found.";
581            case S: return "Bacterial strain inhibited by in vitro concentration of an antimicrobial agent that is associated with a high likelihood of therapeutic success.\nReference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized_Terminolo.htm)\nSynonym (earlier term): Sensitive Projects: ISO 20776-1, ISO 20776-2\r\n\n                        [Note 1: Bacterial strains are categorized as susceptible by applying the appropriate breakpoints in a defined phenotypic system.]\r\n\n                        [Note 2: This breakpoint can be altered due to changes in circumstances (e.g., changes in commonly used drug dosages, emergence of new resistance mechanisms).]";
582            case SDD: return "A category that includes isolates with antimicrobial agent minimum inhibitory concentrations (MICs) that approach usually attainable blood and tissue levels and for which response rates may be lower than for susceptible isolates.\r\n\n                        Reference: CLSI document M44-A2 2009 \"Method for antifungal disk diffusion susceptibility testing of yeasts; approved guideline - second edition\" - page 2.";
583            case SYNS: return "A category for isolates where the bacteria (e.g. enterococci) are susceptible in vitro to a combination therapy (e.g., high-level aminoglycoside and cell wall active agent).  This is predictive that this combination therapy will be effective. \r\n\n                        \n                           Usage Note: Since the use of penicillin or ampicillin alone often results in treatment failure of serious enterococcal or other bacterial infections, combination therapy is usually indicated to enhance bactericidal activity. The synergy between a cell wall active agent (such as penicillin, ampicillin, or vancomycin) and an aminoglycoside (such as gentamicin, kanamycin or streptomycin) is best predicted by screening for high-level bacterial resistance to the aminoglycoside.\r\n\n                        \n                           Open Issue: The print name of the code is very general and the description is very specific to a pair of classes of agents, which may lead to confusion of these concepts in the future should other synergies be found.";
584            case VS: return "The patient is considered as carrier based on the testing results. A carrier is an individual who carries an altered form of a gene which can lead to having a child or offspring in future generations with a genetic disorder.\r\n\n                        \n                           \n                              Deprecation Comment: \n                           This antimicrobial susceptibility test interpretation concept is recommended by OO to be deprecated as it is no longer recommended for use in susceptibility testing by CLSI (reference CLSI document M100-S22; Vol. 32 No.3; CLSI Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement. Jan 2012).";
585            case EX: return "The observation/test result is interpreted as being outside the inclusion range for a particular protocol within which the result is being reported.\n\r\n\n                        Example: A positive result on a Hepatitis screening test.\n                           Open Issue: EX, HX, LX: These three concepts do not seem to meet a clear need in the vocabulary, and their use in observation interpretation appears likely to be covered by other existing concepts (e.g., A, H, L).  The only apparent significant difference is their reference to use in protocols for exclusion of study subjects.\nThese concepts/codes were proposed by RCRIM for use in the CTLaboratory message.  They were submitted and approved in the November 2005 Harmonization cycle in proposal \"030103C_VOCAB_RCRIM_l_quade_RCRIM Obs Interp_20051028154455\".  However, this proposal was not fully implemented in the vocabulary.  The proposal recommended creation of the x_ClinicalResearchExclusion domain in ObservationInterpretation with a value set including those three concepts/codes, but there is no subdomain of that name or equivalent with a binding to either of the value sets that contain these concepts/codes.\nMembers of the OO WG have recently attempted to contact members of RCRIM regarding these concepts, both by email and at the recent WGM in Atlanta, without response.  It is felt by OO that the best course of action to take at this time is to add this comprehensive Open Issue rather than deprecate these three concepts at this time, until further discussion is held.";
586            case HX: return "The observation/test result is interpreted as being outside the inclusion range for a particular protocol within which the result is being reported.\n\r\n\n                        Example: A positive result on a Hepatitis screening test.\n                           Open Issue: EX, HX, LX: These three concepts do not seem to meet a clear need in the vocabulary, and their use in observation interpretation appears likely to be covered by other existing concepts (e.g., A, H, L).  The only apparent significant difference is their reference to use in protocols for exclusion of study subjects.  These concepts/codes were proposed by RCRIM for use in the CTLaboratory message.  They were submitted and approved in the November 2005 Harmonization cycle in proposal \"030103C_VOCAB_RCRIM_l_quade_RCRIM Obs Interp_20051028154455\". However, this proposal was not fully implemented in the vocabulary.  The proposal recommended creation of the x_ClinicalResearchExclusion domain in ObservationInterpretation with a value set including those three concepts/codes, but there is no subdomain of that name or equivalent with a binding to either of the value sets that contain these concepts/codes.  Members of the OO WG have recently attempted to contact members of RCRIM regarding these concepts, both by email and at the recent WGM in Atlanta, without response.  It is felt by OO that the best course of action to take at this time is to add this comprehensive Open Issue rather than deprecate these three concepts at this time, until further discussion is held.";
587            case LX: return "The numeric observation/test result is interpreted as being below the low threshold value for a particular protocol within which the result is being reported.\r\n\n                        Example: A Total White Blood Cell Count falling below a protocol-defined threshold value of 3000/mm^3\n                           Open Issue: EX, HX, LX: These three concepts do not seem to meet a clear need in the vocabulary, and their use in observation interpretation appears likely to be covered by other existing concepts (e.g., A, H, L).  The only apparent significant difference is their reference to use in protocols for exclusion of study subjects.  These concepts/codes were proposed by RCRIM for use in the CTLaboratory message.  They were submitted and approved in the November 2005 Harmonization cycle in proposal \"030103C_VOCAB_RCRIM_l_quade_RCRIM Obs Interp_20051028154455\".  However, this proposal was not fully implemented in the vocabulary.  The proposal recommended creation of the x_ClinicalResearchExclusion domain in ObservationInterpretation with a value set including those three concepts/codes, but there is no subdomain of that name or equivalent with a binding to either of the value sets that contain these concepts/codes.  Members of the OO WG have recently attempted to contact members of RCRIM regarding these concepts, both by email and at the recent WGM in Atlanta, without response.  It is felt by OO that the best course of action to take at this time is to add this comprehensive Open Issue rather than deprecate these three concepts at this time, until further discussion is held.";
588            case OBSERVATIONINTERPRETATIONDETECTION: return "Interpretations of the presence or absence of a component / analyte or organism in a test or of a sign in a clinical observation. In keeping with laboratory data processing practice, these concepts provide a categorical interpretation of the \"meaning\" of the quantitative value for the same observation.";
589            case IND: return "The specified component / analyte, organism or clinical sign could neither be declared positive / negative nor detected / not detected by the performed test or procedure.\r\n\n                        \n                           Usage Note: For example, if the specimen was degraded, poorly processed, or was missing the required anatomic structures, then \"indeterminate\" (i.e. \"cannot be determined\") is the appropriate response, not \"equivocal\".";
590            case E: return "The test or procedure was successfully performed, but the results are borderline and can neither be declared positive / negative nor detected / not detected according to the current established criteria.";
591            case NEG: return "An absence finding of the specified component / analyte, organism or clinical sign based on the established threshold of the performed test or procedure.\r\n\n                        [Note: Negative does not necessarily imply the complete absence of the specified item.]";
592            case ND: return "The presence of the specified component / analyte, organism or clinical sign could not be determined within the limit of detection of the performed test or procedure.";
593            case POS: return "A presence finding of the specified component / analyte, organism or clinical sign based on the established threshold of the performed test or procedure.";
594            case DET: return "The measurement of the specified component / analyte, organism or clinical sign above the limit of detection of the performed test or procedure.";
595            case OBSERVATIONINTERPRETATIONEXPECTATION: return "Interpretation of the observed result taking into account additional information (contraindicators) about the patient's situation. Concepts in this category are mutually exclusive, i.e., at most one is allowed.";
596            case EXP: return "This result has been evaluated in light of known contraindicators.  Once those contraindicators have been taken into account the result is determined to be \"Expected\"  (e.g., presence of drugs in a patient that is taking prescription medication for pain management).";
597            case UNE: return "This result has been evaluated in light of known contraindicators.  Once those contraindicators have been taken into account the result is determined to be \"Unexpected\" (e.g., presence of non-prescribed drugs in a patient that is taking prescription medication for pain management).";
598            case REACTIVITYOBSERVATIONINTERPRETATION: return "Interpretations of the presence and level of reactivity of the specified component / analyte with the reagent in the performed laboratory test.";
599            case NR: return "An absence finding used to indicate that the specified component / analyte did not react measurably with the reagent.";
600            case RR: return "A presence finding used to indicate that the specified component / analyte reacted with the reagent above the reliably measurable limit of the performed test.";
601            case WR: return "A weighted presence finding used to indicate that the specified component / analyte reacted with the reagent, but below the reliably measurable limit of the performed test.";
602            case NULL: return null;
603            default: return "?";
604          }
605        }
606        public String getDisplay() {
607          switch (this) {
608            case _GENETICOBSERVATIONINTERPRETATION: return "GeneticObservationInterpretation";
609            case CAR: return "Carrier";
610            case CARRIER: return "Carrier";
611            case _OBSERVATIONINTERPRETATIONCHANGE: return "ObservationInterpretationChange";
612            case B: return "Better";
613            case D: return "Significant change down";
614            case U: return "Significant change up";
615            case W: return "Worse";
616            case _OBSERVATIONINTERPRETATIONEXCEPTIONS: return "ObservationInterpretationExceptions";
617            case LESS_THAN: return "Off scale low";
618            case GREATER_THAN: return "Off scale high";
619            case AC: return "Anti-complementary substances present";
620            case IE: return "Insufficient evidence";
621            case QCF: return "Quality control failure";
622            case TOX: return "Cytotoxic substance present";
623            case _OBSERVATIONINTERPRETATIONNORMALITY: return "ObservationInterpretationNormality";
624            case A: return "Abnormal";
625            case AA: return "Critical abnormal";
626            case HH: return "Critical high";
627            case LL: return "Critical low";
628            case H: return "High";
629            case H_: return "Significantly high";
630            case HU: return "Significantly high";
631            case L: return "Low";
632            case L_: return "Significantly low";
633            case LU: return "Significantly low";
634            case N: return "Normal";
635            case _OBSERVATIONINTERPRETATIONSUSCEPTIBILITY: return "ObservationInterpretationSusceptibility";
636            case I: return "Intermediate";
637            case MS: return "moderately susceptible";
638            case NS: return "Non-susceptible";
639            case R: return "Resistant";
640            case SYNR: return "Synergy - resistant";
641            case S: return "Susceptible";
642            case SDD: return "Susceptible-dose dependent";
643            case SYNS: return "Synergy - susceptible";
644            case VS: return "very susceptible";
645            case EX: return "outside threshold";
646            case HX: return "above high threshold";
647            case LX: return "below low threshold";
648            case OBSERVATIONINTERPRETATIONDETECTION: return "ObservationInterpretationDetection";
649            case IND: return "Indeterminate";
650            case E: return "Equivocal";
651            case NEG: return "Negative";
652            case ND: return "Not detected";
653            case POS: return "Positive";
654            case DET: return "Detected";
655            case OBSERVATIONINTERPRETATIONEXPECTATION: return "ObservationInterpretationExpectation";
656            case EXP: return "Expected";
657            case UNE: return "Unexpected";
658            case REACTIVITYOBSERVATIONINTERPRETATION: return "ReactivityObservationInterpretation";
659            case NR: return "Non-reactive";
660            case RR: return "Reactive";
661            case WR: return "Weakly reactive";
662            case NULL: return null;
663            default: return "?";
664          }
665    }
666
667
668}