001package org.hl7.fhir.instance.model.valuesets;
002
003/*
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006  
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030*/
031
032// Generated on Wed, Nov 11, 2015 10:54-0500 for FHIR v1.0.2
033
034
035public enum V3ObservationInterpretation {
036
037        /**
038         * Codes that specify interpretation of genetic analysis, such as "positive", "negative", "carrier", "responsive", etc.
039         */
040        _GENETICOBSERVATIONINTERPRETATION, 
041        /**
042         * 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.
043         */
044        CAR, 
045        /**
046         * 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.
047
048                        
049                           
050                              Deprecation Comment: 
051                           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.
052         */
053        CARRIER, 
054        /**
055         * Interpretations of change of quantity and/or severity. At most one of B or W and one of U or D allowed.
056         */
057        _OBSERVATIONINTERPRETATIONCHANGE, 
058        /**
059         * 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).
060
061                        [Note: This can be applied to quantitative or qualitative observations.]
062         */
063        B, 
064        /**
065         * The current result has decreased from the previous result for a quantitative observation (the change is significant as defined in the respective test procedure).
066         */
067        D, 
068        /**
069         * The current result has increased from the previous result for a quantitative observation (the change is significant as defined in the respective test procedure).
070         */
071        U, 
072        /**
073         * 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).
074
075                        [Note: This can be applied to quantitative or qualitative observations.]
076         */
077        W, 
078        /**
079         * Technical exceptions resulting in the inability to provide an interpretation. At most one allowed. Does not imply normality or severity.
080         */
081        _OBSERVATIONINTERPRETATIONEXCEPTIONS, 
082        /**
083         * The result is below the minimum detection limit (the test procedure or equipment is the limiting factor).
084
085                        Synonyms: Below analytical limit, low off scale.
086         */
087        LESS_THAN, 
088        /**
089         * The result is above the maximum quantifiable limit (the test procedure or equipment is the limiting factor).
090
091                        Synonyms: Above analytical limit, high off scale.
092         */
093        GREATER_THAN, 
094        /**
095         * A valid result cannot be obtained for the specified component / analyte due to the presence of anti-complementary substances in the sample.
096         */
097        AC, 
098        /**
099         * There is insufficient evidence that the species in question is a good target for therapy with the drug.  A categorical interpretation is not possible.
100
101                        [Note: A MIC with "IE" and/or a comment may be reported (without an accompanying S, I or R-categorization).]
102         */
103        IE, 
104        /**
105         * A result cannot be considered valid for the specified component / analyte or organism due to failure in the quality control testing component.
106         */
107        QCF, 
108        /**
109         * 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.
110         */
111        TOX, 
112        /**
113         * 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.
114         */
115        _OBSERVATIONINTERPRETATIONNORMALITY, 
116        /**
117         * The result or observation value is outside the reference range or expected norm (as defined for the respective test procedure).
118
119                        [Note: Typically applies to non-numeric results.]
120         */
121        A, 
122        /**
123         * 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).
124
125                        [Note: Typically applies to non-numeric results.  Analogous to critical/panic limits for numeric results.]
126         */
127        AA, 
128        /**
129         * 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).
130
131                        Synonym: Above upper panic limits.
132         */
133        HH, 
134        /**
135         * 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).
136
137                        Synonym: Below lower panic limits.
138         */
139        LL, 
140        /**
141         * The result for a quantitative observation is above the upper limit of the reference range (as defined for the respective test procedure).
142
143                        Synonym: Above high normal
144         */
145        H, 
146        /**
147         * 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'.]
148
149                        
150                           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".
151
152                        [Note: The use of code 'H>' is non-preferred, as this code is deprecated and on track to be retired; use code 'HU' instead.
153         */
154        H_, 
155        /**
156         * The result for a quantitative observation is below the lower limit of the reference range (as defined for the respective test procedure).
157
158                        Synonym: Below low normal
159         */
160        L, 
161        /**
162         * 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'.]
163
164                        
165                           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".
166
167                        [Note: The use of code 'L<' is non-preferred, as this code is deprecated and on track to be retired; use code 'LU' instead.
168         */
169        L_, 
170        /**
171         * The result or observation value is within the reference range or expected norm (as defined for the respective test procedure).
172
173                        [Note: Applies to numeric or non-numeric results.]
174         */
175        N, 
176        /**
177         * Interpretations of anti-microbial susceptibility testing results (microbiology). At most one allowed.
178         */
179        _OBSERVATIONINTERPRETATIONSUSCEPTIBILITY, 
180        /**
181         * 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)
182Projects: ISO 20776-1, ISO 20776-2
183
184                        [Note 1: Bacterial strains are categorized as intermediate by applying the appropriate breakpoints in a defined phenotypic test system.]
185
186                        [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.]
187
188                        [Note 3: This class also indicates a "buffer zone," to prevent small, uncontrolled, technical factors from causing major discrepancies in interpretations.]
189
190                        [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).]
191         */
192        I, 
193        /**
194         * 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.
195
196                        
197                           
198                              Deprecation Comment: 
199                           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).
200         */
201        MS, 
202        /**
203         * 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.
204
205                        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. 
206
207                        NOTE 2: For strains yielding results in the "nonsusceptible" category, organism identification and antimicrobial susceptibility test results should be confirmed.
208
209                        Synonym: decreased susceptibility.
210         */
211        NS, 
212        /**
213         * Bacterial strain inhibited in vitro by a concentration of an antimicrobial agent that is associated with a high likelihood of therapeutic failure.
214Reference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized_Terminolo.htm)  
215Projects: ISO 20776-1, ISO 20776-2
216
217                        [Note 1: Bacterial strains are categorized as resistant by applying the appropriate breakpoints in a defined phenotypic test system.]
218
219                        [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).]
220         */
221        R, 
222        /**
223         * 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. 
224
225                        
226                           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.
227
228                        
229                           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.
230         */
231        SYNR, 
232        /**
233         * Bacterial strain inhibited by in vitro concentration of an antimicrobial agent that is associated with a high likelihood of therapeutic success.
234Reference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized_Terminolo.htm)
235Synonym (earlier term): Sensitive Projects: ISO 20776-1, ISO 20776-2
236
237                        [Note 1: Bacterial strains are categorized as susceptible by applying the appropriate breakpoints in a defined phenotypic system.]
238
239                        [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).]
240         */
241        S, 
242        /**
243         * 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.
244
245                        Reference: CLSI document M44-A2 2009 "Method for antifungal disk diffusion susceptibility testing of yeasts; approved guideline - second edition" - page 2.
246         */
247        SDD, 
248        /**
249         * 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. 
250
251                        
252                           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.
253
254                        
255                           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.
256         */
257        SYNS, 
258        /**
259         * 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.
260
261                        
262                           
263                              Deprecation Comment: 
264                           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).
265         */
266        VS, 
267        /**
268         * The observation/test result is interpreted as being outside the inclusion range for a particular protocol within which the result is being reported.
269
270
271                        Example: A positive result on a Hepatitis screening test.
272                           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.
273These 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.
274Members 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.
275         */
276        EX, 
277        /**
278         * The observation/test result is interpreted as being outside the inclusion range for a particular protocol within which the result is being reported.
279
280
281                        Example: A positive result on a Hepatitis screening test.
282                           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.
283         */
284        HX, 
285        /**
286         * 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.
287
288                        Example: A Total White Blood Cell Count falling below a protocol-defined threshold value of 3000/mm^3
289                           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.
290         */
291        LX, 
292        /**
293         * 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.
294         */
295        OBSERVATIONINTERPRETATIONDETECTION, 
296        /**
297         * The specified component / analyte, organism or clinical sign could neither be declared positive / negative or detected / not detected by the performed test or procedure.
298         */
299        IND, 
300        /**
301         * An absence finding of the specified component / analyte, organism or clinical sign based on the established threshold of the performed test or procedure.
302
303                        [Note: Negative does not necessarily imply the complete absence of the specified item.]
304         */
305        NEG, 
306        /**
307         * 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.
308         */
309        ND, 
310        /**
311         * A presence finding of the specified component / analyte, organism or clinical sign based on the established threshold of the performed test or procedure.
312         */
313        POS, 
314        /**
315         * The measurement of the specified component / analyte, organism or clinical sign above the limit of detection of the performed test or procedure.
316         */
317        DET, 
318        /**
319         * 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.
320         */
321        OBSERVATIONINTERPRETATIONEXPECTATION, 
322        /**
323         * 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).
324         */
325        EXP, 
326        /**
327         * 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).
328         */
329        UNE, 
330        /**
331         * Interpretations of the presence and level of reactivity of the specified component / analyte with the reagent in the performed laboratory test.
332         */
333        REACTIVITYOBSERVATIONINTERPRETATION, 
334        /**
335         * An absence finding used to indicate that the specified component / analyte did not react measurably with the reagent.
336         */
337        NR, 
338        /**
339         * A presence finding used to indicate that the specified component / analyte reacted with the reagent above the reliably measurable limit of the performed test.
340         */
341        RR, 
342        /**
343         * 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.
344         */
345        WR, 
346        /**
347         * added to help the parsers
348         */
349        NULL;
350        public static V3ObservationInterpretation fromCode(String codeString) throws Exception {
351            if (codeString == null || "".equals(codeString))
352                return null;
353        if ("_GeneticObservationInterpretation".equals(codeString))
354          return _GENETICOBSERVATIONINTERPRETATION;
355        if ("CAR".equals(codeString))
356          return CAR;
357        if ("Carrier".equals(codeString))
358          return CARRIER;
359        if ("_ObservationInterpretationChange".equals(codeString))
360          return _OBSERVATIONINTERPRETATIONCHANGE;
361        if ("B".equals(codeString))
362          return B;
363        if ("D".equals(codeString))
364          return D;
365        if ("U".equals(codeString))
366          return U;
367        if ("W".equals(codeString))
368          return W;
369        if ("_ObservationInterpretationExceptions".equals(codeString))
370          return _OBSERVATIONINTERPRETATIONEXCEPTIONS;
371        if ("<".equals(codeString))
372          return LESS_THAN;
373        if (">".equals(codeString))
374          return GREATER_THAN;
375        if ("AC".equals(codeString))
376          return AC;
377        if ("IE".equals(codeString))
378          return IE;
379        if ("QCF".equals(codeString))
380          return QCF;
381        if ("TOX".equals(codeString))
382          return TOX;
383        if ("_ObservationInterpretationNormality".equals(codeString))
384          return _OBSERVATIONINTERPRETATIONNORMALITY;
385        if ("A".equals(codeString))
386          return A;
387        if ("AA".equals(codeString))
388          return AA;
389        if ("HH".equals(codeString))
390          return HH;
391        if ("LL".equals(codeString))
392          return LL;
393        if ("H".equals(codeString))
394          return H;
395        if ("H>".equals(codeString))
396          return H_;
397        if ("L".equals(codeString))
398          return L;
399        if ("L<".equals(codeString))
400          return L_;
401        if ("N".equals(codeString))
402          return N;
403        if ("_ObservationInterpretationSusceptibility".equals(codeString))
404          return _OBSERVATIONINTERPRETATIONSUSCEPTIBILITY;
405        if ("I".equals(codeString))
406          return I;
407        if ("MS".equals(codeString))
408          return MS;
409        if ("NS".equals(codeString))
410          return NS;
411        if ("R".equals(codeString))
412          return R;
413        if ("SYN-R".equals(codeString))
414          return SYNR;
415        if ("S".equals(codeString))
416          return S;
417        if ("SDD".equals(codeString))
418          return SDD;
419        if ("SYN-S".equals(codeString))
420          return SYNS;
421        if ("VS".equals(codeString))
422          return VS;
423        if ("EX".equals(codeString))
424          return EX;
425        if ("HX".equals(codeString))
426          return HX;
427        if ("LX".equals(codeString))
428          return LX;
429        if ("ObservationInterpretationDetection".equals(codeString))
430          return OBSERVATIONINTERPRETATIONDETECTION;
431        if ("IND".equals(codeString))
432          return IND;
433        if ("NEG".equals(codeString))
434          return NEG;
435        if ("ND".equals(codeString))
436          return ND;
437        if ("POS".equals(codeString))
438          return POS;
439        if ("DET".equals(codeString))
440          return DET;
441        if ("ObservationInterpretationExpectation".equals(codeString))
442          return OBSERVATIONINTERPRETATIONEXPECTATION;
443        if ("EXP".equals(codeString))
444          return EXP;
445        if ("UNE".equals(codeString))
446          return UNE;
447        if ("ReactivityObservationInterpretation".equals(codeString))
448          return REACTIVITYOBSERVATIONINTERPRETATION;
449        if ("NR".equals(codeString))
450          return NR;
451        if ("RR".equals(codeString))
452          return RR;
453        if ("WR".equals(codeString))
454          return WR;
455        throw new Exception("Unknown V3ObservationInterpretation code '"+codeString+"'");
456        }
457        public String toCode() {
458          switch (this) {
459            case _GENETICOBSERVATIONINTERPRETATION: return "_GeneticObservationInterpretation";
460            case CAR: return "CAR";
461            case CARRIER: return "Carrier";
462            case _OBSERVATIONINTERPRETATIONCHANGE: return "_ObservationInterpretationChange";
463            case B: return "B";
464            case D: return "D";
465            case U: return "U";
466            case W: return "W";
467            case _OBSERVATIONINTERPRETATIONEXCEPTIONS: return "_ObservationInterpretationExceptions";
468            case LESS_THAN: return "<";
469            case GREATER_THAN: return ">";
470            case AC: return "AC";
471            case IE: return "IE";
472            case QCF: return "QCF";
473            case TOX: return "TOX";
474            case _OBSERVATIONINTERPRETATIONNORMALITY: return "_ObservationInterpretationNormality";
475            case A: return "A";
476            case AA: return "AA";
477            case HH: return "HH";
478            case LL: return "LL";
479            case H: return "H";
480            case H_: return "H>";
481            case L: return "L";
482            case L_: return "L<";
483            case N: return "N";
484            case _OBSERVATIONINTERPRETATIONSUSCEPTIBILITY: return "_ObservationInterpretationSusceptibility";
485            case I: return "I";
486            case MS: return "MS";
487            case NS: return "NS";
488            case R: return "R";
489            case SYNR: return "SYN-R";
490            case S: return "S";
491            case SDD: return "SDD";
492            case SYNS: return "SYN-S";
493            case VS: return "VS";
494            case EX: return "EX";
495            case HX: return "HX";
496            case LX: return "LX";
497            case OBSERVATIONINTERPRETATIONDETECTION: return "ObservationInterpretationDetection";
498            case IND: return "IND";
499            case NEG: return "NEG";
500            case ND: return "ND";
501            case POS: return "POS";
502            case DET: return "DET";
503            case OBSERVATIONINTERPRETATIONEXPECTATION: return "ObservationInterpretationExpectation";
504            case EXP: return "EXP";
505            case UNE: return "UNE";
506            case REACTIVITYOBSERVATIONINTERPRETATION: return "ReactivityObservationInterpretation";
507            case NR: return "NR";
508            case RR: return "RR";
509            case WR: return "WR";
510            default: return "?";
511          }
512        }
513        public String getSystem() {
514          return "http://hl7.org/fhir/v3/ObservationInterpretation";
515        }
516        public String getDefinition() {
517          switch (this) {
518            case _GENETICOBSERVATIONINTERPRETATION: return "Codes that specify interpretation of genetic analysis, such as \"positive\", \"negative\", \"carrier\", \"responsive\", etc.";
519            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.";
520            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.";
521            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.";
522            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.]";
523            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).";
524            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).";
525            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.]";
526            case _OBSERVATIONINTERPRETATIONEXCEPTIONS: return "Technical exceptions resulting in the inability to provide an interpretation. At most one allowed. Does not imply normality or severity.";
527            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.";
528            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.";
529            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.";
530            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).]";
531            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.";
532            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.";
533            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.";
534            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.]";
535            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.]";
536            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.";
537            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.";
538            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";
539            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.";
540            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";
541            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.";
542            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.]";
543            case _OBSERVATIONINTERPRETATIONSUSCEPTIBILITY: return "Interpretations of anti-microbial susceptibility testing results (microbiology). At most one allowed.";
544            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).]";
545            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).";
546            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.";
547            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).]";
548            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.";
549            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).]";
550            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.";
551            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.";
552            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).";
553            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.";
554            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.";
555            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.";
556            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.";
557            case IND: return "The specified component / analyte, organism or clinical sign could neither be declared positive / negative or detected / not detected by the performed test or procedure.";
558            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.]";
559            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.";
560            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.";
561            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.";
562            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.";
563            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).";
564            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).";
565            case REACTIVITYOBSERVATIONINTERPRETATION: return "Interpretations of the presence and level of reactivity of the specified component / analyte with the reagent in the performed laboratory test.";
566            case NR: return "An absence finding used to indicate that the specified component / analyte did not react measurably with the reagent.";
567            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.";
568            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.";
569            default: return "?";
570          }
571        }
572        public String getDisplay() {
573          switch (this) {
574            case _GENETICOBSERVATIONINTERPRETATION: return "GeneticObservationInterpretation";
575            case CAR: return "Carrier";
576            case CARRIER: return "Carrier";
577            case _OBSERVATIONINTERPRETATIONCHANGE: return "ObservationInterpretationChange";
578            case B: return "Better";
579            case D: return "Significant change down";
580            case U: return "Significant change up";
581            case W: return "Worse";
582            case _OBSERVATIONINTERPRETATIONEXCEPTIONS: return "ObservationInterpretationExceptions";
583            case LESS_THAN: return "Off scale low";
584            case GREATER_THAN: return "Off scale high";
585            case AC: return "Anti-complementary substances present";
586            case IE: return "Insufficient evidence";
587            case QCF: return "Quality control failure";
588            case TOX: return "Cytotoxic substance present";
589            case _OBSERVATIONINTERPRETATIONNORMALITY: return "ObservationInterpretationNormality";
590            case A: return "Abnormal";
591            case AA: return "Critical abnormal";
592            case HH: return "Critical high";
593            case LL: return "Critical low";
594            case H: return "High";
595            case H_: return "Significantly high";
596            case L: return "Low";
597            case L_: return "Significantly low";
598            case N: return "Normal";
599            case _OBSERVATIONINTERPRETATIONSUSCEPTIBILITY: return "ObservationInterpretationSusceptibility";
600            case I: return "Intermediate";
601            case MS: return "moderately susceptible";
602            case NS: return "Non-susceptible";
603            case R: return "Resistant";
604            case SYNR: return "Synergy - resistant";
605            case S: return "Susceptible";
606            case SDD: return "Susceptible-dose dependent";
607            case SYNS: return "Synergy - susceptible";
608            case VS: return "very susceptible";
609            case EX: return "outside threshold";
610            case HX: return "above high threshold";
611            case LX: return "below low threshold";
612            case OBSERVATIONINTERPRETATIONDETECTION: return "ObservationInterpretationDetection";
613            case IND: return "Indeterminate";
614            case NEG: return "Negative";
615            case ND: return "Not detected";
616            case POS: return "Positive";
617            case DET: return "Detected";
618            case OBSERVATIONINTERPRETATIONEXPECTATION: return "ObservationInterpretationExpectation";
619            case EXP: return "Expected";
620            case UNE: return "Unexpected";
621            case REACTIVITYOBSERVATIONINTERPRETATION: return "ReactivityObservationInterpretation";
622            case NR: return "Non-reactive";
623            case RR: return "Reactive";
624            case WR: return "Weakly reactive";
625            default: return "?";
626          }
627    }
628
629
630}
631