Explication détaillées

Le group CreatePatient alimente la ressource Patient à partir des éléments d'informations contenus dans le QR, à savoir :

• élément id : génération d'un uuid
• élément name : alimenté à partir des items "Nom patient" (8605698058770) et "Prénom patient" (6214879623503)
• élément identifier : plusieurs identifiants peuvent être créé :
  • le NIR, à partir de l'item "Numéro d'inscription au Répertoire (NIR)" (5711960356160)
  • l'INS, à partir de l'item "Identité Nationale de Santé (INS)" (3764723550987)
• élément birthDate : alimenté à partir de l'item "Date de naissance" (5036133558154)
• élément deceased[x] : alimenté à partir de l'item "Date de décès" (5633552097315). La source de cette information peut être renseigné dans l'extension edsh-death-source à partir de l'item "Source de la date de décès" (9098810065693)
• élémént multipleBirth[x] : alimenté à partir de l'item "Rang gémellaire du bénéficiaire" (6931296968515)
• élément gender : alimenté à partir de l'item "Sexe" (3894630481120)
• élément address : plusieurs informations peuvent être renseigné :
  • le code commune PMSI, issue de l'item "Code géographique de résidence" (2446369196222) alimente l'extension edsh-pmsi-code-geo
  • les coordonnées géographiques alimentent l'extension geolocation :
    • la latitude provient de l'item "Latitude" (3709843054556)
    • la longitude provient de l'item "Longitude" (7651448032665)
  • l'IRIS, issue de l'item "IRIS" (7621032273792) alimente l'extension iso21090-ADXP-censusTract

// Group: Create Patient from QuestionnaireResponse
group CreatePatient(source src : QuestionnaireResponse, target patient : Patient) {
  src -> patient.id = uuid() "patient-id";
  src -> patient.meta = create('Meta') as meta then {
    src -> meta.profile = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-patient' "patient-profile";
  } "patient-meta";

  // Extract patient identity data from linkId 4647259356106 > 2958000860428
  src.item as socioDemo where (linkId = '4647259356106') then {
    socioDemo.item as identity where (linkId = '2958000860428') then {

      // Patient name (linkId 8605698058770 = family, 6214879623503 = given)
      identity -> patient.name = create('HumanName') as name then {
        identity.item as familyItem where (linkId = '8605698058770') then {
          familyItem.answer as ans -> name.family = (%ans.valueString) "set-family";
        } "extract-family";
        identity.item as givenItem where (linkId = '6214879623503') then {
          givenItem.answer as ans -> name.given = (%ans.valueString) "set-given";
        } "extract-given";
      } "set-name";

      // NIR identifier (linkId 5711960356160)
      identity.item as nirItem where (linkId = '5711960356160') then {
        nirItem.answer as ans -> patient.identifier = create('Identifier') as nir then {
          ans -> nir.system = 'urn:oid:1.2.250.1.213.1.4.8' "nir-system";
          ans -> nir.value = (%ans.valueString) "nir-value";
          ans -> nir.type = cc('http://interopsante.org/fhir/CodeSystem/fr-v2-0203', 'NIR') "nir-type";
        } "set-nir";
      } "extract-nir";

      // INS identifier (linkId 3764723550987)
      identity.item as insItem where (linkId = '3764723550987') then {
        insItem.answer as ans -> patient.identifier = create('Identifier') as ins then {
          ans -> ins.system = 'urn:oid:1.2.250.1.213.1.4.10' "ins-system";
          ans -> ins.value = (%ans.valueString) "ins-value";
          ans -> ins.type = cc('http://interopsante.org/fhir/CodeSystem/fr-v2-0203', 'INS-C') "ins-type";
        } "set-ins";
      } "extract-ins";

      // Birth date (linkId 5036133558154)
      identity.item as birthItem where (linkId = '5036133558154') then {
        birthItem.answer as ans -> patient.birthDate = (%ans.valueDate) "set-birthdate";
      } "extract-birthdate";

      // Death date (linkId 5633552097315)
      identity.item as deathItem where (linkId = '5633552097315') then {
        deathItem.answer as ans -> patient.deceased = (%ans.valueDate) "set-deceased-date";
        // Death source (linkId 9098810065693)
        deathItem.item as deathSource where (linkId = '9098810065693') then {
          deathSource.answer as sourceAns -> patient.extension = create('Extension') as ext then {
            sourceAns -> ext.url = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-death-source' "death-source-url";
            sourceAns -> ext.value = (%sourceAns.valueCoding) "death-source-value";
          } "set-death-source-ext";
        } "extract-death-source";
      } "extract-death";

      // Multiple birth rank (linkId 6931296968515)
      identity.item as multipleItem where (linkId = '6931296968515') then {
        multipleItem.answer as ans -> patient.multipleBirth = (%ans.valueInteger) "set-multiple-birth";
      } "extract-multiple-birth";

    } "process-identity";

    // Gender from PMSI data (linkId 3894630481120 within 2825244231605)
    src.item as pmsiGroup where (linkId = '2825244231605') then {
      pmsiGroup.item as sexItem where (linkId = '3894630481120') then {
        sexItem.answer as ans then {
          ans.valueString as female where ($this = 'f') -> patient.gender = 'female' "setGenderF";
          ans.valueString as female where ($this = 'm') -> patient.gender = 'male' "setGenderM";
        } "valueCoding";
      } "extract-gender";

      // Address from code géographique (linkId 2446369196222)
      pmsiGroup.item as codeGeoItem where (linkId = '2446369196222') then {
        codeGeoItem.answer as ans -> patient.address = create('Address') as addr then {
          ans -> addr.extension = create('Extension') as ext then {
            ans -> ext.url = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-pmsi-code-geo' "codegeo-url";
            ans.value as val -> ext.value = cast(val, 'code') "codegeo-value";
          } "set-codegeo-ext";

          // Environnement
          socioDemo.item as environnementItem where (linkId = '5491974639955') then {
            // geolocation
            environnementItem.item as geocodageItem where (linkId = '3816475533472') -> addr.extension = create('Extension') as geolocationExt then {
              geocodageItem.item as latItem where (linkId = '3709843054556') -> geolocationExt.url = 'http://hl7.org/fhir/StructureDefinition/geolocation', geolocationExt.extension = create('Extension') as latExt then {
                latItem.answer as lat -> latExt.url = 'latitude', latExt.value = (%lat.valueDecimal) then {
                  geocodageItem.item as longItem where (linkId = '7651448032665') -> geolocationExt.extension = create('Extension') as longExt then {
                    longItem.answer as long -> longExt.url = 'longitude', longExt.value = (%long.valueDecimal) "setLong";
                  } "createLongExt";
                } "setLat";
              } "createLatExt";
            } "createGeolocExt";
            // IRIS
            environnementItem.item as irisItem where (linkId = '7621032273792') -> addr.line as addrLine, addrLine.extension = create('Extension') as irisExt then {
              irisItem.answer as ans -> irisExt.url = 'http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-censusTract',
              irisExt.valueString = (%ans.valueString) "setIrisExt";
            } "navIrisItem";

          } "navEnv";

        } "set-address";
      } "extract-codegeo";
    } "extract-pmsi-demographics";

  } "process-sociodemographics";
}

map "https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureMap/Q2FSL" = "Q2FSL"

// Transforms QuestionnaireResponse based on Questionnaire Usage Variables socles into FHIR resources conforming to DM profiles

uses "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" alias QuestionnaireResponse as source
uses "http://hl7.org/fhir/StructureDefinition/Bundle" alias Bundle as target

// Main entry point: Transform QuestionnaireResponse to Bundle
group QuestionnaireResponseToBundle(source src : QuestionnaireResponse, target bundle : Bundle) {
  // Initialize Bundle
  src -> bundle.id = uuid() "bundleid";
  src -> bundle.type = 'collection' "bundletype";
  src -> bundle.timestamp = (now()) "setTimestamp";
  // Create Patient resource
  src -> bundle.entry as patientEntry then {
    src -> patientEntry.resource = create('Patient') as patient then {
      src then CreatePatient(src, patient) "createpatient";
      src ->  patient.id as patientId,  patientEntry.fullUrl = append('urn:uuid:', patientId) "setfullUrl";
      // Create Locations from geocoding data
      // src then CreateLocations(src, patient, bundle) "create-locations";
      // Create Encounters from PMSI data
      src then CreateEncounters(src, patient, bundle) "createencounters";
      // Create Laboratory Observations
      src then CreateLaboratoryObservations(src, patient, bundle) "createlabobservations";
      // Create Medication Requests
      src then CreateMedicationRequests(src, patient, bundle) "createmedicationrequests";
      // Create Medication Administrations
      src then CreateMedicationAdministrations(src, patient, bundle) "createmedicationadministrations";
      // Create Vital Sign Observations
      src then CreateVitalSignObservations(src, patient, bundle) "createvitalsigns";
    } "createpatientresource";
  } "patiententry";
}

// Group: Create Patient from QuestionnaireResponse
group CreatePatient(source src : QuestionnaireResponse, target patient : Patient) {
  src -> patient.id = uuid() "patientid";
  src -> patient.meta = create('Meta') as meta then {
    src -> meta.profile = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-patient' "patientprofile";
  } "patientmeta";
  // Extract patient identity data from linkId 4647259356106 > 2958000860428
  src.item as socioDemo where (linkId = '4647259356106') then {
    socioDemo.item as identity where (linkId = '2958000860428') then {
      // Patient name (linkId 8605698058770 = family, 6214879623503 = given)
      identity -> patient.name = create('HumanName') as name then {
        identity.item as familyItem where (linkId = '8605698058770') then {
          familyItem.answer as ans -> name.family = (%ans.valueString) "setfamily";
        } "extractfamily";
        identity.item as givenItem where (linkId = '6214879623503') then {
          givenItem.answer as ans -> name.given = (%ans.valueString) "setgiven";
        } "extractgiven";
      } "setname";
      // NIR identifier (linkId 5711960356160)
      identity.item as nirItem where (linkId = '5711960356160') then {
        nirItem.answer as ans -> patient.identifier = create('Identifier') as nir then {
          ans -> nir.system = 'urn:oid:1.2.250.1.213.1.4.8' "nirsystem";
          ans -> nir.value = (%ans.valueString) "nirvalue";
          ans -> nir.type = cc('http://interopsante.org/fhir/CodeSystem/fr-v2-0203', 'NIR') "nirtype";
        } "setnir";
      } "extractnir";
      // INS identifier (linkId 3764723550987)
      identity.item as insItem where (linkId = '3764723550987') then {
        insItem.answer as ans -> patient.identifier = create('Identifier') as ins then {
          ans -> ins.system = 'urn:oid:1.2.250.1.213.1.4.10' "inssystem";
          ans -> ins.value = (%ans.valueString) "insvalue";
          ans -> ins.type = cc('http://interopsante.org/fhir/CodeSystem/fr-v2-0203', 'INS-C') "instype";
        } "setins";
      } "extractins";
      // Birth date (linkId 5036133558154)
      identity.item as birthItem where (linkId = '5036133558154') then {
        birthItem.answer as ans -> patient.birthDate = (%ans.valueDate) "setbirthdate";
      } "extractbirthdate";
      // Death date (linkId 5633552097315)
      identity.item as deathItem where (linkId = '5633552097315') then {
        deathItem.answer as ans -> patient.deceased = (%ans.valueDate) "setdeceaseddate";
        // Death source (linkId 9098810065693)
        deathItem.item as deathSource where (linkId = '9098810065693') then {
          deathSource.answer as sourceAns -> patient.extension = create('Extension') as ext then {
            sourceAns -> ext.url = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-death-source' "deathsourceurl";
            sourceAns -> ext.value = (%sourceAns.valueCoding) "deathsourcevalue";
          } "setdeathsourceext";
        } "extractdeathsource";
      } "extractdeath";
      // Multiple birth rank (linkId 6931296968515)
      identity.item as multipleItem where (linkId = '6931296968515') then {
        multipleItem.answer as ans -> patient.multipleBirth = (%ans.valueInteger) "setmultiplebirth";
      } "extractmultiplebirth";
    } "processidentity";
    // Gender from PMSI data (linkId 3894630481120 within 2825244231605)
    src.item as pmsiGroup where (linkId = '2825244231605') then {
      pmsiGroup.item as sexItem where (linkId = '3894630481120') then {
        sexItem.answer as ans then {
          ans.valueString as female where ($this = 'f') -> patient.gender = 'female' "setGenderF";
          ans.valueString as female where ($this = 'm') -> patient.gender = 'male' "setGenderM";
        } "valueCoding";
      } "extractgender";
      // Address from code géographique (linkId 2446369196222)
      pmsiGroup.item as codeGeoItem where (linkId = '2446369196222') then {
        codeGeoItem.answer as ans -> patient.address = create('Address') as addr then {
          ans -> addr.extension = create('Extension') as ext then {
            ans -> ext.url = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-pmsi-code-geo' "codegeourl";
            ans.value as val -> ext.value = cast(val, 'code') "codegeovalue";
          } "setcodegeoext";
          // Environnement
          socioDemo.item as environnementItem where (linkId = '5491974639955') then {
            // geolocation
            environnementItem.item as geocodageItem where (linkId = '3816475533472') -> addr.extension = create('Extension') as geolocationExt then {
              geocodageItem.item as latItem where (linkId = '3709843054556') ->  geolocationExt.url = 'http://hl7.org/fhir/StructureDefinition/geolocation',  geolocationExt.extension = create('Extension') as latExt then {
                latItem.answer as lat ->  latExt.url = 'latitude',  latExt.value = (%lat.valueDecimal) then {
                  geocodageItem.item as longItem where (linkId = '7651448032665') -> geolocationExt.extension = create('Extension') as longExt then {
                    longItem.answer as long ->  longExt.url = 'longitude',  longExt.value = (%long.valueDecimal) "setLong";
                  } "createLongExt";
                } "setLat";
              } "createLatExt";
            } "createGeolocExt";
            // IRIS
            environnementItem.item as irisItem where (linkId = '7621032273792') ->  addr.line as addrLine,  addrLine.extension = create('Extension') as irisExt then {
              irisItem.answer as ans ->  irisExt.url = 'http://hl7.org/fhir/StructureDefinition/iso21090-ADXP-censusTract',  irisExt.valueString = (%ans.valueString) "setIrisExt";
            } "navIrisItem";
          } "navEnv";
        } "setaddress";
      } "extractcodegeo";
    } "extractpmsidemographics";
  } "processsociodemographics";
}

// Group: Create Locations from geocoding and IRIS data
group CreateLocations(source src : QuestionnaireResponse, target patient : Patient, target bundle : Bundle) {
  // Extract geocoding data from linkId 4647259356106 > 5491974639955 > 3816475533472
  src.item as socioDemo where (linkId = '4647259356106') then {
    socioDemo.item as environment where (linkId = '5491974639955') then {
      // Geocoding locations (repeating group 3816475533472)
      environment.item as geocodingItem where (linkId = '3816475533472') -> bundle.entry as locationEntry then {
        geocodingItem -> locationEntry.resource = create('Location') as location then {
          geocodingItem -> location.id = uuid() "locationid";
          geocodingItem -> location.meta = create('Meta') as meta then {
            geocodingItem -> meta.profile = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-location' "locationprofile";
          } "locationmeta";
          // Position with latitude and longitude
          geocodingItem -> location.position = create('LocationPosition') as pos then {
            // Latitude (linkId 3709843054556)
            geocodingItem.item as latItem where (linkId = '3709843054556') then {
              latItem.answer as ans -> pos.latitude = (%ans.valueDecimal) "setlatitude";
            } "extractlatitude";
            // Longitude (linkId 7651448032665)
            geocodingItem.item as longItem where (linkId = '7651448032665') then {
              longItem.answer as ans -> pos.longitude = (%ans.valueDecimal) "setlongitude";
            } "extractlongitude";
          } "setposition";
          // Extension for collection date (linkId 1185653257776)
          // geocodingItem.item as dateItem where (linkId = '1185653257776') then {             dateItem.answer as ans -> location.extension = create('Extension') as ext then {               ans -> ext.url = 'http://hl7.org/fhir/StructureDefinition/data-collection-date' "date-url";               ans -> ext.value = (%ans.valueDate) "date-value";             } "set-collection-date";           } "extract-collection-date";
          location -> locationEntry.request as request then {
            location -> request.method = 'POST' "setmethod";
            location -> request.url = 'Location' "seturl";
          } "setrequest";
          location.id as locId -> locationEntry.fullUrl = append('urn:uuid:', locId) "setfullUrl";
        } "createlocation";
      } "geocodinglocationentry";
      // IRIS locations (repeating item 7621032273792)
      environment.item as irisItem where (linkId = '7621032273792') then {
        irisItem.answer as irisAnswer -> bundle.entry as locationEntry then {
          irisAnswer -> locationEntry.resource = create('Location') as location then {
            irisAnswer -> location.id = uuid() "locationid";
            irisAnswer -> location.meta = create('Meta') as meta then {
              irisAnswer -> meta.profile = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-location' "locationprofile";
            } "locationmeta";
            // IRIS code as identifier
            irisAnswer -> location.identifier = create('Identifier') as identifier then {
              irisAnswer -> identifier.system = 'urn:oid:2.16.840.1.113883.2.8.1.5.5' "irissystem";
              irisAnswer -> identifier.value = (%irisAnswer.valueCoding.code) "irisvalue";
            } "setirisidentifier";
            // Collection date from nested item (linkId 4999580038872)
            // irisAnswer.item as dateItem where (linkId = '4999580038872') then {               dateItem.answer as ans -> location.extension = create('Extension') as ext then {                 ans -> ext.url = 'http://hl7.org/fhir/StructureDefinition/data-collection-date' "date-url";                 ans -> ext.value = (%ans.valueDate) "date-value";               } "set-collection-date";             } "extract-iris-date";
            location -> locationEntry.request as request then {
              location -> request.method = 'POST' "setmethod";
              location -> request.url = 'Location' "seturl";
            } "setrequest";
            location.id as locId -> locationEntry.fullUrl = append('urn:uuid:', locId) "setfullUrl";
          } "createirislocation";
        } "irislocationentry";
      } "processiris";
    } "processenvironment";
  } "processsociodemographicslocation";
}

// Group: Create Encounters from PMSI data
group CreateEncounters(source src : QuestionnaireResponse, target patient : Patient, target bundle : Bundle) {
  // PMSI data group (linkId 2825244231605) - Note: This can repeat in the structure
  src.item as pmsiItem where (linkId = '2825244231605') -> bundle.entry as encounterEntry then {
    pmsiItem -> encounterEntry.resource = create('Encounter') as encounter then {
      pmsiItem -> encounter.id = uuid() "encounterid";
      pmsiItem -> encounter.meta = create('Meta') as meta then {
        pmsiItem -> meta.profile = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-encounter' "encounterprofile";
      } "encountermeta";
      // status
      src -> encounter.status = 'finished' "setStatus";
      // class
      src -> encounter.class = c('http://terminology.hl7.org/CodeSystem/v3-ActCode', 'IMP') "setClass";
      // Link to patient
      src ->  encounter.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
      // Encounter period (start: 5991443718282, end: 6114780320846)
      pmsiItem -> encounter.period = create('Period') as period then {
        pmsiItem.item as startItem where (linkId = '5991443718282') then {
          startItem.answer as ans -> period.start = (%ans.valueDate) "setstart";
        } "extractstart";
        pmsiItem.item as endItem where (linkId = '6114780320846') then {
          endItem.answer as ans -> period.end = (%ans.valueDate) "setend";
        } "extractend";
      } "setperiod";
      // Mode d'entrée (linkId 6172398101212)
      pmsiItem.item as modeInItem where (linkId = '6172398101212') then {
        modeInItem.answer as ans then {
          ans.valueString as valueString ->  encounter.hospitalization as hosp,  hosp.admitSource as admitSource,  admitSource.coding as admitSourceCoding,  admitSourceCoding.code = valueString "setadmitsource";
        } "navValue";
      } "extractmodein";
      // Mode de sortie (linkId 3354867075704)
      pmsiItem.item as modeOutItem where (linkId = '3354867075704') then {
        modeOutItem.answer as ans then {
          ans.valueString as valueString ->  encounter.hospitalization as hosp,  hosp.dischargeDisposition as dischargeDisposition,  dischargeDisposition.coding as dischargeDispositionCoding,  dischargeDispositionCoding.code = valueString "setdischargedisposition";
        } "navValue";
      } "extractmodeout";
      src ->  encounter.id as encId,  encounterEntry.fullUrl = append('urn:uuid:', encId) "setfullUrl";
      // Create nested Conditions and Procedures
      pmsiItem then CreateConditions(pmsiItem, patient, encounter, bundle) "createconditions";
      pmsiItem then CreateProcedures(pmsiItem, patient, encounter, bundle) "createprocedures";
    } "createencounter";
  } "encounterentry";
}

// Group: Create Conditions from nested diagnostics
group CreateConditions(source pmsiItem, target patient : Patient, target encounter : Encounter, target bundle : Bundle) {
  // Diagnostics group (linkId 9391816419630) - can repeat
  pmsiItem.item as diagGroup where (linkId = '9391816419630') -> bundle.entry as conditionEntry then {
    diagGroup -> conditionEntry.resource = create('Condition') as condition then {
      diagGroup -> condition.id = uuid() "conditionid";
      diagGroup -> condition.meta = create('Meta') as meta then {
        diagGroup -> meta.profile = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-condition' "conditionprofile";
      } "conditionmeta";
      // Link to patient
      diagGroup ->  condition.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
      // Link to encounter
      diagGroup ->  encounter.id as encId,  condition.encounter = create('Reference') as ref,  ref.reference = append('Encounter/', encId) "setencounter";
      // Diagnostic code (linkId 5505101189372) - CIM-10
      diagGroup.item as diagCodeItem where (linkId = '5505101189372') then {
        diagCodeItem.answer as ans -> condition.code = create('CodeableConcept') as code then {
          ans ->  code.coding as coding,  coding.code = (%ans.valueString) "setcoding";
        } "setcode";
      } "extractdiagcode";
      // Type de diagnostic (linkId 6427586743735) - DP/DAS/DR
      diagGroup.item as diagTypeItem where (linkId = '6427586743735') then {
        diagTypeItem.answer as ans -> condition.category = create('CodeableConcept') as category then {
          ans -> category.coding = create('Coding') as coding then {
            ans -> coding.system = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/CodeSystem/pmsi-mco-diag-type' "diagtypesystem";
            ans -> coding.code = (%ans.valueString) "diagtypecode";
          } "setcategorycoding";
        } "setcategory";
      } "extractdiagtype";
      // Recorded date (linkId 7114466839467)
      diagGroup.item as dateItem where (linkId = '7114466839467') then {
        dateItem.answer as ans -> condition.recordedDate = (%ans.valueDate) "setrecordeddate";
      } "extractrecordeddate";
      // fullurl
      pmsiItem ->  condition.id as condId,  conditionEntry.fullUrl = append('urn:uuid:', condId) "setfullUrl";
    } "createcondition";
  } "conditionentry";
}

// Group: Create Procedures from nested actes
group CreateProcedures(source pmsiItem, target patient : Patient, target encounter : Encounter, target bundle : Bundle) {
  // Actes group (linkId 591926901726) - can repeat
  pmsiItem.item as acteGroup where (linkId = '591926901726') -> bundle.entry as procedureEntry then {
    acteGroup -> procedureEntry.resource = create('Procedure') as procedure then {
      acteGroup -> procedure.id = uuid() "procedureid";
      acteGroup -> procedure.meta = create('Meta') as meta then {
        acteGroup -> meta.profile = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-procedure' "procedureprofile";
      } "proceduremeta";
      // status
      acteGroup -> procedure.status = 'completed' "setStatus";
      // Link to patient
      acteGroup ->  procedure.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
      // Link to encounter
      acteGroup ->  encounter.id as encId,  procedure.encounter = create('Reference') as ref,  ref.reference = append('Encounter/', encId) "setencounter";
      // Acte code (linkId 7758110033600) - CCAM
      acteGroup.item as acteCodeItem where (linkId = '7758110033600') then {
        acteCodeItem.answer as ans -> procedure.code = create('CodeableConcept') as code then {
          ans ->  code.coding as coding,  coding.code = (%ans.valueString) "setcoding";
        } "setcode";
      } "extractactecode";
      // Date de l'acte (linkId 5066866286682)
      acteGroup.item as dateItem where (linkId = '5066866286682') then {
        dateItem.answer as ans -> procedure.performed = (%ans.valueDateTime) "setperformed";
      } "extractperformeddate";
      // fullurl
      pmsiItem ->  procedure.id as procId,  procedureEntry.fullUrl = append('urn:uuid:', procId) "setfullUrl";
    } "createprocedure";
  } "procedureentry";
}

// Group: Create Medication Requests
group CreateMedicationRequests(source src : QuestionnaireResponse, target patient : Patient, target bundle : Bundle) {
  // Exposition médicamenteuse (linkId 817801935685)
  src.item as medExpoGroup where (linkId = '817801935685') then {
    // Médicament prescrit (linkId 156631794800) - repeating
    medExpoGroup.item as prescribedGroup where (linkId = '156631794800') -> bundle.entry as medReqEntry then {
      prescribedGroup -> medReqEntry.resource = create('MedicationRequest') as medReq then {
        prescribedGroup -> medReq.id = uuid() "medreqid";
        // fullurl
        src ->  medReq.id as medReqId,  medReqEntry.fullUrl = append('urn:uuid:', medReqId) "setfullUrl";
        prescribedGroup -> medReq.meta = create('Meta') as meta then {
          prescribedGroup -> meta.profile = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-medication-request' "medreqprofile";
        } "medreqmeta";
        // Link to patient
        prescribedGroup ->  medReq.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
        // Status and intent
        prescribedGroup -> medReq.status = 'active' "setstatus";
        prescribedGroup -> medReq.intent = 'order' "setintent";
        // MedicationCodeableConcept
        prescribedGroup.answer as prescribedMedication then {
          prescribedMedication.item as atcItem where (linkId = '1923143398283') then {
            atcItem.answer as ans ->  medReq.medication = create('CodeableConcept') as medReqCC,  medReqCC.coding as medReqC,  medReqC.code = (%ans.valueString),  medReqC.display = (%prescribedMedication.valueString) "setAtcCoding";
          } "navAtcItem";
        } "navPrescribedMedication";
        // Create Medication resource and reference
        // prescribedGroup -> bundle.entry as medEntry then {           prescribedGroup -> medEntry.resource = create('Medication') as medication then {             prescribedGroup -> medication.id = uuid() "med-id";              // ATC code from nested items             prescribedGroup.item as atcItem where (linkId.contains('ATC')) then {               atcItem.answer as ans -> medication.code = create('CodeableConcept') as code then {                 ans -> code.coding = (%ans.valueCoding) "set-atc-coding";               } "set-med-code";             } "extract-atc";              prescribedGroup -> medication.id as medId, medEntry.fullUrl = append('urn:uuid:', medId) "set-fullUrl";              // Link MedicationRequest to Medication             prescribedGroup -> medication.id as medId, medReq.medication = create('Reference') as ref, ref.reference = append('Medication/', medId) "set-medication-reference";            } "create-medication";         } "medication-entry";
        // Dosage instructions
        prescribedGroup -> medReq.dosageInstruction = create('Dosage') as dosage then {
          // Route
          prescribedGroup.answer as prescribedMedication then {
            prescribedMedication.item as routeItem where (linkId = '387026794874') then {
              routeItem.answer as ans -> dosage.route as route then {
                ans ->  route.coding as routeCoding,  routeCoding.code = (%ans.valueString) "setroutecoding";
              } "setroute";
            } "navRouteItem";
          } "navPrescribedMedication";
          // Timing
          medExpoGroup.item as posoGroup where (linkId = '6348237104421') ->  dosage.timing as timing,  timing.repeat as timingRepeat,  timingRepeat.boundsPeriod as timingPeriod then {
            posoGroup.item as DateDebItem where (linkId = '316347573327') then {
              DateDebItem.answer as ans -> timingPeriod.start = (%ans.valueDate) "setDateDeb";
            } "navDateDeb";
            posoGroup.item as DateFinItem where (linkId = '429570775935') then {
              DateFinItem.answer as ans -> timingPeriod.end = (%ans.valueDate) "setDateFin";
            } "navDateFin";
          } "navPoso";
        } "setdosage";
      } "createmedreq";
    } "medreqentry";
  } "processmedexpo";
}

// Group: Create Medication Administrations
group CreateMedicationAdministrations(source src : QuestionnaireResponse, target patient : Patient, target bundle : Bundle) {
  // Exposition médicamenteuse (linkId 817801935685)
  src.item as medExpoGroup where (linkId = '817801935685') then {
    // Médicament administré (linkId 266852453304) - repeating
    medExpoGroup.item as adminGroup where (linkId = '266852453304') -> bundle.entry as medAdminEntry then {
      adminGroup -> medAdminEntry.resource = create('MedicationAdministration') as medAdmin then {
        adminGroup -> medAdmin.id = uuid() "medadminid";
        // fullurl
        src ->  medAdmin.id as medAdminId,  medAdminEntry.fullUrl = append('urn:uuid:', medAdminId) "setfullUrl";
        adminGroup -> medAdmin.meta = create('Meta') as meta then {
          adminGroup -> meta.profile = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-medication-administration' "medadminprofile";
        } "medadminmeta";
        // Link to patient
        adminGroup ->  medAdmin.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
        // Status
        adminGroup -> medAdmin.status = 'completed' "setstatus";
        // MedicationCodeableConcept
        adminGroup.answer as administeredMedication then {
          administeredMedication.item as atcItem where (linkId = '631972144976') then {
            atcItem.answer as ans ->  medAdmin.medication = create('CodeableConcept') as medAdminCC,  medAdminCC.coding as medAdminC,  medAdminC.code = (%ans.valueString),  medAdminC.display = (%administeredMedication.valueString) "setAtcCoding";
          } "navAtcItem";
        } "navadministeredMedication";
        // Create Medication resource and reference
        // adminGroup -> bundle.entry as medEntry then {           adminGroup -> medEntry.resource = create('Medication') as medication then {             adminGroup -> medication.id = uuid() "med-id";              // ATC code from nested items             adminGroup.item as atcItem where (linkId.contains('ATC')) then {               atcItem.answer as ans -> medication.code = create('CodeableConcept') as code then {                 ans -> code.coding = (%ans.valueCoding) "set-atc-coding";               } "set-med-code";             } "extract-atc";              adminGroup -> medication.id as medId, medEntry.fullUrl = append('Medication/', medId) "set-fullUrl";              // Link MedicationAdministration to Medication             adminGroup -> medication.id as medId, medAdmin.medication = create('Reference') as ref, ref.reference = append('urn:uuid:', medId) "set-medication-reference";            } "create-medication";         } "medication-entry";
        // Dosage (FHIR)
        adminGroup -> medAdmin.dosage as dosage then {
          // Route
          adminGroup.answer as administeredMedication then {
            administeredMedication.item as routeItem where (linkId = '811931484859') then {
              routeItem.answer as ans -> dosage.route = create('CodeableConcept') as route then {
                ans ->  route.coding as routeCoding,  routeCoding.code = (%ans.valueString) "setroutecoding";
              } "setroute";
            } "navRoute";
          } "navadministeredMedication";
          // Dosage (QR)
          medExpoGroup.item as doseGroup where (linkId = '5720103839343') then {
            // Dose
            doseGroup.item as quantityItem where (linkId = '4765772671997') then {
              quantityItem.answer as ans -> dosage.dose = (%ans.valueQuantity) "setDose";
            } "navquantity";
            // Effective period
            doseGroup.item as startItem where (linkId = '1443558617577') then {
              startItem.answer as startAns then {
                doseGroup.item as endItem where (linkId = '780829110731') then {
                  endItem.answer as endAns ->  medAdmin.effectivePeriod as adminPeriod,  adminPeriod.start = (%startAns.value),  adminPeriod.end = (%endAns.value) "setAdminPeriod";
                } "navEnd";
              } "navStartAns";
            } "navStart";
          } "navDosage";
        } "setdosage";
      } "createmedadmin";
    } "medadminentry";
  } "processmedexpoadmin";
}

// Group: Create Vital Sign Observations
group CreateVitalSignObservations(source src : QuestionnaireResponse, target patient : Patient, target bundle : Bundle) {
  // Examen clinique (linkId 214880328197)
  src.item as examGroup where (linkId = '214880328197') then {
    // Dossier de soins (linkId 305831246173) - repeating
    examGroup.item as dossierGroup where (linkId = '305831246173') then {
      // Height (linkId 4846902346416)
      dossierGroup.item as heightItem where (linkId = '4846902346416') then {
        heightItem.answer as ans -> bundle.entry as obsEntry then {
          ans -> obsEntry.resource = create('Observation') as obs then {
            ans -> obs.id = uuid() "obsid";
            ans ->  obs.id as obsId,  obsEntry.fullUrl = append('urn:uuid:', obsId) "setfullUrl";
            ans -> obs.meta = create('Meta') as meta then {
              ans -> meta.profile = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-observation-body-height' "obsprofile";
            } "obsmeta";
            ans -> obs.status = 'final' "obsstatus";
            ans -> obs.category = cc('http://terminology.hl7.org/CodeSystem/observation-category', 'vital-signs') "obscategory";
            ans -> obs.code = cc('http://loinc.org', '8302-2', 'Body height') "obscode";
            // Link to patient
            ans ->  obs.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
            // Value
            ans ->  obs.value = (%ans.valueQuantity) as tgtObsVal,  tgtObsVal.code = (%ans.valueQuantity.unit),  tgtObsVal.system = 'http://unitsofmeasure.org' "setvalue";
            // Effective date from nested item
            ans.item as dateItem where (linkId = '941821315470') then {
              dateItem.answer as dateAns then {
                dateAns.value as val -> obs.effective = cast(val, 'dateTime') "seteffective";
              } "navDateAns";
            } "extracteffective";
          } "createheightobs";
        } "heightobsentry";
      } "extractheight";
      // Weight (linkId 451513217936)
      dossierGroup.item as weightItem where (linkId = '451513217936') then {
        weightItem.answer as ans -> bundle.entry as obsEntry then {
          ans -> obsEntry.resource = create('Observation') as obs then {
            ans -> obs.id = uuid() "obsid";
            ans ->  obs.id as obsId,  obsEntry.fullUrl = append('urn:uuid:', obsId) "setfullUrl";
            ans -> obs.meta = create('Meta') as meta then {
              ans -> meta.profile = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-observation-body-weight' "obsprofile";
            } "obsmeta";
            ans -> obs.status = 'final' "obsstatus";
            ans -> obs.category = cc('http://terminology.hl7.org/CodeSystem/observation-category', 'vital-signs') "obscategory";
            ans -> obs.code = cc('http://loinc.org', '29463-7', 'Body weight') "obscode";
            // Link to patient
            ans ->  obs.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
            // Value
            ans ->  obs.value = (%ans.valueQuantity) as tgtObsVal,  tgtObsVal.code = (%ans.valueQuantity.unit),  tgtObsVal.system = 'http://unitsofmeasure.org' "setvalue";
            // Effective date from nested item
            ans.item as dateItem where (linkId = '151269044052') then {
              dateItem.answer as dateAns then {
                dateAns.value as val -> obs.effective = cast(val, 'dateTime') "seteffective";
              } "navDateAns";
            } "extracteffective";
          } "createweightobs";
        } "weightobsentry";
      } "extractweight";
      // Blood Pressure - need both systolic and diastolic
      dossierGroup.item as sysItem where (linkId = '4160905247955') then {
        sysItem.answer as sysAns then {
          dossierGroup.item as diaItem where (linkId = '848797127998') then {
            diaItem.answer as diaAns -> bundle.entry as obsEntry then {
              sysAns -> obsEntry.resource = create('Observation') as obs then {
                sysAns -> obs.id = uuid() "obsid";
                sysAns ->  obs.id as obsId,  obsEntry.fullUrl = append('urn:uuid:', obsId) "setfullUrl";
                sysAns -> obs.meta = create('Meta') as meta then {
                  sysAns -> meta.profile = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/edsh-observation-blood-pressure' "obsprofile";
                } "obsmeta";
                sysAns -> obs.status = 'final' "obsstatus";
                sysAns -> obs.category = cc('http://terminology.hl7.org/CodeSystem/observation-category', 'vital-signs') "obscategory";
                sysAns -> obs.code = cc('http://loinc.org', '85354-9', 'Blood pressure panel') "obscode";
                // Link to patient
                sysAns ->  obs.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
                // Systolic component
                sysAns -> obs.component as sysComp then {
                  sysAns -> sysComp.code = cc('http://loinc.org', '8480-6', 'Systolic blood pressure') "syscode";
                  sysAns ->  sysComp.value = (%sysAns.valueQuantity) as sysVal,  sysVal.code = (%sysAns.valueQuantity.unit),  sysVal.system = 'http://unitsofmeasure.org' "sysvalue";
                } "setsystolic";
                // Diastolic component
                diaAns -> obs.component as diaComp then {
                  diaAns -> diaComp.code = cc('http://loinc.org', '8462-4', 'Diastolic blood pressure') "diacode";
                  diaAns ->  diaComp.value = (%diaAns.valueQuantity) as diaVal,  diaVal.code = (%diaAns.valueQuantity.unit),  diaVal.system = 'http://unitsofmeasure.org' "diavalue";
                } "setdiastolic";
                // Effective date from nested item
                sysAns.item as sysDateItem where (linkId = '987654638442') then {
                  sysDateItem.answer as dateAns then {
                    dateAns.value as val -> obs.effective = cast(val, 'dateTime') "seteffective";
                  } "navDateAns";
                } "navDate";
              } "createbpobs";
            } "bpobsentr";
          } "extractdiastolic";
        } "processsystolic";
      } "extractbloodpressure";
    } "processdossier";
  } "processexam";
}

// Group: Create Laboratory Observations
group CreateLaboratoryObservations(source src : QuestionnaireResponse, target patient : Patient, target bundle : Bundle) {
  // Biologie group (linkId 7702944131447)
  src.item as bioGroup where (linkId = '7702944131447') then {
    // Fonction rénale (linkId 5241323453538)
    bioGroup.item as renalGroup where (linkId = '5241323453538') then {
      // Urée (linkId 7169026818760)
      renalGroup.item as ureaItem where (linkId = '7169026818760') then {
        ureaItem.answer as ans -> bundle then CreateLabObservation(ans, ureaItem, patient, bundle) "createureaobs";
      } "extracturea";
      // Créatininémie (linkId 500408205043)
      renalGroup.item as creatItem where (linkId = '500408205043') then {
        creatItem.answer as ans -> bundle then CreateLabObservation(ans, creatItem, patient, bundle) "createcreatobs";
      } "extractcreat";
      // DFG (linkId 786621340679)
      renalGroup.item as dfgItem where (linkId = '786621340679') then {
        dfgItem.answer as ans -> bundle then CreateLabObservation(ans, dfgItem, patient, bundle) "createdfgobs";
      } "extractdfg";
    } "processrenal";
    // Hémogramme (linkId 419282985970)
    bioGroup.item as hemoGroup where (linkId = '419282985970') then {
      // Leucocytes (linkId 210077225604)
      hemoGroup.item as leukoItem where (linkId = '210077225604') then {
        leukoItem.answer as ans -> bundle then CreateLabObservation(ans, leukoItem, patient, bundle) "createleukoobs";
      } "extractleuko";
      // Hémoglobine (linkId 304159088493)
      hemoGroup.item as hemoItem where (linkId = '304159088493') then {
        hemoItem.answer as ans -> bundle then CreateLabObservation(ans, hemoItem, patient, bundle) "createhemoobs";
      } "extracthemo";
      // Hématocrite (linkId 813863316705)
      hemoGroup.item as hematItem where (linkId = '813863316705') then {
        hematItem.answer as ans -> bundle then CreateLabObservation(ans, hematItem, patient, bundle) "createhematobs";
      } "extracthemat";
      // Erythrocytes (linkId 459731866614)
      hemoGroup.item as eryItem where (linkId = '459731866614') then {
        eryItem.answer as ans -> bundle then CreateLabObservation(ans, eryItem, patient, bundle) "createeryobs";
      } "extractery";
      // VGM (linkId 163624088831)
      hemoGroup.item as vgmItem where (linkId = '163624088831') then {
        vgmItem.answer as ans -> bundle then CreateLabObservation(ans, vgmItem, patient, bundle) "createvgmobs";
      } "extractvgm";
      // Plaquettes (linkId 794156787471)
      hemoGroup.item as platItem where (linkId = '794156787471') then {
        platItem.answer as ans -> bundle then CreateLabObservation(ans, platItem, patient, bundle) "createplatobs";
      } "extractplat";
      // Neutrophiles (linkId 961905168477)
      hemoGroup.item as neutItem where (linkId = '961905168477') then {
        neutItem.answer as ans -> bundle then CreateLabObservation(ans, neutItem, patient, bundle) "createneutobs";
      } "extractneut";
      // Lymphocytes (linkId 695150914696)
      hemoGroup.item as lymphItem where (linkId = '695150914696') then {
        lymphItem.answer as ans -> bundle then CreateLabObservation(ans, lymphItem, patient, bundle) "createlymphobs";
      } "extractlymph";
      // Eosinophiles (linkId 700490326748)
      hemoGroup.item as eosiItem where (linkId = '700490326748') then {
        eosiItem.answer as ans -> bundle then CreateLabObservation(ans, eosiItem, patient, bundle) "createeosiobs";
      } "extracteosi";
      // Monocytes (linkId 168661900522)
      hemoGroup.item as monoItem where (linkId = '168661900522') then {
        monoItem.answer as ans -> bundle then CreateLabObservation(ans, monoItem, patient, bundle) "createmonoobs";
      } "extractmono";
      // TP (linkId 658898841893)
      hemoGroup.item as tpItem where (linkId = '658898841893') then {
        tpItem.answer as ans -> bundle then CreateLabObservation(ans, tpItem, patient, bundle) "createtpobs";
      } "extracttp";
      // TCA (linkId 795145096241)
      hemoGroup.item as tcaItem where (linkId = '795145096241') then {
        tcaItem.answer as ans -> bundle then CreateLabObservation(ans, tcaItem, patient, bundle) "createtcaobs";
      } "extracttca";
    } "processhemo";
    // Bilan hépatique (linkId 796308115381)
    bioGroup.item as liverGroup where (linkId = '796308115381') then {
      // ASAT (linkId 715226319725)
      liverGroup.item as asatItem where (linkId = '715226319725') then {
        asatItem.answer as ans -> bundle then CreateLabObservation(ans, asatItem, patient, bundle) "createasatobs";
      } "extractasat";
      // ALAT (linkId 876439410327)
      liverGroup.item as alatItem where (linkId = '876439410327') then {
        alatItem.answer as ans -> bundle then CreateLabObservation(ans, alatItem, patient, bundle) "createalatobs";
      } "extractalat";
      // GGT (linkId 287545455976)
      liverGroup.item as ggtItem where (linkId = '287545455976') then {
        ggtItem.answer as ans -> bundle then CreateLabObservation(ans, ggtItem, patient, bundle) "createggtobs";
      } "extractggt";
      // PAL (linkId 508269571594)
      liverGroup.item as palItem where (linkId = '508269571594') then {
        palItem.answer as ans -> bundle then CreateLabObservation(ans, palItem, patient, bundle) "createpalobs";
      } "extractpal";
      // Bilirubine totale (linkId 927344090061)
      liverGroup.item as bilTotItem where (linkId = '927344090061') then {
        bilTotItem.answer as ans -> bundle then CreateLabObservation(ans, bilTotItem, patient, bundle) "createbiltotobs";
      } "extractbiltot";
      // Bilirubine conjuguée (linkId 208196328453)
      liverGroup.item as bilConjItem where (linkId = '208196328453') then {
        bilConjItem.answer as ans -> bundle then CreateLabObservation(ans, bilConjItem, patient, bundle) "createbilconjobs";
      } "extractbilconj";
    } "processliver";
    // Métabolisme glucidique (linkId 334039497382)
    bioGroup.item as glucoseGroup where (linkId = '334039497382') then {
      // Glycémie à jeun (linkId 273778921448)
      glucoseGroup.item as glycItem where (linkId = '273778921448') then {
        glycItem.answer as ans -> bundle then CreateLabObservation(ans, glycItem, patient, bundle) "createglycobs";
      } "extractglyc";
      // HbA1c (linkId 632894677152)
      glucoseGroup.item as hba1cItem where (linkId = '632894677152') then {
        hba1cItem.answer as ans -> bundle then CreateLabObservation(ans, hba1cItem, patient, bundle) "createhba1cobs";
      } "extracthba1c";
    } "processglucose";
  } "processbiology";
}

// Helper: Create a single Laboratory Observation
group CreateLabObservation(source ans, source parentItem, target patient : Patient, target bundle : Bundle) {
  ans -> bundle.entry as obsEntry then {
    ans -> obsEntry.resource = create('Observation') as obs then {
      ans -> obs.id = uuid() "obsid";
      ans ->  obs.id as obsId,  obsEntry.fullUrl = append('urn:uuid:', obsId) "setfullUrl";
      ans -> obs.meta = create('Meta') as meta then {
        ans -> meta.profile = 'https://aphp.github.io/IG-FHIR-EDSH-SOCLE-COMMUN/StructureDefinition/dm-observation-laboratory-generic' "obsprofile";
      } "obsmeta";
      // Status
      ans -> obs.status = 'final' "obsstatus";
      // Category
      ans -> obs.category = create('CodeableConcept') as cat then {
        ans -> cat.coding = create('Coding') as coding then {
          ans -> coding.system = 'http://terminology.hl7.org/CodeSystem/observation-category' "catsystem";
          ans -> coding.code = 'laboratory' "catcode";
        } "setcategorycoding";
      } "setcategory";
      // Link to patient
      ans ->  obs.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
      // Value as Quantity
      ans ->  obs.value = (%ans.valueQuantity) as tgtObsVal,  tgtObsVal.code = (%ans.valueQuantity.unit),  tgtObsVal.system = 'http://unitsofmeasure.org' "setvalue";
      // Extract nested items - LOINC code, effective date, status, reference ranges
      // LOINC code
      ans.item as loincItem where (text.contains('code loinc')) then {
        loincItem.answer as loincAns ->  obs.code as code,  code.coding as coding,  coding.code = (%loincAns.valueString) "setloinccoding";
      } "extractloinc";
      // effectiveDateTime
      ans.item as dateItem where (text.contains('Date et heure du prélèvement')) then {
        dateItem.answer as dateAns -> obs.effective = (%dateAns.valueDateTime) "seteffective";
      } "extracteffective";
      // parentItem.item as statusItem where (linkId.contains('Statut de validation')) then {         statusItem.answer as statusAns -> obs.extension = create('Extension') as ext then {           statusAns -> ext.url = 'http://hl7.org/fhir/StructureDefinition/observation-status' "status-url";           statusAns -> ext.value = (%statusAns.valueString) "status-value";         } "set-status-ext";       } "extract-validation-status";
      // Reference ranges (low and high)
      ans -> obs.referenceRange as refRange then {
        ans.item as lowItem where (text.contains('Borne inférieure')) then {
          lowItem.answer as lowAns ->  refRange.low = (%lowAns.valueQuantity) as tgtLow,  tgtLow.code = (%ans.valueQuantity.unit),  tgtLow.system = 'http://unitsofmeasure.org' "setlow";
        } "extractlow";
        ans.item as highItem where (text.contains('Borne supérieure')) then {
          highItem.answer as highAns ->  refRange.high = (%highAns.valueQuantity) as tgtHigh,  tgtHigh.code = (%ans.valueQuantity.unit),  tgtHigh.system = 'http://unitsofmeasure.org' "sethigh";
        } "extracthigh";
      } "setrefrange";
    } "createobs";
  } "obsentry";
}