HEARTLAND Protocol

HEARTLAND Protocol FHIR Implementation Guide
0.3.0 - United States of America flag

HEARTLAND FHIR candidate 0.3.0 — draft, experimental R4 4.0.1 reference. Prepared for technical review; not evidence of clinical validation or vendor interoperability.

: HEARTLAND Evidence Level

Draft as of 2026-09-29

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/heartland-evidence-level> a fhir:CodeSystem ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "heartland-evidence-level"] ;
  fhir:Resource.language [ fhir:value "en"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem heartland-evidence-level</b></p><a name=\"heartland-evidence-level\"> </a><a name=\"hcheartland-evidence-level\"> </a><p>This case-sensitive code system <code>https://fhir.heartlandprotocol.org/CodeSystem/heartland-evidence-level</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">established<a name=\"heartland-evidence-level-established\"> </a></td><td>Established Evidence</td><td>Interventions with strong guideline support, such as SGLT2i for all HF phenotypes endorsed by the 2022 AHA/ACC/HFSA guideline.</td></tr><tr><td style=\"white-space:nowrap\">emerging<a name=\"heartland-evidence-level-emerging\"> </a></td><td>Emerging Evidence</td><td>Recent trial findings not yet fully incorporated into guidelines, such as finerenone for HFpEF based on the FINEARTS-HF trial.</td></tr><tr><td style=\"white-space:nowrap\">pragmatic<a name=\"heartland-evidence-level-pragmatic\"> </a></td><td>Pragmatic Heuristic</td><td>Tools developed for clinical utility without formal statistical validation, such as the HEARTLAND Risk Score itself.</td></tr></table></div>"
  ] ;
  fhir:CodeSystem.url [ fhir:value "https://fhir.heartlandprotocol.org/CodeSystem/heartland-evidence-level"] ;
  fhir:CodeSystem.version [ fhir:value "0.3.0"] ;
  fhir:CodeSystem.name [ fhir:value "HeartlandEvidenceLevel"] ;
  fhir:CodeSystem.title [ fhir:value "HEARTLAND Evidence Level"] ;
  fhir:CodeSystem.status [ fhir:value "draft"] ;
  fhir:CodeSystem.experimental [ fhir:value "true"^^xsd:boolean] ;
  fhir:CodeSystem.date [ fhir:value "2026-09-29T19:00:36-04:00"^^xsd:dateTime] ;
  fhir:CodeSystem.publisher [ fhir:value "Vicky Muller Ferreira, MD"] ;
  fhir:CodeSystem.contact [
     fhir:index -1 ;
     fhir:ContactDetail.name [ fhir:value "Vicky Muller Ferreira, MD" ] ;
     fhir:ContactDetail.telecom [
       fhir:index -1 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "https://heartlandprotocol.org" ]
     ], [
       fhir:index -1 ;
       fhir:ContactPoint.system [ fhir:value "email" ] ;
       fhir:ContactPoint.value [ fhir:value "vickymuller@heartlandprotocol.org" ]
     ]
  ], [
     fhir:index -1 ;
     fhir:ContactDetail.name [ fhir:value "Vicky Muller Ferreira, MD" ] ;
     fhir:ContactDetail.telecom [
       fhir:index -1 ;
       fhir:ContactPoint.system [ fhir:value "email" ] ;
       fhir:ContactPoint.value [ fhir:value "vickymuller@heartlandprotocol.org" ] ;
       fhir:ContactPoint.use [ fhir:value "work" ]
     ], [
       fhir:index -1 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "https://heartlandprotocol.org" ]
     ]
  ] ;
  fhir:CodeSystem.description [ fhir:value "Three-tiered transparency labels distinguishing evidence strength behind HEARTLAND Protocol v3.2 recommendations, helping clinicians calibrate clinical decisions."] ;
  fhir:CodeSystem.jurisdiction [
     fhir:index -1 ;
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ] ;
       fhir:Coding.code [ fhir:value "US" ]
     ]
  ] ;
  fhir:CodeSystem.copyright [ fhir:value "CC-BY 4.0"] ;
  fhir:CodeSystem.caseSensitive [ fhir:value "true"^^xsd:boolean] ;
  fhir:CodeSystem.content [ fhir:value "complete"] ;
  fhir:CodeSystem.count [ fhir:value "3"^^xsd:nonNegativeInteger] ;
  fhir:CodeSystem.concept [
     fhir:index -1 ;
     fhir:CodeSystem.concept.code [ fhir:value "established" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Established Evidence" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Interventions with strong guideline support, such as SGLT2i for all HF phenotypes endorsed by the 2022 AHA/ACC/HFSA guideline." ]
  ], [
     fhir:index -1 ;
     fhir:CodeSystem.concept.code [ fhir:value "emerging" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Emerging Evidence" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Recent trial findings not yet fully incorporated into guidelines, such as finerenone for HFpEF based on the FINEARTS-HF trial." ]
  ], [
     fhir:index -1 ;
     fhir:CodeSystem.concept.code [ fhir:value "pragmatic" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Pragmatic Heuristic" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Tools developed for clinical utility without formal statistical validation, such as the HEARTLAND Risk Score itself." ]
  ] .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/heartland-evidence-level.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/CodeSystem/heartland-evidence-level.ttl> .