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Risk Assessments

Risk assessments (FHIR RiskAssessment) capture the results of clinical risk evaluations. They record the method used, the predictions made, and any recommended mitigation actions.

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Create a Risk Assessment

const { data: risk } = await clinik.riskAssessments.create({
  status: 'final',
  patientId: 'pt_abc123',
  performerId: 'prac_def456',
  method: 'Framingham Risk Score',
  code: 'cardiovascular-risk',
  conditionId: 'cond_hypertension',
  prediction: [
    {
      outcome: 'Myocardial infarction',
      probabilityDecimal: 0.12,
      qualitativeRisk: 'moderate',
      rationale: '10-year ASCVD risk based on age, cholesterol, blood pressure, smoking status',
    },
  ],
  mitigation: 'Start statin therapy. Lifestyle modifications recommended.',
  reasonCode: ['Hypertension', 'Hyperlipidemia'],
});

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Common Use Cases

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Cardiovascular Risk Score

const { data } = await clinik.riskAssessments.create({
  status: 'final',
  patientId: 'pt_abc123',
  performerId: 'prac_cardiologist',
  method: 'ASCVD Pooled Cohort Equations',
  code: '10-year-ascvd-risk',
  prediction: [
    {
      outcome: 'Atherosclerotic cardiovascular disease event',
      probabilityDecimal: 0.15,
      qualitativeRisk: 'high',
      rationale: 'Age 62, male, total cholesterol 240, HDL 38, systolic BP 148, on BP meds, non-diabetic, smoker',
    },
  ],
  mitigation: 'High-intensity statin therapy. Smoking cessation counseling. Blood pressure optimization.',
});

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Fall Risk Assessment

const { data } = await clinik.riskAssessments.create({
  status: 'final',
  patientId: 'pt_elderly',
  performerId: 'prac_nurse',
  method: 'Morse Fall Scale',
  code: 'fall-risk',
  prediction: [
    {
      outcome: 'Fall',
      qualitativeRisk: 'high',
      rationale: 'Score 55: history of falling, secondary diagnosis, ambulatory aid, IV therapy, impaired gait',
    },
  ],
  mitigation: 'Fall precautions: bed alarm, non-slip footwear, call light within reach, hourly rounding',
});

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Cancer Screening Risk

const { data } = await clinik.riskAssessments.create({
  status: 'final',
  patientId: 'pt_abc123',
  performerId: 'prac_oncologist',
  method: 'Gail Model',
  code: 'breast-cancer-risk',
  prediction: [
    {
      outcome: 'Invasive breast cancer',
      probabilityDecimal: 0.023,
      qualitativeRisk: 'moderate',
      relativeRisk: 1.8,
      rationale: '5-year risk based on age, family history, reproductive history, prior biopsies',
    },
  ],
  mitigation: 'Annual mammography. Consider MRI screening. Discuss chemoprevention options.',
  reasonCode: ['Family history of breast cancer', 'Prior atypical ductal hyperplasia'],
});

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Update Predictions

const { data } = await clinik.riskAssessments.update(risk.id, {
  status: 'amended',
  prediction: [
    {
      outcome: 'Myocardial infarction',
      probabilityDecimal: 0.08,
      qualitativeRisk: 'moderate',
      rationale: 'Revised after 6 months of statin therapy and lifestyle changes',
    },
  ],
  mitigation: 'Continue current statin therapy. Reassess in 6 months.',
});

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Search Risk Assessments

const { data } = await clinik.riskAssessments.search({
  patientId: 'pt_abc123',
  status: 'final',
  method: 'Framingham',
});