archetype (adl_version=1.4; uid=8506814e-6017-4f12-a0ce-67f9d632b9ed)
	openEHR-EHR-CLUSTER.tos.v1

concept
	[at0000]	-- Tos Classification
language
	original_language = <[ISO_639-1::en]>
description
	original_author = <
		["name"] = <"Heather Leslie">
		["organisation"] = <"Ocean Informatics">
		["email"] = <"heather.leslie@oceaninformatics.com">
		["date"] = <"2013-01-14">
	>
	details = <
		["en"] = <
			language = <[ISO_639-1::en]>
			purpose = <"To record the grading of attic retraction of the tympanic membrane, based on the classification by Tos and Poulsen.">
			use = <"Use to record the grading of tympanic membrane retraction, particularly by specialist physicians. 

Designed to be optionally nested within the CLUSTER.exam_tympanic_membrane archetype to provide additional detail on tympanic membrane retraction, if it is useful within a given clinical scenario.

This archetype extends the Tos Classification to allow recording of Tos Grade 5 which is described in some documentation but is not described in the original paper and appears not to be in common usage.">
			keywords = <"retraction", "tympanic", "membrane", "pars flaccida", "attic", "drum">
			misuse = <"">
			copyright = <"© openEHR Foundation">
		>
	>
	lifecycle_state = <"published">
	other_contributors = <"Kerrie Lee, Australia", ...>
	other_details = <
		["licence"] = <"This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/.">
		["custodian_organisation"] = <"Ocean Informatics">
		["references"] = <"Tos M, Poulsen G. Attic retractions following secretory otitis. Acta Otolaryngol. 1980 May-Jun;89(5-6):479-86. PubMed PMID: 7192477.">
		["current_contact"] = <"Heather Leslie, Ocean Informatics, heather.leslie@oceaninformatics.com">
		["original_namespace"] = <"com.oceaninformatics">
		["original_publisher"] = <"Ocean Informatics">
		["custodian_namespace"] = <"com.oceaninformatics">
		["MD5-CAM-1.0.1"] = <"5D35C39402591C0DFB783A2E4FF6A24A">
		["build_uid"] = <"1f28294d-232a-46aa-8568-2b2841b85604">
		["revision"] = <"1.0.0">
	>

definition
	CLUSTER[at0000] matches {	-- Tos Classification
		items cardinality matches {1..*; unordered} matches {
			ELEMENT[at0001] occurrences matches {0..1} matches {	-- Tos Classification
				value matches {
					1|[local::at0002], 	-- Grade 1
					2|[local::at0003], 	-- Grade 2
					3|[local::at0004], 	-- Grade 3
					4|[local::at0005], 	-- Grade 4
					5|[local::at0006]  	-- Grade 5
				}
			}
		}
	}

ontology
	term_definitions = <
		["en"] = <
			items = <
				["at0000"] = <
					text = <"Tos Classification">
					description = <"A classification of the degree of tympanic membrane pars flaccida retraction, related to extent and severity and as described by Tos and Poulsen.">
				>
				["at0001"] = <
					text = <"Tos Classification">
					description = <"Grading of the degree of tympanic membrane pars tensa retraction / atelectasis based on the Tos & Poulson Classification.">
				>
				["at0002"] = <
					text = <"Grade 1">
					description = <"Pars flaccida is dimpled and is more retracted than normal. It is not adherent to the malleus (airspace visible).">
				>
				["at0003"] = <
					text = <"Grade 2">
					description = <"Retraction onto neck of malleus - no airspace visible behind membrane.">
				>
				["at0004"] = <
					text = <"Grade 3">
					description = <"Retraction extends beyond osseous malleus full extent seen.">
				>
				["at0005"] = <
					text = <"Grade 4">
					description = <"Erosion of outer attic wall. Part of the retraction pocket may be hidden.">
				>
				["at0006"] = <
					text = <"Grade 5">
					description = <"Bottom of the retraction pocket can be seen only by using an endoscope.">
				>
			>
		>
	>