Skip to main content
DataCrafters synthetic data · demonstration

Staff surface Definitions and reviews

Definition library

Every executable definition, side-panel definition and catalogue entry, in three groups by the licence of its source, with its threshold in our own words and the source it is cited to. All are drafts pending review; a definition shows as reviewed only when both a clinical and a coding approval are recorded. Default set library_default_set@1.1.

Local criteria: site choices among published definitions and named local variants of the side-panel definitions, each with a change record, two approvals and an outcome preview.

Coder worklist

Setting: show extended capabilities on clinician screens

Current on clinician screens: Off (default) When on, findings from extended definitions appear on the side panel and the per-note screen under their own heading, after the core findings. Off or on, every check runs and replays the same, and the coder view shows both groups. The guided demo's four cases are unaffected.

CDI or coding staff can change this setting: switch the demo user.

Licence status

Thresholds are stated in our own words. Verbatim text is kept only from U.S. government works and openly licensed (CC BY) sources, with the attribution the licence asks for; copyrighted guidelines are cited by title, body and year, with a locator. No endorsement by the cited bodies is implied. This is not legal advice: counsel should review before commercial release.

Cancer-treatment adverse-event grading scale (NCI CTCAE): off by default

CTCAE grades describe adverse events in people receiving cancer treatment, usually in trials; they are not diagnostic criteria, and several grades depend on the laboratory reference range or on clinical descriptors that are not encoded. Using them outside that setting is a local decision for the clinical reviewer.

Current: Off (default) When on, grading entries are shown only as "another published definition gives …" or as values needing clinical judgement; they never raise a "not stated" item.

CDI or coding staff can change this setting. A clinician account records clinical reviews; a coding or documentation account records coding reviews: switch the demo user.

6 of 75 entries shown · open an entry for its source, threshold and review.

Heart failure category by LVEF: HFrEF, HFmrEF, HFpEF, HFimpEF (Universal Definition 2021) uhf2021_hf_ef_category@1.0 1 Open licence (CC BY) Draft · pending review draft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft — requires clinical and coding review)
Condition
Heart failure (EF category)
Tier
1
Licence
Open licence (CC BY)
Source checked
opened on 2026-11-14: PMC9254673 opened 2026-11-14 in the resourcing build: reduced 40% or lower, mildly reduced 41% to 49%, preserved 50% or higher, improved = baseline 40% or lower, rise of 10 points or more, second above 40%; matches the categories. CC BY 4.0 licence line read on the page.
Use here
default set (heart_failure_ef)
Edition
2021 universal definition (as restated in 2022) (2021) (a newer edition exists)
Second source
none opened · not found: The co-published Eur J Heart Fail 2021;23:352-380 abstract (PMID:33605000) states the same cut-offs but is the same document, not an independent source. The 2022 AHA/ACC/HFSA guideline abstract does not state them; its full text was not opened.
Contested
no: The same cut-offs appear in the co-published Eur J Heart Fail and J Card Fail versions; some guidelines describe HFmrEF differently in wording only (not opened).

Clinical implications of the universal definition for the prevention and treatment of heart failure

uhf2021_hf_ef_category@1.0

In our words: Reduced ejection fraction: 40% or lower. Mildly reduced: 41% to 49%. Preserved: 50% or higher. Improved: an earlier ejection fraction of 40% or lower, a later one above 40%, and a rise of at least 10 points. Applies only once heart failure is diagnosed (2021 edition).

HFrEF, LVEF ≤ 40%; HF with mildly reduced ejection fraction (HFmrEF), LVEF of 41%–to 49%; ... HFpEF, LVEF ≥ 50%; and HF with improved ejection fraction (HFimpEF): baseline LVEF ≤ 40% with ≥10‐pt increase from baseline and second LVEF > 40%.

Chandramouli C, Stewart S, Almahmeed W, Lam CSP (Clin Cardiol 2022;45(Suppl 1):S2-S12, doi:10.1002/clc.23842) (2022) · Section 1.3 'New universal definition' (LVEF classification; Figure 2) · source

open licence: CC BY 4.0, attribution: Chandramouli C, Stewart S, Almahmeed W, Lam CSP. Clinical implications of the universal definition for the prevention and treatment of heart failure. Clin Cardiol 2022;45(Suppl 1):S2-S12, doi:10.1002/clc.23842. Licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). No endorsement by the cited bodies is implied.

See also:
  • Universal Definition and Classification of Heart Failure, HFSA, HFA-ESC and JHFS (J Card Fail 2021;27:387-413; Eur J Heart Fail 2021;23:352-380) (2021), Abstract · link — earlier primary of this entry; numbers restated; text not reproduced
  • Second Universal Definition of Heart Failure, AHA/ACC/ESC/WHF (Eur Heart J 2026;47:4357-74) (2026) — not opened; reported (secondary summary) to drop fixed cut-offs between reduced and preserved EF
  • Accelerating heart failure research, National Heart, Lung, and Blood Institute (2022) · link — federal cross-check; uses below 40% (not 40% or lower) for reduced EF; not used for the bands
  • ICD-10-CM FY2027 tabular list (I50.2-, I50.3-), CDC/NCHS (2026), I50.2-, I50.3- · link — coding terms: reduced EF under systolic HF, preserved EF under diastolic HF; no index entry for mildly reduced or improved EF

Review

Reviewed only when both a clinical review and a coding review are recorded as approved.

Clinical review: none recorded yet.

Coding review: none recorded yet.

Heart failure acuity: indicators in the record (evidence only; acuity is a clinical judgement) front_hf_acuity_indicators@1.0 evidence_only Open licence (CC BY) Draft · pending review draft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft)
Condition
Heart failure
Tier
evidence_only
Licence
Open licence (CC BY)
To confirm
  • To confirm with a clinician: the one-week weight comparison (a weight 5 to 9 days before the latest) and the 14-day window for documented symptoms are local conventions.
Source checked
opened on 2026-11-14: Opened the editorial: decompensated heart failure is described as needing escalated care or rescue therapy; it gives no natriuretic peptide cut-off, so none is shown.
Use here
evidence only (not executed)
Edition
2026

The second universal definition of heart failure (2026). What's new?

front_hf_acuity_indicators@1.0

In our words: Acuity (acute, chronic, acute on chronic) is a clinical judgement. Documented symptoms, natriuretic peptide results, weights and intravenous diuretic orders are shown for review; no threshold is applied and no acuity is concluded.

Biegus J, Ponikowski P (ESC Heart Failure) (2026) · section on decompensated heart failure · source

open licence: CC BY 4.0, attribution: Biegus J, Ponikowski P. The second universal definition of heart failure (2026). What's new? ESC Heart Fail 2026;13(5):xvag240. doi:10.1093/eschf/xvag240. Licensed under the Creative Commons Attribution licence. No endorsement by the cited bodies is implied.

See also:
  • Second universal definition of heart failure, Walsh MN et al. (Eur Heart J) (2026) — consensus document, not opened; licence not checked

Review

Reviewed only when both a clinical review and a coding review are recorded as approved.

Clinical review: none recorded yet.

Coding review: none recorded yet.

Heart failure type by ejection fraction (four categories, 2021 universal definition as restated in 2022) front_hf_ef_type@1.0 judgement Open licence (CC BY) Draft · pending review draft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft)
Condition
Heart failure
Tier
judgement
Licence
Open licence (CC BY)
To confirm
  • To confirm with a clinician: the boundary wording at exactly 40%. This file reads reduced as 40% or lower (the openly licensed source); the federal cross-check says below 40%. A reported 40% is shown as reduced.
  • To confirm with a clinician: the improved-category baseline rule. The baseline is the first earlier ejection fraction of 40% or lower on file and the comparison value is the latest; another reading (lowest earlier value, or the value just before the latest) can give a different answer.
  • To confirm with a clinician: whether the 2021 categories should stay the shown edition now that a 2026 edition reportedly drops fixed cut-offs between reduced and preserved.
Source checked
opened on 2026-11-14: Opened the article page (section 1.3, New universal definition). Each threshold checked against the page: 40% or lower; 41% to 49%; 50% or higher; improved = baseline 40% or lower, a rise of at least 10 points and a second value above 40%. All four match this file's thresholds and boundary tests.
Use here
front condition (side panel options)
Edition
2022
Why not executable
The 2021 categories are shown as the 2021 edition. A 2026 second universal definition reportedly drops fixed cut-offs between reduced and preserved ejection fraction while keeping the improved category (summary of an openly licensed editorial; the consensus document itself was not opened). Clinical decision needed before release. A federal cross-check (NHLBI, 2022) describes reduced ejection fraction as below 40%, not 40% or lower: the boundary at exactly 40% differs between sources.

Clinical implications of the universal definition for the prevention and treatment of heart failure

front_hf_ef_type@1.0

In our words: Reduced ejection fraction: 40% or lower. Mildly reduced: 41% to 49%. Preserved: 50% or higher. Improved: an earlier ejection fraction of 40% or lower, a later one above 40%, and a rise of at least 10 points. (2021 edition, as restated in an openly licensed 2022 paper.)

HFrEF, LVEF ≤ 40%

Chandramouli C, Stewart S, Almahmeed W, Lam CSP (Clinical Cardiology) (2022) · Section 1.3 'New universal definition' (classification by left ventricular ejection fraction) · source

open licence: CC BY 4.0, attribution: Chandramouli C, Stewart S, Almahmeed W, Lam CSP. Clinical implications of the universal definition for the prevention and treatment of heart failure. Clin Cardiol 2022;45(Suppl 1):S2-S12. doi:10.1002/clc.23842. Licensed under CC BY 4.0. No endorsement by the cited bodies is implied.

See also:
  • Universal definition and classification of heart failure, Bozkurt B et al. (J Card Fail / Eur J Heart Fail) (2021), classification by ejection fraction — society consensus (no open licence seen); numbers restated; text not reproduced
  • Second universal definition of heart failure, Walsh MN et al. (Eur Heart J) (2026) — newer edition, not opened; reportedly drops fixed cut-offs between reduced and preserved; numbers not used
  • Accelerating heart failure research, National Heart, Lung, and Blood Institute (2022), description of reduced ejection fraction · link — federal cross-check only; describes reduced ejection fraction as below 40% (boundary at exactly 40% differs)
  • ICD-10-CM FY2027 tabular list and index, CDC National Center for Health Statistics (2026), I50.2-, I50.3- · link — coder reference only; no index entry for mildly reduced or improved ejection fraction

Review

Reviewed only when both a clinical review and a coding review are recorded as approved.

Clinical review: none recorded yet.

Coding review: none recorded yet.

Adult malnutrition: global consensus criteria (alternative definition; shown in the details, not executed) front_malnutrition_global_consensus@1.0 alternative Open licence (CC BY) Draft · pending review draft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft)
Condition
Malnutrition
Tier
alternative
Licence
Open licence (CC BY)
To confirm
  • To confirm with a clinician and the dietitian lead: whether this definition is shown at all to VA users, who were trained on the US consensus characteristics; it is shown only in the library and, with extended capabilities on, as another published definition in the card's details.
Source checked
opened on 2026-11-14: Opened Tables 3 and 4: weight loss over 5% within 6 months or over 10% beyond; intake 50% or less of requirement for over a week or any reduction for over 2 weeks; severe stage over 10% within 6 months or over 20% beyond, body-mass index below 18.5 under 70 or below 20 at 70 and over. All match the paraphrase.
Use here
alternative definition (shown, not executed)
Edition
2019

GLIM criteria for the diagnosis of malnutrition: a consensus report from the global clinical nutrition community

front_malnutrition_global_consensus@1.0

In our words: Global consensus: at least one physical finding (weight loss over 5% in 6 months or over 10% over a longer period; low body-mass index; reduced muscle mass) and one cause (eating half or less of needs for over a week, or less than usual for over 2 weeks, or a condition affecting absorption; inflammation). Severe: weight loss over 10% in 6 months or over 20% over a longer period, or a body-mass index below 18.5 under age 70 or below 20 at 70 and over.

Cederholm T et al. (Journal of Cachexia, Sarcopenia and Muscle) (2019) · Tables 3 and 4 · source

open licence: CC BY 4.0, attribution: Cederholm T et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. J Cachexia Sarcopenia Muscle 2019;10(1):207-217. doi:10.1002/jcsm.12383. Licensed under CC BY 4.0. No endorsement by the cited bodies is implied.

See also:
  • GLIM criteria for the diagnosis of malnutrition, Cederholm T et al. (Clin Nutr; JPEN) (2019) — original publications; no open licence seen; not quoted

Review

Reviewed only when both a clinical review and a coding review are recorded as approved.

Clinical review: none recorded yet.

Coding review: none recorded yet.

Malnutrition (GLIM criteria) glim2019_malnutrition catalogue Open licence (CC BY) Draft · pending review draft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft — requires clinical and coding review)
Condition
Malnutrition
Tier
2
Licence
Open licence (CC BY)
Source checked
opened on 2026-11-14: PMC6438340 opened 2026-11-14 in the resourcing build: Table 3, Table 4 and section 3.8 read; CC BY 4.0 licence line read. The intake criterion is at or below 50% (the earlier entry said 50%).
Use here
catalogue (not executable)
Edition
2019
Why not executable
Diagnosis needs at least one phenotypic and one etiologic criterion. Reduced muscle mass needs a validated body-composition method or examination, and the etiologic criteria (reduced intake or assimilation, inflammation from acute or chronic disease) are clinical judgements. GLIM also requires prior risk screening. Numbers alone cannot decide it.

GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community

glim2019_malnutrition

In our words: GLIM: at least one physical finding (weight loss over 5% in 6 months or over 10% longer; low BMI; low muscle mass) and one cause (eating half or less of needs for over a week, or less for over 2 weeks; inflammation). Severe: weight loss over 10% in 6 months or over 20% longer, or BMI below 18.5 under 70 / below 20 at 70 and over.

>5% within past 6 months, or>10% beyond 6 months | <20 if <70 years, or <22 if >70 years | Asia: <18.5 if <70 years, or <20 if >70 years | ≤50% of ER >1 week, or any reduction for >2 weeks

Cederholm T et al., GLIM Core Leadership Committee and Working Group (J Cachexia Sarcopenia Muscle 2019;10(1):207-217, doi:10.1002/jcsm.12383) (2019) · Table 3 (phenotypic and etiologic criteria); Table 4 (severity); section 3.8 (diagnosis rule) · source

open licence: CC BY 4.0, attribution: Cederholm T et al. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. J Cachexia Sarcopenia Muscle 2019;10(1):207-217, doi:10.1002/jcsm.12383. Licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). No endorsement by the cited bodies is implied.

See also:
  • GLIM criteria for the diagnosis of malnutrition, GLIM (Clin Nutr 2019;38:1-9; JPEN 2019) (2019) · link — original publications; no open licence per Europe PMC
  • GLIM five-year update, GLIM (2025) — summary only; not opened

Review

Reviewed only when both a clinical review and a coding review are recorded as approved.

Clinical review: none recorded yet.

Coding review: none recorded yet.

Heart failure acuity and stage uhf2021_hf_acuity_and_stage catalogue Open licence (CC BY) Draft · pending review draft — pending clinical and coding review
Status
draft — pending clinical and coding review (draft — requires clinical and coding review)
Condition
Heart failure acuity
Tier
2
Licence
Open licence (CC BY)
Source checked
opened on 2026-11-14: PMC9254673 opened 2026-11-14: stages and trajectory terms read in sections 1.3 and 2.4.
Use here
catalogue (not executable)
Edition
2022
Why not executable
The universal definition's stages (at risk, pre-HF, HF, advanced HF) and acuity or trajectory (new onset, worsening, persistent, in remission) depend on symptoms, signs, structural disease and response to therapy. Only the EF category is numeric and is executable as uhf2021_hf_ef_category.

Clinical implications of the universal definition for the prevention and treatment of heart failure

uhf2021_hf_acuity_and_stage

In our words: Stage (at risk, pre-HF, HF, advanced HF) and acuity are clinical judgements; the record values are shown for review.

at risk for HF, pre‐HF, HF, and advanced HF in place of the previous stages A–D

Chandramouli C, Stewart S, Almahmeed W, Lam CSP (Clin Cardiol 2022;45(Suppl 1):S2-S12, doi:10.1002/clc.23842) (2022) · Section 1.3 'New universal definition' (stages); section 2.4 (trajectory terms) · source

open licence: CC BY 4.0, attribution: Chandramouli C, Stewart S, Almahmeed W, Lam CSP. Clinical implications of the universal definition for the prevention and treatment of heart failure. Clin Cardiol 2022;45(Suppl 1):S2-S12, doi:10.1002/clc.23842. Licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). No endorsement by the cited bodies is implied.

See also:
  • The second universal definition of heart failure (2026). What's new?, Biegus J, Ponikowski P (ESC Heart Fail 2026;13(5):xvag240) (2026) · link — edition note: CC BY editorial; not opened in this build (captcha); reported to prefer 'decompensated HF' defined by escalated care
  • Universal Definition and Classification of Heart Failure, HFSA, HFA-ESC and JHFS (J Card Fail 2021;27:387-413) (2021) · link — earlier primary; text not reproduced

Review

Reviewed only when both a clinical review and a coding review are recorded as approved.

Clinical review: none recorded yet.

Coding review: none recorded yet.