{"id":"F2021L01910","name":"Statement of Principles concerning aortic stenosis (Reasonable Hypothesis) (No. 13 of 2022)","slug":"statement-of-principles-concerning-aortic-stenosis-reasonable-hypothesis-no-13-of-2022","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":441150,"registerId":"F2021L01910-fast-fetch-1775956527032","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning aortic stenosis (Reasonable Hypothesis) (No. 13 of 2022)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 20.2\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nAORTIC STENOSIS (Reasonable Hypothesis)\n\n(No. 13 of 2022)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n \n\nDated 24 December 2021\n\n \n\n \n\n \n\n \n\n \n\n| The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:
|\n| --- |\n|
Professor Terence Campbell AM
Chairperson
|\n\n\n \n\n \n\n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Repeal\n\n5 Application\n\n6 Definitions\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n8 Basis for determining the factors\n\n9 Factors that must exist\n\n10 Relationship to service\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nSchedule 1 - Dictionary\n\n1 Definitions\n\n \n\n\n\n\n1 Name\n\nThis is the Statement of Principles concerning aortic stenosis (Reasonable Hypothesis) (No. 13 of 2022).\n\n2 Commencement\n\n This instrument commences on 31 January 2022.\n\n3 Authority\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning aortic stenosis No. 21 of 2013 (Federal Register of Legislation No. F2013L00718) made under subsections 196B(2) and (8) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies.\n\n6 Definitions\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n(1) This Statement of Principles is about aortic stenosis and death from aortic stenosis.\n\nMeaning of aortic stenosis\n\n(2) For the purposes of this Statement of Principles, aortic stenosis:\n\n(a) means obstruction of the blood flow across the aortic valve due to thickening and calcification of the aortic valve; and\n\n(b) excludes:\n\n(i) aortic stenosis due to rheumatic heart disease;\n\n(ii) congenital stenosis of the aortic valve; and\n\n(iii) obstruction to blood flow across the aortic valve due to narrowing of the supravalvular or subvalvular regions.\n\nNote 1: Symptoms of aortic stenosis typically include shortness of breath or chest pain on exertion, dizziness and fainting (syncope).\n\nNote 2: Aortic stenosis is usually confirmed by echocardiography and demonstration of a significant pressure gradient (a maximum aortic velocity of at least 2 metres/second).\n\n(3) While aortic stenosis attracts ICD‑10‑AM code I35.0 or I35.2, in applying this Statement of Principles the meaning of aortic stenosis is that given in subsection (2).\n\n(4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.\n\nDeath from aortic stenosis\n\n(5) For the purposes of this Statement of Principles, aortic stenosis, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's aortic stenosis.\n\nNote: terminal event is defined in the Schedule 1 - Dictionary.\n\n8 Basis for determining the factors\n\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that aortic stenosis and death from aortic stenosis can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the MRCA.\n\nNote: MRCA, relevant service and VEA are defined in the Schedule 1 - Dictionary.\n\n9 Factors that must exist\n\nAt least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting aortic stenosis or death from aortic stenosis with the circumstances of a person's relevant service:\n\n(1) having infective endocarditis before the clinical onset of aortic stenosis;\n\n(2) having a systemic autoimmune connective tissue disease before the clinical onset of aortic stenosis;\n\nNote: Examples of systemic autoimmune connective tissue diseases are systemic lupus erythematosus, rheumatoid arthritis, scleroderma and Sjögren syndrome.\n\n(3) having chronic kidney disease at the time of the clinical onset of aortic stenosis;\n\nNote: chronic kidney disease is defined in the Schedule 1 - Dictionary.\n\n(4) having hypertension before the clinical onset of aortic stenosis;\n\n(5) having dyslipidaemia before the clinical onset of aortic stenosis;\n\nNote: dyslipidaemia is defined in the Schedule 1 - Dictionary.\n\n(6) having diabetes mellitus before the clinical onset of aortic stenosis;\n\n(7) being overweight or obese for at least 5 years within the 20 years before the clinical onset of aortic stenosis;\n\nNote: being overweight or obese is defined in the Schedule 1 - Dictionary.\n\n(8) having smoked tobacco products:\n\n(a) in amount of at least 10 pack-years before the clinical onset of aortic stenosis; and\n\n(b) if smoking has ceased before the clinical onset of aortic stenosis, then that onset occurred within 20 years of cessation;\n\nNote: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(9) having received a cumulative equivalent dose of at least 0.5 sievert of ionising radiation to the heart before the clinical onset of aortic stenosis;\n\nNote: cumulative equivalent dose is defined in the Schedule 1 - Dictionary.\n\n(10) undergoing a course of therapeutic radiation for cancer, where the heart was in the field of radiation, before the clinical onset of aortic stenosis;\n\n(11) having primary hyperparathyroidism before the clinical onset of aortic stenosis;\n\n(12) having Paget's disease of bone before the clinical onset of aortic stenosis;\n\n(13) having infective endocarditis before the clinical worsening of aortic stenosis;\n\n(14) having a systemic autoimmune connective tissue disease before the clinical worsening of aortic stenosis;\n\nNote: Examples of systemic autoimmune connective tissue diseases are systemic lupus erythematosus, rheumatoid arthritis, scleroderma and Sjögren syndrome.\n\n(15) having chronic kidney disease at the time of the clinical worsening of aortic stenosis;\n\nNote: chronic kidney disease is defined in the Schedule 1 - Dictionary.\n\n(16) having hypertension before the clinical worsening of aortic stenosis;\n\n(17) having dyslipidaemia before the clinical worsening of aortic stenosis;\n\nNote: dyslipidaemia is defined in the Schedule 1 - Dictionary.\n\n(18) having diabetes mellitus before the clinical worsening of aortic stenosis;\n\n(19) being overweight or obese for at least 5 years within the 20 years before the clinical worsening of aortic stenosis;\n\nNote: being overweight or obese is defined in the Schedule 1 - Dictionary.\n\n(20) having smoked tobacco products:\n\n(a) in amount of at least 10 pack-years before the clinical worsening of aortic stenosis; and\n\n(b) if smoking has ceased before the clinical worsening of aortic stenosis, then that worsening occurred within 20 years of cessation;\n\nNote: one pack-year is defined in the Schedule 1 - Dictionary.\n\n(21) having received a cumulative equivalent dose of at least 0.5 sievert of ionising radiation to the heart before the clinical worsening of aortic stenosis;\n\nNote: cumulative equivalent dose is defined in the Schedule 1 - Dictionary.\n\n(22) undergoing a course of therapeutic radiation for cancer, where the heart was in the field of radiation, before the clinical worsening of aortic stenosis;\n\n(23) having primary hyperparathyroidism before the clinical worsening of aortic stenosis;\n\n(24) having Paget's disease of bone before the clinical worsening of aortic stenosis;\n\n(25) being pregnant within the 6 weeks before the clinical worsening of aortic stenosis;\n\n(26) for symptomatic or severe aortic stenosis only, having surgery requiring a general, spinal or epidural anaesthetic within the 30 days before the clinical worsening of aortic stenosis;\n\nNote: severe aortic stenosis is defined in the Schedule 1 - Dictionary.\n\n(27) inability to obtain appropriate clinical management for aortic stenosis.\n\n10 Relationship to service\n\n(1) The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.\n\n(2) The factors set out in subsections 9(13) to 9(27) apply only to material contribution to, or aggravation of, aortic stenosis where the person's aortic stenosis was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nIn this Statement of Principles:\n\n(1) if a factor referred to in section 9 applies in relation to a person; and\n\n(2) that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(2) of the VEA;\n\nthen the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.\n\n \n\n \n\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\n albuminuria means an albumin to creatinine ratio of at least 3 mg/mmol.\n\n aortic stenosis—see subsection 7(2).\n\n being overweight or obese means:\n\n(a) having a Body Mass Index (BMI) of 25 or greater; or\n\n(b) for males, having a waist circumference exceeding 94 centimetres; or\n\n(c) for females, having a waist circumference exceeding 80 centimetres.\n\nNote: BMI is also defined in the Schedule 1 - Dictionary.\n\n BMI means W/H2 where:\n\n(a) W is the person's weight in kilograms; and\n\n(b) H is the person's height in metres.\n\n chronic kidney disease means:\n\n(a) having a glomerular filtration rate of less than 60 mL/min/1.73 m2 for at least 3 months; or\n\n(b) having albuminuria for at least 3 months; or\n\n(c) having kidney damage, as evidenced by renal biopsy, imaging studies, urinary sediment abnormalities or other markers of abnormal renal function; or\n\n(d) having had a kidney transplant.\n\nNote: albuminuria is also defined in the Schedule 1 - Dictionary.\n\ncumulative equivalent dose means the total dose of ionising radiation received by the particular organ or tissue from external exposure, internal exposure or both, apart from normal background radiation exposure in Australia, calculated in accordance with the methodology set out in Guide to calculation of 'cumulative equivalent dose' for the purpose of applying ionising radiation factors contained in Statements of Principles determined under Part XIA of the Veterans' Entitlements Act 1986 (Cth), Australian Radiation Protection and Nuclear Safety Agency, as in force on 2 August 2017.\n\nNote 1: Examples of circumstances that might lead to exposure to ionising radiation include being present during or subsequent to the testing or use of nuclear weapons, undergoing diagnostic or therapeutic medical procedures involving ionising radiation, and being a member of an aircrew, leading to increased levels of exposure to cosmic radiation.\n\nNote 2: For the purpose of dose reconstruction, dose is calculated as an average over the mass of a specific tissue or organ. If a tissue is exposed to multiple sources of ionising radiation, the various dose estimates for each type of radiation must be combined.\n\n dyslipidaemia means persistently abnormal blood lipid levels, diagnosed by a medical practitioner and evidenced by:\n\n(a) a serum high density lipoprotein cholesterol level less than 1.0 mmol/L; or\n\n(b) a serum low density lipoprotein level greater than 4.0 mmol/L; or\n\n(c) a serum triglyceride level greater than or equal to 2.0 mmol/L; or\n\n(d) a total serum cholesterol level greater than 5.5 mmol/L; or\n\n(e) the regular administration of drug therapy to normalise blood lipid levels.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n one pack-year means the amount of tobacco consumed in smoking 20 cigarettes per day for a period of 1 year, or an equivalent amount of tobacco products.\n\nNote 1: An equivalent amount of tobacco products is 7,300 grams of smoking tobacco by weight, either in cigarettes, pipe tobacco or cigars, or a combination of same. For pipe tobacco, cigars or combinations of multiple tobacco types, 1 gram of tobacco is considered to be equal to one cigarette.\n\nNote 2: Pack-years are calculated by dividing the number of cigarettes smoked per day by 20 and multiplying this number by the number of years the person has smoked. For example, smoking 10 cigarettes per day for 10 years is equal to 5 pack-years, and smoking 40 cigarettes per day for 10 years is equal to 20 pack-years.\n\n relevant service means:\n\n(a) operational service under the VEA;\n\n(b) peacekeeping service under the VEA;\n\n(c) hazardous service under the VEA;\n\n(d) British nuclear test defence service under the VEA;\n\n(e) warlike service under the MRCA; or\n\n(f) non-warlike service under the MRCA.\n\nNote: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\n severe aortic stenosis means:\n\n(a) a maximum aortic velocity of at least 4 metres/second; or\n\n(b) a mean pressure gradient of at least 40 mmHg, or\n\n(c) an aortic valve area of 1.0 centimetre2 or less.\n\n terminal event means the proximate or ultimate cause of death and includes the following:\n\n(a) pneumonia;\n\n(b) respiratory failure;\n\n(c) cardiac arrest;\n\n(d) circulatory failure; or\n\n(e) cessation of brain function.\n\n VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":4,"scope_assessment":{"changed":false,"description":"This is a standard replacement Statement of Principles under the veterans' compensation scheme, repealing the 2013 version (No. 21 of 2013). It maintains the established scope of determining medical eligibility for aortic stenosis claims under the 'reasonable hypothesis' standard. The structure and purpose align with the original legislative intent under Part XIA of the Veterans' Entitlements Act 1986."},"complexity_factors":["Multiple defined terms in Schedule 1 (approximately 12 technical definitions including 'cumulative equivalent dose', 'chronic kidney disease', 'dyslipidaemia')","Precise quantitative thresholds throughout (e.g., 'at least 0.5 sievert', 'at least 10 pack-years', 'BMI of 25 or greater', 'maximum aortic velocity of at least 4 metres/second')","Temporal requirements with specific windows (e.g., 'within 20 years before', 'within 6 weeks before', 'within 30 days before', 'for at least 5 years within the 20 years before')","Dual structure covering both 'clinical onset' (factors 1-12) and 'clinical worsening' (factors 13-27) with overlapping but not identical factor lists","Conditional logic in factor 26 limiting application to 'symptomatic or severe aortic stenosis only'","Cross-reference to external documents (ICD-10-AM Tenth Edition, ARPANSA Guide to calculation of cumulative equivalent dose)","Nested definitions (e.g., 'albuminuria' defined separately and then used in 'chronic kidney disease' definition)","Section 11 creates dynamic incorporation of other Statements of Principles by reference ('as in force from time to time')"],"plain_english_summary":"This Statement of Principles sets medical criteria for when a reasonable hypothesis exists that aortic stenosis was caused or worsened by Australian military service — the lower evidentiary test used in veterans’ compensation. It lists specific medical factors (e.g., endocarditis, autoimmune disease, CKD, cardiovascular risk factors, certain radiation or cancer treatments, obesity, smoking) and defines terms, notes exclusions (rheumatic or congenital causes), and thus guides eligibility for veterans, peacekeepers and current/former defence members."},"flash_summary":{"complexity_score":5,"scope_assessment":{"changed":true,"description":"This instrument replaces the 2013 Statement of Principles for aortic stenosis (section 4) and, relative to the earlier instrument, appears to broaden the set of explicit factors and to add clearer exposure thresholds and temporal rules. Concrete expansions include: explicit radiation dose criteria (cumulative equivalent dose ≥ 0.5 sievert) and therapeutic radiation to the heart (sections 9(9), 9(10), 9(21), 9(22)); inclusion of pregnancy within six weeks before clinical worsening (s9(25)); a surgical/anaesthetic proximate trigger for worsening for symptomatic/severe cases (s9(26)); and a non-clinical factor \"inability to obtain appropriate clinical management\" (s9(27)). The instrument also separates factors that establish onset from those that establish material contribution or aggravation when the condition existed before or during service (see s10). These additions broaden the practical pathways by which a claimant can meet the medical causation test and therefore expand the SOP’s operational scope."},"complexity_factors":["27 enumerated factors in section 9 (split between factors before clinical onset and before clinical worsening)","13+ defined terms in Schedule 1 (e.g. chronic kidney disease, dyslipidaemia, cumulative equivalent dose, pack-year, severe aortic stenosis)","Temporal distinctions and conditional logic (\"before clinical onset\" v. \"before clinical worsening\"; special application rules in section 10)","Cross-references to other Statements of Principles where a listed factor is itself covered by another SOP (section 11)","Technical/measurement thresholds requiring specialist evidence (e.g. cumulative equivalent dose ≥ 0.5 sievert; BMI and waist measures; pack-year calculations)","Inclusion of both clinical triggers (e.g. infective endocarditis) and non-clinical/adjudicative factors (\"inability to obtain appropriate clinical management\") that require different evidentiary approaches","Repeal and replacement of a prior SOP (section 4) — requires mapping changes from earlier instrument for consistent application"],"plain_english_summary":"**What this instrument does (mechanics)\n\n- This is a \"Statement of Principles\" (SOP) made by the Repatriation Medical Authority under the Veterans' Entitlements Act. It replaces the earlier aortic stenosis SOP that was made in 2013 (see section 4). It commenced on 31 January 2022 (section 2).\n\n- The SOP sets out the medical findings and the specific factors that, if present and related to a person’s relevant service, are sufficient to raise a \"reasonable hypothesis\" that that person’s aortic stenosis (or death from it) is connected with their service. It applies to claims under the VEA or the Military Rehabilitation and Compensation Act as specified (section 5).\n\n- The SOP defines what is meant by \"aortic stenosis\" for these purposes, and specifically excludes stenosis caused by rheumatic heart disease, congenital valve stenosis, and supravalvular/subvalvular obstructions (section 7(2)). It also treats death from a terminal event that was contributed to by aortic stenosis as part of the condition (section 7(5)).\n\n- The SOP lists the medical and exposure factors that can establish the reasonable hypothesis. At least one of those factors must be present and must be related to the veteran’s relevant service (section 9 and section 10).\n\nKey factors that can establish the link (summary of section 9)\n\n- Pre-existing or preceding medical conditions: infective endocarditis (before onset), systemic autoimmune connective tissue disease (e.g. lupus, rheumatoid arthritis), chronic kidney disease, hypertension, dyslipidaemia, diabetes mellitus, primary hyperparathyroidism, Paget’s disease of bone.\n\n- Lifestyle and biometric factors: overweight/obesity (BMI ≥25 or waist thresholds) for at least 5 years within the 20 years before clinical onset, and smoking of at least 10 pack-years (and if smoking stopped, onset/worsening must be within 20 years of cessation).\n\n- Radiation exposures: a cumulative equivalent dose of at least 0.5 sievert to the heart, or therapeutic radiation courses where the heart was in the radiation field.\n\n- Events proximate to clinical worsening: infective endocarditis, autoimmune disease, chronic kidney disease, hypertension, dyslipidaemia, diabetes, overweight/obesity, smoking, radiation exposures, pregnancy within 6 weeks before clinical worsening, and (for symptomatic or severe aortic stenosis only) surgery with general/spinal/epidural anaesthetic within 30 days before clinical worsening.\n\n- A non-clinical factor: inability to obtain appropriate clinical management for aortic stenosis (listed at s9(27)).\n\nCross-references and definitions\n\n- Several medical and technical terms are defined in the Schedule (for example: chronic kidney disease, dyslipidaemia, pack‑years, cumulative equivalent dose, severe aortic stenosis). The SOP also says that where a listed factor refers to a condition already covered by another SOP, that other SOP applies to that factor as it operates from time to time (section 11).\n\nWhat the SOP claims as its basis (the authority’s view)\n\n- The Repatriation Medical Authority states it has sound medical‑scientific evidence that aortic stenosis and death from it can be related to relevant service (section 8). The SOP therefore records the factual criteria the decision-maker should use to decide whether a reasonable hypothesis is raised.\n\nHow this matters in practice (who decides, who pays, and what changes)\n\n- Who decides: decision-makers in the Department of Veterans’ Affairs or under the MRCA use this SOP as the medical framework to determine whether a reasonable hypothesis exists linking aortic stenosis to service (see sections 5, 8, 9 and 10). The SOP does not itself grant benefits; it informs the medical causation test used in claims processing.\n\n- Who pays: if the SOP supports a reasonable hypothesis and the other legal elements of an entitlement claim are met, the department (and ultimately the Commonwealth budget) meets approved medical and compensation entitlements under the VEA or MRCA.\n\n- Behavioural and administrative effects: the SOP specifies measurable criteria (e.g. radiation dose threshold; BMI/waist thresholds; pack‑year cut-off; time limits after smoking cessation). That narrows factual enquiries but increases the need for medical records, occupational/service exposure records (particularly for radiation dose reconstruction), and evidence of timing (onset vs worsening). The inclusion of \"inability to obtain appropriate clinical management\" introduces a non-medical evidentiary line that will require adjudication of access to care.\n\nAnalytical test of the SOP’s claims and trade-offs\n\n- Costs and incentives: by listing multiple risk factors and explicit exposure thresholds (e.g. 0.5 sievert), the SOP can increase the number of claims that meet the medical threshold, which raises administrative workload for the decision-maker and potentially financial exposure for the department. The SOP concentrates benefits on claimants who can document one or more of the listed factors; costs (administration and possible increases in approvals) are borne by the Commonwealth.\n\n- Evidentiary and implementation risks: verifying some factors is straightforward (documented diagnoses like diabetes or CKD); some are harder—reconstructing cumulative cardiac radiation dose requires specialist dose-reconstruction using ARPANSA methodology (see Schedule definition of cumulative equivalent dose); documenting long-term overweight/obesity or historical pack-years depends on historical medical and lifestyle records. The temporal rules (pre-onset vs pre-worsening, and the special rules in s10 about material contribution/aggravation) create additional complexity in adjudication.\n\n- Incentives for claimants and providers: claimants are incentivised to produce records that prove a listed factor or to argue that service caused or materially contributed to a listed factor. Medical and occupational evidence from treating practitioners and exposure specialists will become more important.\n\n- Interactions with other SOPs: where a factor itself is covered by another SOP, that other SOP governs (section 11), which increases cross-referencing and potential for layered assessments.\n\nBottom line\n\n- Mechanically, the SOP lists specific medical and exposure factors and precise definitions that, if present and service-related, are sufficient to raise a reasonable hypothesis that aortic stenosis (or death from it) is related to service. That standard guides administrative decisions on veterans’ entitlement claims. The SOP narrows the medical test into concrete, evidence-based lines of enquiry, but it also creates practical evidentiary and dose-reconstruction burdens that decision-makers and claimants must meet (see sections 7–11 and the Dictionary)."},"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-aortic-stenosis-reasonable-hypothesis-no-13-of-2022","history":"/api/acts/statement-of-principles-concerning-aortic-stenosis-reasonable-hypothesis-no-13-of-2022/history","analysis":"/api/acts/statement-of-principles-concerning-aortic-stenosis-reasonable-hypothesis-no-13-of-2022/analysis","conflicts":"/api/acts/statement-of-principles-concerning-aortic-stenosis-reasonable-hypothesis-no-13-of-2022/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-aortic-stenosis-reasonable-hypothesis-no-13-of-2022/important-cases","documents":"/api/acts/statement-of-principles-concerning-aortic-stenosis-reasonable-hypothesis-no-13-of-2022/documents"}}