ICHOM Patient Centered Outcomes Measure Set for Breast Cancer
1.0.0 - trial-use

ICHOM Patient Centered Outcomes Measure Set for Breast Cancer, published by HL7 International - Clinical Interoperability Council Group. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/fhir-ichom-breast-cancer-ig/ and changes regularly. See the Directory of published versions

## Resource Profile: Cancer Stage Group ( Experimental )

Official URL: http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/breast-cancer-stage-group | Version: 1.0.0
Standards status: Informative | Computable Name: BreastCancerStageGroup

A staging system to describe the amount and spread of breast cancer in a patient’s body, using TNM staging (per AJCC 8th Ed.). This profile is in alignment with the mCODE TNM Stage Group Profile.

Usage:

- Examples for this Resource Profile: Observation/ClinicalTNMStagePatient147 and Observation/PathologicalTNMStagePatient147

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Differential Table
- Key Elements Table
- Snapshot Table
- Statistics/References
- All

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation |  | 0..* | Observation | Measurements and simple assertions
code | S | 1..1 | CodeableConcept | Type of observation (code / type) Binding: Staging Type for Stage Group ValueSet (required)
subject | S | 0..1 | Reference(Breast cancer patient) | Who and/or what the observation is about
Slices for hasMember | S | 0..* | Reference(Observation) | Related resource that belongs to the Observation group Slice: Unordered, Open by pattern:$this.resolve().code
hasMember:TNMPrimaryTumorStage | S | 0..1 | Reference(TNM Primary Tumor Stage) | TNM Primary Tumor Stage
hasMember:TNMRegionalNodalStage | S | 0..1 | Reference(TNM Regional Nodal Stage) | TNM Regional Nodal Stage
hasMember:TNMDistantMetastases | S | 0..1 | Reference(TNM Distant Metastases) | TNM Distant Metastases
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet
Observation.code | required | TNMStageGroupVS

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: Staging Type for Stage Group ValueSet (required)
subject | S Σ | 0..1 | Reference(Breast cancer patient) | Who and/or what the observation is about
Slices for hasMember | S Σ | 0..* | Reference(Observation) | Related resource that belongs to the Observation group Slice: Unordered, Open by pattern:$this.resolve().code
hasMember:TNMPrimaryTumorStage | S Σ | 0..1 | Reference(TNM Primary Tumor Stage) | TNM Primary Tumor Stage
hasMember:TNMRegionalNodalStage | S Σ | 0..1 | Reference(TNM Regional Nodal Stage) | TNM Regional Nodal Stage
hasMember:TNMDistantMetastases | S Σ | 0..1 | Reference(TNM Distant Metastases) | TNM Distant Metastases
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet
Observation.status | required | ObservationStatus
Observation.code | required | TNMStageGroupVS

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business Identifier for observation
basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event
status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category |  | 0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: Staging Type for Stage Group ValueSet (required)
subject | S Σ | 0..1 | Reference(Breast cancer patient) | Who and/or what the observation is about
focus | Σ TU | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
encounter | Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made
effective[x] | Σ | 0..1 |  | Clinically relevant time/time-period for observation
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
effectiveInstant |  |  | instant |
issued | Σ | 0..1 | instant | Date/Time this version was made available
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
value[x] | Σ C | 0..1 |  | Actual result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note |  | 0..* | Annotation | Comments about the observation
bodySite |  | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method |  | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen |  | 0..1 | Reference(Specimen) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
referenceRange | C | 0..* | BackboneElement | Provides guide for interpretation
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | C | 0..1 | SimpleQuantity | Low Range, if relevant
high | C | 0..1 | SimpleQuantity | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
Slices for hasMember | S Σ | 0..* | Reference(Observation) | Related resource that belongs to the Observation group Slice: Unordered, Open by pattern:$this.resolve().code
hasMember:TNMPrimaryTumorStage | S Σ | 0..1 | Reference(TNM Primary Tumor Stage) | TNM Primary Tumor Stage
hasMember:TNMRegionalNodalStage | S Σ | 0..1 | Reference(TNM Regional Nodal Stage) | TNM Regional Nodal Stage
hasMember:TNMDistantMetastases | S Σ | 0..1 | Reference(TNM Distant Metastases) | TNM Distant Metastases
derivedFrom | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from
component | Σ | 0..* | BackboneElement | Component results
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 0..1 |  | Actual component result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet
Observation.language | preferred | CommonLanguages
Additional Bindings | Purpose
AllLanguages | Max Binding
Observation.status | required | ObservationStatus
Observation.category | preferred | ObservationCategoryCodes
Observation.code | required | TNMStageGroupVS
Observation.dataAbsentReason | extensible | DataAbsentReason
Observation.interpretation | extensible | ObservationInterpretationCodes
Observation.bodySite | example | SNOMEDCTBodyStructures
Observation.method | example | ObservationMethods
Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodes
Observation.component.code | example | LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason | extensible | DataAbsentReason
Observation.component.interpretation | extensible | ObservationInterpretationCodes

This structure is derived from Observation

Summary

Must-Support: 6 elements

Structures

This structure refers to these other structures:

- Breast cancer patient (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/patient)
- TNM Primary Tumor Stage (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/tnm-primary-tumor-stage)
- TNM Regional Nodal Stage (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/tnm-regional-nodes-stage)
- TNM Distant Metastases (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/tnm-distant-metastases)

Slices

This structure defines the following Slices:

- The element Observation.hasMember is sliced based on the value of pattern:$this.resolve().code

Differential View

This structure is derived from Observation

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation |  | 0..* | Observation | Measurements and simple assertions
code | S | 1..1 | CodeableConcept | Type of observation (code / type) Binding: Staging Type for Stage Group ValueSet (required)
subject | S | 0..1 | Reference(Breast cancer patient) | Who and/or what the observation is about
Slices for hasMember | S | 0..* | Reference(Observation) | Related resource that belongs to the Observation group Slice: Unordered, Open by pattern:$this.resolve().code
hasMember:TNMPrimaryTumorStage | S | 0..1 | Reference(TNM Primary Tumor Stage) | TNM Primary Tumor Stage
hasMember:TNMRegionalNodalStage | S | 0..1 | Reference(TNM Regional Nodal Stage) | TNM Regional Nodal Stage
hasMember:TNMDistantMetastases | S | 0..1 | Reference(TNM Distant Metastases) | TNM Distant Metastases
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet
Observation.code | required | TNMStageGroupVS

Key Elements View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: Staging Type for Stage Group ValueSet (required)
subject | S Σ | 0..1 | Reference(Breast cancer patient) | Who and/or what the observation is about
Slices for hasMember | S Σ | 0..* | Reference(Observation) | Related resource that belongs to the Observation group Slice: Unordered, Open by pattern:$this.resolve().code
hasMember:TNMPrimaryTumorStage | S Σ | 0..1 | Reference(TNM Primary Tumor Stage) | TNM Primary Tumor Stage
hasMember:TNMRegionalNodalStage | S Σ | 0..1 | Reference(TNM Regional Nodal Stage) | TNM Regional Nodal Stage
hasMember:TNMDistantMetastases | S Σ | 0..1 | Reference(TNM Distant Metastases) | TNM Distant Metastases
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet
Observation.status | required | ObservationStatus
Observation.code | required | TNMStageGroupVS

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
Observation | C | 0..* | Observation | Measurements and simple assertions
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | Business Identifier for observation
basedOn | Σ | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order
partOf | Σ | 0..* | Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) | Part of referenced event
status | ?!Σ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category |  | 0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code | S Σ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: Staging Type for Stage Group ValueSet (required)
subject | S Σ | 0..1 | Reference(Breast cancer patient) | Who and/or what the observation is about
focus | Σ TU | 0..* | Reference(Resource) | What the observation is about, when it is not about the subject of record
encounter | Σ | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made
effective[x] | Σ | 0..1 |  | Clinically relevant time/time-period for observation
effectiveDateTime |  |  | dateTime |
effectivePeriod |  |  | Period |
effectiveTiming |  |  | Timing |
effectiveInstant |  |  | instant |
issued | Σ | 0..1 | instant | Date/Time this version was made available
performer | Σ | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation
value[x] | Σ C | 0..1 |  | Actual result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note |  | 0..* | Annotation | Comments about the observation
bodySite |  | 0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method |  | 0..1 | CodeableConcept | How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen |  | 0..1 | Reference(Specimen) | Specimen used for this observation
device |  | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device
referenceRange | C | 0..* | BackboneElement | Provides guide for interpretation
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
low | C | 0..1 | SimpleQuantity | Low Range, if relevant
high | C | 0..1 | SimpleQuantity | High Range, if relevant
type |  | 0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo |  | 0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age |  | 0..1 | Range | Applicable age range, if relevant
text |  | 0..1 | string | Text based reference range in an observation
Slices for hasMember | S Σ | 0..* | Reference(Observation) | Related resource that belongs to the Observation group Slice: Unordered, Open by pattern:$this.resolve().code
hasMember:TNMPrimaryTumorStage | S Σ | 0..1 | Reference(TNM Primary Tumor Stage) | TNM Primary Tumor Stage
hasMember:TNMRegionalNodalStage | S Σ | 0..1 | Reference(TNM Regional Nodal Stage) | TNM Regional Nodal Stage
hasMember:TNMDistantMetastases | S Σ | 0..1 | Reference(TNM Distant Metastases) | TNM Distant Metastases
derivedFrom | Σ | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from
component | Σ | 0..* | BackboneElement | Component results
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x] | Σ | 0..1 |  | Actual component result
valueQuantity |  |  | Quantity |
valueCodeableConcept |  |  | CodeableConcept |
valueString |  |  | string |
valueBoolean |  |  | boolean |
valueInteger |  |  | integer |
valueRange |  |  | Range |
valueRatio |  |  | Ratio |
valueSampledData |  |  | SampledData |
valueTime |  |  | time |
valueDateTime |  |  | dateTime |
valuePeriod |  |  | Period |
dataAbsentReason | C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation |  | 0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange |  | 0..* | See referenceRange (Observation) | Provides guide for interpretation of component result
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet
Observation.language | preferred | CommonLanguages
Additional Bindings | Purpose
AllLanguages | Max Binding
Observation.status | required | ObservationStatus
Observation.category | preferred | ObservationCategoryCodes
Observation.code | required | TNMStageGroupVS
Observation.dataAbsentReason | extensible | DataAbsentReason
Observation.interpretation | extensible | ObservationInterpretationCodes
Observation.bodySite | example | SNOMEDCTBodyStructures
Observation.method | example | ObservationMethods
Observation.referenceRange.type | preferred | ObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesTo | example | ObservationReferenceRangeAppliesToCodes
Observation.component.code | example | LOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReason | extensible | DataAbsentReason
Observation.component.interpretation | extensible | ObservationInterpretationCodes

This structure is derived from Observation

Summary

Must-Support: 6 elements

Structures

This structure refers to these other structures:

- Breast cancer patient (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/patient)
- TNM Primary Tumor Stage (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/tnm-primary-tumor-stage)
- TNM Regional Nodal Stage (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/tnm-regional-nodes-stage)
- TNM Distant Metastases (http://hl7.org/fhir/uv/ichom-breast-cancer/StructureDefinition/tnm-distant-metastases)

Slices

This structure defines the following Slices:

- The element Observation.hasMember is sliced based on the value of pattern:$this.resolve().code

Other representations of profile: CSV, Excel, Schematron