minimal Common Oncology Data Elements (mCODE) Implementation Guide
3.0.0 - STU3 Release United States of America flag

minimal Common Oncology Data Elements (mCODE) Implementation Guide, published by HL7 International / Clinical Interoperability Council. This is not an authorized publication; it is the continuous build for version 3.0.0). This version is based on the current content of https://github.com/HL7/fhir-mCODE-ig/ and changes regularly. See the Directory of published versions

Resource Profile: TNM Stage Group Profile

Official URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tnm-stage-group Version: 3.0.0
Draft as of 2023-10-25 Maturity Level: 4 Computable Name: TNMStageGroup

Reporting of the stage group representing the overall extent of a cancer, based on AJCC staging guidelines.

Conformance

Observation resources associated with an in-scope patient with Observation.code of LOINC 21908-9, 21902-2, or 21914-7 SHALL conform to this profile. Beyond this requirement, a producer of resources SHOULD ensure that any resource instance associated with an mCODE patient that would reasonably be expected to conform to this profile SHOULD be published in this form.

Usage:

Formal Views of Profile Content

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

This structure is derived from CancerStage

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*CancerStageMeasurements and simple assertions
... code 1..1CodeableConceptThe type of stage information reported.
Binding: TNM Stage Group Staging Type Value Set (preferred)
Additional BindingsPurpose
TNM Stage Group Staging Type Maximum Value SetMax Binding
... focus 1..1Reference(Primary Cancer Condition Profile)The cancer condition associated with staging assessment.
... value[x] 0..1CodeableConceptThe stage group
Binding: TNM Stage Group Value Set (preferred)
Additional BindingsPurpose
TNM Stage Group Maximum Value SetMax Binding
... Slices for hasMember S0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
Slice: Unordered, Open by profile:$this.resolve()
.... hasMember:TNMCategory S0..3Reference(Observation | QuestionnaireResponse | MolecularSequence)Prognostic factors contributing to stage determination.
... component 0..*BackboneElementNot used in this profile

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Observation.codepreferredTNMStageGroupStagingTypeVS
Additional Bindings Purpose
TNM Stage Group Staging Type Maximum Value Set Max Binding
Observation.value[x]preferredTNMStageGroupVS
Additional Bindings Purpose
TNM Stage Group Maximum Value Set Max Binding
Observation.methodextensibleTNMStagingMethodVS
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*CancerStageMeasurements and simple assertions
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... subject SΣ0..1Reference(Cancer Patient Profile)Who and/or what the observation is about
... focus SΣ1..1Reference(Primary Cancer Condition Profile)The cancer condition associated with staging assessment.
... effective[x] SΣ0..1Clinically relevant time/time-period for observation
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
.... effectiveTimingTiming
.... effectiveInstantinstant
... value[x] SΣC0..1CodeableConceptThe stage group
Binding: TNM Stage Group Value Set (preferred)
Additional BindingsPurpose
TNM Stage Group Maximum Value SetMax Binding
... method S1..1CodeableConceptThe staging system used.
Binding: TNM Staging Method Value Set (extensible)
... Slices for hasMember SΣ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
Slice: Unordered, Open by profile:$this.resolve()
.... hasMember:TNMCategory SΣ0..3Reference(Observation | QuestionnaireResponse | MolecularSequence)Prognostic factors contributing to stage determination.
... component Σ0..*BackboneElementNot used in this profile
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Observation.statusrequiredObservationStatus
Observation.codepreferredTNMStageGroupStagingTypeVS
Additional Bindings Purpose
TNM Stage Group Staging Type Maximum Value Set Max Binding
Observation.value[x]preferredTNMStageGroupVS
Additional Bindings Purpose
TNM Stage Group Maximum Value Set Max Binding
Observation.methodextensibleTNMStagingMethodVS
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*CancerStageMeasurements and simple assertions
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... category 0..*CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


... code SΣ1..1CodeableConceptThe type of stage information reported.
Binding: TNM Stage Group Staging Type Value Set (preferred)
Additional BindingsPurpose
TNM Stage Group Staging Type Maximum Value SetMax Binding
... subject SΣ0..1Reference(Cancer Patient Profile)Who and/or what the observation is about
... focus SΣ1..1Reference(Primary Cancer Condition Profile)The cancer condition associated with staging assessment.
... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣ0..1Clinically relevant time/time-period for observation
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
.... effectiveTimingTiming
.... effectiveInstantinstant
... issued Σ0..1instantDate/Time this version was made available
... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣC0..1CodeableConceptThe stage group
Binding: TNM Stage Group Value Set (preferred)
Additional BindingsPurpose
TNM Stage Group Maximum Value SetMax Binding
... dataAbsentReason C0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..*AnnotationComments about the observation
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

... method S1..1CodeableConceptThe staging system used.
Binding: TNM Staging Method Value Set (extensible)
... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)Not used in this profile
... referenceRange C0..*BackboneElementNot used in this profile
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low C0..1SimpleQuantityLow Range, if relevant
.... high C0..1SimpleQuantityHigh Range, if relevant
.... type 0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... Slices for hasMember SΣ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
Slice: Unordered, Open by profile:$this.resolve()
.... hasMember:TNMCategory SΣ0..3Reference(Observation | QuestionnaireResponse | MolecularSequence)Prognostic factors contributing to stage determination.
... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from
... component Σ0..*BackboneElementNot used in this profile
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... value[x] Σ0..1Actual component result
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason C0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


.... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Observation.statusrequiredObservationStatus
Observation.categorypreferredObservationCategoryCodes
Observation.codepreferredTNMStageGroupStagingTypeVS
Additional Bindings Purpose
TNM Stage Group Staging Type Maximum Value Set Max Binding
Observation.value[x]preferredTNMStageGroupVS
Additional Bindings Purpose
TNM Stage Group Maximum Value Set Max Binding
Observation.dataAbsentReasonextensibleDataAbsentReason
Observation.interpretationextensibleObservationInterpretationCodes
Observation.bodySiteexampleSNOMEDCTBodyStructures
Observation.methodextensibleTNMStagingMethodVS
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationextensibleObservationInterpretationCodes

This structure is derived from CancerStage

Summary

Mandatory: 2 elements
Must-Support: 2 elements

Slices

This structure defines the following Slices:

  • The element Observation.hasMember is sliced based on the value of profile:$this.resolve()

Maturity: 4

Differential View

This structure is derived from CancerStage

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*CancerStageMeasurements and simple assertions
... code 1..1CodeableConceptThe type of stage information reported.
Binding: TNM Stage Group Staging Type Value Set (preferred)
Additional BindingsPurpose
TNM Stage Group Staging Type Maximum Value SetMax Binding
... focus 1..1Reference(Primary Cancer Condition Profile)The cancer condition associated with staging assessment.
... value[x] 0..1CodeableConceptThe stage group
Binding: TNM Stage Group Value Set (preferred)
Additional BindingsPurpose
TNM Stage Group Maximum Value SetMax Binding
... Slices for hasMember S0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
Slice: Unordered, Open by profile:$this.resolve()
.... hasMember:TNMCategory S0..3Reference(Observation | QuestionnaireResponse | MolecularSequence)Prognostic factors contributing to stage determination.
... component 0..*BackboneElementNot used in this profile

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Observation.codepreferredTNMStageGroupStagingTypeVS
Additional Bindings Purpose
TNM Stage Group Staging Type Maximum Value Set Max Binding
Observation.value[x]preferredTNMStageGroupVS
Additional Bindings Purpose
TNM Stage Group Maximum Value Set Max Binding
Observation.methodextensibleTNMStagingMethodVS

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*CancerStageMeasurements and simple assertions
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... subject SΣ0..1Reference(Cancer Patient Profile)Who and/or what the observation is about
... focus SΣ1..1Reference(Primary Cancer Condition Profile)The cancer condition associated with staging assessment.
... effective[x] SΣ0..1Clinically relevant time/time-period for observation
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
.... effectiveTimingTiming
.... effectiveInstantinstant
... value[x] SΣC0..1CodeableConceptThe stage group
Binding: TNM Stage Group Value Set (preferred)
Additional BindingsPurpose
TNM Stage Group Maximum Value SetMax Binding
... method S1..1CodeableConceptThe staging system used.
Binding: TNM Staging Method Value Set (extensible)
... Slices for hasMember SΣ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
Slice: Unordered, Open by profile:$this.resolve()
.... hasMember:TNMCategory SΣ0..3Reference(Observation | QuestionnaireResponse | MolecularSequence)Prognostic factors contributing to stage determination.
... component Σ0..*BackboneElementNot used in this profile
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Observation.statusrequiredObservationStatus
Observation.codepreferredTNMStageGroupStagingTypeVS
Additional Bindings Purpose
TNM Stage Group Staging Type Maximum Value Set Max Binding
Observation.value[x]preferredTNMStageGroupVS
Additional Bindings Purpose
TNM Stage Group Maximum Value Set Max Binding
Observation.methodextensibleTNMStagingMethodVS
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*CancerStageMeasurements and simple assertions
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... category 0..*CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


... code SΣ1..1CodeableConceptThe type of stage information reported.
Binding: TNM Stage Group Staging Type Value Set (preferred)
Additional BindingsPurpose
TNM Stage Group Staging Type Maximum Value SetMax Binding
... subject SΣ0..1Reference(Cancer Patient Profile)Who and/or what the observation is about
... focus SΣ1..1Reference(Primary Cancer Condition Profile)The cancer condition associated with staging assessment.
... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣ0..1Clinically relevant time/time-period for observation
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
.... effectiveTimingTiming
.... effectiveInstantinstant
... issued Σ0..1instantDate/Time this version was made available
... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣC0..1CodeableConceptThe stage group
Binding: TNM Stage Group Value Set (preferred)
Additional BindingsPurpose
TNM Stage Group Maximum Value SetMax Binding
... dataAbsentReason C0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..*AnnotationComments about the observation
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

... method S1..1CodeableConceptThe staging system used.
Binding: TNM Staging Method Value Set (extensible)
... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)Not used in this profile
... referenceRange C0..*BackboneElementNot used in this profile
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low C0..1SimpleQuantityLow Range, if relevant
.... high C0..1SimpleQuantityHigh Range, if relevant
.... type 0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... Slices for hasMember SΣ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
Slice: Unordered, Open by profile:$this.resolve()
.... hasMember:TNMCategory SΣ0..3Reference(Observation | QuestionnaireResponse | MolecularSequence)Prognostic factors contributing to stage determination.
... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from
... component Σ0..*BackboneElementNot used in this profile
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... value[x] Σ0..1Actual component result
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason C0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


.... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
AllLanguages Max Binding
Observation.statusrequiredObservationStatus
Observation.categorypreferredObservationCategoryCodes
Observation.codepreferredTNMStageGroupStagingTypeVS
Additional Bindings Purpose
TNM Stage Group Staging Type Maximum Value Set Max Binding
Observation.value[x]preferredTNMStageGroupVS
Additional Bindings Purpose
TNM Stage Group Maximum Value Set Max Binding
Observation.dataAbsentReasonextensibleDataAbsentReason
Observation.interpretationextensibleObservationInterpretationCodes
Observation.bodySiteexampleSNOMEDCTBodyStructures
Observation.methodextensibleTNMStagingMethodVS
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationextensibleObservationInterpretationCodes

This structure is derived from CancerStage

Summary

Mandatory: 2 elements
Must-Support: 2 elements

Slices

This structure defines the following Slices:

  • The element Observation.hasMember is sliced based on the value of profile:$this.resolve()

Maturity: 4

 

Other representations of profile: CSV, Excel, Schematron