Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab vs http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities

Left:US Core Laboratory Result Observation Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab)
Right:Comorbidities Profile (http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities)

Messages

ErrorStructureDefinition.urlValues for url differ: 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab' vs 'http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities'
ErrorStructureDefinition.versionValues for version differ: '7.0.0-ballot' vs '4.0.0-ballot'
InformationStructureDefinition.nameValues for name differ: 'USCoreLaboratoryResultObservationProfile' vs 'Comorbidities'
InformationStructureDefinition.titleValues for title differ: 'US Core Laboratory Result Observation Profile' vs 'Comorbidities Profile'
InformationStructureDefinition.dateValues for date differ: '2023-10-17' vs '2024-04-09T21:21:25+00:00'
InformationStructureDefinition.publisherValues for publisher differ: 'HL7 International / Cross-Group Projects' vs 'HL7 International / Clinical Interoperability Council'
ErrorStructureDefinition.baseDefinitionValues for baseDefinition differ: 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-result' vs 'http://hl7.org/fhir/StructureDefinition/Observation'
InformationStructureDefinition.definitionValues for definition differ: '\-' vs 'Measurements and simple assertions made about a patient, device or other subject.'
InformationStructureDefinition.commentValues for comment differ: '\-' vs 'Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.'
InformationStructureDefinition.shortValues for short differ: 'Additional content defined by implementations' vs 'Extension'
InformationStructureDefinition.definitionValues for definition differ: 'May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'An Extension'
WarningObservation.extensionElements differ in definition for mustSupport: 'false' vs 'true'
WarningObservation.categoryElements differ in definition for mustSupport: 'true' vs 'false'
InformationObservation.categoryElement minimum cardinalities differ: '1' vs '0'
InformationStructureDefinition.shortValues for short differ: 'Laboratory Test Name' vs 'Type of observation (code / type)'
InformationStructureDefinition.definitionValues for definition differ: 'The name of the clinical test or procedure performed on a patient. A LOINC **SHALL** be used if the concept is present in LOINC.' vs 'Describes what was observed. Sometimes this is called the observation 'name'.'
InformationStructureDefinition.commentValues for comment differ: 'The typical patterns for codes are: 1) a LOINC code either as a translation from a 'local' code or as a primary code, or 2) a local code only if no suitable LOINC exists, or 3) both the local and the LOINC translation. Systems SHALL be capable of sending the local code if one exists. When using LOINC , Use either the SHORTNAME or LONG_COMMON_NAME field for the display.' vs '*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.'
InformationStructureDefinition.definitionValues for definition differ: 'The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation.' vs 'The patient whose comorbidities are recorded.'
InformationObservation.subjectElement minimum cardinalities differ: '1' vs '0'
InformationStructureDefinition.shortValues for short differ: 'What the observation is about, when it is not about the subject of record' vs 'The Index Condition'
InformationStructureDefinition.definitionValues for definition differ: 'The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.' vs 'Comorbid conditions are typically defined with respect to a specific 'index' condition. For example, the US Centers for Disease Control (CDC) has provided a list of comorbid conditions important to COVID-19. In this case, the focus would be COVID-19 and the comorbid condition categories would be those specified by CDC, namely obesity, renal disease, respiratory disease, etc.'
WarningObservation.focusElements differ in definition for mustSupport: 'false' vs 'true'
InformationStructureDefinition.shortValues for short differ: 'Encounter associated with Observation' vs 'Healthcare event during which this observation is made'
WarningObservation.encounterElements differ in definition for mustSupport: 'true' vs 'false'
InformationStructureDefinition.shortValues for short differ: 'Result Value' vs 'Actual result'
InformationStructureDefinition.definitionValues for definition differ: 'The Laboratory result value. If a coded value, the valueCodeableConcept.code **SHOULD** be selected from [SNOMED CT](http://hl7.org/fhir/ValueSet/uslab-obs-codedresults) if the concept exists. If a numeric value, valueQuantity.code **SHALL** be selected from [UCUM](http://unitsofmeasure.org). A FHIR [UCUM Codes value set](http://hl7.org/fhir/STU3/valueset-ucum-units.html) that defines all UCUM codes is in the FHIR specification.' vs 'Comorbidity score or risk index'
WarningObservation.value[x]Elements differ in definition for mustSupport: 'true' vs 'false'
WarningObservation.dataAbsentReasonElements differ in definition for mustSupport: 'true' vs 'false'
InformationStructureDefinition.shortValues for short differ: 'Result interpretation' vs 'High, low, normal, etc.'
InformationStructureDefinition.commentValues for comment differ: 'Categorical assessment of a laboratory value, often in relation to a test's reference range. Examples include but are not limited to high, low, critical, and normal.' vs 'Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.'
WarningObservation.interpretationElements differ in definition for mustSupport: 'true' vs 'false'
InformationStructureDefinition.shortValues for short differ: 'Observed body part' vs 'Not used in this profile'
InformationStructureDefinition.definitionValues for definition differ: 'Indicates the site on the subject's body where the observation was made (i.e. the target site).' vs 'Not used in this profile'
InformationStructureDefinition.shortValues for short differ: 'How it was done' vs 'Comorbidity framework used.'
InformationStructureDefinition.definitionValues for definition differ: 'Indicates the mechanism used to perform the observation.' vs 'The formal methodology used, such as Charlson, NCI, Elixhauser, or ACE-27. The method must be specified if a comorbidity index is specified, otherwise the index cannot be correctly interpreted.'
InformationStructureDefinition.shortValues for short differ: 'Specimen used for this observation' vs 'Not used in this profile'
InformationStructureDefinition.definitionValues for definition differ: 'The specimen that was used when this observation was made.' vs 'Not used in this profile'
WarningObservation.specimenElements differ in definition for mustSupport: 'true' vs 'false'
InformationStructureDefinition.shortValues for short differ: '(Measurement) Device' vs 'Not used in this profile'
InformationStructureDefinition.definitionValues for definition differ: 'The device used to generate the observation data.' vs 'Not used in this profile'
InformationStructureDefinition.shortValues for short differ: 'Result reference range' vs 'Provides guide for interpretation'
InformationStructureDefinition.commentValues for comment differ: 'Upper and lower limit of test values expected for a designated population of individuals. Reference range values may differ by patient characteristics, laboratory test manufacturer and laboratory test performer.' vs 'Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.'
WarningObservation.referenceRangeElements differ in definition for mustSupport: 'true' vs 'false'
InformationStructureDefinition.shortValues for short differ: 'Related resource that belongs to the Observation group' vs 'Not used in this profile'
InformationStructureDefinition.definitionValues for definition differ: 'This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.' vs 'Not used in this profile'
InformationStructureDefinition.shortValues for short differ: 'Component results' vs 'Not used in this profile'
InformationStructureDefinition.definitionValues for definition differ: 'Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.' vs 'Not used in this profile'

Metadata

NameValueComments
.abstractfalse
    .baseDefinitionhttp://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-clinical-resulthttp://hl7.org/fhir/StructureDefinition/Observation
    • Values Differ
    .copyrightUsed by permission of HL7 International, all rights reserved Creative Commons License
    • Removed the item 'Used by permission of HL7 International, all rights reserved Creative Commons License'
    .date2023-10-172024-04-09T21:21:25+00:00
    • Values Differ
    .descriptionThe US Core Laboratory Result Observation Profile is based upon the US Core Observation Clinical Result Profile and, along with the US Core DiagnosticReport Profile for Laboratory Results Reporting, meets the U.S. Core Data for Interoperability (USCDI) Laboratory requirements. Laboratory results are grouped and summarized using the DiagnosticReport resource, which references Observation resources. Each Observation resource represents an individual laboratory test and result value, a “nested” panel (such as a microbial susceptibility panel) that references other observations, or rarely a laboratory test with component result values. The US Core Laboratory Result Observation Profile sets minimum expectations for the Observation resource to record, search, and fetch laboratory test results associated with a patient to promote interoperability and adoption through common implementation. It identifies which core elements, extensions, vocabularies, and value sets SHALL be present in the resource and constrains the way the elements are used when using this profile. It provides the floor for standards development for specific use cases.General structure for capturing comorbid conditions with respect to a primary ('index') condition. The user can use this profile in three ways: (1) free-form, listing any conditions they wish to highlight as significant comorbidities, (2) following a formal paradigm such as the Charlson Comorbidity Index or the NCI Comorbidity Index, or (3) use disease categories defined for registry reporting purposes, such as those defined by Center for International Blood and Marrow Transplant Research (CIBMTR).
    • Values Differ
    .experimentalfalse
    • Removed the item 'false'
    .fhirVersion4.0.1
      .jurisdiction
        ..jurisdiction[0]urn:iso:std:iso:3166#US
          .kindresource
            .nameUSCoreLaboratoryResultObservationProfileComorbidities
            • Values Differ
            .publisherHL7 International / Cross-Group ProjectsHL7 International / Clinical Interoperability Council
            • Values Differ
            .purpose
              .statusactive
                .titleUS Core Laboratory Result Observation ProfileComorbidities Profile
                • Values Differ
                .typeObservation
                  .urlhttp://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-labhttp://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities
                  • Values Differ
                  .version7.0.0-ballot4.0.0-ballot
                  • Values Differ

                  Structure

                  NameL FlagsL Card.L TypeL Description & ConstraintsR FlagsR Card.R TypeR Description & ConstraintsCommentsdoco
                  .. Observation C0..*USCoreObservationClinicalResultProfileMeasurements and simple assertions
                  obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
                  obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
                  us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present
                  C0..*ObservationMeasurements and simple assertions
                  obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
                  obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
                    ... id Σ0..1idLogical id of this artifactΣ0..1idLogical id of this artifact
                      ... meta Σ0..1MetaMetadata about the resourceΣ0..1MetaMetadata about the resource
                        ... implicitRules ?!Σ0..1uriA set of rules under which this content was created?!Σ0..1uriA set of rules under which this content was created
                          ... language 0..1codeLanguage of the resource content
                          Binding: ?? (preferred): A human language.

                          Additional BindingsPurpose
                          ??Max Binding
                          0..1codeLanguage of the resource content
                          Binding: ?? (preferred): A human language.

                          Additional BindingsPurpose
                          ??Max Binding
                            ... text 0..1NarrativeText summary of the resource, for human interpretation0..1NarrativeText summary of the resource, for human interpretation
                              ... contained 0..*ResourceContained, inline Resources
                              0..*ResourceContained, inline Resources
                                ... extension 0..*ExtensionAdditional content defined by implementations
                                S0..*ExtensionExtension
                                Slice: Unordered, Open by value:url
                                • Elements differ in definition for mustSupport: 'false' vs 'true'
                                ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
                                ?!0..*ExtensionExtensions that cannot be ignored
                                  ... identifier Σ0..*IdentifierBusiness Identifier for observation
                                  Σ0..*IdentifierBusiness Identifier for observation
                                    ... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
                                    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
                                      Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
                                        ... status ?!SΣ1..1coderegistered | preliminary | final | amended +
                                        Binding: ?? (required): Codes providing the status of an observation.

                                        ?!SΣ1..1coderegistered | preliminary | final | amended +
                                        Binding: ?? (required): Codes providing the status of an observation.

                                          ... Slices for category S1..*CodeableConceptClassification of type of observation
                                          Slice: Unordered, Open by pattern:$this
                                          Binding: ?? (preferred): Codes for high level observation categories.


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


                                          • Elements differ in definition for mustSupport: 'true' vs 'false'
                                          • Element minimum cardinalities differ: '1' vs '0'
                                          ... code SΣ1..1CodeableConceptLaboratory Test Name
                                          Binding: ?? (extensible): Laboratory LOINC Codes

                                          SΣ1..1CodeableConceptType of observation (code / type)
                                          Binding: ?? (example): Codes identifying names of simple observations.


                                          Required Pattern: {"coding":[{"system":"http://snomed.info/sct","code":"398192003"}]}
                                            ... subject SΣ1..1Reference(US Core Patient Profile S | Group | Device | US Core Location Profile)Who and/or what the observation is aboutSΣ0..1Reference(Cancer Patient Profile)Who and/or what the observation is about
                                            • Element minimum cardinalities differ: '1' vs '0'
                                            ... focus Σ0..*Reference(Resource)What the observation is about, when it is not about the subject of record
                                            SΣ0..*Reference(Primary Cancer Condition Profile)The Index Condition
                                            • Elements differ in definition for mustSupport: 'false' vs 'true'
                                            ... encounter SΣ0..1Reference(US Core Encounter Profile)Encounter associated with ObservationΣ0..1Reference(Encounter)Healthcare event during which this observation is made
                                            • Elements differ in definition for mustSupport: 'true' vs 'false'
                                            ... effective[x] SΣC0..1dateTime S, Period, Timing, instantClinically relevant time/time-period for observation
                                            us-core-1: Datetime must be at least to day.
                                            SΣ0..1dateTime, Period, Timing, instantClinically relevant time/time-period for observation
                                              ... issued Σ0..1instantDate/Time this version was made availableΣ0..1instantDate/Time this version was made available
                                                ... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
                                                Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
                                                  ... value[x] SΣC0..1Quantity S, CodeableConcept S, string S, boolean, integer, Range, Ratio, SampledData, time, dateTime, PeriodResult Value
                                                  us-core-3: SHALL use UCUM for coded quantity units.
                                                  us-core-4: SHOULD use Snomed CT for coded Results
                                                  ΣC0..1Quantity, integerActual result
                                                  • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                  ... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
                                                  Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.

                                                  C0..1CodeableConceptWhy the result is missing
                                                  Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.

                                                  • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                  ... interpretation S0..*CodeableConceptResult interpretation
                                                  Binding: ?? (extensible): Observation Interpretation Codes


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


                                                  • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                  ... note 0..*AnnotationComments about the observation
                                                  0..*AnnotationComments about the observation
                                                    ... bodySite 0..1CodeableConceptObserved body part
                                                    Binding: ?? (example): Codes describing anatomical locations. May include laterality.

                                                    0..1CodeableConceptNot used in this profile
                                                    Binding: ?? (example): Codes describing anatomical locations. May include laterality.

                                                      ... method 0..1CodeableConceptHow it was done
                                                      Binding: ?? (example): Methods for simple observations.

                                                      0..1CodeableConceptComorbidity framework used.
                                                      Binding: ?? (example): Methods for simple observations.

                                                        ... specimen S0..1Reference(US Core Specimen Profile)Specimen used for this observation0..1Reference(Specimen)Not used in this profile
                                                        • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                        ... device 0..1Reference(Device | DeviceMetric)(Measurement) Device0..1Reference(Device | DeviceMetric)Not used in this profile
                                                          ... referenceRange SC0..*BackboneElementResult reference range
                                                          obs-3: Must have at least a low or a high or text
                                                          C0..*BackboneElementProvides guide for interpretation
                                                          obs-3: Must have at least a low or a high or text
                                                          • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                          .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                            .... extension 0..*ExtensionAdditional content defined by implementations
                                                            0..*ExtensionAdditional content defined by implementations
                                                              .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                              ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                .... low C0..1??Low Range, if relevantC0..1??Low Range, if relevant
                                                                  .... high C0..1??High Range, if relevantC0..1??High Range, if relevant
                                                                    .... type 0..1CodeableConceptReference range qualifier
                                                                    Binding: ?? (preferred): Code for the meaning of a reference range.

                                                                    0..1CodeableConceptReference range qualifier
                                                                    Binding: ?? (preferred): Code for the meaning of a reference range.

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


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


                                                                        .... age 0..1RangeApplicable age range, if relevant0..1RangeApplicable age range, if relevant
                                                                          .... text 0..1stringText based reference range in an observation0..1stringText based reference range in an observation
                                                                            ... hasMember Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Related resource that belongs to the Observation group
                                                                            Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Not used in this profile
                                                                              ... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from
                                                                              Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from
                                                                                ... component Σ0..*BackboneElementComponent results
                                                                                Σ0..*BackboneElementNot used in this profile
                                                                                  .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                                    .... extension 0..*ExtensionAdditional content defined by implementations
                                                                                    0..*ExtensionAdditional content defined by implementations
                                                                                      .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                      ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                                        .... code Σ1..1CodeableConceptType of component observation (code / type)
                                                                                        Binding: ?? (example): Codes identifying names of simple observations.

                                                                                        Σ1..1CodeableConceptType of component observation (code / type)
                                                                                        Binding: ?? (example): Codes identifying names of simple observations.

                                                                                          .... value[x] Σ0..1Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, PeriodActual component resultΣ0..1Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, PeriodActual component result
                                                                                            .... dataAbsentReason C0..1CodeableConceptWhy the component result is missing
                                                                                            Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.

                                                                                            C0..1CodeableConceptWhy the component result is missing
                                                                                            Binding: ?? (extensible): Codes specifying why the result (Observation.value[x]) is missing.

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


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


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

                                                                                                  doco Documentation for this format