Genomics Reporting Implementation Guide
4.0.0-cibuild - CI Build

Genomics Reporting Implementation Guide, published by HL7 International / Clinical Genomics. This guide is not an authorized publication; it is the continuous build for version 4.0.0-cibuild built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/genomics-reporting/ and changes regularly. See the Directory of published versions

## Resource Profile: Variant - Detailed Descriptions

Page standards status: Trial-use | Maturity Level: 2

Definitions for the variant resource profile.

- Key Elements Table
- Differential Elements Table
- Snapshot Elements Table

Guidance on how to interpret the contents of this table can be foundhere

0. Observation
Definition | Measurements and simple assertions made about a patient, device or other subject.
Short | VariantMeasurements and simple assertions
Comments | 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.
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Vital Signs, Measurement, Results, Tests
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (`dataAbsentReason.empty() or value.empty()`) 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 (`value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()`) obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty()) 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 (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
2. Observation.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Observation.extension:secondary-finding
Slice Name | secondary-finding
Definition | Secondary findings are genetic test results that provide information about variants in a gene unrelated to the primary purpose for the testing, most often discovered when Whole Exome Sequencing (WES) or Whole Genome Sequencing (WGS) is performed. This extension should be used to denote when a genetic finding is being shared as a secondary finding, and ideally refer to a corresponding guideline or policy statement. For more detail, please see: https://ghr.nlm.nih.gov/primer/testing/secondaryfindings.
Short | Secondary findings are genetic test results that provide information about variants in a gene unrelated to the primary purpose for the testing, most often discovered when [Whole Exome Sequencing (WES)](https://en.wikipedia.org/wiki/Exome_sequencing) or [Whole Genome Sequencing (WGS)](https://en.wikipedia.org/wiki/Whole_genome_sequencing) is performed. This extension should be used to denote when a genetic finding is being shared as a secondary finding, and ideally refer to a corresponding guideline or policy statement. For more detail, please see: https://ghr.nlm.nih.gov/primer/testing/secondaryfindings
Control | 0..1
Type | Extension(Observation Secondary Finding) (Extension Type: CodeableConcept)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Observation.extension:body-structure
Slice Name | body-structure
Definition | Record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.
Short | Target anatomic location or structure
Control | 0..1
Type | Extension(BodyStructure Reference) (Extension Type: Reference(BodyStructure))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. Observation.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. Observation.status
Definition | The status of the result value.
Short | registered | preliminary | final | amended +
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 (required to `http://hl7.org/fhir/ValueSet/observation-status|4.0.1` ) Codes providing the status of an observation.
Type | code
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to track the status of individual results. Some results are finalized before the whole report is finalized.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. Observation.category
Definition | A code that classifies the general type of observation being made.
Short | Classification of type of observation
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 20..*
Binding | The codes SHOULD be taken from ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/observation-category|4.0.1` ) Codes for high level observation categories.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Observation.category`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ coding
14. Observation.category:labCategory
Slice Name | labCategory
Definition | A code that classifies the general type of observation being made.
Short | Classification of type of observation
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 10..1*
Binding | The codes SHOULD be taken from ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/observation-category|4.0.1` ) Codes for high level observation categories.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. Observation.category:labCategory.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 10..1*
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Pattern Value | `{ "system" : "http://terminology.hl7.org/CodeSystem/observation-category", "code" : "laboratory" }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. Observation.category:geCategory
Slice Name | geCategory
Definition | A code that classifies the general type of observation being made.
Short | Classification of type of observation
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 10..1*
Binding | The codes SHOULD be taken from ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category|4.0.1 (preferred to `http://hl7.org/fhir/ValueSet/observation-category|4.0.1` ) Codes for high level observation categories.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Observation.category:geCategory.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 10..1*
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Pattern Value | `{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0074", "code" : "GE" }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. Observation.code
Definition | Describes what was observed. Sometimes this is called the observation "name".
Short | 69548-6Type of observation (code / type)
Comments | 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.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Alternate Names | Name
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "69548-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. Observation.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual result
Comments | An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: obs-7
Type | Choice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Observation.value[x]`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
26. Observation.value[x]:valueCodeableConcept
Slice Name | valueCodeableConcept
Definition | The presence or absence of the variant described in the components. If not searching for specific variations and merely reporting what's found, the profile's value should be set to 'Present'. The information determined as a result of making the observation, if the information has a simple value.
Short | Indeterminate | No call | Present | Absent.Actual result
Comments | See here for usage guidance. An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: obs-7
Binding | The codes SHALL be taken from For codes, see LOINC Answer List LL1971-2 (required to `http://loinc.org/vs/LL1971-2` )
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. Observation.method
Definition | Indicates the mechanism used to perform the observation.
Short | Sequencing | SNP array | PCR | Computational analysis | ...How it was done
Comments | Only used if not implicit in code for Observation.code.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from For example codes, see LOINC Answer List LL4048-6 http://hl7.org/fhir/ValueSet/observation-methods|4.0.1 (extensible to `http://loinc.org/vs/LL4048-6` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. Observation.derivedFrom
Definition | The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.
Short | Related measurements the observation is made from
Comments | All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.
Control | 0..*
Type | Reference(DocumentReference, ImagingStudy, Media, QuestionnaireResponse, Observation, MolecularSequence)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Observation.derivedFrom`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
32. Observation.component
Definition | 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.
Short | Component results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
Slicing | This element introduces a set of slices on `Observation.component`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ code
34. Observation.component.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
36. Observation.component.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. Observation.component:conclusion-string
Slice Name | conclusion-string
Definition | Concise and clinically contextualized summary conclusion (interpretation/impression) of the observation 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.
Short | Clinical ConclusionComponent results
Comments | An example would be the interpretative information, typically canned, about a variant identified in the patient. For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Need to be able to provide a conclusion that is not lost among the basic result data. Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Observation.component:conclusion-string.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
42. Observation.component:conclusion-string.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | conclusion-stringType of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs", "code" : "conclusion-string" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. Observation.component:gene-studied
Slice Name | gene-studied
Definition | The gene(s) on which the variant is located. 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.
Short | Gene StudiedComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. Observation.component:gene-studied.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
48. Observation.component:gene-studied.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48018-6Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48018-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. Observation.component:gene-studied.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | The HGNC gene symbol is to be used as display text and the HGNC gene ID used as the code. If no HGNC code issued for this gene yet, NCBI gene IDs SHALL be used.Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from For codes, see HUGO Gene Nomenclature Committee Gene Names (HGNC) (extensible to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgnc-vs` )
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. Observation.component:cytogenetic-location
Slice Name | cytogenetic-location
Definition | The relevant chromosomal region. The combination of numbers and letters provide a genetic 'address'. 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.
Short | Cytogenetic (Chromosome) LocationComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. Observation.component:cytogenetic-location.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
56. Observation.component:cytogenetic-location.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48001-2Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48001-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. Observation.component:cytogenetic-location.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Example: 1q21.1Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. Observation.component:reference-sequence-assembly
Slice Name | reference-sequence-assembly
Definition | The reference genome/assembly used in this analysis. 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.
Short | Human Reference Sequence AssemblyComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. Observation.component:reference-sequence-assembly.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
64. Observation.component:reference-sequence-assembly.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 62374-4Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "62374-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. Observation.component:reference-sequence-assembly.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | GRCh37 | GRCh38 | ...Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from For codes, see LOINC Answer List LL1040-6 (extensible to `http://loinc.org/vs/LL1040-6` )
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. Observation.component:chromosome-identifier
Slice Name | chromosome-identifier
Definition | An indicator, enumerated in humans by numbers 1-22, X, and Y, representing the chromosome on which the finding is located. 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.
Short | Chromosome IdentifierComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. Observation.component:chromosome-identifier.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
72. Observation.component:chromosome-identifier.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48000-4Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48000-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
74. Observation.component:chromosome-identifier.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Chromosome 1 | Chromosome 2 | ... | Chromosome 22 | Chromosome X | Chromosome YActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | The codes SHALL be taken from For codes, see LOINC Answer List LL2938-0 (required to `http://loinc.org/vs/LL2938-0` )
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. Observation.component:representative-coding-hgvs
Slice Name | representative-coding-hgvs
Definition | Human Genome Variation Society (HGVS) nomenclature for a single DNA marker. The use of the nomenclature must be extended to describe non-variations (aka. wild types) see samples for wild type examples. 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.
Short | DNA change (c.HGVS)Component results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. Observation.component:representative-coding-hgvs.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
80. Observation.component:representative-coding-hgvs.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48004-6Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48004-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
82. Observation.component:representative-coding-hgvs.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | A valid HGVS-formatted 'c.' string, e.g. NM_005228.5:c.2369C>T.Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | The codes SHALL be taken from For codes, see Human Genome Variation Society (HGVS) Nomenclature (required to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgvs-vs` )
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. Observation.component:genomic-hgvs
Slice Name | genomic-hgvs
Definition | Description of the genomic (gDNA) sequence change using a valid HGVS-formatted string. 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.
Short | Genomic (gDNA) Change - gHGVSComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. Observation.component:genomic-hgvs.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
88. Observation.component:genomic-hgvs.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 81290-9Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81290-9" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. Observation.component:genomic-hgvs.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | A valid HGVS-formatted 'g.' string, e.g. NC_000016.9:g.2124200_2138612dupActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | The codes SHALL be taken from For codes, see Human Genome Variation Society (HGVS) Nomenclature (required to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgvs-vs` )
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
92. Observation.component:cytogenomic-nomenclature
Slice Name | cytogenomic-nomenclature
Definition | Fully describes a variant with a single code. Typically a large variant such as a mosaic, abnormal chromosome numbers, etc. 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.
Short | Cytogenomic Nomenclature (ISCN)Component results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
94. Observation.component:cytogenomic-nomenclature.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
96. Observation.component:cytogenomic-nomenclature.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 81291-7Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81291-7" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
98. Observation.component:cytogenomic-nomenclature.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | Binding not yet defined
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. Observation.component:genomic-ref-seq
Slice Name | genomic-ref-seq
Definition | ID of the genomic reference sequence, which includes transcribed and non transcribed stretches 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.
Short | Genomic Reference SequenceComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. Observation.component:genomic-ref-seq.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
104. Observation.component:genomic-ref-seq.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48013-7Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48013-7" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
106. Observation.component:genomic-ref-seq.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Versioned genomic reference sequence identifierActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | Multiple bindings acceptable (NCBI or LRG)
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
108. Observation.component:representative-protein-ref-seq
Slice Name | representative-protein-ref-seq
Definition | ID of the protein reference sequence, which includes transcribed and non transcribed stretches. It covers the entire protein described. 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.
Short | Protein Reference SequenceComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. Observation.component:representative-protein-ref-seq.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
112. Observation.component:representative-protein-ref-seq.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | protein-ref-seqType of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs", "code" : "protein-ref-seq" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. Observation.component:representative-protein-ref-seq.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Versioned protein reference sequence identifierActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | Multiple bindings acceptable (NCBI or LRG)
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. Observation.component:representative-transcript-ref-seq
Slice Name | representative-transcript-ref-seq
Definition | NCBI's RefSeq ('NM_...'), Ensembl ('ENST...'), and LRG ('LRG...' plus 't1' to indicate transcript) 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.
Short | Reference TranscriptComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
118. Observation.component:representative-transcript-ref-seq.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
120. Observation.component:representative-transcript-ref-seq.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 51958-7Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "51958-7" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
122. Observation.component:representative-transcript-ref-seq.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Versioned transcript reference sequence identifierActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | Multiple bindings acceptable (NCBI or LRG)
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
124. Observation.component:exact-start-end
Slice Name | exact-start-end
Definition | The exact integer-based genomic coordinates of the start and end of the variant region. 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.
Short | Exact Start-EndComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
126. Observation.component:exact-start-end.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
128. Observation.component:exact-start-end.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 81254-5Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81254-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
130. Observation.component:exact-start-end.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Range in question. 'High' can be omitted for single nucleotide variants.Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Range, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
132. Observation.component:inner-start-end
Slice Name | inner-start-end
Definition | The genomic coordinates of the narrowest genomic range in which the variant might reside. Used when the exact boundaries of the variant are not clear. 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.
Short | Inner Start-EndComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
134. Observation.component:inner-start-end.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
136. Observation.component:inner-start-end.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 81302-2Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81302-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
138. Observation.component:inner-start-end.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Imprecise variant inner-bounding rangeActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Range, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
140. Observation.component:outer-start-end
Slice Name | outer-start-end
Definition | The genomic coordinates of the widest genomic range in which the variant might reside. Used when the exact boundaries of the variant are not clear. 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.
Short | Outer Start-EndComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
142. Observation.component:outer-start-end.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
144. Observation.component:outer-start-end.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 81301-4Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81301-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
146. Observation.component:outer-start-end.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Imprecise variant outer-bounding rangeActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Range, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
148. Observation.component:coordinate-system
Slice Name | coordinate-system
Definition | These are different ways of identifying nucleotides or amino acids within a sequence. In the 1-based system, the first unit of the polymer (e.g. the first nucleotide) is counted as number 1. In the 0-based system, the number 0 designates the location before the first nucleotide. Different databases and file types may use different systems. 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.
Short | Coordinate SystemComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
150. Observation.component:coordinate-system.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
152. Observation.component:coordinate-system.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 92822-6Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "92822-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
154. Observation.component:coordinate-system.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | 0-based interval counting | 0-based character counting | 1-based character countingActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from For codes, see LOINC Answer List LL5323-2 (extensible to `http://loinc.org/vs/LL5323-2` )
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
156. Observation.component:ref-allele
Slice Name | ref-allele
Definition | Reference values ('normal') examined within the Reference Sequence. 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.
Short | Genomic Ref AlleleComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
158. Observation.component:ref-allele.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
160. Observation.component:ref-allele.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 69547-8Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "69547-8" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
162. Observation.component:ref-allele.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Normalized string per the VCF format.Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | string, dateTime, boolean, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
164. Observation.component:alt-allele
Slice Name | alt-allele
Definition | The genomic alternate allele is the contiguous segment of DNA in the test sample that differs from the reference allele at the same location and thus defines a variant. 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.
Short | Genomic Alt AlleleComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
166. Observation.component:alt-allele.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
168. Observation.component:alt-allele.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 69551-0Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "69551-0" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
170. Observation.component:alt-allele.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Normalized string per the VCF format.Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | string, dateTime, boolean, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
172. Observation.component:coding-change-type
Slice Name | coding-change-type
Definition | Type of DNA change observed. Convenience property for variants with exact breakpoints, required otherwise. 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.
Short | Coding DNA Change TypeComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
174. Observation.component:coding-change-type.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
176. Observation.component:coding-change-type.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48019-4Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48019-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
178. Observation.component:coding-change-type.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | deletion | insertion | delins | SNV | copy_number_gain | copy_number_loss | ... (many)Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from For codes, see DNA Change Type (extensible to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/dna-change-type-vs` ) Concepts in sequence ontology under SO:0002072
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
180. Observation.component:genomic-source-class
Slice Name | genomic-source-class
Definition | The genomic class of the specimen being analyzed: Germline for inherited genome, somatic for cancer genome, and prenatal for fetal genome. 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.
Short | Genomic Source ClassComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
182. Observation.component:genomic-source-class.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
184. Observation.component:genomic-source-class.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48002-0Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48002-0" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
186. Observation.component:genomic-source-class.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Germline | Somatic | Fetal | Likely germline | Likely somatic | Likely fetal | Unknown genomic origin | De novoActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from For codes, see LOINC Answer List LL378-1 (extensible to `http://loinc.org/vs/LL378-1` )
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
188. Observation.component:sample-allelic-frequency
Slice Name | sample-allelic-frequency
Definition | The relative frequency of the allele at a given locus in the sample. 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.
Short | Sample Allelic FrequencyComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
190. Observation.component:sample-allelic-frequency.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
192. Observation.component:sample-allelic-frequency.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 81258-6Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81258-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
194. Observation.component:sample-allelic-frequency.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Relative frequency in the sampleActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Quantity, dateTime, boolean, string, SampledData, Period, Ratio, integer, time, Range, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
196. Observation.component:sample-allelic-frequency.value[x].comparator
Definition | How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..1
Binding | The codes SHALL be taken from QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
198. Observation.component:sample-allelic-frequency.value[x].system
Definition | The identification of the system that provides the coded form of the unit.
Short | System that defines coded unit form
Control | 0..1 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Pattern Value | `http://unitsofmeasure.org`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
200. Observation.component:allelic-read-depth
Slice Name | allelic-read-depth
Definition | Specifies the number of reads that identified the allele in question whether it consists of one or a small sequence of contiguous nucleotides. Different methods and purposes require different numbers of reads to be acceptable. Often >400, sometimes as few as 2-4. 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.
Short | Allelic Read DepthComponent results
Comments | See here for usage guidance. For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
202. Observation.component:allelic-read-depth.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
204. Observation.component:allelic-read-depth.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 82121-5Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "82121-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
206. Observation.component:allelic-read-depth.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Unfiltered count of supporting readsActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Quantity, dateTime, boolean, string, SampledData, Period, Ratio, integer, time, Range, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
208. Observation.component:allelic-state
Slice Name | allelic-state
Definition | The observed level of occurrence of the variant in the set of chromosomes. 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.
Short | Allelic StateComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
210. Observation.component:allelic-state.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
212. Observation.component:allelic-state.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 53034-5Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "53034-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
214. Observation.component:allelic-state.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Heteroplasmic | Homoplasmic | Homozygous | Heterozygous | HemizygousActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from For codes, see LOINC Answer List LL381-5 (extensible to `http://loinc.org/vs/LL381-5` )
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
216. Observation.component:variant-inheritance
Slice Name | variant-inheritance
Definition | The source or inheritance of a specific germline variation found in an individual patient. 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.
Short | Origin of germline genetic variantComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
218. Observation.component:variant-inheritance.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
220. Observation.component:variant-inheritance.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 94186-4Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "94186-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
222. Observation.component:variant-inheritance.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Maternal | Paternal | UnknownActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from For codes, see LOINC Answer List LL5489-1 (extensible to `http://loinc.org/vs/LL5489-1` )
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
224. Observation.component:variant-inheritance-basis
Slice Name | variant-inheritance-basis
Definition | The method by which the variant inheritance is determined. 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.
Short | Evidential basis for variant inheritanceComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
226. Observation.component:variant-inheritance-basis.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
228. Observation.component:variant-inheritance-basis.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | Basis for allelic phaseType of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "82309-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
230. Observation.component:variant-inheritance-basis.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Directly measured | Family DNA | Family history | Inferred from population dataActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | Unless not suitable, these codes SHALL be taken from For codes, see LOINC Answer List LL4050-2 (extensible to `http://loinc.org/vs/LL4050-2` )
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
232. Observation.component:variation-code
Slice Name | variation-code
Definition | Accession number in a variant database such as ClinVar, given for cross-reference. 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.
Short | Variation CodeComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
234. Observation.component:variation-code.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
236. Observation.component:variation-code.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 81252-9Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81252-9" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
238. Observation.component:variation-code.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | ClinVar ID or similarActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | Multiple bindings acceptable
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
240. Observation.component:representative-protein-hgvs
Slice Name | representative-protein-hgvs
Definition | Description of the protein (amino acid) sequence change using a valid HGVS-formatted string. The description of the variant is surrounded in parentheses if it is calculated rather than directly observed. 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.
Short | Protein (Amino Acid) Change - pHGVSComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
242. Observation.component:representative-protein-hgvs.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
244. Observation.component:representative-protein-hgvs.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48005-3Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48005-3" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
246. Observation.component:representative-protein-hgvs.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | A valid HGVS-formatted 'p.' string, e.g. NP_000050.2:p.(Asn1836Lys)Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | The codes SHALL be taken from For codes, see Human Genome Variation Society (HGVS) Nomenclature (required to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgvs-vs` )
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
248. Observation.component:copy-number
Slice Name | copy-number
Definition | The copy number of the large variant. In HGVS, this is the numeric value following the “X”. It is a unit-less value. If the value determined by the assay is not a whole number, a range or decimal number can be specified. Note that a copy number of 1 can imply a deletion. 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.
Short | Genomic Structural Variant Copy NumberComponent results
Comments | Copy number variants are often described with a single copy number value. However, due to the nature of assays, such as qPCR and microarray, it can be difficult to assign an exact copy number. Therefore, labs sometimes report a range instead of an exact copy number. They may alternatively choose to report decimal numbers, even if whole numbers are biologically correct. In general, it can be difficult to estimate a copy number from measurements taken on a heterogenous population of cells, such as a tumor. As indicated in the ISCN 2020 specifications, it is appropriate to express the measurements using a range. Furthermore, regardless of cell population, many assays use fluorescent probes to detect copy number. These testing methodologies do not always provide an exact, discrete value for this data point. For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | There SHALL be a code with a value of '1' if there is a value. If system is present, it SHALL be UCUM. Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
250. Observation.component:copy-number.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
252. Observation.component:copy-number.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 82155-3Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "82155-3" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
254. Observation.component:copy-number.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Choice of: Quantity, Range, dateTime, boolean, string, SampledData, Period, Ratio, integer, time, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
256. Observation.component:variant-confidence-status
Slice Name | variant-confidence-status
Definition | A code that represents the confidence of a true positive variant call. 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.
Short | Variant Confidence StatusComponent results
Comments | See here for usage guidance. For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
258. Observation.component:variant-confidence-status.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
260. Observation.component:variant-confidence-status.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | variant-confidence-statusType of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs", "code" : "variant-confidence-status" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
262. Observation.component:variant-confidence-status.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | High | Intermediate | LowActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Binding | The codes SHALL be taken from For codes, see Variant Confidence Status (required to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/variant-confidence-status-vs` )
Type | CodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
264. Observation.component:repeat-motif
Slice Name | repeat-motif
Definition | Nucleotides of a repeat expansion motif. 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.
Short | Repeat MotifComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
266. Observation.component:repeat-motif.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Observation.component.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
268. Observation.component:repeat-motif.extension:repeat-motif-order
Slice Name | repeat-motif-order
Definition | Use to group and order repeat expansion motifs.
Short | Repeat Motif Order
Comments | If there are multiple repeat expansion pairs, this must be used both to indicate the sequence position of a given repeat-motif and repeat-number pair and to group the related components together. Components with the same extension value describe the same motif.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Repeat Motif Order) (Extension Type: positiveInt)
Is Modifier | false
Summary | false
Requirements | The value must be a natural number starting from 1 and increasing sequentially
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
270. Observation.component:repeat-motif.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
272. Observation.component:repeat-motif.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | repeat-motifType of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs", "code" : "repeat-motif" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
274. Observation.component:repeat-motif.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | CAGActual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Type | string, dateTime, boolean, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
276. Observation.component:repeat-number
Slice Name | repeat-number
Definition | Number of repeats of a repeat expansion. 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.
Short | Repeat NumberComponent results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
278. Observation.component:repeat-number.extension
Definition | An Extension May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | ExtensionAdditional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
Slicing | This element introduces a set of slices on `Observation.component.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
280. Observation.component:repeat-number.extension:repeat-motif-order
Slice Name | repeat-motif-order
Definition | Use to group and order repeat expansion motifs.
Short | Repeat Motif Order
Comments | If there are multiple repeat expansion pairs, this must be used both to indicate the sequence position of a given repeat-motif and repeat-number pair and to group the related components together. Components with the same extension value describe the same motif.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Repeat Motif Order) (Extension Type: positiveInt)
Is Modifier | false
Summary | false
Requirements | The value must be a natural number starting from 1 and increasing sequentially
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
282. Observation.component:repeat-number.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
284. Observation.component:repeat-number.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | repeat-numberType of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes http://hl7.org/fhir/ValueSet/observation-codes|4.0.1 (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs", "code" : "repeat-number" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
286. Observation.component:repeat-number.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | 40Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 10..1
Type | Quantity, dateTime, boolean, string, SampledData, Period, Ratio, integer, time, Range, CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be foundhere

0. Observation
Short | Variant
2. Observation.code
Short | 69548-6
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "69548-6" }] }`
4. Observation.value[x]
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Slicing | This element introduces a set of slices on `Observation.value[x]`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
6. Observation.value[x]:valueCodeableConcept
Slice Name | valueCodeableConcept
Definition | The presence or absence of the variant described in the components. If not searching for specific variations and merely reporting what's found, the profile's value should be set to 'Present'.
Short | Indeterminate | No call | Present | Absent.
Comments | See here for usage guidance.
Control | 0..1
Binding | The codes SHALL be taken from LOINC Answer List LL1971-2 (required to `http://loinc.org/vs/LL1971-2` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
8. Observation.method
Short | Sequencing | SNP array | PCR | Computational analysis | ...
Binding | Unless not suitable, these codes SHALL be taken from LOINC Answer List LL4048-6 (extensible to `http://loinc.org/vs/LL4048-6` )
10. Observation.component:representative-coding-hgvs
Slice Name | representative-coding-hgvs
Definition | Human Genome Variation Society (HGVS) nomenclature for a single DNA marker. The use of the nomenclature must be extended to describe non-variations (aka. wild types) see samples for wild type examples.
Short | DNA change (c.HGVS)
Control | 0..1
12. Observation.component:representative-coding-hgvs.code
Short | 48004-6
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48004-6" }] }`
14. Observation.component:representative-coding-hgvs.value[x]
Short | A valid HGVS-formatted 'c.' string, e.g. NM_005228.5:c.2369C>T.
Control | 1..?
Binding | The codes SHALL be taken from Human Genome Variation Society (HGVS) Nomenclature (required to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgvs-vs` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
16. Observation.component:genomic-hgvs
Slice Name | genomic-hgvs
Definition | Description of the genomic (gDNA) sequence change using a valid HGVS-formatted string.
Short | Genomic (gDNA) Change - gHGVS
Control | 0..1
18. Observation.component:genomic-hgvs.code
Short | 81290-9
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81290-9" }] }`
20. Observation.component:genomic-hgvs.value[x]
Short | A valid HGVS-formatted 'g.' string, e.g. NC_000016.9:g.2124200_2138612dup
Control | 1..?
Binding | The codes SHALL be taken from Human Genome Variation Society (HGVS) Nomenclature (required to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgvs-vs` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
22. Observation.component:cytogenomic-nomenclature
Slice Name | cytogenomic-nomenclature
Definition | Fully describes a variant with a single code. Typically a large variant such as a mosaic, abnormal chromosome numbers, etc.
Short | Cytogenomic Nomenclature (ISCN)
Control | 0..1
24. Observation.component:cytogenomic-nomenclature.code
Short | 81291-7
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81291-7" }] }`
26. Observation.component:cytogenomic-nomenclature.value[x]
Control | 1..?
Binding | Binding not yet defined
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
28. Observation.component:genomic-ref-seq
Slice Name | genomic-ref-seq
Definition | ID of the genomic reference sequence, which includes transcribed and non transcribed stretches
Short | Genomic Reference Sequence
Control | 0..1
30. Observation.component:genomic-ref-seq.code
Short | 48013-7
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48013-7" }] }`
32. Observation.component:genomic-ref-seq.value[x]
Short | Versioned genomic reference sequence identifier
Control | 1..?
Binding | Multiple bindings acceptable (NCBI or LRG)
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
34. Observation.component:representative-protein-ref-seq
Slice Name | representative-protein-ref-seq
Definition | ID of the protein reference sequence, which includes transcribed and non transcribed stretches. It covers the entire protein described.
Short | Protein Reference Sequence
Control | 0..1
36. Observation.component:representative-protein-ref-seq.code
Short | protein-ref-seq
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs", "code" : "protein-ref-seq" }] }`
38. Observation.component:representative-protein-ref-seq.value[x]
Short | Versioned protein reference sequence identifier
Control | 1..?
Binding | Multiple bindings acceptable (NCBI or LRG)
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
40. Observation.component:representative-transcript-ref-seq
Slice Name | representative-transcript-ref-seq
Definition | NCBI's RefSeq ('NM_...'), Ensembl ('ENST...'), and LRG ('LRG...' plus 't1' to indicate transcript)
Short | Reference Transcript
Control | 0..1
42. Observation.component:representative-transcript-ref-seq.code
Short | 51958-7
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "51958-7" }] }`
44. Observation.component:representative-transcript-ref-seq.value[x]
Short | Versioned transcript reference sequence identifier
Control | 1..?
Binding | Multiple bindings acceptable (NCBI or LRG)
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
46. Observation.component:exact-start-end
Slice Name | exact-start-end
Definition | The exact integer-based genomic coordinates of the start and end of the variant region.
Short | Exact Start-End
Control | 0..1
48. Observation.component:exact-start-end.code
Short | 81254-5
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81254-5" }] }`
50. Observation.component:exact-start-end.value[x]
Short | Range in question. 'High' can be omitted for single nucleotide variants.
Type | Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
52. Observation.component:inner-start-end
Slice Name | inner-start-end
Definition | The genomic coordinates of the narrowest genomic range in which the variant might reside. Used when the exact boundaries of the variant are not clear.
Short | Inner Start-End
Control | 0..1
54. Observation.component:inner-start-end.code
Short | 81302-2
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81302-2" }] }`
56. Observation.component:inner-start-end.value[x]
Short | Imprecise variant inner-bounding range
Type | Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
58. Observation.component:outer-start-end
Slice Name | outer-start-end
Definition | The genomic coordinates of the widest genomic range in which the variant might reside. Used when the exact boundaries of the variant are not clear.
Short | Outer Start-End
Control | 0..1
60. Observation.component:outer-start-end.code
Short | 81301-4
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81301-4" }] }`
62. Observation.component:outer-start-end.value[x]
Short | Imprecise variant outer-bounding range
Type | Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
64. Observation.component:coordinate-system
Slice Name | coordinate-system
Definition | These are different ways of identifying nucleotides or amino acids within a sequence. In the 1-based system, the first unit of the polymer (e.g. the first nucleotide) is counted as number 1. In the 0-based system, the number 0 designates the location before the first nucleotide. Different databases and file types may use different systems.
Short | Coordinate System
Control | 0..1
66. Observation.component:coordinate-system.code
Short | 92822-6
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "92822-6" }] }`
68. Observation.component:coordinate-system.value[x]
Short | 0-based interval counting | 0-based character counting | 1-based character counting
Control | 1..?
Binding | Unless not suitable, these codes SHALL be taken from LOINC Answer List LL5323-2 (extensible to `http://loinc.org/vs/LL5323-2` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
70. Observation.component:ref-allele
Slice Name | ref-allele
Definition | Reference values ('normal') examined within the Reference Sequence.
Short | Genomic Ref Allele
Control | 0..1
72. Observation.component:ref-allele.code
Short | 69547-8
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "69547-8" }] }`
74. Observation.component:ref-allele.value[x]
Short | Normalized string per the VCF format.
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
76. Observation.component:alt-allele
Slice Name | alt-allele
Definition | The genomic alternate allele is the contiguous segment of DNA in the test sample that differs from the reference allele at the same location and thus defines a variant.
Short | Genomic Alt Allele
Control | 0..1
78. Observation.component:alt-allele.code
Short | 69551-0
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "69551-0" }] }`
80. Observation.component:alt-allele.value[x]
Short | Normalized string per the VCF format.
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
82. Observation.component:coding-change-type
Slice Name | coding-change-type
Definition | Type of DNA change observed. Convenience property for variants with exact breakpoints, required otherwise.
Short | Coding DNA Change Type
Control | 0..1
84. Observation.component:coding-change-type.code
Short | 48019-4
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48019-4" }] }`
86. Observation.component:coding-change-type.value[x]
Short | deletion | insertion | delins | SNV | copy_number_gain | copy_number_loss | ... (many)
Control | 1..?
Binding | Unless not suitable, these codes SHALL be taken from DNA Change Type (extensible to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/dna-change-type-vs` ) Concepts in sequence ontology under SO:0002072
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
88. Observation.component:genomic-source-class
Slice Name | genomic-source-class
Definition | The genomic class of the specimen being analyzed: Germline for inherited genome, somatic for cancer genome, and prenatal for fetal genome.
Short | Genomic Source Class
Control | 0..1
90. Observation.component:genomic-source-class.code
Short | 48002-0
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48002-0" }] }`
92. Observation.component:genomic-source-class.value[x]
Short | Germline | Somatic | Fetal | Likely germline | Likely somatic | Likely fetal | Unknown genomic origin | De novo
Control | 1..?
Binding | Unless not suitable, these codes SHALL be taken from LOINC Answer List LL378-1 (extensible to `http://loinc.org/vs/LL378-1` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
94. Observation.component:sample-allelic-frequency
Slice Name | sample-allelic-frequency
Definition | The relative frequency of the allele at a given locus in the sample.
Short | Sample Allelic Frequency
Control | 0..1
96. Observation.component:sample-allelic-frequency.code
Short | 81258-6
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81258-6" }] }`
98. Observation.component:sample-allelic-frequency.value[x]
Short | Relative frequency in the sample
Type | Quantity
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
100. Observation.component:sample-allelic-frequency.value[x].system
Pattern Value | `http://unitsofmeasure.org`
102. Observation.component:allelic-read-depth
Slice Name | allelic-read-depth
Definition | Specifies the number of reads that identified the allele in question whether it consists of one or a small sequence of contiguous nucleotides. Different methods and purposes require different numbers of reads to be acceptable. Often >400, sometimes as few as 2-4.
Short | Allelic Read Depth
Comments | See here for usage guidance.
Control | 0..1
104. Observation.component:allelic-read-depth.code
Short | 82121-5
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "82121-5" }] }`
106. Observation.component:allelic-read-depth.value[x]
Short | Unfiltered count of supporting reads
Type | Quantity
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
108. Observation.component:allelic-state
Slice Name | allelic-state
Definition | The observed level of occurrence of the variant in the set of chromosomes.
Short | Allelic State
Control | 0..1
110. Observation.component:allelic-state.code
Short | 53034-5
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "53034-5" }] }`
112. Observation.component:allelic-state.value[x]
Short | Heteroplasmic | Homoplasmic | Homozygous | Heterozygous | Hemizygous
Control | 1..?
Binding | Unless not suitable, these codes SHALL be taken from LOINC Answer List LL381-5 (extensible to `http://loinc.org/vs/LL381-5` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
114. Observation.component:variant-inheritance
Slice Name | variant-inheritance
Definition | The source or inheritance of a specific germline variation found in an individual patient.
Short | Origin of germline genetic variant
Control | 0..1
116. Observation.component:variant-inheritance.code
Short | 94186-4
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "94186-4" }] }`
118. Observation.component:variant-inheritance.value[x]
Short | Maternal | Paternal | Unknown
Control | 1..?
Binding | Unless not suitable, these codes SHALL be taken from LOINC Answer List LL5489-1 (extensible to `http://loinc.org/vs/LL5489-1` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
120. Observation.component:variant-inheritance-basis
Slice Name | variant-inheritance-basis
Definition | The method by which the variant inheritance is determined.
Short | Evidential basis for variant inheritance
Control | 0..1
122. Observation.component:variant-inheritance-basis.code
Short | Basis for allelic phase
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "82309-6" }] }`
124. Observation.component:variant-inheritance-basis.value[x]
Short | Directly measured | Family DNA | Family history | Inferred from population data
Control | 1..?
Binding | Unless not suitable, these codes SHALL be taken from LOINC Answer List LL4050-2 (extensible to `http://loinc.org/vs/LL4050-2` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
126. Observation.component:variation-code
Slice Name | variation-code
Definition | Accession number in a variant database such as ClinVar, given for cross-reference.
Short | Variation Code
Control | 0..*
128. Observation.component:variation-code.code
Short | 81252-9
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81252-9" }] }`
130. Observation.component:variation-code.value[x]
Short | ClinVar ID or similar
Control | 1..?
Binding | Multiple bindings acceptable
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
132. Observation.component:representative-protein-hgvs
Slice Name | representative-protein-hgvs
Definition | Description of the protein (amino acid) sequence change using a valid HGVS-formatted string. The description of the variant is surrounded in parentheses if it is calculated rather than directly observed.
Short | Protein (Amino Acid) Change - pHGVS
Control | 0..1
134. Observation.component:representative-protein-hgvs.code
Short | 48005-3
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48005-3" }] }`
136. Observation.component:representative-protein-hgvs.value[x]
Short | A valid HGVS-formatted 'p.' string, e.g. NP_000050.2:p.(Asn1836Lys)
Control | 1..?
Binding | The codes SHALL be taken from Human Genome Variation Society (HGVS) Nomenclature (required to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgvs-vs` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
138. Observation.component:copy-number
Slice Name | copy-number
Definition | The copy number of the large variant. In HGVS, this is the numeric value following the “X”. It is a unit-less value. If the value determined by the assay is not a whole number, a range or decimal number can be specified. Note that a copy number of 1 can imply a deletion.
Short | Genomic Structural Variant Copy Number
Comments | Copy number variants are often described with a single copy number value. However, due to the nature of assays, such as qPCR and microarray, it can be difficult to assign an exact copy number. Therefore, labs sometimes report a range instead of an exact copy number. They may alternatively choose to report decimal numbers, even if whole numbers are biologically correct. In general, it can be difficult to estimate a copy number from measurements taken on a heterogenous population of cells, such as a tumor. As indicated in the ISCN 2020 specifications, it is appropriate to express the measurements using a range. Furthermore, regardless of cell population, many assays use fluorescent probes to detect copy number. These testing methodologies do not always provide an exact, discrete value for this data point.
Control | 0..1
Requirements | There SHALL be a code with a value of '1' if there is a value. If system is present, it SHALL be UCUM.
140. Observation.component:copy-number.code
Short | 82155-3
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "82155-3" }] }`
142. Observation.component:copy-number.value[x]
Type | Choice of: Quantity, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
144. Observation.component:variant-confidence-status
Slice Name | variant-confidence-status
Definition | A code that represents the confidence of a true positive variant call.
Short | Variant Confidence Status
Comments | See here for usage guidance.
Control | 0..1
146. Observation.component:variant-confidence-status.code
Short | variant-confidence-status
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs", "code" : "variant-confidence-status" }] }`
148. Observation.component:variant-confidence-status.value[x]
Short | High | Intermediate | Low
Control | 1..?
Binding | The codes SHALL be taken from Variant Confidence Status (required to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/variant-confidence-status-vs` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
150. Observation.component:repeat-motif
Slice Name | repeat-motif
Definition | Nucleotides of a repeat expansion motif.
Short | Repeat Motif
Control | 0..*
152. Observation.component:repeat-motif.extension
Slicing | This element introduces a set of slices on `Observation.component.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
154. Observation.component:repeat-motif.extension:repeat-motif-order
Slice Name | repeat-motif-order
Comments | If there are multiple repeat expansion pairs, this must be used both to indicate the sequence position of a given repeat-motif and repeat-number pair and to group the related components together. Components with the same extension value describe the same motif.
Control | 0..1
Type | Extension(Repeat Motif Order) (Extension Type: positiveInt)
Requirements | The value must be a natural number starting from 1 and increasing sequentially
156. Observation.component:repeat-motif.code
Short | repeat-motif
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs", "code" : "repeat-motif" }] }`
158. Observation.component:repeat-motif.value[x]
Short | CAG
Control | 1..?
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
160. Observation.component:repeat-number
Slice Name | repeat-number
Definition | Number of repeats of a repeat expansion.
Short | Repeat Number
Control | 0..*
162. Observation.component:repeat-number.extension
Slicing | This element introduces a set of slices on `Observation.component.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
164. Observation.component:repeat-number.extension:repeat-motif-order
Slice Name | repeat-motif-order
Comments | If there are multiple repeat expansion pairs, this must be used both to indicate the sequence position of a given repeat-motif and repeat-number pair and to group the related components together. Components with the same extension value describe the same motif.
Control | 0..1
Type | Extension(Repeat Motif Order) (Extension Type: positiveInt)
Requirements | The value must be a natural number starting from 1 and increasing sequentially
166. Observation.component:repeat-number.code
Short | repeat-number
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs", "code" : "repeat-number" }] }`
168. Observation.component:repeat-number.value[x]
Short | 40
Control | 1..?
Type | Quantity
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]

Guidance on how to interpret the contents of this table can be foundhere

0. Observation
Definition | Measurements and simple assertions made about a patient, device or other subject.
Short | Variant
Comments | 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.
Control | 0..*
Is Modifier | false
Summary | false
Alternate Names | Vital Signs, Measurement, Results, Tests
Invariants | dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (`contained.contained.empty()`) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (`contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (`contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (`contained.meta.security.empty()`) dom-6: A resource should have narrative for robust management (`text.`div`.exists()`) obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (`dataAbsentReason.empty() or value.empty()`) 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 (`value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()`)
2. Observation.id
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Short | Logical id of this artifact
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
Control | 0..1
Type | id
Is Modifier | false
Summary | true
4. Observation.meta
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Short | Metadata about the resource
Control | 0..1
Type | Meta
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
6. Observation.implicitRules
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Short | A set of rules under which this content was created
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
Control | 0..1
Type | uri
Is Modifier | true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
8. Observation.language
Definition | The base language in which the resource is written.
Short | Language of the resource content
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Control | 0..1
Binding | The codes SHOULD be taken from CommonLanguages (preferred to `http://hl7.org/fhir/ValueSet/languages|4.0.1` ) A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
10. Observation.text
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Short | Text summary of the resource, for human interpretation
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
Control | 0..1
Type | Narrative
Is Modifier | false
Summary | false
Alternate Names | narrative, html, xhtml, display
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
12. Observation.contained
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Short | Contained, inline Resources
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Control | 0..*
Type | Resource
Is Modifier | false
Summary | false
Alternate Names | inline resources, anonymous resources, contained resources
14. Observation.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
16. Observation.extension:secondary-finding
Slice Name | secondary-finding
Definition | Secondary findings are genetic test results that provide information about variants in a gene unrelated to the primary purpose for the testing, most often discovered when Whole Exome Sequencing (WES) or Whole Genome Sequencing (WGS) is performed. This extension should be used to denote when a genetic finding is being shared as a secondary finding, and ideally refer to a corresponding guideline or policy statement. For more detail, please see: https://ghr.nlm.nih.gov/primer/testing/secondaryfindings.
Short | Secondary findings are genetic test results that provide information about variants in a gene unrelated to the primary purpose for the testing, most often discovered when [Whole Exome Sequencing (WES)](https://en.wikipedia.org/wiki/Exome_sequencing) or [Whole Genome Sequencing (WGS)](https://en.wikipedia.org/wiki/Whole_genome_sequencing) is performed. This extension should be used to denote when a genetic finding is being shared as a secondary finding, and ideally refer to a corresponding guideline or policy statement. For more detail, please see: https://ghr.nlm.nih.gov/primer/testing/secondaryfindings
Control | 0..1
Type | Extension(Observation Secondary Finding) (Extension Type: CodeableConcept)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
18. Observation.extension:body-structure
Slice Name | body-structure
Definition | Record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.
Short | Target anatomic location or structure
Control | 0..1
Type | Extension(BodyStructure Reference) (Extension Type: Reference(BodyStructure))
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
20. Observation.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summary | false
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
22. Observation.identifier
Definition | A unique identifier assigned to this observation.
Short | Business Identifier for observation
Note | This is a business identifier, not a resource identifier (see discussion)
Control | 0..*
Type | Identifier
Is Modifier | false
Summary | true
Requirements | Allows observations to be distinguished and referenced.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
24. Observation.basedOn
Definition | A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.
Short | Fulfills plan, proposal or order
Control | 0..*
Type | Reference(CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest)
Is Modifier | false
Summary | true
Requirements | Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.
Alternate Names | Fulfills
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
26. Observation.partOf
Definition | A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.
Short | Part of referenced event
Comments | To link an Observation to an Encounter use `encounter`. See the Notes below for guidance on referencing another Observation.
Control | 0..*
Type | Reference(MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Immunization, ImagingStudy, Genomic Study)
Is Modifier | false
Summary | true
Alternate Names | Container
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
28. Observation.status
Definition | The status of the result value.
Short | registered | preliminary | final | amended +
Comments | This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
Control | 1..1
Binding | The codes SHALL be taken from ObservationStatus (required to `http://hl7.org/fhir/ValueSet/observation-status|4.0.1` ) Codes providing the status of an observation.
Type | code
Is Modifier | true because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to track the status of individual results. Some results are finalized before the whole report is finalized.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
30. Observation.category
Definition | A code that classifies the general type of observation being made.
Short | Classification of type of observation
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 2..*
Binding | The codes SHOULD be taken from ObservationCategoryCodes (preferred to `http://hl7.org/fhir/ValueSet/observation-category|4.0.1` ) Codes for high level observation categories.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Observation.category`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ coding
32. Observation.category:labCategory
Slice Name | labCategory
Definition | A code that classifies the general type of observation being made.
Short | Classification of type of observation
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 1..1
Binding | The codes SHOULD be taken from ObservationCategoryCodes (preferred to `http://hl7.org/fhir/ValueSet/observation-category|4.0.1` ) Codes for high level observation categories.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
34. Observation.category:labCategory.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
36. Observation.category:labCategory.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.category.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
38. Observation.category:labCategory.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 1..1
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Pattern Value | `{ "system" : "http://terminology.hl7.org/CodeSystem/observation-category", "code" : "laboratory" }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
40. Observation.category:labCategory.text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
42. Observation.category:geCategory
Slice Name | geCategory
Definition | A code that classifies the general type of observation being made.
Short | Classification of type of observation
Comments | In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.
Control | 1..1
Binding | The codes SHOULD be taken from ObservationCategoryCodes (preferred to `http://hl7.org/fhir/ValueSet/observation-category|4.0.1` ) Codes for high level observation categories.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Used for filtering what observations are retrieved and displayed.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
44. Observation.category:geCategory.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
46. Observation.category:geCategory.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.category.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
48. Observation.category:geCategory.coding
Definition | A reference to a code defined by a terminology system.
Short | Code defined by a terminology system
Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Control | 1..1
Type | Coding
Is Modifier | false
Summary | true
Requirements | Allows for alternative encodings within a code system, and translations to other code systems.
Pattern Value | `{ "system" : "http://terminology.hl7.org/CodeSystem/v2-0074", "code" : "GE" }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
50. Observation.category:geCategory.text
Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Short | Plain text representation of the concept
Comments | Very often the text is the same as a displayName of one of the codings.
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
52. Observation.code
Definition | Describes what was observed. Sometimes this is called the observation "name".
Short | 69548-6
Comments | 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.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Alternate Names | Name
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "69548-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
54. Observation.subject
Definition | 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.
Short | Who and/or what the observation is about
Comments | One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.
Control | 0..1
Type | Reference(Patient, Group, Device, Location)
Is Modifier | false
Summary | true
Requirements | Observations have no value if you don't know who or what they're about.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
56. Observation.focus
Definition | 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.
Short | What the observation is about, when it is not about the subject of record
Comments | Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use `specimen` if a reference to a specimen is required. If a code is required instead of a resource use either `bodysite` for bodysites or the standard extension focusCode.
Control | 0..*
Type | Reference(Resource)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
58. Observation.encounter
Definition | The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.
Short | Healthcare event during which this observation is made
Comments | This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).
Control | 0..1
Type | Reference(Encounter)
Is Modifier | false
Summary | true
Requirements | For some observations it may be important to know the link between an observation and a particular encounter.
Alternate Names | Context
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
60. Observation.effective[x]
Definition | The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.
Short | Clinically relevant time/time-period for observation
Comments | At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.
Control | 0..1
Type | Choice of: dateTime, Period, Timing, instant
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Knowing when an observation was deemed true is important to its relevance as well as determining trends.
Alternate Names | Occurrence
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
62. Observation.issued
Definition | The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.
Short | Date/Time this version was made available
Comments | For Observations that don’t require review and verification, it may be the same as the `lastUpdated` time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the `lastUpdated` time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.
Control | 0..1
Type | instant
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
64. Observation.performer
Definition | Who was responsible for asserting the observed value as "true".
Short | Who is responsible for the observation
Control | 0..*
Type | Reference(Practitioner, PractitionerRole, Organization, CareTeam, Patient, RelatedPerson)
Is Modifier | false
Summary | true
Requirements | May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
66. Observation.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual result
Comments | An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1 This element is affected by the following invariants: obs-7
Type | Choice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Observation.value[x]`. The slices areUnordered and Open, and can be differentiated using the following discriminators: type @ $this
68. Observation.value[x]:valueCodeableConcept
Slice Name | valueCodeableConcept
Definition | The presence or absence of the variant described in the components. If not searching for specific variations and merely reporting what's found, the profile's value should be set to 'Present'.
Short | Indeterminate | No call | Present | Absent.
Comments | See here for usage guidance.
Control | 0..1 This element is affected by the following invariants: obs-7
Binding | The codes SHALL be taken from LOINC Answer List LL1971-2 (required to `http://loinc.org/vs/LL1971-2` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
70. Observation.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.value[x] is missing.
Short | Why the result is missing
Comments | Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
72. Observation.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
74. Observation.note
Definition | Comments about the observation or the results.
Short | Comments about the Observation that also contain a coded type
Comments | May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation. The CodedAnnotation data type, while not allowing for or intending to make the content computable, does allow the author to indicate the type of note. This does not replace the use of interpretation, value, or component values. One important note is that Annotation is a FHIR data type, this is NOT about annotations in the genomic context.
Control | 0..*
Type | Annotation(Coded Annotation)
Is Modifier | false
Summary | false
Requirements | Need to be able to provide free text additional information. Notes SHALL NOT contain information which can be captured in a structured way.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
76. Observation.bodySite
Definition | Indicates the site on the subject's body where the observation was made (i.e. the target site).
Short | Observed body part
Comments | Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component. If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.
Control | 0..1
Binding | For example codes, see SNOMEDCTBodyStructures (example to `http://hl7.org/fhir/ValueSet/body-site|4.0.1` ) Codes describing anatomical locations. May include laterality.
Type | CodeableConcept
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
78. Observation.method
Definition | Indicates the mechanism used to perform the observation.
Short | Sequencing | SNP array | PCR | Computational analysis | ...
Comments | Only used if not implicit in code for Observation.code.
Control | 0..1
Binding | Unless not suitable, these codes SHALL be taken from LOINC Answer List LL4048-6 (extensible to `http://loinc.org/vs/LL4048-6` )
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
80. Observation.specimen
Definition | The specimen that was used when this observation was made.
Short | Specimen used for this observation
Comments | Should only be used if not implicit in code found in `Observation.code`. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).
Control | 0..1
Type | Reference(Specimen)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
82. Observation.device
Definition | The device used to generate the observation data.
Short | (Measurement) Device
Comments | Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.
Control | 0..1
Type | Reference(Device, DeviceMetric)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
84. Observation.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two `referenceRange` elements would be used.
Short | Provides guide for interpretation
Comments | 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.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) obs-3: Must have at least a low or a high or text (`low.exists() or high.exists() or text.exists()`)
86. Observation.referenceRange.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
88. Observation.referenceRange.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
90. Observation.referenceRange.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
92. Observation.referenceRange.low
Definition | The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).
Short | Low Range, if relevant
Control | 0..1 This element is affected by the following invariants: obs-3
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
94. Observation.referenceRange.high
Definition | The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).
Short | High Range, if relevant
Control | 0..1 This element is affected by the following invariants: obs-3
Type | Quantity(SimpleQuantity)
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
96. Observation.referenceRange.type
Definition | Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.
Short | Reference range qualifier
Comments | This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.
Control | 0..1
Binding | The codes SHOULD be taken from ObservationReferenceRangeMeaningCodes (preferred to `http://hl7.org/fhir/ValueSet/referencerange-meaning|4.0.1` ) Code for the meaning of a reference range.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
98. Observation.referenceRange.appliesTo
Definition | Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple `appliesTo` are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.
Short | Reference range population
Comments | This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.
Control | 0..*
Binding | For example codes, see ObservationReferenceRangeAppliesToCodes (example to `http://hl7.org/fhir/ValueSet/referencerange-appliesto|4.0.1` ) Codes identifying the population the reference range applies to.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | Need to be able to identify the target population for proper interpretation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
100. Observation.referenceRange.age
Definition | The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.
Short | Applicable age range, if relevant
Control | 0..1
Type | Range
Is Modifier | false
Summary | false
Requirements | Some analytes vary greatly over age.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
102. Observation.referenceRange.text
Definition | Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals".
Short | Text based reference range in an observation
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
104. Observation.hasMember
Definition | 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.
Short | Related resource that belongs to the Observation group
Comments | When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.
Control | 0..*
Type | Reference(Observation, QuestionnaireResponse, MolecularSequence)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
106. Observation.derivedFrom
Definition | The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.
Short | Related measurements the observation is made from
Comments | All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.
Control | 0..*
Type | Reference(DocumentReference, ImagingStudy, Media, QuestionnaireResponse, Observation, MolecularSequence)
Is Modifier | false
Summary | true
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Observation.derivedFrom`. The slices areUnordered and Open, and can be differentiated using the following discriminators: profile @ resolve()
108. Observation.component
Definition | 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.
Short | Component results
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
Slicing | This element introduces a set of slices on `Observation.component`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ code
110. Observation.component.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
112. Observation.component.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
114. Observation.component.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
116. Observation.component.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | Type of component observation (code / type)
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
118. Observation.component.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Choice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
120. Observation.component.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
122. Observation.component.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
124. Observation.component.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
126. Observation.component:conclusion-string
Slice Name | conclusion-string
Definition | Concise and clinically contextualized summary conclusion (interpretation/impression) of the observation
Short | Clinical Conclusion
Comments | An example would be the interpretative information, typically canned, about a variant identified in the patient.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Need to be able to provide a conclusion that is not lost among the basic result data.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
128. Observation.component:conclusion-string.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
130. Observation.component:conclusion-string.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
132. Observation.component:conclusion-string.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
134. Observation.component:conclusion-string.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | conclusion-string
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs", "code" : "conclusion-string" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
136. Observation.component:conclusion-string.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Summary conclusion (interpretation/impression)
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
138. Observation.component:conclusion-string.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
140. Observation.component:conclusion-string.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
142. Observation.component:conclusion-string.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
144. Observation.component:gene-studied
Slice Name | gene-studied
Definition | The gene(s) on which the variant is located.
Short | Gene Studied
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
146. Observation.component:gene-studied.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
148. Observation.component:gene-studied.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
150. Observation.component:gene-studied.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
152. Observation.component:gene-studied.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48018-6
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48018-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
154. Observation.component:gene-studied.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | The HGNC gene symbol is to be used as display text and the HGNC gene ID used as the code. If no HGNC code issued for this gene yet, NCBI gene IDs SHALL be used.
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from HUGO Gene Nomenclature Committee Gene Names (HGNC) (extensible to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgnc-vs` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
156. Observation.component:gene-studied.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
158. Observation.component:gene-studied.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
160. Observation.component:gene-studied.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
162. Observation.component:cytogenetic-location
Slice Name | cytogenetic-location
Definition | The relevant chromosomal region. The combination of numbers and letters provide a genetic 'address'.
Short | Cytogenetic (Chromosome) Location
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
164. Observation.component:cytogenetic-location.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
166. Observation.component:cytogenetic-location.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
168. Observation.component:cytogenetic-location.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
170. Observation.component:cytogenetic-location.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48001-2
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48001-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
172. Observation.component:cytogenetic-location.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Example: 1q21.1
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
174. Observation.component:cytogenetic-location.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
176. Observation.component:cytogenetic-location.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
178. Observation.component:cytogenetic-location.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
180. Observation.component:reference-sequence-assembly
Slice Name | reference-sequence-assembly
Definition | The reference genome/assembly used in this analysis.
Short | Human Reference Sequence Assembly
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
182. Observation.component:reference-sequence-assembly.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
184. Observation.component:reference-sequence-assembly.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
186. Observation.component:reference-sequence-assembly.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
188. Observation.component:reference-sequence-assembly.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 62374-4
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "62374-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
190. Observation.component:reference-sequence-assembly.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | GRCh37 | GRCh38 | ...
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from LOINC Answer List LL1040-6 (extensible to `http://loinc.org/vs/LL1040-6` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
192. Observation.component:reference-sequence-assembly.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
194. Observation.component:reference-sequence-assembly.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
196. Observation.component:reference-sequence-assembly.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
198. Observation.component:chromosome-identifier
Slice Name | chromosome-identifier
Definition | An indicator, enumerated in humans by numbers 1-22, X, and Y, representing the chromosome on which the finding is located.
Short | Chromosome Identifier
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
200. Observation.component:chromosome-identifier.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
202. Observation.component:chromosome-identifier.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
204. Observation.component:chromosome-identifier.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
206. Observation.component:chromosome-identifier.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48000-4
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48000-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
208. Observation.component:chromosome-identifier.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Chromosome 1 | Chromosome 2 | ... | Chromosome 22 | Chromosome X | Chromosome Y
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | The codes SHALL be taken from LOINC Answer List LL2938-0 (required to `http://loinc.org/vs/LL2938-0` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
210. Observation.component:chromosome-identifier.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
212. Observation.component:chromosome-identifier.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
214. Observation.component:chromosome-identifier.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
216. Observation.component:representative-coding-hgvs
Slice Name | representative-coding-hgvs
Definition | Human Genome Variation Society (HGVS) nomenclature for a single DNA marker. The use of the nomenclature must be extended to describe non-variations (aka. wild types) see samples for wild type examples.
Short | DNA change (c.HGVS)
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
218. Observation.component:representative-coding-hgvs.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
220. Observation.component:representative-coding-hgvs.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
222. Observation.component:representative-coding-hgvs.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
224. Observation.component:representative-coding-hgvs.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48004-6
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48004-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
226. Observation.component:representative-coding-hgvs.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | A valid HGVS-formatted 'c.' string, e.g. NM_005228.5:c.2369C>T.
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | The codes SHALL be taken from Human Genome Variation Society (HGVS) Nomenclature (required to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgvs-vs` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
228. Observation.component:representative-coding-hgvs.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
230. Observation.component:representative-coding-hgvs.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
232. Observation.component:representative-coding-hgvs.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
234. Observation.component:genomic-hgvs
Slice Name | genomic-hgvs
Definition | Description of the genomic (gDNA) sequence change using a valid HGVS-formatted string.
Short | Genomic (gDNA) Change - gHGVS
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
236. Observation.component:genomic-hgvs.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
238. Observation.component:genomic-hgvs.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
240. Observation.component:genomic-hgvs.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
242. Observation.component:genomic-hgvs.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 81290-9
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81290-9" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
244. Observation.component:genomic-hgvs.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | A valid HGVS-formatted 'g.' string, e.g. NC_000016.9:g.2124200_2138612dup
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | The codes SHALL be taken from Human Genome Variation Society (HGVS) Nomenclature (required to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgvs-vs` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
246. Observation.component:genomic-hgvs.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
248. Observation.component:genomic-hgvs.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
250. Observation.component:genomic-hgvs.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
252. Observation.component:cytogenomic-nomenclature
Slice Name | cytogenomic-nomenclature
Definition | Fully describes a variant with a single code. Typically a large variant such as a mosaic, abnormal chromosome numbers, etc.
Short | Cytogenomic Nomenclature (ISCN)
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
254. Observation.component:cytogenomic-nomenclature.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
256. Observation.component:cytogenomic-nomenclature.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
258. Observation.component:cytogenomic-nomenclature.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
260. Observation.component:cytogenomic-nomenclature.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 81291-7
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81291-7" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
262. Observation.component:cytogenomic-nomenclature.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | Binding not yet defined
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
264. Observation.component:cytogenomic-nomenclature.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
266. Observation.component:cytogenomic-nomenclature.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
268. Observation.component:cytogenomic-nomenclature.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
270. Observation.component:genomic-ref-seq
Slice Name | genomic-ref-seq
Definition | ID of the genomic reference sequence, which includes transcribed and non transcribed stretches
Short | Genomic Reference Sequence
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
272. Observation.component:genomic-ref-seq.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
274. Observation.component:genomic-ref-seq.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
276. Observation.component:genomic-ref-seq.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
278. Observation.component:genomic-ref-seq.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48013-7
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48013-7" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
280. Observation.component:genomic-ref-seq.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Versioned genomic reference sequence identifier
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | Multiple bindings acceptable (NCBI or LRG)
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
282. Observation.component:genomic-ref-seq.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
284. Observation.component:genomic-ref-seq.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
286. Observation.component:genomic-ref-seq.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
288. Observation.component:representative-protein-ref-seq
Slice Name | representative-protein-ref-seq
Definition | ID of the protein reference sequence, which includes transcribed and non transcribed stretches. It covers the entire protein described.
Short | Protein Reference Sequence
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
290. Observation.component:representative-protein-ref-seq.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
292. Observation.component:representative-protein-ref-seq.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
294. Observation.component:representative-protein-ref-seq.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
296. Observation.component:representative-protein-ref-seq.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | protein-ref-seq
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs", "code" : "protein-ref-seq" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
298. Observation.component:representative-protein-ref-seq.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Versioned protein reference sequence identifier
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | Multiple bindings acceptable (NCBI or LRG)
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
300. Observation.component:representative-protein-ref-seq.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
302. Observation.component:representative-protein-ref-seq.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
304. Observation.component:representative-protein-ref-seq.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
306. Observation.component:representative-transcript-ref-seq
Slice Name | representative-transcript-ref-seq
Definition | NCBI's RefSeq ('NM_...'), Ensembl ('ENST...'), and LRG ('LRG...' plus 't1' to indicate transcript)
Short | Reference Transcript
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
308. Observation.component:representative-transcript-ref-seq.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
310. Observation.component:representative-transcript-ref-seq.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
312. Observation.component:representative-transcript-ref-seq.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
314. Observation.component:representative-transcript-ref-seq.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 51958-7
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "51958-7" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
316. Observation.component:representative-transcript-ref-seq.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Versioned transcript reference sequence identifier
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | Multiple bindings acceptable (NCBI or LRG)
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
318. Observation.component:representative-transcript-ref-seq.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
320. Observation.component:representative-transcript-ref-seq.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
322. Observation.component:representative-transcript-ref-seq.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
324. Observation.component:exact-start-end
Slice Name | exact-start-end
Definition | The exact integer-based genomic coordinates of the start and end of the variant region.
Short | Exact Start-End
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
326. Observation.component:exact-start-end.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
328. Observation.component:exact-start-end.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
330. Observation.component:exact-start-end.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
332. Observation.component:exact-start-end.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 81254-5
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81254-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
334. Observation.component:exact-start-end.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Range in question. 'High' can be omitted for single nucleotide variants.
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
336. Observation.component:exact-start-end.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
338. Observation.component:exact-start-end.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
340. Observation.component:exact-start-end.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
342. Observation.component:inner-start-end
Slice Name | inner-start-end
Definition | The genomic coordinates of the narrowest genomic range in which the variant might reside. Used when the exact boundaries of the variant are not clear.
Short | Inner Start-End
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
344. Observation.component:inner-start-end.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
346. Observation.component:inner-start-end.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
348. Observation.component:inner-start-end.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
350. Observation.component:inner-start-end.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 81302-2
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81302-2" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
352. Observation.component:inner-start-end.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Imprecise variant inner-bounding range
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
354. Observation.component:inner-start-end.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
356. Observation.component:inner-start-end.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
358. Observation.component:inner-start-end.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
360. Observation.component:outer-start-end
Slice Name | outer-start-end
Definition | The genomic coordinates of the widest genomic range in which the variant might reside. Used when the exact boundaries of the variant are not clear.
Short | Outer Start-End
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
362. Observation.component:outer-start-end.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
364. Observation.component:outer-start-end.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
366. Observation.component:outer-start-end.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
368. Observation.component:outer-start-end.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 81301-4
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81301-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
370. Observation.component:outer-start-end.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Imprecise variant outer-bounding range
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
372. Observation.component:outer-start-end.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
374. Observation.component:outer-start-end.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
376. Observation.component:outer-start-end.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
378. Observation.component:coordinate-system
Slice Name | coordinate-system
Definition | These are different ways of identifying nucleotides or amino acids within a sequence. In the 1-based system, the first unit of the polymer (e.g. the first nucleotide) is counted as number 1. In the 0-based system, the number 0 designates the location before the first nucleotide. Different databases and file types may use different systems.
Short | Coordinate System
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
380. Observation.component:coordinate-system.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
382. Observation.component:coordinate-system.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
384. Observation.component:coordinate-system.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
386. Observation.component:coordinate-system.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 92822-6
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "92822-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
388. Observation.component:coordinate-system.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | 0-based interval counting | 0-based character counting | 1-based character counting
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from LOINC Answer List LL5323-2 (extensible to `http://loinc.org/vs/LL5323-2` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
390. Observation.component:coordinate-system.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
392. Observation.component:coordinate-system.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
394. Observation.component:coordinate-system.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
396. Observation.component:ref-allele
Slice Name | ref-allele
Definition | Reference values ('normal') examined within the Reference Sequence.
Short | Genomic Ref Allele
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
398. Observation.component:ref-allele.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
400. Observation.component:ref-allele.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
402. Observation.component:ref-allele.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
404. Observation.component:ref-allele.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 69547-8
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "69547-8" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
406. Observation.component:ref-allele.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Normalized string per the VCF format.
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
408. Observation.component:ref-allele.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
410. Observation.component:ref-allele.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
412. Observation.component:ref-allele.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
414. Observation.component:alt-allele
Slice Name | alt-allele
Definition | The genomic alternate allele is the contiguous segment of DNA in the test sample that differs from the reference allele at the same location and thus defines a variant.
Short | Genomic Alt Allele
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
416. Observation.component:alt-allele.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
418. Observation.component:alt-allele.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
420. Observation.component:alt-allele.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
422. Observation.component:alt-allele.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 69551-0
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "69551-0" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
424. Observation.component:alt-allele.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Normalized string per the VCF format.
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
426. Observation.component:alt-allele.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
428. Observation.component:alt-allele.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
430. Observation.component:alt-allele.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
432. Observation.component:coding-change-type
Slice Name | coding-change-type
Definition | Type of DNA change observed. Convenience property for variants with exact breakpoints, required otherwise.
Short | Coding DNA Change Type
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
434. Observation.component:coding-change-type.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
436. Observation.component:coding-change-type.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
438. Observation.component:coding-change-type.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
440. Observation.component:coding-change-type.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48019-4
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48019-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
442. Observation.component:coding-change-type.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | deletion | insertion | delins | SNV | copy_number_gain | copy_number_loss | ... (many)
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from DNA Change Type (extensible to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/dna-change-type-vs` ) Concepts in sequence ontology under SO:0002072
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
444. Observation.component:coding-change-type.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
446. Observation.component:coding-change-type.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
448. Observation.component:coding-change-type.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
450. Observation.component:genomic-source-class
Slice Name | genomic-source-class
Definition | The genomic class of the specimen being analyzed: Germline for inherited genome, somatic for cancer genome, and prenatal for fetal genome.
Short | Genomic Source Class
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
452. Observation.component:genomic-source-class.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
454. Observation.component:genomic-source-class.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
456. Observation.component:genomic-source-class.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
458. Observation.component:genomic-source-class.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48002-0
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48002-0" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
460. Observation.component:genomic-source-class.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Germline | Somatic | Fetal | Likely germline | Likely somatic | Likely fetal | Unknown genomic origin | De novo
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from LOINC Answer List LL378-1 (extensible to `http://loinc.org/vs/LL378-1` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
462. Observation.component:genomic-source-class.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
464. Observation.component:genomic-source-class.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
466. Observation.component:genomic-source-class.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
468. Observation.component:sample-allelic-frequency
Slice Name | sample-allelic-frequency
Definition | The relative frequency of the allele at a given locus in the sample.
Short | Sample Allelic Frequency
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
470. Observation.component:sample-allelic-frequency.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
472. Observation.component:sample-allelic-frequency.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
474. Observation.component:sample-allelic-frequency.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
476. Observation.component:sample-allelic-frequency.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 81258-6
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81258-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
478. Observation.component:sample-allelic-frequency.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Relative frequency in the sample
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Quantity
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
480. Observation.component:sample-allelic-frequency.value[x].id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
482. Observation.component:sample-allelic-frequency.value[x].extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.component.value[x].extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
484. Observation.component:sample-allelic-frequency.value[x].value
Definition | The value of the measured amount. The value includes an implicit precision in the presentation of the value.
Short | Numerical value (with implicit precision)
Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).
Control | 0..1
Type | decimal
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Precision is handled implicitly in almost all cases of measurement.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
486. Observation.component:sample-allelic-frequency.value[x].comparator
Definition | How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.
Short | < | <= | >= | > - how to understand the value
Control | 0..1
Binding | The codes SHALL be taken from QuantityComparator (required to `http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1` ) How the Quantity should be understood and represented.
Type | code
Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.
Meaning if Missing | If there is no comparator, then there is no modification of the value
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
488. Observation.component:sample-allelic-frequency.value[x].unit
Definition | A human-readable form of the unit.
Short | Unit representation
Control | 0..1
Type | string
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
490. Observation.component:sample-allelic-frequency.value[x].system
Definition | The identification of the system that provides the coded form of the unit.
Short | System that defines coded unit form
Control | 0..1 This element is affected by the following invariants: qty-3
Type | uri
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need to know the system that defines the coded form of the unit.
Pattern Value | `http://unitsofmeasure.org`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
492. Observation.component:sample-allelic-frequency.value[x].code
Definition | A computer processable form of the unit in some unit representation system.
Short | Coded form of the unit
Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.
Control | 0..1
Type | code
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
494. Observation.component:sample-allelic-frequency.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
496. Observation.component:sample-allelic-frequency.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
498. Observation.component:sample-allelic-frequency.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
500. Observation.component:allelic-read-depth
Slice Name | allelic-read-depth
Definition | Specifies the number of reads that identified the allele in question whether it consists of one or a small sequence of contiguous nucleotides. Different methods and purposes require different numbers of reads to be acceptable. Often >400, sometimes as few as 2-4.
Short | Allelic Read Depth
Comments | See here for usage guidance.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
502. Observation.component:allelic-read-depth.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
504. Observation.component:allelic-read-depth.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
506. Observation.component:allelic-read-depth.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
508. Observation.component:allelic-read-depth.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 82121-5
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "82121-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
510. Observation.component:allelic-read-depth.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Unfiltered count of supporting reads
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Quantity
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
512. Observation.component:allelic-read-depth.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
514. Observation.component:allelic-read-depth.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
516. Observation.component:allelic-read-depth.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
518. Observation.component:allelic-state
Slice Name | allelic-state
Definition | The observed level of occurrence of the variant in the set of chromosomes.
Short | Allelic State
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
520. Observation.component:allelic-state.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
522. Observation.component:allelic-state.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
524. Observation.component:allelic-state.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
526. Observation.component:allelic-state.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 53034-5
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "53034-5" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
528. Observation.component:allelic-state.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Heteroplasmic | Homoplasmic | Homozygous | Heterozygous | Hemizygous
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from LOINC Answer List LL381-5 (extensible to `http://loinc.org/vs/LL381-5` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
530. Observation.component:allelic-state.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
532. Observation.component:allelic-state.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
534. Observation.component:allelic-state.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
536. Observation.component:variant-inheritance
Slice Name | variant-inheritance
Definition | The source or inheritance of a specific germline variation found in an individual patient.
Short | Origin of germline genetic variant
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
538. Observation.component:variant-inheritance.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
540. Observation.component:variant-inheritance.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
542. Observation.component:variant-inheritance.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
544. Observation.component:variant-inheritance.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 94186-4
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "94186-4" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
546. Observation.component:variant-inheritance.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Maternal | Paternal | Unknown
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from LOINC Answer List LL5489-1 (extensible to `http://loinc.org/vs/LL5489-1` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
548. Observation.component:variant-inheritance.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
550. Observation.component:variant-inheritance.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
552. Observation.component:variant-inheritance.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
554. Observation.component:variant-inheritance-basis
Slice Name | variant-inheritance-basis
Definition | The method by which the variant inheritance is determined.
Short | Evidential basis for variant inheritance
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
556. Observation.component:variant-inheritance-basis.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
558. Observation.component:variant-inheritance-basis.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
560. Observation.component:variant-inheritance-basis.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
562. Observation.component:variant-inheritance-basis.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | Basis for allelic phase
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "82309-6" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
564. Observation.component:variant-inheritance-basis.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Directly measured | Family DNA | Family history | Inferred from population data
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | Unless not suitable, these codes SHALL be taken from LOINC Answer List LL4050-2 (extensible to `http://loinc.org/vs/LL4050-2` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
566. Observation.component:variant-inheritance-basis.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
568. Observation.component:variant-inheritance-basis.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
570. Observation.component:variant-inheritance-basis.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
572. Observation.component:variation-code
Slice Name | variation-code
Definition | Accession number in a variant database such as ClinVar, given for cross-reference.
Short | Variation Code
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
574. Observation.component:variation-code.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
576. Observation.component:variation-code.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
578. Observation.component:variation-code.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
580. Observation.component:variation-code.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 81252-9
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "81252-9" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
582. Observation.component:variation-code.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | ClinVar ID or similar
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | Multiple bindings acceptable
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
584. Observation.component:variation-code.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
586. Observation.component:variation-code.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
588. Observation.component:variation-code.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
590. Observation.component:representative-protein-hgvs
Slice Name | representative-protein-hgvs
Definition | Description of the protein (amino acid) sequence change using a valid HGVS-formatted string. The description of the variant is surrounded in parentheses if it is calculated rather than directly observed.
Short | Protein (Amino Acid) Change - pHGVS
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
592. Observation.component:representative-protein-hgvs.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
594. Observation.component:representative-protein-hgvs.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
596. Observation.component:representative-protein-hgvs.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
598. Observation.component:representative-protein-hgvs.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 48005-3
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "48005-3" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
600. Observation.component:representative-protein-hgvs.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | A valid HGVS-formatted 'p.' string, e.g. NP_000050.2:p.(Asn1836Lys)
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | The codes SHALL be taken from Human Genome Variation Society (HGVS) Nomenclature (required to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgvs-vs` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
602. Observation.component:representative-protein-hgvs.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
604. Observation.component:representative-protein-hgvs.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
606. Observation.component:representative-protein-hgvs.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
608. Observation.component:copy-number
Slice Name | copy-number
Definition | The copy number of the large variant. In HGVS, this is the numeric value following the “X”. It is a unit-less value. If the value determined by the assay is not a whole number, a range or decimal number can be specified. Note that a copy number of 1 can imply a deletion.
Short | Genomic Structural Variant Copy Number
Comments | Copy number variants are often described with a single copy number value. However, due to the nature of assays, such as qPCR and microarray, it can be difficult to assign an exact copy number. Therefore, labs sometimes report a range instead of an exact copy number. They may alternatively choose to report decimal numbers, even if whole numbers are biologically correct. In general, it can be difficult to estimate a copy number from measurements taken on a heterogenous population of cells, such as a tumor. As indicated in the ISCN 2020 specifications, it is appropriate to express the measurements using a range. Furthermore, regardless of cell population, many assays use fluorescent probes to detect copy number. These testing methodologies do not always provide an exact, discrete value for this data point.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | There SHALL be a code with a value of '1' if there is a value. If system is present, it SHALL be UCUM.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
610. Observation.component:copy-number.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
612. Observation.component:copy-number.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
614. Observation.component:copy-number.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
616. Observation.component:copy-number.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | 82155-3
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://loinc.org", "code" : "82155-3" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
618. Observation.component:copy-number.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | Actual component result
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 0..1
Type | Choice of: Quantity, Range
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
620. Observation.component:copy-number.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
622. Observation.component:copy-number.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
624. Observation.component:copy-number.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
626. Observation.component:variant-confidence-status
Slice Name | variant-confidence-status
Definition | A code that represents the confidence of a true positive variant call.
Short | Variant Confidence Status
Comments | See here for usage guidance.
Control | 0..1
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
628. Observation.component:variant-confidence-status.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
630. Observation.component:variant-confidence-status.extension
Definition | May be used to represent additional information that is not part of the basic definition of the element. 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.
Short | Additional content defined by implementations
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Alternate Names | extensions, user content
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
632. Observation.component:variant-confidence-status.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
634. Observation.component:variant-confidence-status.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | variant-confidence-status
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs", "code" : "variant-confidence-status" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
636. Observation.component:variant-confidence-status.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | High | Intermediate | Low
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Binding | The codes SHALL be taken from Variant Confidence Status (required to `http://hl7.org/fhir/uv/genomics-reporting/ValueSet/variant-confidence-status-vs` )
Type | CodeableConcept
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
638. Observation.component:variant-confidence-status.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
640. Observation.component:variant-confidence-status.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
642. Observation.component:variant-confidence-status.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
644. Observation.component:repeat-motif
Slice Name | repeat-motif
Definition | Nucleotides of a repeat expansion motif.
Short | Repeat Motif
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
646. Observation.component:repeat-motif.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
648. Observation.component:repeat-motif.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.component.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
650. Observation.component:repeat-motif.extension:repeat-motif-order
Slice Name | repeat-motif-order
Definition | Use to group and order repeat expansion motifs.
Short | Repeat Motif Order
Comments | If there are multiple repeat expansion pairs, this must be used both to indicate the sequence position of a given repeat-motif and repeat-number pair and to group the related components together. Components with the same extension value describe the same motif.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Repeat Motif Order) (Extension Type: positiveInt)
Is Modifier | false
Summary | false
Requirements | The value must be a natural number starting from 1 and increasing sequentially
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
652. Observation.component:repeat-motif.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
654. Observation.component:repeat-motif.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | repeat-motif
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs", "code" : "repeat-motif" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
656. Observation.component:repeat-motif.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | CAG
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Type | string
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Primitive Value | This primitive element may be present, or absent, or replaced by an extension
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
658. Observation.component:repeat-motif.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
660. Observation.component:repeat-motif.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
662. Observation.component:repeat-motif.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
664. Observation.component:repeat-number
Slice Name | repeat-number
Definition | Number of repeats of a repeat expansion.
Short | Repeat Number
Comments | For a discussion on the ways Observations can be assembled in groups together see Notes below.
Control | 0..*
Type | BackboneElement
Is Modifier | false
Summary | true
Requirements | Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
666. Observation.component:repeat-number.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Short | Unique id for inter-element referencing
Control | 0..1
Type | string
Is Modifier | false
XML Format | In the XML format, this property is represented as an attribute.
Summary | false
668. Observation.component:repeat-number.extension
Definition | An Extension
Short | Extension
Control | 0..*
Type | Extension
Is Modifier | false
Summary | false
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
Slicing | This element introduces a set of slices on `Observation.component.extension`. The slices areUnordered and Open, and can be differentiated using the following discriminators: value @ url
670. Observation.component:repeat-number.extension:repeat-motif-order
Slice Name | repeat-motif-order
Definition | Use to group and order repeat expansion motifs.
Short | Repeat Motif Order
Comments | If there are multiple repeat expansion pairs, this must be used both to indicate the sequence position of a given repeat-motif and repeat-number pair and to group the related components together. Components with the same extension value describe the same motif.
Control | 0..1 This element is affected by the following invariants: ele-1
Type | Extension(Repeat Motif Order) (Extension Type: positiveInt)
Is Modifier | false
Summary | false
Requirements | The value must be a natural number starting from 1 and increasing sequentially
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
672. Observation.component:repeat-number.modifierExtension
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Short | Extensions that cannot be ignored even if unrecognized
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Control | 0..*
Type | Extension
Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summary | true
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.
Alternate Names | extensions, user content, modifiers
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`) ext-1: Must have either extensions or value[x], not both (`extension.exists() != value.exists()`)
674. Observation.component:repeat-number.code
Definition | Describes what was observed. Sometimes this is called the observation "code".
Short | repeat-number
Comments | All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
Control | 1..1
Binding | For example codes, see LOINCCodes (example to `http://hl7.org/fhir/ValueSet/observation-codes|4.0.1` ) Codes identifying names of simple observations.
Type | CodeableConcept
Is Modifier | false
Summary | true
Requirements | Knowing what kind of observation is being made is essential to understanding the observation.
Pattern Value | `{ "coding" : [{ "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs", "code" : "repeat-number" }] }`
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
676. Observation.component:repeat-number.value[x]
Definition | The information determined as a result of making the observation, if the information has a simple value.
Short | 40
Comments | Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.
Control | 1..1
Type | Quantity
[x] Note | SeeChoice of Data Typesfor further information about how to use [x]
Is Modifier | false
Summary | true
Requirements | An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
678. Observation.component:repeat-number.dataAbsentReason
Definition | Provides a reason why the expected value in the element Observation.component.value[x] is missing.
Short | Why the component result is missing
Comments | "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.
Control | 0..1 This element is affected by the following invariants: obs-6
Binding | Unless not suitable, these codes SHALL be taken from DataAbsentReason (extensible to `http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1` ) Codes specifying why the result (`Observation.value[x]`) is missing.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For many results it is necessary to handle exceptional values in measurements.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
680. Observation.component:repeat-number.interpretation
Definition | A categorical assessment of an observation value. For example, high, low, normal.
Short | High, low, normal, etc.
Comments | 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.
Control | 0..*
Binding | Unless not suitable, these codes SHALL be taken from ObservationInterpretationCodes (extensible to `http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1` ) Codes identifying interpretations of observations.
Type | CodeableConcept
Is Modifier | false
Summary | false
Requirements | For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.
Alternate Names | Abnormal Flag
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)
682. Observation.component:repeat-number.referenceRange
Definition | Guidance on how to interpret the value by comparison to a normal or recommended range.
Short | Provides guide for interpretation of component result
Comments | 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.
Control | 0..*
Type | Seettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
Is Modifier | false
Summary | false
Requirements | Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.
Invariants | ele-1: All FHIR elements must have a @value or children (`hasValue() or (children().count() > id.count())`)