HL7 FHIR Implementation Guide: Breast Cancer Data, Release 1 - US Realm (Draft for Comment 2)

BreastCancerHistologicGradeModel

 

The official URL for this logical model is:

http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastCancerHistologicGrade-model

The Elston Grade/Nottingham Score, representative of the aggressive potential of the tumor. Well differentiated cells (Grade 1) look similar to normal cells and are usually slow growing, while poorly differentiated cells (Grade 3) look very different than normal and are fast-growing.

This logical model was published on Fri Aug 17 00:00:00 UTC 2018 as a draft by The HL7 Cancer Interoperability Group sponsored by Clinical Interoperability Council Work Group (CIC).

View the corresponding BreastCancerHistologicGradeProfile profile.

NameFlagsCard.TypeDescription & Constraintsdoco
.. oncology-BreastCancerHistologicGrade-model 0..*
... personOfRecord 1..1Reference(BC PersonOfRecord Logical Model)The person this entry belongs to.
... laboratoryObservationTopic 1..1BackboneElementThe topic composition for laboratory observations. A specimen is required, anatomical location is excluded (since the specimen indicates the collection body site). Also includes a diagnostic service (indicating the type of laboratory), not present in general observations.
.... topicCode 1..1CodingThe concept representing the finding or action that is the topic of the statement.
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 44648-4
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... findingMethod 0..1CodingThe technique used to create the finding, for example, the specific imaging technical, lab test code, or assessment vehicle.
Binding: http://loinc.org/vs (preferred)
.... details 0..1stringA text note containing additional details, explanation, description, comment, or summarization. Details can discuss, support, explain changes to, or dispute information.
.... category 1..*CodingA class or division of people or things having particular shared characteristics
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/observation-category
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: laboratory
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... breastSpecimen 1..1Reference(BC BreastSpecimen Logical Model)Specimen resulting from biopsy or excision of breast and surrounding tissue.
.... precondition 0..*Coding, Reference(BC Observation Logical Model)A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.
.... evaluationComponent 0..1A simplified, non-separable evaluation consisting of a finding code (represented by the Concept), value (or exception value), reference range, and interpretation. The subject of the evaluation component is the same as in the parent evaluation.
..... tubuleFormationScore 0..1http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-TubuleFormationScore-modelThe degree of glandular differentiation or tubule formation in breast carcinoma is one component of the Nottingham histologic grade, which is a prognostic indicator for patients with breast carcinoma. Less aggressive cancers have more tubule formation.
..... nuclearPleomorphismScore 0..1http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-NuclearPleomorphismScore-modelThe degree of nuclear pleomorphism (variability of nuclei) in breast carcinoma is one component of the Nottingham histologic grade, which is a prognostic indicator for patients with breast carcinoma. Increasing degrees of pleomorphism are associated with increasingly aggressive cancers.
..... mitoticCountScore 0..1http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MitoticCountScore-modelThe degree of mitotic activity in breast carcinoma is one component of the Nottingham histologic grade, which is a prognostic indicator for patients with breast carcinoma. Mitotic activity is assessed as the number of mitoses per 10 high power fields (HPF), with increasing mitotic activity being an indicator of more aggressive cancer. The specific scores assigned to the number of mitoses depends on the size of the HPF. For example, for a HPF size of 0.274 mm^2, less than 10 mitoses per 10 HPF gets a score of 1, 10-19 gets a score of 2, and greater than or equal to 20 gets a score of 3. When larger or smaller HPFs are used, the cutoffs for the number of mitoses corresponding to a specific score are adjusted according to published guidelines.
.... diagnosticService 0..*CodingThe service completing the observations, e.g. biochemistry, microbiology, blood bank.
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/v2/0074
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: PAT
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
... observationContext 1..1BackboneElementContext for recording an evaluation result, used to indicate an evaluation has been made.
.... contextCode 1..1CodingA code representing the ontological status of the statement, e.g., whether it exists, does not exist, is planned, etc.
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... system Σ1..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ1..1codeSymbol in syntax defined by the system
Fixed Value: 424975005
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... encounter 0..1http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-encounter-Encounter-modelA description of an interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.
.... interpretation 0..1CodingA clinical interpretation of a finding (applies to both assertions and observation).
Binding: Observation Interpretation Codes (extensible)
.... findingStatus 1..1codeIndicates whether the finding is preliminary, amended, final, etc.
Binding: ObservationStatus (required)
.... relevantTime 0..1dateTime, http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-TimePeriod-modelThe time or time period that the finding addresses.
.... resultValue 0..1CodingThe finding itself, such as the blood pressure value recorded.
Binding: LOINC Answer List LL4561-8 (required)
.... exceptionValue 0..1CodingReason that a value associated with a test or other finding is missing.
Binding: DataAbsentReason (extensible)
.... deltaFlag 0..1CodingIndicator of significant change (delta) from the last or previous measurement.
Binding: BC DeltaFlagVS ValueSet (required)
.... issued 0..1instantThe date and time this observation was made available to providers, typically after the results have been reviewed and verified.
.... observer 0..*Reference(BC Practitioner Logical Model | BC Organization Logical Model | BC Patient Logical Model | BC RelatedPerson Logical Model)The person or organization who observed or informed the reporter about the characteristic, potentially the clinician, the patient, or a related person.

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON, TTL)