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

BreastTumorProfile

 

The official URL for this profile is:

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

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm. (source: NCI)

This profile builds on US Core Condition (a.k.a Problem) Profile.

This profile 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 BreastTumorModel logical model.

Summary

Mandatory: 0 element (7 nested mandatory elements)
Fixed Value: 4 elements
Prohibited: 3 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Condition.extension.valueCodeableConcept.coding is sliced based on the value of value:code

BC Mapping Source

This structure represents the following BC mapping definition:

oncology.BreastTumor maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition:
  PersonOfRecord maps to subject
  FindingSiteConditionTopic.Category maps to category
  FindingSiteConditionTopic.TopicCode maps to code
  constrain bodySite to 0..0
  FindingSiteConditionTopic.AnatomicalLocation maps to http://hl7.org/fhir/StructureDefinition/condition-targetBodySite
  ConditionPresenceContext.Encounter maps to context
  ConditionPresenceContext.ClinicalStatus maps to clinicalStatus
  ConditionPresenceContext.VerificationStatus maps to verificationStatus
  ConditionPresenceContext.Onset maps to onset[x]
  ConditionPresenceContext.Abatement maps to abatement[x]
  ConditionPresenceContext.Severity maps to severity
  ConditionPresenceContext.Stage maps to stage
  ConditionPresenceContext.Stage.CodeableConcept maps to stage.summary
  ConditionPresenceContext.Stage.StageDetail maps to stage.assessment

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition BC BreastTumor Profile
... extension 2..*
... condition-targetBodySite 0..1Reference(BodySite)Extension
URL: http://hl7.org/fhir/StructureDefinition/condition-targetBodySite
... cimi-topic-TopicCode-extension 1..1CodeableConceptBC TopicCode Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-topic-TopicCode-extension
.... valueCodeableConcept
..... coding Slice: Unordered, Open by value:code
..... coding Σ1..1CodingTumor finding (finding)
...... system Fixed Value: http://snomed.info/sct
...... code Fixed Value: 395557000
... shr-core-Category-extension 1..1CodeableConceptBC Category Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Category-extension
.... valueCodeableConcept
..... coding Slice: Unordered, Open by value:code
..... coding Σ1..1Coding
...... system Fixed Value: http://hl7.org/fhir/observation-category
...... code Fixed Value: exam
... clinicalStatus 1..1
... severity 0..0
... bodySite 0..0
... context Reference(BC Encounter Profile)
... stage 0..0

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition I0..*BC BreastTumor Profile
us-core-1: A code in Condition.category SHOULD be from US Core Condition Category Codes value set.
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
Max Binding: All Languages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 2..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
... condition-targetBodySite 0..1Reference(BodySite)Extension
URL: http://hl7.org/fhir/StructureDefinition/condition-targetBodySite
... cimi-topic-TopicCode-extension 1..1CodeableConceptBC TopicCode Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-topic-TopicCode-extension
.... id 0..1stringxml:id (or equivalent in JSON)
.... url 1..1uri"http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-topic-TopicCode-extension"
.... valueCodeableConcept 1..1CodeableConceptValue of extension
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
..... coding Σ1..1CodingTumor finding (finding)
...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: 395557000
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... shr-core-Category-extension 1..1CodeableConceptBC Category Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Category-extension
.... id 0..1stringxml:id (or equivalent in JSON)
.... url 1..1uri"http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Category-extension"
.... valueCodeableConcept 1..1CodeableConceptValue of extension
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
..... coding Σ1..1Coding
...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/observation-category
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: exam
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!SΣI1..1codeactive | recurrence | inactive | remission | resolved
Binding: Condition Clinical Status Codes (required)
... verificationStatus ?!SΣI1..1codeprovisional | differential | confirmed | refuted | entered-in-error | unknown
Binding: ConditionVerificationStatus (required)
... category S1..*CodeableConceptproblem-list-item | encounter-diagnosis
Binding: US Core Condition Category Codes (preferred)
... code SΣ1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: Problem Value Set (extensible)
... subject SΣ1..1Reference(US Core Patient Profile)Who has the condition?
... context Σ0..1Reference(BC Encounter Profile)Encounter or episode when condition first asserted
... onset[x] Σ0..1dateTime, Age, Period, Range, stringEstimated or actual date, date-time, or age
... abatement[x] I0..1dateTime, Age, boolean, Period, Range, stringIf/when in resolution/remission
... assertedDate Σ0..1dateTimeDate record was believed accurate
... asserter Σ0..1Reference(Practitioner | Patient | RelatedPerson)Person who asserts this condition
... evidence I0..*BackboneElementSupporting evidence
con-2: evidence SHALL have code or details
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code ΣI0..*CodeableConceptManifestation/symptom
Binding: Manifestation and Symptom Codes (example)
.... detail ΣI0..*Reference(Resource)Supporting information found elsewhere
... note 0..*AnnotationAdditional information about the Condition

doco Documentation for this format

Summary

Mandatory: 0 element (7 nested mandatory elements)
Fixed Value: 4 elements
Prohibited: 3 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Condition.extension.valueCodeableConcept.coding is sliced based on the value of value:code

BC Mapping Source

This structure represents the following BC mapping definition:

oncology.BreastTumor maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition:
  PersonOfRecord maps to subject
  FindingSiteConditionTopic.Category maps to category
  FindingSiteConditionTopic.TopicCode maps to code
  constrain bodySite to 0..0
  FindingSiteConditionTopic.AnatomicalLocation maps to http://hl7.org/fhir/StructureDefinition/condition-targetBodySite
  ConditionPresenceContext.Encounter maps to context
  ConditionPresenceContext.ClinicalStatus maps to clinicalStatus
  ConditionPresenceContext.VerificationStatus maps to verificationStatus
  ConditionPresenceContext.Onset maps to onset[x]
  ConditionPresenceContext.Abatement maps to abatement[x]
  ConditionPresenceContext.Severity maps to severity
  ConditionPresenceContext.Stage maps to stage
  ConditionPresenceContext.Stage.CodeableConcept maps to stage.summary
  ConditionPresenceContext.Stage.StageDetail maps to stage.assessment

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition BC BreastTumor Profile
... extension 2..*
... condition-targetBodySite 0..1Reference(BodySite)Extension
URL: http://hl7.org/fhir/StructureDefinition/condition-targetBodySite
... cimi-topic-TopicCode-extension 1..1CodeableConceptBC TopicCode Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-topic-TopicCode-extension
.... valueCodeableConcept
..... coding Slice: Unordered, Open by value:code
..... coding Σ1..1CodingTumor finding (finding)
...... system Fixed Value: http://snomed.info/sct
...... code Fixed Value: 395557000
... shr-core-Category-extension 1..1CodeableConceptBC Category Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Category-extension
.... valueCodeableConcept
..... coding Slice: Unordered, Open by value:code
..... coding Σ1..1Coding
...... system Fixed Value: http://hl7.org/fhir/observation-category
...... code Fixed Value: exam
... clinicalStatus 1..1
... severity 0..0
... bodySite 0..0
... context Reference(BC Encounter Profile)
... stage 0..0

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition I0..*BC BreastTumor Profile
us-core-1: A code in Condition.category SHOULD be from US Core Condition Category Codes value set.
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
Max Binding: All Languages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 2..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
... condition-targetBodySite 0..1Reference(BodySite)Extension
URL: http://hl7.org/fhir/StructureDefinition/condition-targetBodySite
... cimi-topic-TopicCode-extension 1..1CodeableConceptBC TopicCode Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-topic-TopicCode-extension
.... id 0..1stringxml:id (or equivalent in JSON)
.... url 1..1uri"http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-topic-TopicCode-extension"
.... valueCodeableConcept 1..1CodeableConceptValue of extension
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
..... coding Σ1..1CodingTumor finding (finding)
...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://snomed.info/sct
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: 395557000
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... shr-core-Category-extension 1..1CodeableConceptBC Category Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Category-extension
.... id 0..1stringxml:id (or equivalent in JSON)
.... url 1..1uri"http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Category-extension"
.... valueCodeableConcept 1..1CodeableConceptValue of extension
..... id 0..1stringxml:id (or equivalent in JSON)
..... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
..... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
..... coding Σ1..1Coding
...... id 0..1stringxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
...... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/observation-category
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: exam
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!SΣI1..1codeactive | recurrence | inactive | remission | resolved
Binding: Condition Clinical Status Codes (required)
... verificationStatus ?!SΣI1..1codeprovisional | differential | confirmed | refuted | entered-in-error | unknown
Binding: ConditionVerificationStatus (required)
... category S1..*CodeableConceptproblem-list-item | encounter-diagnosis
Binding: US Core Condition Category Codes (preferred)
... code SΣ1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: Problem Value Set (extensible)
... subject SΣ1..1Reference(US Core Patient Profile)Who has the condition?
... context Σ0..1Reference(BC Encounter Profile)Encounter or episode when condition first asserted
... onset[x] Σ0..1dateTime, Age, Period, Range, stringEstimated or actual date, date-time, or age
... abatement[x] I0..1dateTime, Age, boolean, Period, Range, stringIf/when in resolution/remission
... assertedDate Σ0..1dateTimeDate record was believed accurate
... asserter Σ0..1Reference(Practitioner | Patient | RelatedPerson)Person who asserts this condition
... evidence I0..*BackboneElementSupporting evidence
con-2: evidence SHALL have code or details
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code ΣI0..*CodeableConceptManifestation/symptom
Binding: Manifestation and Symptom Codes (example)
.... detail ΣI0..*Reference(Resource)Supporting information found elsewhere
... note 0..*AnnotationAdditional information about the Condition

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON, TTL), Schema: XML Schematron

 

Terminology Bindings

PathConformanceValueSet
Condition:oncology-BreastTumor.clinicalStatusrequiredCondition Clinical Status Codes
Condition:oncology-BreastTumor.verificationStatusrequiredConditionVerificationStatus
Condition:oncology-BreastTumor.categorypreferredUS Core Condition Category Codes
Condition:oncology-BreastTumor.codeextensibleProblem Value Set

 

Constraints

IdPathDetailsRequirements
dom-2ConditionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-1ConditionIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-4ConditionIf 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-3ConditionIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
con-4ConditionIf condition is abated, then clinicalStatus must be either inactive, resolved, or remission
: abatement.empty() or (abatement as boolean).not() or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive'
con-3ConditionCondition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error
: verificationStatus='entered-in-error' or clinicalStatus.exists()
us-core-1ConditionA code in Condition.category SHOULD be from US Core Condition Category Codes value set.
: where(category in 'http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category').exists()
ele-1Condition.evidenceAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
con-2Condition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()