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

EstrogenReceptorStatusModel

 

The official URL for this logical model is:

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

Estrogen receptor alpha is the predominant estrogen receptor expressed in breast tissue and is overexpressed in around 50% of breast carcinomas. ER status (positive=present or overexpressed; negative=absent) is a factor in determining prognosis and treatment options. The current approach is that positive/negative designation is a value, even though that value is (in fact) an interpretation of evidence (NuclearPositivity and AverageStainingIntensity).

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 EstrogenReceptorStatusProfile profile.

NameFlagsCard.TypeDescription & Constraintsdoco
.. oncology-EstrogenReceptorStatus-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.
Binding: BC EstrogenReceptorInterpretationTestsVS ValueSet (required)
.... 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.
..... estrogenReceptorNuclearPositivity 0..1http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-EstrogenReceptorNuclearPositivity-modelThe percentage of cells that test (stain) positive for the presence of estrogen receptors. We are seeking feedback on whether nuclear positivity should be an exact percentage or a range of percentages. As currently defined, an exact nuclear positivity could be represented by a zero-width range, where the lower and upper bounds would be the same number.
..... estrogenReceptorAverageStainingIntensity 0..1http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-EstrogenReceptorAverageStainingIntensity-modelThe degree or magnitude of staining across positively stained tumor cells on the entire tissue section relative to the intensity of positive controls run with the same batch.
.... 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: BC PositiveNegativeIndeterminateVS ValueSet (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)