MII IG Kerndatensatz-Modul Molekulares Tumorboard, published by Medizininformatik-Initiative. This guide is not an authorized publication; it is the continuous build for version 2026.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/medizininformatik-initiative/kerndatensatzmodul-molekulares-tumorboard/ and changes regularly. See the Directory of published versions
Resource Profile: MII PR MTB Response Befund
| Official URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-response-befund | Version: 2026.0.0 | |||
| Active as of 2026-02-09 | Computable Name: MII_PR_MTB_Response_Befund | |||
Response Beurteilung nach DNPM
Usages:
- Examples for this Profile: Observation/MII-EXA-MTB-Response-Befund-1, Observation/MII-EXA-MTB-Response-Befund-2 and Observation/MII-EXA-MTB-Response-Befund-Beispiel-1
- CapabilityStatements using this Profile: MII CPS MTB CapabilityStatement
You can also check for usages in the FHIR IG Statistics
Formal Views of Profile Content
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints Filter:   |
|---|---|---|---|---|
  Observation |
C | 0..* | MII_PR_Onko_Verlauf | Measurements and simple assertions Constraints: obs-7, obs-6 |
  meta |
SΣ | 0..1 | Meta | Metadata about the resource |
   profile |
SΣ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to |
 implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
 modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url |
| identifier |
SΣ | 0..* | Identifier | Business Identifier for observation |
 partOf |
SΣC | 0..* | Reference(MII PR MTB Systemische Therapie | Procedure) | Systemische Therapie Constraints: ref-1 |
| status |
?!SΣ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. |
| code |
SΣ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. |
 coding |
Σ | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following |
 id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
 system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 396432002 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Status of regression of tumor (observable entity) | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| subject |
SΣC | 1..1 | Reference(Patient) | Who and/or what the observation is about Constraints: ref-1 |
| focus |
SΣC | 1..1 | Reference(MII PR Onkologie Diagnose Primärtumor | MII PR MTB Diagnose Primärtumor) | What the observation is about, when it is not about the subject of record Constraints: ref-1 |
| encounter |
SΣC | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made Constraints: ref-1 |
 Slices for effective[x] |
SΣ | 0..1 | Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this | |
 effectiveDateTime |
dateTime | |||
| effectivePeriod |
Period | |||
| effectiveTiming |
Timing | |||
| effectiveInstant |
instant | |||
  effective[x]:effectiveDateTime |
SΣ | 0..1 | dateTime | Zeitpunkt |
| Slices for value[x] |
SΣC | 0..1 | CodeableConcept | Actual result Slice: Unordered, Closed by type:$this |
 value[x]:valueCodeableConcept |
SΣC | 0..1 | CodeableConcept | Actual result Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (extensible) |
 Slices for coding |
Σ | 0..* | Coding | Datum der Untersuchung im Verlauf Slice: Unordered, Open by pattern:system |
  coding:All Slices |
Content/Rules for all slices | |||
 system |
SΣ | 0..1 | uri | Identity of the terminology system |
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system |
| coding:oBDS |
SΣ | 0..* | Coding | Response Beurteilung nach oBDS-Kriterien |
 system |
SΣ | 1..1 | uri | Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-gesamtbeurteilung |
 code |
SΣ | 0..1 | code | Symbol in syntax defined by the system Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (required) |
| coding:MTB |
SΣ | 0..* | Coding | Response Beurteilung nach Recist oder Rano im Rahmen des MTB |
| system |
SΣ | 1..1 | uri | Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-response-befund-beurteilung |
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system Binding: MII VS Response Befund Beurteilung (required) |
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. |
| method |
S | 1..1 | CodeableConcept | Beurteilungsmethode Binding: MII VS Response Befund Beurteilung (required) |
| hasMember |
SΣC | 0..* | Reference(Observation) | Related resource that belongs to the Observation group Constraints: ref-1 |
| Slices for component |
SΣ | 0..* | BackboneElement | Component results Slice: Unordered, Open by pattern:code.coding |
| component:All Slices |
Content/Rules for all slices | |||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. |
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. |
| component:Tumor_Verlauf |
SΣ | 0..1 | BackboneElement | Component results |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
 code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. |
 coding |
Σ | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 445200009 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Status of residual neoplasm (observable entity) | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| value[x] |
Σ | 0..1 | CodeableConcept | Actual component result Binding: MII VS Onkologie Verlauf Primärtumor (required) |
| coding |
Σ | 0..* | Coding | Gesamtbeurteilung Primärtumor im Verlauf |
| system |
SΣ | 0..1 | uri | Identity of the terminology system |
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system |
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. |
| component:Lymphknoten_Verlauf |
SΣ | 0..1 | BackboneElement | Component results |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. |
| coding |
Σ | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 399656008 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Presence of metastatic neoplasm in regional lymph node (observable entity) | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| value[x] |
Σ | 0..1 | CodeableConcept | Actual component result Binding: MII VS Onkologie Verlauf Lymphknoten (required) |
| coding |
Σ | 0..* | Coding | Gesamtbeurteilung Lymphknoten im Verlauf |
| system |
SΣ | 0..1 | uri | Identity of the terminology system |
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system |
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. |
| component:Fernmetastasen_Verlauf |
SΣ | 0..1 | BackboneElement | Component results |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. |
| coding |
Σ | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 399608002 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Status of distant metastasis (observable entity) | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| value[x] |
Σ | 0..1 | CodeableConcept | Actual component result Binding: MII VS Onkologie Verlauf Fernmetastasen (required) |
| coding |
Σ | 0..* | Coding | Gesamtbeurteilung Fernmetastasen im Verlauf |
| system |
SΣ | 0..1 | uri | Identity of the terminology system |
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system |
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. |
| Documentation for this format | ||||
Terminology Bindings
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| Observation.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.value[x]:valueCodeableConcept | Base | extensible | MII VS Onkologie Verlauf Gesamtbeurteilung | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.value[x]:valueCodeableConcept.coding:oBDS.code | Base | required | MII VS Onkologie Verlauf Gesamtbeurteilung | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.value[x]:valueCodeableConcept.coding:MTB.code | Base | required | MII VS Response Befund Beurteilung | 📦2026.0.0 | This IG |
| Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.method | Base | required | MII VS Response Befund Beurteilung | 📦2026.0.0 | This IG |
| Observation.component.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component:Tumor_Verlauf.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Tumor_Verlauf.value[x] | Base | required | MII VS Onkologie Verlauf Primärtumor | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.component:Tumor_Verlauf.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component:Lymphknoten_Verlauf.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Lymphknoten_Verlauf.value[x] | Base | required | MII VS Onkologie Verlauf Lymphknoten | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.component:Lymphknoten_Verlauf.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component:Fernmetastasen_Verlauf.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Fernmetastasen_Verlauf.value[x] | Base | required | MII VS Onkologie Verlauf Fernmetastasen | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.component:Fernmetastasen_Verlauf.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
Constraints
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | Observation | 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 | error | Observation | 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 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | Observation | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| obs-6 | error | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present |
dataAbsentReason.empty() or value.empty()
|
| obs-7 | error | Observation | 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()
|
| ref-1 | error | Observation.partOf, Observation.subject, Observation.focus, Observation.encounter, Observation.hasMember | SHALL have a contained resource if a local reference is provided |
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
|
This structure is derived from MII_PR_Onko_Verlauf
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Observation |
0..* | MII_PR_Onko_Verlauf | Measurements and simple assertions | |
| meta |
S | 0..1 | Meta | Metadata about the resource |
| partOf |
S | 0..* | Reference(MII PR MTB Systemische Therapie | Procedure) | Systemische Therapie |
| status |
S | 1..1 | code | registered | preliminary | final | amended + |
| focus |
1..1 | Reference(MII PR Onkologie Diagnose Primärtumor | MII PR MTB Diagnose Primärtumor) | What the observation is about, when it is not about the subject of record | |
| Slices for effective[x] |
Content/Rules for all slices | |||
| effective[x]:effectiveDateTime |
0..1 | dateTime | Zeitpunkt | |
| Slices for value[x] |
Content/Rules for all slices | |||
| value[x]:valueCodeableConcept |
S | 0..1 | CodeableConcept | Actual result |
| Slices for coding |
0..* | Coding | Datum der Untersuchung im Verlauf Slice: Unordered, Open by pattern:system | |
| coding:oBDS |
S | 0..* | Coding | Response Beurteilung nach oBDS-Kriterien |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-gesamtbeurteilung | |
| code |
0..1 | code | Symbol in syntax defined by the system Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (required) | |
| coding:MTB |
S | 0..* | Coding | Response Beurteilung nach Recist oder Rano im Rahmen des MTB |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-response-befund-beurteilung | |
| code |
0..1 | code | Symbol in syntax defined by the system Binding: MII VS Response Befund Beurteilung (required) | |
| method |
S | 1..1 | CodeableConcept | Beurteilungsmethode Binding: MII VS Response Befund Beurteilung (required) |
| Documentation for this format | ||||
Terminology Bindings (Differential)
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.value[x]:valueCodeableConcept.coding:oBDS.code | Base | required | MII VS Onkologie Verlauf Gesamtbeurteilung | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.value[x]:valueCodeableConcept.coding:MTB.code | Base | required | MII VS Response Befund Beurteilung | 📦2026.0.0 | This IG |
| Observation.method | Base | required | MII VS Response Befund Beurteilung | 📦2026.0.0 | This IG |
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| Observation |
C | 0..* | MII_PR_Onko_Verlauf | Measurements and simple assertions Constraints: obs-7, obs-6 | ||||
| id |
Σ | 0..1 | id | Logical id of this artifact | ||||
| meta |
SΣ | 0..1 | Meta | Metadata about the resource | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
 extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| versionId |
Σ | 0..1 | id | Version specific identifier | ||||
| lastUpdated |
Σ | 0..1 | instant | When the resource version last changed | ||||
| source |
Σ | 0..1 | uri | Identifies where the resource comes from | ||||
| profile |
SΣ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | ||||
| security |
Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | ||||
| tag |
Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | ||||
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url | ||||
| identifier |
SΣ | 0..* | Identifier | Business Identifier for observation | ||||
| basedOn |
ΣC | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order Constraints: ref-1 | ||||
| partOf |
SΣC | 0..* | Reference(MII PR MTB Systemische Therapie | Procedure) | Systemische Therapie Constraints: ref-1 | ||||
| status |
?!SΣ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. | ||||
| category |
0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | |||||
| code |
SΣ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 396432002 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Status of regression of tumor (observable entity) | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| subject |
SΣC | 1..1 | Reference(Patient) | Who and/or what the observation is about Constraints: ref-1 | ||||
| focus |
SΣC | 1..1 | Reference(MII PR Onkologie Diagnose Primärtumor | MII PR MTB Diagnose Primärtumor) | What the observation is about, when it is not about the subject of record Constraints: ref-1 | ||||
| encounter |
SΣC | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made Constraints: ref-1 | ||||
| Slices for effective[x] |
SΣ | 0..1 | Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this | |||||
| effectiveDateTime |
dateTime | |||||||
| effectivePeriod |
Period | |||||||
| effectiveTiming |
Timing | |||||||
| effectiveInstant |
instant | |||||||
| effective[x]:effectiveDateTime |
SΣ | 0..1 | dateTime | Zeitpunkt | ||||
| issued |
Σ | 0..1 | instant | Date/Time this version was made available | ||||
| performer |
ΣC | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation Constraints: ref-1 | ||||
| Slices for value[x] |
SΣC | 0..1 | CodeableConcept | Actual result Slice: Unordered, Closed by type:$this | ||||
| value[x]:valueCodeableConcept |
SΣC | 0..1 | CodeableConcept | Actual result Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (extensible) | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| Slices for coding |
Σ | 0..* | Coding | Datum der Untersuchung im Verlauf Slice: Unordered, Open by pattern:system | ||||
| coding:All Slices |
Content/Rules for all slices | |||||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
SΣ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| coding:oBDS |
SΣ | 0..* | Coding | Response Beurteilung nach oBDS-Kriterien | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
SΣ | 1..1 | uri | Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-gesamtbeurteilung | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (required) | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| coding:MTB |
SΣ | 0..* | Coding | Response Beurteilung nach Recist oder Rano im Rahmen des MTB | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
SΣ | 1..1 | uri | Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-response-befund-beurteilung | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system Binding: MII VS Response Befund Beurteilung (required) | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| note |
0..* | Annotation | Comments about the observation | |||||
| bodySite |
0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | |||||
| method |
S | 1..1 | CodeableConcept | Beurteilungsmethode Binding: MII VS Response Befund Beurteilung (required) | ||||
| specimen |
C | 0..1 | Reference(Specimen) | Specimen used for this observation Constraints: ref-1 | ||||
| device |
C | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device Constraints: ref-1 | ||||
| referenceRange |
C | 0..* | BackboneElement | Provides guide for interpretation Constraints: obs-3 | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| low |
C | 0..1 | SimpleQuantity | Low Range, if relevant Constraints: qty-3, sqty-1 | ||||
| high |
C | 0..1 | SimpleQuantity | High Range, if relevant Constraints: qty-3, sqty-1 | ||||
| type |
0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range. | |||||
| appliesTo |
0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to. | |||||
| age |
C | 0..1 | Range | Applicable age range, if relevant Constraints: rng-2 | ||||
| text |
0..1 | string | Text based reference range in an observation | |||||
| hasMember |
SΣC | 0..* | Reference(Observation) | Related resource that belongs to the Observation group Constraints: ref-1 | ||||
| derivedFrom |
ΣC | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from Constraints: ref-1 | ||||
| Slices for component |
SΣ | 0..* | BackboneElement | Component results Slice: Unordered, Open by pattern:code.coding | ||||
| component:All Slices |
Content/Rules for all slices | |||||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
 value[x] |
Σ | 0..1 | Actual component result | |||||
| valueQuantity |
Quantity | |||||||
| valueCodeableConcept |
CodeableConcept | |||||||
| valueString |
string | |||||||
| valueBoolean |
boolean | |||||||
| valueInteger |
integer | |||||||
| valueRange |
Range | |||||||
| valueRatio |
Ratio | |||||||
| valueSampledData |
SampledData | |||||||
| valueTime |
time | |||||||
| valueDateTime |
dateTime | |||||||
| valuePeriod |
Period | |||||||
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| referenceRange |
0..* | See referenceRange (Observation) | Provides guide for interpretation of component result | |||||
| component:Tumor_Verlauf |
SΣ | 0..1 | BackboneElement | Component results | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 445200009 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Status of residual neoplasm (observable entity) | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
Σ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
Σ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| value[x] |
Σ | 0..1 | CodeableConcept | Actual component result Binding: MII VS Onkologie Verlauf Primärtumor (required) | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 0..* | Coding | Gesamtbeurteilung Primärtumor im Verlauf | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
SΣ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| referenceRange |
0..* | See referenceRange (Observation) | Provides guide for interpretation of component result | |||||
| component:Lymphknoten_Verlauf |
SΣ | 0..1 | BackboneElement | Component results | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 399656008 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Presence of metastatic neoplasm in regional lymph node (observable entity) | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
Σ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
Σ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| value[x] |
Σ | 0..1 | CodeableConcept | Actual component result Binding: MII VS Onkologie Verlauf Lymphknoten (required) | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 0..* | Coding | Gesamtbeurteilung Lymphknoten im Verlauf | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
SΣ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| referenceRange |
0..* | See referenceRange (Observation) | Provides guide for interpretation of component result | |||||
| component:Fernmetastasen_Verlauf |
SΣ | 0..1 | BackboneElement | Component results | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 399608002 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Status of distant metastasis (observable entity) | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
Σ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
Σ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| value[x] |
Σ | 0..1 | CodeableConcept | Actual component result Binding: MII VS Onkologie Verlauf Fernmetastasen (required) | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 0..* | Coding | Gesamtbeurteilung Fernmetastasen im Verlauf | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
SΣ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| referenceRange |
0..* | See referenceRange (Observation) | Provides guide for interpretation of component result | |||||
| Documentation for this format | ||||||||
Terminology Bindings
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.meta.security | Base | extensible | SecurityLabels | 📦4.0.1 | FHIR Std. |
| Observation.meta.tag | Base | example | Common Tags | 📦4.0.1 | FHIR Std. |
| Observation.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std. |
| Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| Observation.category | Base | preferred | Observation Category Codes | 📦4.0.1 | FHIR Std. |
| Observation.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.value[x]:valueCodeableConcept | Base | extensible | MII VS Onkologie Verlauf Gesamtbeurteilung | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.value[x]:valueCodeableConcept.coding:oBDS.code | Base | required | MII VS Onkologie Verlauf Gesamtbeurteilung | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.value[x]:valueCodeableConcept.coding:MTB.code | Base | required | MII VS Response Befund Beurteilung | 📦2026.0.0 | This IG |
| Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.interpretation | Base | extensible | Observation Interpretation Codes | 📦4.0.1 | FHIR Std. |
| Observation.bodySite | Base | example | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std. |
| Observation.method | Base | required | MII VS Response Befund Beurteilung | 📦2026.0.0 | This IG |
| Observation.referenceRange.type | Base | preferred | Observation Reference Range Meaning Codes | 📦4.0.1 | FHIR Std. |
| Observation.referenceRange.appliesTo | Base | example | Observation Reference Range Applies To Codes | 📦4.0.1 | FHIR Std. |
| Observation.component.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component.interpretation | Base | extensible | Observation Interpretation Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Tumor_Verlauf.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Tumor_Verlauf.value[x] | Base | required | MII VS Onkologie Verlauf Primärtumor | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.component:Tumor_Verlauf.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component:Tumor_Verlauf.interpretation | Base | extensible | Observation Interpretation Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Lymphknoten_Verlauf.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Lymphknoten_Verlauf.value[x] | Base | required | MII VS Onkologie Verlauf Lymphknoten | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.component:Lymphknoten_Verlauf.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component:Lymphknoten_Verlauf.interpretation | Base | extensible | Observation Interpretation Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Fernmetastasen_Verlauf.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Fernmetastasen_Verlauf.value[x] | Base | required | MII VS Onkologie Verlauf Fernmetastasen | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.component:Fernmetastasen_Verlauf.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component:Fernmetastasen_Verlauf.interpretation | Base | extensible | Observation Interpretation Codes | 📦4.0.1 | FHIR Std. |
Constraints
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | Observation | 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 | error | Observation | 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 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | Observation | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| obs-3 | error | Observation.referenceRange | Must have at least a low or a high or text |
low.exists() or high.exists() or text.exists()
|
| obs-6 | error | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present |
dataAbsentReason.empty() or value.empty()
|
| obs-7 | error | Observation | 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()
|
| qty-3 | error | Observation.referenceRange.low, Observation.referenceRange.high | If a code for the unit is present, the system SHALL also be present |
code.empty() or system.exists()
|
| ref-1 | error | Observation.basedOn, Observation.partOf, Observation.subject, Observation.focus, Observation.encounter, Observation.performer, Observation.specimen, Observation.device, Observation.hasMember, Observation.derivedFrom | SHALL have a contained resource if a local reference is provided |
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
|
| rng-2 | error | Observation.referenceRange.age | If present, low SHALL have a lower value than high |
low.empty() or high.empty() or (low <= high)
|
| sqty-1 | error | Observation.referenceRange.low, Observation.referenceRange.high | The comparator is not used on a SimpleQuantity |
comparator.empty()
|
This structure is derived from MII_PR_Onko_Verlauf
Summary
Mandatory: 1 element(2 nested mandatory elements)
Must-Support: 7 elements
Structures
This structure refers to these other structures:
- MII PR MTB Systemische Therapie (https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-systemische-therapie)
- MII PR Onkologie Diagnose Primärtumor (https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-diagnose-primaertumor)
- MII PR MTB Diagnose Primärtumor (https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-diagnose-primaertumor)
Slices
This structure defines the following Slices:
- The element 1 is sliced based on the value of Observation.value[x].coding
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Observation |
C | 0..* | MII_PR_Onko_Verlauf | Measurements and simple assertions Constraints: obs-7, obs-6 |
| meta |
SΣ | 0..1 | Meta | Metadata about the resource |
| profile |
SΣ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to |
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url |
| identifier |
SΣ | 0..* | Identifier | Business Identifier for observation |
| partOf |
SΣC | 0..* | Reference(MII PR MTB Systemische Therapie | Procedure) | Systemische Therapie Constraints: ref-1 |
| status |
?!SΣ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. |
| code |
SΣ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. |
| coding |
Σ | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 396432002 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Status of regression of tumor (observable entity) | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| subject |
SΣC | 1..1 | Reference(Patient) | Who and/or what the observation is about Constraints: ref-1 |
| focus |
SΣC | 1..1 | Reference(MII PR Onkologie Diagnose Primärtumor | MII PR MTB Diagnose Primärtumor) | What the observation is about, when it is not about the subject of record Constraints: ref-1 |
| encounter |
SΣC | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made Constraints: ref-1 |
| Slices for effective[x] |
SΣ | 0..1 | Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this | |
| effectiveDateTime |
dateTime | |||
| effectivePeriod |
Period | |||
| effectiveTiming |
Timing | |||
| effectiveInstant |
instant | |||
| effective[x]:effectiveDateTime |
SΣ | 0..1 | dateTime | Zeitpunkt |
| Slices for value[x] |
SΣC | 0..1 | CodeableConcept | Actual result Slice: Unordered, Closed by type:$this |
| value[x]:valueCodeableConcept |
SΣC | 0..1 | CodeableConcept | Actual result Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (extensible) |
| Slices for coding |
Σ | 0..* | Coding | Datum der Untersuchung im Verlauf Slice: Unordered, Open by pattern:system |
| coding:All Slices |
Content/Rules for all slices | |||
| system |
SΣ | 0..1 | uri | Identity of the terminology system |
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system |
| coding:oBDS |
SΣ | 0..* | Coding | Response Beurteilung nach oBDS-Kriterien |
| system |
SΣ | 1..1 | uri | Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-gesamtbeurteilung |
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (required) |
| coding:MTB |
SΣ | 0..* | Coding | Response Beurteilung nach Recist oder Rano im Rahmen des MTB |
| system |
SΣ | 1..1 | uri | Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-response-befund-beurteilung |
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system Binding: MII VS Response Befund Beurteilung (required) |
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. |
| method |
S | 1..1 | CodeableConcept | Beurteilungsmethode Binding: MII VS Response Befund Beurteilung (required) |
| hasMember |
SΣC | 0..* | Reference(Observation) | Related resource that belongs to the Observation group Constraints: ref-1 |
| Slices for component |
SΣ | 0..* | BackboneElement | Component results Slice: Unordered, Open by pattern:code.coding |
| component:All Slices |
Content/Rules for all slices | |||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. |
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. |
| component:Tumor_Verlauf |
SΣ | 0..1 | BackboneElement | Component results |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. |
| coding |
Σ | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 445200009 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Status of residual neoplasm (observable entity) | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| value[x] |
Σ | 0..1 | CodeableConcept | Actual component result Binding: MII VS Onkologie Verlauf Primärtumor (required) |
| coding |
Σ | 0..* | Coding | Gesamtbeurteilung Primärtumor im Verlauf |
| system |
SΣ | 0..1 | uri | Identity of the terminology system |
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system |
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. |
| component:Lymphknoten_Verlauf |
SΣ | 0..1 | BackboneElement | Component results |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. |
| coding |
Σ | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 399656008 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Presence of metastatic neoplasm in regional lymph node (observable entity) | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| value[x] |
Σ | 0..1 | CodeableConcept | Actual component result Binding: MII VS Onkologie Verlauf Lymphknoten (required) |
| coding |
Σ | 0..* | Coding | Gesamtbeurteilung Lymphknoten im Verlauf |
| system |
SΣ | 0..1 | uri | Identity of the terminology system |
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system |
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. |
| component:Fernmetastasen_Verlauf |
SΣ | 0..1 | BackboneElement | Component results |
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. |
| coding |
Σ | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 399608002 | |
| display |
1..1 | string | Representation defined by the system Fixed Value: Status of distant metastasis (observable entity) | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| value[x] |
Σ | 0..1 | CodeableConcept | Actual component result Binding: MII VS Onkologie Verlauf Fernmetastasen (required) |
| coding |
Σ | 0..* | Coding | Gesamtbeurteilung Fernmetastasen im Verlauf |
| system |
SΣ | 0..1 | uri | Identity of the terminology system |
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system |
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. |
| Documentation for this format | ||||
Terminology Bindings
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| Observation.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.value[x]:valueCodeableConcept | Base | extensible | MII VS Onkologie Verlauf Gesamtbeurteilung | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.value[x]:valueCodeableConcept.coding:oBDS.code | Base | required | MII VS Onkologie Verlauf Gesamtbeurteilung | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.value[x]:valueCodeableConcept.coding:MTB.code | Base | required | MII VS Response Befund Beurteilung | 📦2026.0.0 | This IG |
| Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.method | Base | required | MII VS Response Befund Beurteilung | 📦2026.0.0 | This IG |
| Observation.component.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component:Tumor_Verlauf.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Tumor_Verlauf.value[x] | Base | required | MII VS Onkologie Verlauf Primärtumor | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.component:Tumor_Verlauf.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component:Lymphknoten_Verlauf.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Lymphknoten_Verlauf.value[x] | Base | required | MII VS Onkologie Verlauf Lymphknoten | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.component:Lymphknoten_Verlauf.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component:Fernmetastasen_Verlauf.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Fernmetastasen_Verlauf.value[x] | Base | required | MII VS Onkologie Verlauf Fernmetastasen | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.component:Fernmetastasen_Verlauf.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
Constraints
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | Observation | 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 | error | Observation | 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 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | Observation | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| obs-6 | error | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present |
dataAbsentReason.empty() or value.empty()
|
| obs-7 | error | Observation | 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()
|
| ref-1 | error | Observation.partOf, Observation.subject, Observation.focus, Observation.encounter, Observation.hasMember | SHALL have a contained resource if a local reference is provided |
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
|
Differential View
This structure is derived from MII_PR_Onko_Verlauf
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Observation |
0..* | MII_PR_Onko_Verlauf | Measurements and simple assertions | |
| meta |
S | 0..1 | Meta | Metadata about the resource |
| partOf |
S | 0..* | Reference(MII PR MTB Systemische Therapie | Procedure) | Systemische Therapie |
| status |
S | 1..1 | code | registered | preliminary | final | amended + |
| focus |
1..1 | Reference(MII PR Onkologie Diagnose Primärtumor | MII PR MTB Diagnose Primärtumor) | What the observation is about, when it is not about the subject of record | |
| Slices for effective[x] |
Content/Rules for all slices | |||
| effective[x]:effectiveDateTime |
0..1 | dateTime | Zeitpunkt | |
| Slices for value[x] |
Content/Rules for all slices | |||
| value[x]:valueCodeableConcept |
S | 0..1 | CodeableConcept | Actual result |
| Slices for coding |
0..* | Coding | Datum der Untersuchung im Verlauf Slice: Unordered, Open by pattern:system | |
| coding:oBDS |
S | 0..* | Coding | Response Beurteilung nach oBDS-Kriterien |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-gesamtbeurteilung | |
| code |
0..1 | code | Symbol in syntax defined by the system Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (required) | |
| coding:MTB |
S | 0..* | Coding | Response Beurteilung nach Recist oder Rano im Rahmen des MTB |
| system |
1..1 | uri | Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-response-befund-beurteilung | |
| code |
0..1 | code | Symbol in syntax defined by the system Binding: MII VS Response Befund Beurteilung (required) | |
| method |
S | 1..1 | CodeableConcept | Beurteilungsmethode Binding: MII VS Response Befund Beurteilung (required) |
| Documentation for this format | ||||
Terminology Bindings (Differential)
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.value[x]:valueCodeableConcept.coding:oBDS.code | Base | required | MII VS Onkologie Verlauf Gesamtbeurteilung | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.value[x]:valueCodeableConcept.coding:MTB.code | Base | required | MII VS Response Befund Beurteilung | 📦2026.0.0 | This IG |
| Observation.method | Base | required | MII VS Response Befund Beurteilung | 📦2026.0.0 | This IG |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| Observation |
C | 0..* | MII_PR_Onko_Verlauf | Measurements and simple assertions Constraints: obs-7, obs-6 | ||||
| id |
Σ | 0..1 | id | Logical id of this artifact | ||||
| meta |
SΣ | 0..1 | Meta | Metadata about the resource | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| versionId |
Σ | 0..1 | id | Version specific identifier | ||||
| lastUpdated |
Σ | 0..1 | instant | When the resource version last changed | ||||
| source |
Σ | 0..1 | uri | Identifies where the resource comes from | ||||
| profile |
SΣ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | ||||
| security |
Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | ||||
| tag |
Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | ||||
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored Slice: Unordered, Open by value:url | ||||
| identifier |
SΣ | 0..* | Identifier | Business Identifier for observation | ||||
| basedOn |
ΣC | 0..* | Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) | Fulfills plan, proposal or order Constraints: ref-1 | ||||
| partOf |
SΣC | 0..* | Reference(MII PR MTB Systemische Therapie | Procedure) | Systemische Therapie Constraints: ref-1 | ||||
| status |
?!SΣ | 1..1 | code | registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. | ||||
| category |
0..* | CodeableConcept | Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. | |||||
| code |
SΣ | 1..1 | CodeableConcept | Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 0..* | Coding | Code defined by a terminology system Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 396432002 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Status of regression of tumor (observable entity) | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| subject |
SΣC | 1..1 | Reference(Patient) | Who and/or what the observation is about Constraints: ref-1 | ||||
| focus |
SΣC | 1..1 | Reference(MII PR Onkologie Diagnose Primärtumor | MII PR MTB Diagnose Primärtumor) | What the observation is about, when it is not about the subject of record Constraints: ref-1 | ||||
| encounter |
SΣC | 0..1 | Reference(Encounter) | Healthcare event during which this observation is made Constraints: ref-1 | ||||
| Slices for effective[x] |
SΣ | 0..1 | Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this | |||||
| effectiveDateTime |
dateTime | |||||||
| effectivePeriod |
Period | |||||||
| effectiveTiming |
Timing | |||||||
| effectiveInstant |
instant | |||||||
| effective[x]:effectiveDateTime |
SΣ | 0..1 | dateTime | Zeitpunkt | ||||
| issued |
Σ | 0..1 | instant | Date/Time this version was made available | ||||
| performer |
ΣC | 0..* | Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) | Who is responsible for the observation Constraints: ref-1 | ||||
| Slices for value[x] |
SΣC | 0..1 | CodeableConcept | Actual result Slice: Unordered, Closed by type:$this | ||||
| value[x]:valueCodeableConcept |
SΣC | 0..1 | CodeableConcept | Actual result Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (extensible) | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| Slices for coding |
Σ | 0..* | Coding | Datum der Untersuchung im Verlauf Slice: Unordered, Open by pattern:system | ||||
| coding:All Slices |
Content/Rules for all slices | |||||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
SΣ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| coding:oBDS |
SΣ | 0..* | Coding | Response Beurteilung nach oBDS-Kriterien | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
SΣ | 1..1 | uri | Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/CodeSystem/mii-cs-onko-verlauf-gesamtbeurteilung | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (required) | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| coding:MTB |
SΣ | 0..* | Coding | Response Beurteilung nach Recist oder Rano im Rahmen des MTB | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
SΣ | 1..1 | uri | Identity of the terminology system Required Pattern: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-response-befund-beurteilung | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system Binding: MII VS Response Befund Beurteilung (required) | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| note |
0..* | Annotation | Comments about the observation | |||||
| bodySite |
0..1 | CodeableConcept | Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality. | |||||
| method |
S | 1..1 | CodeableConcept | Beurteilungsmethode Binding: MII VS Response Befund Beurteilung (required) | ||||
| specimen |
C | 0..1 | Reference(Specimen) | Specimen used for this observation Constraints: ref-1 | ||||
| device |
C | 0..1 | Reference(Device | DeviceMetric) | (Measurement) Device Constraints: ref-1 | ||||
| referenceRange |
C | 0..* | BackboneElement | Provides guide for interpretation Constraints: obs-3 | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| low |
C | 0..1 | SimpleQuantity | Low Range, if relevant Constraints: qty-3, sqty-1 | ||||
| high |
C | 0..1 | SimpleQuantity | High Range, if relevant Constraints: qty-3, sqty-1 | ||||
| type |
0..1 | CodeableConcept | Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range. | |||||
| appliesTo |
0..* | CodeableConcept | Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to. | |||||
| age |
C | 0..1 | Range | Applicable age range, if relevant Constraints: rng-2 | ||||
| text |
0..1 | string | Text based reference range in an observation | |||||
| hasMember |
SΣC | 0..* | Reference(Observation) | Related resource that belongs to the Observation group Constraints: ref-1 | ||||
| derivedFrom |
ΣC | 0..* | Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) | Related measurements the observation is made from Constraints: ref-1 | ||||
| Slices for component |
SΣ | 0..* | BackboneElement | Component results Slice: Unordered, Open by pattern:code.coding | ||||
| component:All Slices |
Content/Rules for all slices | |||||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
| value[x] |
Σ | 0..1 | Actual component result | |||||
| valueQuantity |
Quantity | |||||||
| valueCodeableConcept |
CodeableConcept | |||||||
| valueString |
string | |||||||
| valueBoolean |
boolean | |||||||
| valueInteger |
integer | |||||||
| valueRange |
Range | |||||||
| valueRatio |
Ratio | |||||||
| valueSampledData |
SampledData | |||||||
| valueTime |
time | |||||||
| valueDateTime |
dateTime | |||||||
| valuePeriod |
Period | |||||||
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| referenceRange |
0..* | See referenceRange (Observation) | Provides guide for interpretation of component result | |||||
| component:Tumor_Verlauf |
SΣ | 0..1 | BackboneElement | Component results | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 445200009 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Status of residual neoplasm (observable entity) | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
Σ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
Σ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| value[x] |
Σ | 0..1 | CodeableConcept | Actual component result Binding: MII VS Onkologie Verlauf Primärtumor (required) | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 0..* | Coding | Gesamtbeurteilung Primärtumor im Verlauf | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
SΣ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| referenceRange |
0..* | See referenceRange (Observation) | Provides guide for interpretation of component result | |||||
| component:Lymphknoten_Verlauf |
SΣ | 0..1 | BackboneElement | Component results | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 399656008 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Presence of metastatic neoplasm in regional lymph node (observable entity) | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
Σ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
Σ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| value[x] |
Σ | 0..1 | CodeableConcept | Actual component result Binding: MII VS Onkologie Verlauf Lymphknoten (required) | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 0..* | Coding | Gesamtbeurteilung Lymphknoten im Verlauf | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
SΣ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| referenceRange |
0..* | See referenceRange (Observation) | Provides guide for interpretation of component result | |||||
| component:Fernmetastasen_Verlauf |
SΣ | 0..1 | BackboneElement | Component results | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| modifierExtension |
?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
| code |
Σ | 1..1 | CodeableConcept | Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 1..* | Coding | Code defined by a terminology system Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://snomed.info/sct | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: 399608002 | |||||
| display |
1..1 | string | Representation defined by the system Fixed Value: Status of distant metastasis (observable entity) | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
Σ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
Σ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| value[x] |
Σ | 0..1 | CodeableConcept | Actual component result Binding: MII VS Onkologie Verlauf Fernmetastasen (required) | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| coding |
Σ | 0..* | Coding | Gesamtbeurteilung Fernmetastasen im Verlauf | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| system |
SΣ | 0..1 | uri | Identity of the terminology system | ||||
| version |
Σ | 0..1 | string | Version of the system - if relevant | ||||
| code |
SΣ | 0..1 | code | Symbol in syntax defined by the system | ||||
| display |
Σ | 0..1 | string | Representation defined by the system | ||||
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user | ||||
| text |
Σ | 0..1 | string | Plain text representation of the concept | ||||
| dataAbsentReason |
C | 0..1 | CodeableConcept | Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing. | ||||
| interpretation |
0..* | CodeableConcept | High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations. | |||||
| referenceRange |
0..* | See referenceRange (Observation) | Provides guide for interpretation of component result | |||||
| Documentation for this format | ||||||||
Terminology Bindings
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.meta.security | Base | extensible | SecurityLabels | 📦4.0.1 | FHIR Std. |
| Observation.meta.tag | Base | example | Common Tags | 📦4.0.1 | FHIR Std. |
| Observation.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std. |
| Observation.status | Base | required | ObservationStatus | 📍4.0.1 | FHIR Std. |
| Observation.category | Base | preferred | Observation Category Codes | 📦4.0.1 | FHIR Std. |
| Observation.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.value[x]:valueCodeableConcept | Base | extensible | MII VS Onkologie Verlauf Gesamtbeurteilung | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.value[x]:valueCodeableConcept.coding:oBDS.code | Base | required | MII VS Onkologie Verlauf Gesamtbeurteilung | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.value[x]:valueCodeableConcept.coding:MTB.code | Base | required | MII VS Response Befund Beurteilung | 📦2026.0.0 | This IG |
| Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.interpretation | Base | extensible | Observation Interpretation Codes | 📦4.0.1 | FHIR Std. |
| Observation.bodySite | Base | example | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std. |
| Observation.method | Base | required | MII VS Response Befund Beurteilung | 📦2026.0.0 | This IG |
| Observation.referenceRange.type | Base | preferred | Observation Reference Range Meaning Codes | 📦4.0.1 | FHIR Std. |
| Observation.referenceRange.appliesTo | Base | example | Observation Reference Range Applies To Codes | 📦4.0.1 | FHIR Std. |
| Observation.component.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component.interpretation | Base | extensible | Observation Interpretation Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Tumor_Verlauf.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Tumor_Verlauf.value[x] | Base | required | MII VS Onkologie Verlauf Primärtumor | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.component:Tumor_Verlauf.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component:Tumor_Verlauf.interpretation | Base | extensible | Observation Interpretation Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Lymphknoten_Verlauf.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Lymphknoten_Verlauf.value[x] | Base | required | MII VS Onkologie Verlauf Lymphknoten | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.component:Lymphknoten_Verlauf.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component:Lymphknoten_Verlauf.interpretation | Base | extensible | Observation Interpretation Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Fernmetastasen_Verlauf.code | Base | example | LOINC Codes | 📦4.0.1 | FHIR Std. |
| Observation.component:Fernmetastasen_Verlauf.value[x] | Base | required | MII VS Onkologie Verlauf Fernmetastasen | 📦2026.0.1 | MII IG Onkologie v2026.0 |
| Observation.component:Fernmetastasen_Verlauf.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component:Fernmetastasen_Verlauf.interpretation | Base | extensible | Observation Interpretation Codes | 📦4.0.1 | FHIR Std. |
Constraints
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | Observation | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | Observation | 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 | error | Observation | 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 | error | Observation | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | Observation | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| obs-3 | error | Observation.referenceRange | Must have at least a low or a high or text |
low.exists() or high.exists() or text.exists()
|
| obs-6 | error | Observation | dataAbsentReason SHALL only be present if Observation.value[x] is not present |
dataAbsentReason.empty() or value.empty()
|
| obs-7 | error | Observation | 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()
|
| qty-3 | error | Observation.referenceRange.low, Observation.referenceRange.high | If a code for the unit is present, the system SHALL also be present |
code.empty() or system.exists()
|
| ref-1 | error | Observation.basedOn, Observation.partOf, Observation.subject, Observation.focus, Observation.encounter, Observation.performer, Observation.specimen, Observation.device, Observation.hasMember, Observation.derivedFrom | SHALL have a contained resource if a local reference is provided |
reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids'))
|
| rng-2 | error | Observation.referenceRange.age | If present, low SHALL have a lower value than high |
low.empty() or high.empty() or (low <= high)
|
| sqty-1 | error | Observation.referenceRange.low, Observation.referenceRange.high | The comparator is not used on a SimpleQuantity |
comparator.empty()
|
This structure is derived from MII_PR_Onko_Verlauf
Summary
Mandatory: 1 element(2 nested mandatory elements)
Must-Support: 7 elements
Structures
This structure refers to these other structures:
- MII PR MTB Systemische Therapie (https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-systemische-therapie)
- MII PR Onkologie Diagnose Primärtumor (https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-diagnose-primaertumor)
- MII PR MTB Diagnose Primärtumor (https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-diagnose-primaertumor)
Slices
This structure defines the following Slices:
- The element 1 is sliced based on the value of Observation.value[x].coding
Other representations of profile: CSV, Excel, Schematron