MII IG Kerndatensatz-Modul Molekulares Tumorboard
2026.0.0 - release Unknown region code '276'

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_RNA_Fusion - Detailed Descriptions

Active as of 2026-02-09

Definitions for the mii-pr-mtb-rna-fusion resource profile.

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

0. Observation
Definition

Measurements and simple assertions made about a patient, device or other subject.

ShortVariantMeasurements and simple assertions
Comments

Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.

Control0..*
Is Modifierfalse
Alternate NamesVital Signs, Measurement, Results, Tests
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
2. Observation.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control0..1
This element is affected by the following invariants: ele-1
TypeMeta
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Observation.meta.profile
Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.


A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

ShortProfiles this resource claims to conform to
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Control0..*
Typecanonical(StructureDefinition)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. Observation.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
This element is affected by the following invariants: ele-1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Observation.extension:secondary-finding
Slice Namesecondary-finding
Definition

Secondary findings are genetic test results that provide information about variants in a gene unrelated to the primary purpose for the testing, most often discovered when Whole Exome Sequencing (WES) or Whole Genome Sequencing (WGS) is performed. This extension should be used to denote when a genetic finding is being shared as a secondary finding, and ideally refer to a corresponding guideline or policy statement.

For more detail, please see: https://ghr.nlm.nih.gov/primer/testing/secondaryfindings.

ShortSecondary findings are genetic test results that provide information about variants in a gene unrelated to the primary purpose for the testing, most often discovered when [Whole Exome Sequencing (WES)](https://en.wikipedia.org/wiki/Exome_sequencing) or [Whole Genome Sequencing (WGS)](https://en.wikipedia.org/wiki/Whole_genome_sequencing) is performed. This extension should be used to denote when a genetic finding is being shared as a secondary finding, and ideally refer to a corresponding guideline or policy statement. For more detail, please see: https://ghr.nlm.nih.gov/primer/testing/secondaryfindings
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(Observation Secondary Finding) (Extension Type: CodeableConcept)
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. Observation.extension:body-structure
Slice Namebody-structure
Definition

Record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.

ShortTarget anatomic location or structure
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..1
This element is affected by the following invariants: ele-1
TypeExtension(BodyStructure Reference) (Extension Type: Reference(BodyStructure))
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. Observation.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Observation.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 14. Observation.identifier
    Definition

    A unique identifier assigned to this observation.

    ShortVariantenId innerhalb des NGS-BefundesBusiness Identifier for observation
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeIdentifier
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Requirements

    Allows observations to be distinguished and referenced.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. Observation.status
    Definition

    Status der Beobachtung


    The status of the result value.

    ShortStatusregistered | preliminary | final | amended +
    Comments

    This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

    Control1..1
    This element is affected by the following invariants: ele-1
    BindingThe codes SHALL be taken from ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status|4.0.1
    (required to http://hl7.org/fhir/ValueSet/observation-status|4.0.1)

    Codes providing the status of an observation.

    Typecode
    Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    Need to track the status of individual results. Some results are finalized before the whole report is finalized.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Observation.category
    Definition

    Klassifizierung der Beobachtungsart


    A code that classifies the general type of observation being made.

    ShortKategorieClassification of type of observation
    Comments

    In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

    Control20..*
    This element is affected by the following invariants: ele-1
    BindingThe codes SHOULD be taken from ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-category|4.0.1
    (preferred to http://hl7.org/fhir/ValueSet/observation-category)

    Codes for high level observation categories.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Requirements

    Used for filtering what observations are retrieved and displayed.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on Observation.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ coding
    • 20. Observation.category:labCategory
      Slice NamelabCategory
      Definition

      A code that classifies the general type of observation being made.

      ShortClassification of type of observation
      Comments

      In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

      Control10..1*
      This element is affected by the following invariants: ele-1
      BindingThe codes SHOULD be taken from ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-category|4.0.1
      (preferred to http://hl7.org/fhir/ValueSet/observation-category)

      Codes for high level observation categories.

      TypeCodeableConcept
      Is Modifierfalse
      Requirements

      Used for filtering what observations are retrieved and displayed.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Observation.category:labCategory.coding
      Definition

      A reference to a code defined by a terminology system.

      ShortCode defined by a terminology system
      Comments

      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

      Control10..1*
      This element is affected by the following invariants: ele-1
      TypeCoding
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

      Pattern Value{
        "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
        "code" : "laboratory"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      24. Observation.category:geCategory
      Slice NamegeCategory
      Definition

      A code that classifies the general type of observation being made.

      ShortClassification of type of observation
      Comments

      In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

      Control10..1*
      This element is affected by the following invariants: ele-1
      BindingThe codes SHOULD be taken from ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-category|4.0.1
      (preferred to http://hl7.org/fhir/ValueSet/observation-category)

      Codes for high level observation categories.

      TypeCodeableConcept
      Is Modifierfalse
      Requirements

      Used for filtering what observations are retrieved and displayed.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. Observation.category:geCategory.coding
      Definition

      A reference to a code defined by a terminology system.

      ShortCode defined by a terminology system
      Comments

      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

      Control10..1*
      This element is affected by the following invariants: ele-1
      TypeCoding
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

      Pattern Value{
        "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
        "code" : "GE"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. Observation.code
      Definition

      Code zur Identifizierung der Varianten-Beobachtung


      Describes what was observed. Sometimes this is called the observation "name".

      ShortCodeType of observation (code / type)
      Comments

      All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

      Control1..1
      This element is affected by the following invariants: ele-1
      BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
      (example to http://hl7.org/fhir/ValueSet/observation-codes)

      Codes identifying names of simple observations.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summarytrue
      Requirements

      Knowing what kind of observation is being made is essential to understanding the observation.

      Alternate NamesName
      Pattern Value{
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "69548-6"
        }]
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. Observation.subject
      Definition

      Der Patient oder die Gruppe auf die sich die Variante bezieht


      The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

      ShortPatient oder ProbandWho and/or what the observation is about
      Comments

      One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

      Control10..1
      This element is affected by the following invariants: ele-1
      TypeReference(Patient, Group, Patient, Group, Device, Location)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Requirements

      Observations have no value if you don't know who or what they're about.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ref-1: 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')))
      32. Observation.focus
      Definition

      The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

      ShortWhat the observation is about, when it is not about the subject of record
      Comments

      Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use specimen if a reference to a specimen is required. If a code is required instead of a resource use either bodysite for bodysites or the standard extension focusCode.

      Control0..*
      This element is affected by the following invariants: ele-1
      TypeReference(MII PR Onkologie Diagnose Primärtumor, MII PR MTB Diagnose Primärtumor, Resource)
      Is Modifierfalse
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ref-1: 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')))
      34. Observation.effective[x]
      Definition

      Klinisch relevanter Zeitpunkt oder Zeitraum der Beobachtung


      The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

      ShortZeitpunkt der BeobachtungClinically relevant time/time-period for observation
      Comments

      At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

      Control0..1
      This element is affected by the following invariants: ele-1
      TypeChoice of: dateTime, Period, Timing, instant
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Requirements

      Knowing when an observation was deemed true is important to its relevance as well as determining trends.

      Alternate NamesOccurrence
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. Observation.issued
      Definition

      Datum und Uhrzeit der Freigabe der Beobachtung


      The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.

      ShortFreigabedatumDate/Time this version was made available
      Comments

      For Observations that don’t require review and verification, it may be the same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

      Control0..1
      This element is affected by the following invariants: ele-1
      Typeinstant
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. Observation.value[x]
      Definition

      Das Ergebnis der Variantenanalyse - vorhanden oder abwesend


      The information determined as a result of making the observation, if the information has a simple value.

      ShortErgebniswertActual result
      Comments

      An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

      Control0..1
      This element is affected by the following invariants: ele-1, obs-7
      TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      Summarytrue
      Requirements

      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Observation.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • type @ $this
      • 40. Observation.value[x]:valueCodeableConcept
        Slice NamevalueCodeableConcept
        Definition

        The presence or absence of the variant described in the components. If not searching for specific variations and merely reporting what's found, the profile's value should be set to 'Present'.


        The information determined as a result of making the observation, if the information has a simple value.

        ShortIndeterminate | No call | Present | Absent.Actual result
        Comments

        See here for usage guidance.


        An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

        Control0..1
        This element is affected by the following invariants: ele-1, obs-7
        BindingThe codes SHALL be taken from For codes, see LOINC Answer List LL1971-2
        (required to http://loinc.org/vs/LL1971-2)
        TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summarytrue
        Requirements

        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. Observation.dataAbsentReason
        Definition

        Provides a reason why the expected value in the element Observation.value[x] is missing.

        ShortWhy the result is missing
        Comments

        Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory".

        The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

        Control0..1
        This element is affected by the following invariants: ele-1, obs-6
        BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
        (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

        Codes specifying why the result (Observation.value[x]) is missing.

        TypeCodeableConcept
        Is Modifierfalse
        Requirements

        For many results it is necessary to handle exceptional values in measurements.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. Observation.method
        Definition

        Die verwendete Untersuchungsmethode


        Indicates the mechanism used to perform the observation.

        ShortMethodeHow it was done
        Comments

        Only used if not implicit in code for Observation.code.

        Control0..1
        This element is affected by the following invariants: ele-1
        BindingUnless not suitable, these codes SHALL be taken from For example codes, see LOINC Answer List LL4048-6http://hl7.org/fhir/ValueSet/observation-methods|4.0.1
        (extensible to http://loinc.org/vs/LL4048-6)

        Methods for simple observations.

        TypeCodeableConcept
        Is Modifierfalse
        Must Supporttrue
        Requirements

        In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. Observation.specimen
        Definition

        Die untersuchte Probe


        The specimen that was used when this observation was made.

        ShortProbeSpecimen used for this observation
        Comments

        Should only be used if not implicit in code found in Observation.code. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeReference(Specimen, Specimen)
        Is Modifierfalse
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ref-1: 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')))
        48. Observation.device
        Definition

        Das verwendete Analysegerät


        The device used to generate the observation data.

        ShortGerät(Measurement) Device
        Comments

        Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeReference(Device, DeviceMetric, Device, DeviceMetric)
        Is Modifierfalse
        Must Supporttrue
        Must Support TypesNo must-support rules about the choice of types/profiles
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ref-1: 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')))
        50. Observation.derivedFrom
        Definition

        The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

        ShortRelated measurements the observation is made from
        Comments

        All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeReference(DocumentReference, ImagingStudy, Media, QuestionnaireResponse, Observation, MolecularSequence, DocumentReference, ImagingStudy, Media, QuestionnaireResponse, Observation, MolecularSequence)
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ref-1: 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')))
        SlicingThis element introduces a set of slices on Observation.derivedFrom. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • profile @ resolve()
        • 52. Observation.component
          Definition

          Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

          ShortComponent results
          Comments

          For a discussion on the ways Observations can be assembled in groups together see Notes below.

          Control100..*
          This element is affected by the following invariants: ele-1
          TypeBackboneElement
          Is Modifierfalse
          Summarytrue
          Requirements

          Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Observation.component. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ code
          • 54. Observation.component.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            56. Observation.component.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            58. Observation.component.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            60. Observation.component:conclusion-string
            Slice Nameconclusion-string
            Definition

            Textuelle Zusammenfassung oder Schlussfolgerung zur Variante


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortSchlussfolgerung - TextComponent results
            Comments

            An example would be the interpretative information, typically canned, about a variant identified in the patient.


            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Need to be able to provide a conclusion that is not lost among the basic result data.


            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            62. Observation.component:conclusion-string.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            64. Observation.component:conclusion-string.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Shortconclusion-stringType of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
                "code" : "conclusion-string"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            66. Observation.component:conclusion-string.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            68. Observation.component:gene-studied
            Slice Namegene-studied
            Definition

            Das untersuchte Gen identifiziert durch HGNC-ID


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortUntersuchtes GenComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            70. Observation.component:gene-studied.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            72. Observation.component:gene-studied.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short48018-6Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "48018-6"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            74. Observation.component:gene-studied.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortThe HGNC gene symbol is to be used as display text and the HGNC gene ID used as the code. If no HGNC code issued for this gene yet, NCBI gene IDs SHALL be used.Actual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see HUGO Gene Nomenclature Committee Gene Names (HGNC)
            (extensible to http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgnc-vs)
            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            76. Observation.component:gene-studied.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            78. Observation.component:cytogenetic-location
            Slice Namecytogenetic-location
            Definition

            Chromosomale Position der Variante in Bandennomenklatur


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortZytogenetische LokalisationComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            80. Observation.component:cytogenetic-location.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            82. Observation.component:cytogenetic-location.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short48001-2Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "48001-2"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            84. Observation.component:cytogenetic-location.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortExample: 1q21.1Actual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            86. Observation.component:cytogenetic-location.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            88. Observation.component:reference-sequence-assembly
            Slice Namereference-sequence-assembly
            Definition

            Die verwendete Referenzgenom-Version wie z.B. GRCh37 oder GRCh38


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortReferenzgenom-AssemblyComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            90. Observation.component:reference-sequence-assembly.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            92. Observation.component:reference-sequence-assembly.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short62374-4Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "62374-4"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            94. Observation.component:reference-sequence-assembly.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortGRCh37 | GRCh38 | ...Actual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see LOINC Answer List LL1040-6
            (extensible to http://loinc.org/vs/LL1040-6)
            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            96. Observation.component:reference-sequence-assembly.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            98. Observation.component:chromosome-identifier
            Slice Namechromosome-identifier
            Definition

            Das betroffene Chromosom


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortChromosomComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            100. Observation.component:chromosome-identifier.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            102. Observation.component:chromosome-identifier.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short48000-4Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "48000-4"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            104. Observation.component:chromosome-identifier.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortChromosome 1 | Chromosome 2 | ... | Chromosome 22 | Chromosome X | Chromosome YActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            BindingThe codes SHALL be taken from For codes, see LOINC Answer List LL2938-0
            (required to http://loinc.org/vs/LL2938-0)
            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            106. Observation.component:chromosome-identifier.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            108. Observation.component:representative-coding-hgvs
            Slice Namerepresentative-coding-hgvs
            Definition

            Die cDNA-Änderung in HGVS-Nomenklatur auf Transkriptebene


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortDNA-Änderung c.HGVSComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            110. Observation.component:representative-coding-hgvs.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            112. Observation.component:representative-coding-hgvs.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short48004-6Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "48004-6"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            114. Observation.component:representative-coding-hgvs.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortA valid HGVS-formatted 'c.' string, e.g. NM_005228.5:c.2369C>T.Actual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            BindingThe codes SHALL be taken from For codes, see Human Genome Variation Society (HGVS) Nomenclature
            (required to http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgvs-vs)
            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            116. Observation.component:representative-coding-hgvs.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            118. Observation.component:genomic-hgvs
            Slice Namegenomic-hgvs
            Definition

            Die genomische DNA-Änderung in HGVS-Nomenklatur


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortGenomische DNA-Änderung g.HGVSComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            120. Observation.component:genomic-hgvs.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            122. Observation.component:genomic-hgvs.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short81290-9Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "81290-9"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            124. Observation.component:genomic-hgvs.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortA valid HGVS-formatted 'g.' string, e.g. NC_000016.9:g.2124200_2138612dupActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            BindingThe codes SHALL be taken from For codes, see Human Genome Variation Society (HGVS) Nomenclature
            (required to http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgvs-vs)
            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            126. Observation.component:genomic-hgvs.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            128. Observation.component:cytogenomic-nomenclature
            Slice Namecytogenomic-nomenclature
            Definition

            Fully describes a variant with a single code. Typically a large variant such as a mosaic, abnormal chromosome numbers, etc.


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortCytogenomic Nomenclature (ISCN)Component results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            130. Observation.component:cytogenomic-nomenclature.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            132. Observation.component:cytogenomic-nomenclature.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short81291-7Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "81291-7"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            134. Observation.component:cytogenomic-nomenclature.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            Binding

            Binding not yet defined

            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            136. Observation.component:cytogenomic-nomenclature.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            138. Observation.component:genomic-ref-seq
            Slice Namegenomic-ref-seq
            Definition

            Die genomische Referenzsequenz-ID wie z.B. NC_000007.14


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortGenomische ReferenzsequenzComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            140. Observation.component:genomic-ref-seq.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            142. Observation.component:genomic-ref-seq.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short48013-7Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "48013-7"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            144. Observation.component:genomic-ref-seq.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortVersioned genomic reference sequence identifierActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            Binding

            Multiple bindings acceptable (NCBI or LRG)

            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            146. Observation.component:genomic-ref-seq.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            148. Observation.component:representative-protein-ref-seq
            Slice Namerepresentative-protein-ref-seq
            Definition

            ID of the protein reference sequence, which includes transcribed and non transcribed stretches. It covers the entire protein described.


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortProtein Reference SequenceComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            150. Observation.component:representative-protein-ref-seq.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            152. Observation.component:representative-protein-ref-seq.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Shortprotein-ref-seqType of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
                "code" : "protein-ref-seq"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            154. Observation.component:representative-protein-ref-seq.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortVersioned protein reference sequence identifierActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            Binding

            Multiple bindings acceptable (NCBI or LRG)

            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            156. Observation.component:representative-protein-ref-seq.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            158. Observation.component:representative-transcript-ref-seq
            Slice Namerepresentative-transcript-ref-seq
            Definition

            Die Transkript-Referenzsequenz-ID wie z.B. NM_004333.4


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortTranskript-ReferenzsequenzComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            160. Observation.component:representative-transcript-ref-seq.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            162. Observation.component:representative-transcript-ref-seq.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short51958-7Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "51958-7"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            164. Observation.component:representative-transcript-ref-seq.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortVersioned transcript reference sequence identifierActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            Binding

            Multiple bindings acceptable (NCBI or LRG)

            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            166. Observation.component:representative-transcript-ref-seq.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            168. Observation.component:exact-start-end
            Slice Nameexact-start-end
            Definition

            Die exakten genomischen Koordinaten der Variante - Start und Ende


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortExakte Start-End-PositionComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            170. Observation.component:exact-start-end.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            172. Observation.component:exact-start-end.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short81254-5Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "81254-5"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            174. Observation.component:exact-start-end.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            176. Observation.component:inner-start-end
            Slice Nameinner-start-end
            Definition

            Der innere Bereich bei strukturellen Varianten


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortInnere Start-End-PositionComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            178. Observation.component:inner-start-end.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            180. Observation.component:inner-start-end.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short81302-2Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "81302-2"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            182. Observation.component:inner-start-end.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            184. Observation.component:outer-start-end
            Slice Nameouter-start-end
            Definition

            Der äußere Bereich bei strukturellen Varianten


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortÄußere Start-End-PositionComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            186. Observation.component:outer-start-end.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            188. Observation.component:outer-start-end.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short81301-4Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "81301-4"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            190. Observation.component:outer-start-end.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            192. Observation.component:coordinate-system
            Slice Namecoordinate-system
            Definition

            These are different ways of identifying nucleotides or amino acids within a sequence. In the 1-based system, the first unit of the polymer (e.g. the first nucleotide) is counted as number 1. In the 0-based system, the number 0 designates the location before the first nucleotide. Different databases and file types may use different systems.


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortCoordinate SystemComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            194. Observation.component:coordinate-system.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            196. Observation.component:coordinate-system.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short92822-6Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "92822-6"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            198. Observation.component:coordinate-system.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            Short0-based interval counting | 0-based character counting | 1-based character countingActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see LOINC Answer List LL5323-2
            (extensible to http://loinc.org/vs/LL5323-2)
            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            200. Observation.component:coordinate-system.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            202. Observation.component:ref-allele
            Slice Nameref-allele
            Definition

            Die Nukleotidsequenz des Referenz-Allels


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortReferenz-AllelComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            204. Observation.component:ref-allele.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            206. Observation.component:ref-allele.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short69547-8Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "69547-8"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            208. Observation.component:ref-allele.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            210. Observation.component:alt-allele
            Slice Namealt-allele
            Definition

            Die Nukleotidsequenz des alternativen - mutierten - Allels


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortAlternatives AllelComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            212. Observation.component:alt-allele.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            214. Observation.component:alt-allele.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short69551-0Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "69551-0"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            216. Observation.component:alt-allele.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            218. Observation.component:coding-change-type
            Slice Namecoding-change-type
            Definition

            Der Typ der DNA-Änderung wie z.B. Substitution oder Deletion


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortDNA-ÄnderungstypComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            220. Observation.component:coding-change-type.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            222. Observation.component:coding-change-type.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short48019-4Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "48019-4"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            224. Observation.component:coding-change-type.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            Shortdeletion | insertion | delins | SNV | copy_number_gain | copy_number_loss | ... (many)Actual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see DNA Change Type
            (extensible to http://hl7.org/fhir/uv/genomics-reporting/ValueSet/dna-change-type-vs)

            Concepts in sequence ontology under SO:0002072

            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            226. Observation.component:coding-change-type.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            228. Observation.component:genomic-source-class
            Slice Namegenomic-source-class
            Definition

            Die Herkunft der Variante wie z.B. somatisch oder Keimbahn


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortGenomische HerkunftsklasseComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            230. Observation.component:genomic-source-class.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            232. Observation.component:genomic-source-class.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short48002-0Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "48002-0"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            234. Observation.component:genomic-source-class.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortGermline | Somatic | Fetal | Likely germline | Likely somatic | Likely fetal | Unknown genomic origin | De novoActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see LOINC Answer List LL378-1
            (extensible to http://loinc.org/vs/LL378-1)
            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            236. Observation.component:genomic-source-class.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            238. Observation.component:sample-allelic-frequency
            Slice Namesample-allelic-frequency
            Definition

            Die Häufigkeit des varianten Allels in der untersuchten Probe


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortAllelfrequenz in der ProbeComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            240. Observation.component:sample-allelic-frequency.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            242. Observation.component:sample-allelic-frequency.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short81258-6Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "81258-6"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            244. Observation.component:sample-allelic-frequency.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            246. Observation.component:allelic-read-depth
            Slice Nameallelic-read-depth
            Definition

            Die Anzahl der Reads die das Allel unterstützen


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortNumber reported readsComponent results
            Comments

            See here for usage guidance.


            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            248. Observation.component:allelic-read-depth.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            250. Observation.component:allelic-read-depth.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short82121-5Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "82121-5"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            252. Observation.component:allelic-read-depth.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortUnfiltered count of supporting readsActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeQuantity, dateTime, boolean, string, SampledData, Period, Ratio, integer, time, Range, CodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            254. Observation.component:allelic-read-depth.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            256. Observation.component:allelic-state
            Slice Nameallelic-state
            Definition

            Der Allelstatus wie z.B. heterozygot oder homozygot


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortAllelstatusComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            258. Observation.component:allelic-state.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            260. Observation.component:allelic-state.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short53034-5Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "53034-5"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            262. Observation.component:allelic-state.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortHeteroplasmic | Homoplasmic | Homozygous | Heterozygous | HemizygousActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see LOINC Answer List LL381-5
            (extensible to http://loinc.org/vs/LL381-5)
            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            264. Observation.component:allelic-state.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            266. Observation.component:variant-inheritance
            Slice Namevariant-inheritance
            Definition

            Die Vererbungsart der Variante wie z.B. maternal oder paternal


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortVarianten-VererbungComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            268. Observation.component:variant-inheritance.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            270. Observation.component:variant-inheritance.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short94186-4Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "94186-4"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            272. Observation.component:variant-inheritance.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortMaternal | Paternal | UnknownActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see LOINC Answer List LL5489-1
            (extensible to http://loinc.org/vs/LL5489-1)
            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            274. Observation.component:variant-inheritance.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            276. Observation.component:variant-inheritance-basis
            Slice Namevariant-inheritance-basis
            Definition

            The method by which the variant inheritance is determined.


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortEvidential basis for variant inheritanceComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            278. Observation.component:variant-inheritance-basis.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            280. Observation.component:variant-inheritance-basis.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortBasis for allelic phaseType of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "82309-6"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            282. Observation.component:variant-inheritance-basis.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortDirectly measured | Family DNA | Family history | Inferred from population dataActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see LOINC Answer List LL4050-2
            (extensible to http://loinc.org/vs/LL4050-2)
            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            284. Observation.component:variant-inheritance-basis.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            286. Observation.component:variation-code
            Slice Namevariation-code
            Definition

            Eindeutiger Identifikator der Variante aus externen Datenbanken wie z.B. ClinVar oder dbSNP


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortVariant database ID (e.g. COSMIC)Component results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            288. Observation.component:variation-code.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            290. Observation.component:variation-code.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short81252-9Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "81252-9"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            292. Observation.component:variation-code.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortClinVar ID or similarActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            Binding

            Multiple bindings acceptable

            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            294. Observation.component:variation-code.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            296. Observation.component:representative-protein-hgvs
            Slice Namerepresentative-protein-hgvs
            Definition

            Die Aminosäure-Änderung in HGVS-Nomenklatur auf Proteinebene


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortAminosäure-Änderung p.HGVSComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            298. Observation.component:representative-protein-hgvs.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            300. Observation.component:representative-protein-hgvs.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short48005-3Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "48005-3"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            302. Observation.component:representative-protein-hgvs.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortA valid HGVS-formatted 'p.' string, e.g. NP_000050.2:p.(Asn1836Lys)Actual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            BindingThe codes SHALL be taken from For codes, see Human Genome Variation Society (HGVS) Nomenclature
            (required to http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgvs-vs)
            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            304. Observation.component:representative-protein-hgvs.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            306. Observation.component:copy-number
            Slice Namecopy-number
            Definition

            Die Anzahl der Kopien eines genomischen Abschnitts


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortKopienzahlComponent results
            Comments

            Copy number variants are often described with a single copy number value. However, due to the nature of assays, such as qPCR and microarray, it can be difficult to assign an exact copy number. Therefore, labs sometimes report a range instead of an exact copy number. They may alternatively choose to report decimal numbers, even if whole numbers are biologically correct.

            In general, it can be difficult to estimate a copy number from measurements taken on a heterogenous population of cells, such as a tumor. As indicated in the ISCN 2020 specifications, it is appropriate to express the measurements using a range. Furthermore, regardless of cell population, many assays use fluorescent probes to detect copy number. These testing methodologies do not always provide an exact, discrete value for this data point.


            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            There SHALL be a code with a value of '1' if there is a value. If system is present, it SHALL be UCUM.


            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            308. Observation.component:copy-number.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            310. Observation.component:copy-number.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short82155-3Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "82155-3"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            312. Observation.component:copy-number.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            314. Observation.component:variant-confidence-status
            Slice Namevariant-confidence-status
            Definition

            Der Vertrauensstatus der Variantendetektion


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortKonfidenzstatus der VarianteComponent results
            Comments

            See here for usage guidance.


            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            316. Observation.component:variant-confidence-status.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            318. Observation.component:variant-confidence-status.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Shortvariant-confidence-statusType of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
                "code" : "variant-confidence-status"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            320. Observation.component:variant-confidence-status.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortHigh | Intermediate | LowActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            BindingThe codes SHALL be taken from For codes, see Variant Confidence Status
            (required to http://hl7.org/fhir/uv/genomics-reporting/ValueSet/variant-confidence-status-vs)
            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            322. Observation.component:variant-confidence-status.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            324. Observation.component:repeat-motif
            Slice Namerepeat-motif
            Definition

            Nucleotides of a repeat expansion motif.


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortRepeat MotifComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            326. Observation.component:repeat-motif.extension:repeat-motif-order
            Slice Namerepeat-motif-order
            Definition

            Use to group and order repeat expansion motifs.

            ShortRepeat Motif Order
            Comments

            If there are multiple repeat expansion pairs, this must be used both to indicate the sequence position of a given repeat-motif and repeat-number pair and to group the related components together. Components with the same extension value describe the same motif.

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Repeat Motif Order) (Extension Type: positiveInt)
            Requirements

            The value must be a natural number starting from 1 and increasing sequentially

            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            328. Observation.component:repeat-motif.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            330. Observation.component:repeat-motif.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Shortrepeat-motifType of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
                "code" : "repeat-motif"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            332. Observation.component:repeat-motif.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortCAGActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            Typestring, dateTime, boolean, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            334. Observation.component:repeat-motif.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            336. Observation.component:repeat-number
            Slice Namerepeat-number
            Definition

            Number of repeats of a repeat expansion.


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortRepeat NumberComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            338. Observation.component:repeat-number.extension:repeat-motif-order
            Slice Namerepeat-motif-order
            Definition

            Use to group and order repeat expansion motifs.

            ShortRepeat Motif Order
            Comments

            If there are multiple repeat expansion pairs, this must be used both to indicate the sequence position of a given repeat-motif and repeat-number pair and to group the related components together. Components with the same extension value describe the same motif.

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Repeat Motif Order) (Extension Type: positiveInt)
            Requirements

            The value must be a natural number starting from 1 and increasing sequentially

            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            340. Observation.component:repeat-number.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            342. Observation.component:repeat-number.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Shortrepeat-numberType of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
                "code" : "repeat-number"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            344. Observation.component:repeat-number.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            Short40Actual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            TypeQuantity, dateTime, boolean, string, SampledData, Period, Ratio, integer, time, Range, CodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            346. Observation.component:repeat-number.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            348. Observation.component:dna-region
            Slice Namedna-region
            Definition

            Ein lesbarer Name für die untersuchte Region. Typischerweise Exon # oder Intron # oder andere.


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortDNA-RegionsnameComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            350. Observation.component:dna-region.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            352. Observation.component:dna-region.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            Short47999-8Type of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "47999-8"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            354. Observation.component:dna-region.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            Typestring, dateTime, boolean, SampledData, Quantity, Period, Ratio, integer, time, Range, CodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            356. Observation.component:dna-region.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            358. Observation.component:gene-fusion
            Slice Namegene-fusion
            Definition

            Details zur Genfusion in Blut oder Gewebe mittels molekulargenetischer Methode


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortGenfusionComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            360. Observation.component:gene-fusion.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            362. Observation.component:gene-fusion.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "95123-6"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            364. Observation.component:gene-fusion.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortHGNC-Format für Genfusionen GENESYMBOL1::GENESYMBOL2 und Readthrough-Transkripte GENESYMBOL1-GENESYMBOL2Actual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control10..1
            This element is affected by the following invariants: ele-1
            BindingUnless not suitable, these codes SHALL be taken from For codes, see HUGO Gene Nomenclature Committee Gene Names (HGNC)
            (extensible to http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgnc-vs)
            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            366. Observation.component:gene-fusion.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            368. Observation.component:detection-limit
            Slice Namedetection-limit
            Definition

            Die Nachweisgrenze des Laborgeräts


            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            ShortNachweisgrenzeComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control0..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            370. Observation.component:detection-limit.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            372. Observation.component:detection-limit.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "http://loinc.org",
                "code" : "87706-8"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            374. Observation.component:detection-limit.dataAbsentReason
            Definition

            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

            ShortWhy the component result is missing
            Comments

            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

            Control0..1
            This element is affected by the following invariants: ele-1, obs-6
            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

            Codes specifying why the result (Observation.value[x]) is missing.

            TypeCodeableConcept
            Is Modifierfalse
            Requirements

            For many results it is necessary to handle exceptional values in measurements.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            376. Observation.component:five-prime-gene
            Slice Namefive-prime-gene
            Definition

            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

            Short5' Domain - GeneComponent results
            Comments

            For a discussion on the ways Observations can be assembled in groups together see Notes below.

            Control10..1*
            This element is affected by the following invariants: ele-1
            TypeBackboneElement
            Is Modifierfalse
            Must Supporttrue
            Summarytrue
            Requirements

            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            378. Observation.component:five-prime-gene.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            380. Observation.component:five-prime-gene.code
            Definition

            Describes what was observed. Sometimes this is called the observation "code".

            ShortType of component observation (code / type)
            Comments

            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Control1..1
            This element is affected by the following invariants: ele-1
            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
            (example to http://hl7.org/fhir/ValueSet/observation-codes)

            Codes identifying names of simple observations.

            TypeCodeableConcept
            Is Modifierfalse
            Summarytrue
            Requirements

            Knowing what kind of observation is being made is essential to understanding the observation.

            Pattern Value{
              "coding" : [{
                "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                "code" : "five-prime-gene"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            382. Observation.component:five-prime-gene.value[x]
            Definition

            The information determined as a result of making the observation, if the information has a simple value.

            ShortActual component result
            Comments

            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summarytrue
            Requirements

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • type @ $this
            • 384. Observation.component:five-prime-gene.value[x]:valueCodeableConcept
              Slice NamevalueCodeableConcept
              Definition

              The information determined as a result of making the observation, if the information has a simple value.

              ShortActual component result
              Comments

              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              386. Observation.component:five-prime-gene.dataAbsentReason
              Definition

              Provides a reason why the expected value in the element Observation.component.value[x] is missing.

              ShortWhy the component result is missing
              Comments

              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

              The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

              Control0..1
              This element is affected by the following invariants: ele-1, obs-6
              BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
              (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

              Codes specifying why the result (Observation.value[x]) is missing.

              TypeCodeableConcept
              Is Modifierfalse
              Requirements

              For many results it is necessary to handle exceptional values in measurements.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              388. Observation.component:five-prime-transcript-id
              Slice Namefive-prime-transcript-id
              Definition

              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

              Short5' Transcript - IdentifierComponent results
              Comments

              For a discussion on the ways Observations can be assembled in groups together see Notes below.

              Control10..1*
              This element is affected by the following invariants: ele-1
              TypeBackboneElement
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              390. Observation.component:five-prime-transcript-id.modifierExtension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored even if unrecognized
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Summarytrue
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              392. Observation.component:five-prime-transcript-id.code
              Definition

              Describes what was observed. Sometimes this is called the observation "code".

              ShortType of component observation (code / type)
              Comments

              All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

              Control1..1
              This element is affected by the following invariants: ele-1
              BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
              (example to http://hl7.org/fhir/ValueSet/observation-codes)

              Codes identifying names of simple observations.

              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Requirements

              Knowing what kind of observation is being made is essential to understanding the observation.

              Pattern Value{
                "coding" : [{
                  "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                  "code" : "five-prime-transcript-id"
                }]
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              394. Observation.component:five-prime-transcript-id.value[x]
              Definition

              The information determined as a result of making the observation, if the information has a simple value.

              ShortActual component result
              Comments

              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

              Control0..1
              This element is affected by the following invariants: ele-1
              TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • type @ $this
              • 396. Observation.component:five-prime-transcript-id.value[x]:valueCodeableConcept
                Slice NamevalueCodeableConcept
                Definition

                The information determined as a result of making the observation, if the information has a simple value.

                ShortActual component result
                Comments

                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                398. Observation.component:five-prime-transcript-id.dataAbsentReason
                Definition

                Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                ShortWhy the component result is missing
                Comments

                "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                Control0..1
                This element is affected by the following invariants: ele-1, obs-6
                BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
                (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                Codes specifying why the result (Observation.value[x]) is missing.

                TypeCodeableConcept
                Is Modifierfalse
                Requirements

                For many results it is necessary to handle exceptional values in measurements.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                400. Observation.component:five-prime-exon-id
                Slice Namefive-prime-exon-id
                Definition

                Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                Short5' Exon - IdentifierComponent results
                Comments

                For a discussion on the ways Observations can be assembled in groups together see Notes below.

                Control10..1*
                This element is affected by the following invariants: ele-1
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Requirements

                Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                402. Observation.component:five-prime-exon-id.modifierExtension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                Summarytrue
                Requirements

                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                Alternate Namesextensions, user content, modifiers
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                404. Observation.component:five-prime-exon-id.code
                Definition

                Describes what was observed. Sometimes this is called the observation "code".

                ShortType of component observation (code / type)
                Comments

                All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                Control1..1
                This element is affected by the following invariants: ele-1
                BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
                (example to http://hl7.org/fhir/ValueSet/observation-codes)

                Codes identifying names of simple observations.

                TypeCodeableConcept
                Is Modifierfalse
                Summarytrue
                Requirements

                Knowing what kind of observation is being made is essential to understanding the observation.

                Pattern Value{
                  "coding" : [{
                    "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                    "code" : "five-prime-exon-id"
                  }]
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                406. Observation.component:five-prime-exon-id.value[x]
                Definition

                The information determined as a result of making the observation, if the information has a simple value.

                ShortActual component result
                Comments

                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • type @ $this
                • 408. Observation.component:five-prime-exon-id.value[x]:valueCodeableConcept
                  Slice NamevalueCodeableConcept
                  Definition

                  The information determined as a result of making the observation, if the information has a simple value.

                  ShortActual component result
                  Comments

                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  410. Observation.component:five-prime-exon-id.dataAbsentReason
                  Definition

                  Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                  ShortWhy the component result is missing
                  Comments

                  "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                  The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                  Control0..1
                  This element is affected by the following invariants: ele-1, obs-6
                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                  Codes specifying why the result (Observation.value[x]) is missing.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Requirements

                  For many results it is necessary to handle exceptional values in measurements.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  412. Observation.component:five-prime-position
                  Slice Namefive-prime-position
                  Definition

                  Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                  Short5' Domain - PositionComponent results
                  Comments

                  For a discussion on the ways Observations can be assembled in groups together see Notes below.

                  Control10..1*
                  This element is affected by the following invariants: ele-1
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supporttrue
                  Summarytrue
                  Requirements

                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  414. Observation.component:five-prime-position.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  416. Observation.component:five-prime-position.code
                  Definition

                  Describes what was observed. Sometimes this is called the observation "code".

                  ShortType of component observation (code / type)
                  Comments

                  All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                  Control1..1
                  This element is affected by the following invariants: ele-1
                  BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
                  (example to http://hl7.org/fhir/ValueSet/observation-codes)

                  Codes identifying names of simple observations.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Knowing what kind of observation is being made is essential to understanding the observation.

                  Pattern Value{
                    "coding" : [{
                      "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                      "code" : "five-prime-position"
                    }]
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  418. Observation.component:five-prime-position.value[x]
                  Definition

                  The information determined as a result of making the observation, if the information has a simple value.

                  ShortActual component result
                  Comments

                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • type @ $this
                  • 420. Observation.component:five-prime-position.value[x]:valueRange
                    Slice NamevalueRange
                    Definition

                    The information determined as a result of making the observation, if the information has a simple value.

                    ShortActual component result
                    Comments

                    Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeRange, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, CodeableConcept
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    422. Observation.component:five-prime-position.dataAbsentReason
                    Definition

                    Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                    ShortWhy the component result is missing
                    Comments

                    "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                    The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                    Control0..1
                    This element is affected by the following invariants: ele-1, obs-6
                    BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
                    (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                    Codes specifying why the result (Observation.value[x]) is missing.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Requirements

                    For many results it is necessary to handle exceptional values in measurements.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    424. Observation.component:five-prime-strand
                    Slice Namefive-prime-strand
                    Definition

                    Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                    Short5' StrandComponent results
                    Comments

                    For a discussion on the ways Observations can be assembled in groups together see Notes below.

                    Control10..1*
                    This element is affected by the following invariants: ele-1
                    TypeBackboneElement
                    Is Modifierfalse
                    Must Supporttrue
                    Summarytrue
                    Requirements

                    Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    426. Observation.component:five-prime-strand.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                    Summarytrue
                    Requirements

                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                    Alternate Namesextensions, user content, modifiers
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    428. Observation.component:five-prime-strand.code
                    Definition

                    Describes what was observed. Sometimes this is called the observation "code".

                    ShortType of component observation (code / type)
                    Comments

                    All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                    Control1..1
                    This element is affected by the following invariants: ele-1
                    BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
                    (example to http://hl7.org/fhir/ValueSet/observation-codes)

                    Codes identifying names of simple observations.

                    TypeCodeableConcept
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Knowing what kind of observation is being made is essential to understanding the observation.

                    Pattern Value{
                      "coding" : [{
                        "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                        "code" : "five-prime-strand"
                      }]
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    430. Observation.component:five-prime-strand.value[x]
                    Definition

                    The information determined as a result of making the observation, if the information has a simple value.

                    ShortActual component result
                    Comments

                    Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                    Control0..1
                    This element is affected by the following invariants: ele-1
                    TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    Requirements

                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 432. Observation.component:five-prime-strand.value[x]:valueCodeableConcept
                      Slice NamevalueCodeableConcept
                      Definition

                      The information determined as a result of making the observation, if the information has a simple value.

                      ShortActual component result
                      Comments

                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      434. Observation.component:five-prime-strand.dataAbsentReason
                      Definition

                      Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                      ShortWhy the component result is missing
                      Comments

                      "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                      The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                      Control0..1
                      This element is affected by the following invariants: ele-1, obs-6
                      BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
                      (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                      Codes specifying why the result (Observation.value[x]) is missing.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Requirements

                      For many results it is necessary to handle exceptional values in measurements.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      436. Observation.component:three-prime-gene
                      Slice Namethree-prime-gene
                      Definition

                      Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                      Short3' Domain - GeneComponent results
                      Comments

                      For a discussion on the ways Observations can be assembled in groups together see Notes below.

                      Control10..1*
                      This element is affected by the following invariants: ele-1
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supporttrue
                      Summarytrue
                      Requirements

                      Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      438. Observation.component:three-prime-gene.modifierExtension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                      ShortExtensions that cannot be ignored even if unrecognized
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      This element is affected by the following invariants: ele-1
                      TypeExtension
                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                      Summarytrue
                      Requirements

                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                      Alternate Namesextensions, user content, modifiers
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      440. Observation.component:three-prime-gene.code
                      Definition

                      Describes what was observed. Sometimes this is called the observation "code".

                      ShortType of component observation (code / type)
                      Comments

                      All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                      Control1..1
                      This element is affected by the following invariants: ele-1
                      BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
                      (example to http://hl7.org/fhir/ValueSet/observation-codes)

                      Codes identifying names of simple observations.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Summarytrue
                      Requirements

                      Knowing what kind of observation is being made is essential to understanding the observation.

                      Pattern Value{
                        "coding" : [{
                          "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                          "code" : "three-prime-gene"
                        }]
                      }
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      442. Observation.component:three-prime-gene.value[x]
                      Definition

                      The information determined as a result of making the observation, if the information has a simple value.

                      ShortActual component result
                      Comments

                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                      Control0..1
                      This element is affected by the following invariants: ele-1
                      TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Requirements

                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • type @ $this
                      • 444. Observation.component:three-prime-gene.value[x]:valueCodeableConcept
                        Slice NamevalueCodeableConcept
                        Definition

                        The information determined as a result of making the observation, if the information has a simple value.

                        ShortActual component result
                        Comments

                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        446. Observation.component:three-prime-gene.dataAbsentReason
                        Definition

                        Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                        ShortWhy the component result is missing
                        Comments

                        "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                        The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                        Control0..1
                        This element is affected by the following invariants: ele-1, obs-6
                        BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
                        (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                        Codes specifying why the result (Observation.value[x]) is missing.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Requirements

                        For many results it is necessary to handle exceptional values in measurements.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        448. Observation.component:three-prime-transcript-id
                        Slice Namethree-prime-transcript-id
                        Definition

                        Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                        Short3' Transcript - IdentifierComponent results
                        Comments

                        For a discussion on the ways Observations can be assembled in groups together see Notes below.

                        Control10..1*
                        This element is affected by the following invariants: ele-1
                        TypeBackboneElement
                        Is Modifierfalse
                        Must Supporttrue
                        Summarytrue
                        Requirements

                        Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        450. Observation.component:three-prime-transcript-id.modifierExtension
                        Definition

                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                        ShortExtensions that cannot be ignored even if unrecognized
                        Comments

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Control0..*
                        This element is affected by the following invariants: ele-1
                        TypeExtension
                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                        Summarytrue
                        Requirements

                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                        Alternate Namesextensions, user content, modifiers
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        452. Observation.component:three-prime-transcript-id.code
                        Definition

                        Describes what was observed. Sometimes this is called the observation "code".

                        ShortType of component observation (code / type)
                        Comments

                        All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                        Control1..1
                        This element is affected by the following invariants: ele-1
                        BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
                        (example to http://hl7.org/fhir/ValueSet/observation-codes)

                        Codes identifying names of simple observations.

                        TypeCodeableConcept
                        Is Modifierfalse
                        Summarytrue
                        Requirements

                        Knowing what kind of observation is being made is essential to understanding the observation.

                        Pattern Value{
                          "coding" : [{
                            "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                            "code" : "three-prime-transcript-id"
                          }]
                        }
                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        454. Observation.component:three-prime-transcript-id.value[x]
                        Definition

                        The information determined as a result of making the observation, if the information has a simple value.

                        ShortActual component result
                        Comments

                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                        Control0..1
                        This element is affected by the following invariants: ele-1
                        TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Is Modifierfalse
                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                        Summarytrue
                        Requirements

                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                        • type @ $this
                        • 456. Observation.component:three-prime-transcript-id.value[x]:valueCodeableConcept
                          Slice NamevalueCodeableConcept
                          Definition

                          The information determined as a result of making the observation, if the information has a simple value.

                          ShortActual component result
                          Comments

                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          458. Observation.component:three-prime-transcript-id.dataAbsentReason
                          Definition

                          Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                          ShortWhy the component result is missing
                          Comments

                          "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                          The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                          Control0..1
                          This element is affected by the following invariants: ele-1, obs-6
                          BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
                          (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                          Codes specifying why the result (Observation.value[x]) is missing.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Requirements

                          For many results it is necessary to handle exceptional values in measurements.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          460. Observation.component:three-prime-exon-id
                          Slice Namethree-prime-exon-id
                          Definition

                          Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                          Short3' Exon - IdentifierComponent results
                          Comments

                          For a discussion on the ways Observations can be assembled in groups together see Notes below.

                          Control10..1*
                          This element is affected by the following invariants: ele-1
                          TypeBackboneElement
                          Is Modifierfalse
                          Must Supporttrue
                          Summarytrue
                          Requirements

                          Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          462. Observation.component:three-prime-exon-id.modifierExtension
                          Definition

                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                          ShortExtensions that cannot be ignored even if unrecognized
                          Comments

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Control0..*
                          This element is affected by the following invariants: ele-1
                          TypeExtension
                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                          Summarytrue
                          Requirements

                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                          Alternate Namesextensions, user content, modifiers
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          464. Observation.component:three-prime-exon-id.code
                          Definition

                          Describes what was observed. Sometimes this is called the observation "code".

                          ShortType of component observation (code / type)
                          Comments

                          All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                          Control1..1
                          This element is affected by the following invariants: ele-1
                          BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
                          (example to http://hl7.org/fhir/ValueSet/observation-codes)

                          Codes identifying names of simple observations.

                          TypeCodeableConcept
                          Is Modifierfalse
                          Summarytrue
                          Requirements

                          Knowing what kind of observation is being made is essential to understanding the observation.

                          Pattern Value{
                            "coding" : [{
                              "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                              "code" : "three-prime-exon-id"
                            }]
                          }
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          466. Observation.component:three-prime-exon-id.value[x]
                          Definition

                          The information determined as a result of making the observation, if the information has a simple value.

                          ShortActual component result
                          Comments

                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                          Control0..1
                          This element is affected by the following invariants: ele-1
                          TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Requirements

                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • type @ $this
                          • 468. Observation.component:three-prime-exon-id.value[x]:valueCodeableConcept
                            Slice NamevalueCodeableConcept
                            Definition

                            The information determined as a result of making the observation, if the information has a simple value.

                            ShortActual component result
                            Comments

                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            470. Observation.component:three-prime-exon-id.dataAbsentReason
                            Definition

                            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                            ShortWhy the component result is missing
                            Comments

                            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                            Control0..1
                            This element is affected by the following invariants: ele-1, obs-6
                            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
                            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                            Codes specifying why the result (Observation.value[x]) is missing.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Requirements

                            For many results it is necessary to handle exceptional values in measurements.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            472. Observation.component:three-prime-position
                            Slice Namethree-prime-position
                            Definition

                            Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                            Short3' Domain - PositionComponent results
                            Comments

                            For a discussion on the ways Observations can be assembled in groups together see Notes below.

                            Control10..1*
                            This element is affected by the following invariants: ele-1
                            TypeBackboneElement
                            Is Modifierfalse
                            Must Supporttrue
                            Summarytrue
                            Requirements

                            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            474. Observation.component:three-prime-position.modifierExtension
                            Definition

                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                            ShortExtensions that cannot be ignored even if unrecognized
                            Comments

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeExtension
                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                            Summarytrue
                            Requirements

                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                            Alternate Namesextensions, user content, modifiers
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            476. Observation.component:three-prime-position.code
                            Definition

                            Describes what was observed. Sometimes this is called the observation "code".

                            ShortType of component observation (code / type)
                            Comments

                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                            Control1..1
                            This element is affected by the following invariants: ele-1
                            BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
                            (example to http://hl7.org/fhir/ValueSet/observation-codes)

                            Codes identifying names of simple observations.

                            TypeCodeableConcept
                            Is Modifierfalse
                            Summarytrue
                            Requirements

                            Knowing what kind of observation is being made is essential to understanding the observation.

                            Pattern Value{
                              "coding" : [{
                                "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                "code" : "three-prime-position"
                              }]
                            }
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            478. Observation.component:three-prime-position.value[x]
                            Definition

                            The information determined as a result of making the observation, if the information has a simple value.

                            ShortActual component result
                            Comments

                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                            Control0..1
                            This element is affected by the following invariants: ele-1
                            TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                            Is Modifierfalse
                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                            Summarytrue
                            Requirements

                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • type @ $this
                            • 480. Observation.component:three-prime-position.value[x]:valueRange
                              Slice NamevalueRange
                              Definition

                              The information determined as a result of making the observation, if the information has a simple value.

                              ShortActual component result
                              Comments

                              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeRange, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, CodeableConcept
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              482. Observation.component:three-prime-position.dataAbsentReason
                              Definition

                              Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                              ShortWhy the component result is missing
                              Comments

                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                              The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                              Control0..1
                              This element is affected by the following invariants: ele-1, obs-6
                              BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
                              (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                              Codes specifying why the result (Observation.value[x]) is missing.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Requirements

                              For many results it is necessary to handle exceptional values in measurements.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              484. Observation.component:three-prime-strand
                              Slice Namethree-prime-strand
                              Definition

                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                              Short3' StrandComponent results
                              Comments

                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                              Control10..1*
                              This element is affected by the following invariants: ele-1
                              TypeBackboneElement
                              Is Modifierfalse
                              Must Supporttrue
                              Summarytrue
                              Requirements

                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              486. Observation.component:three-prime-strand.modifierExtension
                              Definition

                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                              ShortExtensions that cannot be ignored even if unrecognized
                              Comments

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Control0..*
                              This element is affected by the following invariants: ele-1
                              TypeExtension
                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                              Summarytrue
                              Requirements

                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                              Alternate Namesextensions, user content, modifiers
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              488. Observation.component:three-prime-strand.code
                              Definition

                              Describes what was observed. Sometimes this is called the observation "code".

                              ShortType of component observation (code / type)
                              Comments

                              All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                              Control1..1
                              This element is affected by the following invariants: ele-1
                              BindingFor example codes, see LOINCCodeshttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                              Codes identifying names of simple observations.

                              TypeCodeableConcept
                              Is Modifierfalse
                              Summarytrue
                              Requirements

                              Knowing what kind of observation is being made is essential to understanding the observation.

                              Pattern Value{
                                "coding" : [{
                                  "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                  "code" : "three-prime-strand"
                                }]
                              }
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              490. Observation.component:three-prime-strand.value[x]
                              Definition

                              The information determined as a result of making the observation, if the information has a simple value.

                              ShortActual component result
                              Comments

                              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                              Control0..1
                              This element is affected by the following invariants: ele-1
                              TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                              Summarytrue
                              Requirements

                              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                              • type @ $this
                              • 492. Observation.component:three-prime-strand.value[x]:valueCodeableConcept
                                Slice NamevalueCodeableConcept
                                Definition

                                The information determined as a result of making the observation, if the information has a simple value.

                                ShortActual component result
                                Comments

                                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                Control0..1
                                This element is affected by the following invariants: ele-1
                                TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Must Supporttrue
                                Summarytrue
                                Requirements

                                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                494. Observation.component:three-prime-strand.dataAbsentReason
                                Definition

                                Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                ShortWhy the component result is missing
                                Comments

                                "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                Control0..1
                                This element is affected by the following invariants: ele-1, obs-6
                                BindingUnless not suitable, these codes SHALL be taken from DataAbsentReasonhttp://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1
                                (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                Codes specifying why the result (Observation.value[x]) is missing.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Requirements

                                For many results it is necessary to handle exceptional values in measurements.

                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

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

                                0. Observation
                                2. Observation.meta
                                Must Supporttrue
                                4. Observation.meta.profile
                                Must Supporttrue
                                6. Observation.identifier
                                ShortVariantenId innerhalb des NGS-Befundes
                                NoteThis is a business identifier, not a resource identifier (see discussion)
                                Must Supporttrue
                                8. Observation.focus
                                TypeReference(MII PR Onkologie Diagnose Primärtumor, MII PR MTB Diagnose Primärtumor)
                                Must Supporttrue
                                Must Support TypesNo must-support rules about the choice of types/profiles
                                10. Observation.component
                                Control10..?
                                12. Observation.component:allelic-read-depth
                                Slice Nameallelic-read-depth
                                ShortNumber reported reads
                                14. Observation.component:allelic-read-depth.code
                                Must Supporttrue
                                16. Observation.component:allelic-read-depth.value[x]
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Must Supporttrue
                                18. Observation.component:variation-code
                                Slice Namevariation-code
                                ShortVariant database ID (e.g. COSMIC)
                                20. Observation.component:five-prime-gene
                                Slice Namefive-prime-gene
                                Short5' Domain - Gene
                                Control1..1
                                Must Supporttrue
                                22. Observation.component:five-prime-gene.code
                                Pattern Value{
                                  "coding" : [{
                                    "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                    "code" : "five-prime-gene"
                                  }]
                                }
                                24. Observation.component:five-prime-gene.value[x]
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • type @ $this
                                • 26. Observation.component:five-prime-gene.value[x]:valueCodeableConcept
                                  Slice NamevalueCodeableConcept
                                  Control0..1
                                  TypeCodeableConcept
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Must Supporttrue
                                  28. Observation.component:five-prime-transcript-id
                                  Slice Namefive-prime-transcript-id
                                  Short5' Transcript - Identifier
                                  Control1..1
                                  Must Supporttrue
                                  30. Observation.component:five-prime-transcript-id.code
                                  Pattern Value{
                                    "coding" : [{
                                      "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                      "code" : "five-prime-transcript-id"
                                    }]
                                  }
                                  32. Observation.component:five-prime-transcript-id.value[x]
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                  • type @ $this
                                  • 34. Observation.component:five-prime-transcript-id.value[x]:valueCodeableConcept
                                    Slice NamevalueCodeableConcept
                                    Control0..1
                                    TypeCodeableConcept
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Must Supporttrue
                                    36. Observation.component:five-prime-exon-id
                                    Slice Namefive-prime-exon-id
                                    Short5' Exon - Identifier
                                    Control1..1
                                    Must Supporttrue
                                    38. Observation.component:five-prime-exon-id.code
                                    Pattern Value{
                                      "coding" : [{
                                        "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                        "code" : "five-prime-exon-id"
                                      }]
                                    }
                                    40. Observation.component:five-prime-exon-id.value[x]
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • type @ $this
                                    • 42. Observation.component:five-prime-exon-id.value[x]:valueCodeableConcept
                                      Slice NamevalueCodeableConcept
                                      Control0..1
                                      TypeCodeableConcept
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      Must Supporttrue
                                      44. Observation.component:five-prime-position
                                      Slice Namefive-prime-position
                                      Short5' Domain - Position
                                      Control1..1
                                      Must Supporttrue
                                      46. Observation.component:five-prime-position.code
                                      Pattern Value{
                                        "coding" : [{
                                          "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                          "code" : "five-prime-position"
                                        }]
                                      }
                                      48. Observation.component:five-prime-position.value[x]
                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                      SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                      • type @ $this
                                      • 50. Observation.component:five-prime-position.value[x]:valueRange
                                        Slice NamevalueRange
                                        Control0..1
                                        TypeRange
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        Must Supporttrue
                                        52. Observation.component:five-prime-strand
                                        Slice Namefive-prime-strand
                                        Short5' Strand
                                        Control1..1
                                        Must Supporttrue
                                        54. Observation.component:five-prime-strand.code
                                        Pattern Value{
                                          "coding" : [{
                                            "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                            "code" : "five-prime-strand"
                                          }]
                                        }
                                        56. Observation.component:five-prime-strand.value[x]
                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                        SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • type @ $this
                                        • 58. Observation.component:five-prime-strand.value[x]:valueCodeableConcept
                                          Slice NamevalueCodeableConcept
                                          Control0..1
                                          TypeCodeableConcept
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          Must Supporttrue
                                          60. Observation.component:three-prime-gene
                                          Slice Namethree-prime-gene
                                          Short3' Domain - Gene
                                          Control1..1
                                          Must Supporttrue
                                          62. Observation.component:three-prime-gene.code
                                          Pattern Value{
                                            "coding" : [{
                                              "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                              "code" : "three-prime-gene"
                                            }]
                                          }
                                          64. Observation.component:three-prime-gene.value[x]
                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                          SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • type @ $this
                                          • 66. Observation.component:three-prime-gene.value[x]:valueCodeableConcept
                                            Slice NamevalueCodeableConcept
                                            Control0..1
                                            TypeCodeableConcept
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Must Supporttrue
                                            68. Observation.component:three-prime-transcript-id
                                            Slice Namethree-prime-transcript-id
                                            Short3' Transcript - Identifier
                                            Control1..1
                                            Must Supporttrue
                                            70. Observation.component:three-prime-transcript-id.code
                                            Pattern Value{
                                              "coding" : [{
                                                "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                                "code" : "three-prime-transcript-id"
                                              }]
                                            }
                                            72. Observation.component:three-prime-transcript-id.value[x]
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • type @ $this
                                            • 74. Observation.component:three-prime-transcript-id.value[x]:valueCodeableConcept
                                              Slice NamevalueCodeableConcept
                                              Control0..1
                                              TypeCodeableConcept
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Must Supporttrue
                                              76. Observation.component:three-prime-exon-id
                                              Slice Namethree-prime-exon-id
                                              Short3' Exon - Identifier
                                              Control1..1
                                              Must Supporttrue
                                              78. Observation.component:three-prime-exon-id.code
                                              Pattern Value{
                                                "coding" : [{
                                                  "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                                  "code" : "three-prime-exon-id"
                                                }]
                                              }
                                              80. Observation.component:three-prime-exon-id.value[x]
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                              • type @ $this
                                              • 82. Observation.component:three-prime-exon-id.value[x]:valueCodeableConcept
                                                Slice NamevalueCodeableConcept
                                                Control0..1
                                                TypeCodeableConcept
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                Must Supporttrue
                                                84. Observation.component:three-prime-position
                                                Slice Namethree-prime-position
                                                Short3' Domain - Position
                                                Control1..1
                                                Must Supporttrue
                                                86. Observation.component:three-prime-position.code
                                                Pattern Value{
                                                  "coding" : [{
                                                    "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                                    "code" : "three-prime-position"
                                                  }]
                                                }
                                                88. Observation.component:three-prime-position.value[x]
                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                • type @ $this
                                                • 90. Observation.component:three-prime-position.value[x]:valueRange
                                                  Slice NamevalueRange
                                                  Control0..1
                                                  TypeRange
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  Must Supporttrue
                                                  92. Observation.component:three-prime-strand
                                                  Slice Namethree-prime-strand
                                                  Short3' Strand
                                                  Control1..1
                                                  Must Supporttrue
                                                  94. Observation.component:three-prime-strand.code
                                                  Pattern Value{
                                                    "coding" : [{
                                                      "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                                      "code" : "three-prime-strand"
                                                    }]
                                                  }
                                                  96. Observation.component:three-prime-strand.value[x]
                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                  SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                  • type @ $this
                                                  • 98. Observation.component:three-prime-strand.value[x]:valueCodeableConcept
                                                    Slice NamevalueCodeableConcept
                                                    Control0..1
                                                    TypeCodeableConcept
                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                    Must Supporttrue

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

                                                    0. Observation
                                                    Definition

                                                    Measurements and simple assertions made about a patient, device or other subject.

                                                    ShortVariant
                                                    Comments

                                                    Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.

                                                    Control0..*
                                                    Alternate NamesVital Signs, Measurement, Results, Tests
                                                    Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                                                    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
                                                    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
                                                    dom-6: A resource should have narrative for robust management (text.`div`.exists())
                                                    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                                                    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present (value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty())
                                                    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
                                                    2. Observation.id
                                                    Definition

                                                    The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                                                    ShortLogical id of this artifact
                                                    Comments

                                                    The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                                                    Control0..1
                                                    Typeid
                                                    Summarytrue
                                                    4. Observation.meta
                                                    Definition

                                                    The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                                                    ShortMetadata about the resource
                                                    Control0..1
                                                    This element is affected by the following invariants: ele-1
                                                    TypeMeta
                                                    Must Supporttrue
                                                    Summarytrue
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    6. Observation.meta.id
                                                    Definition

                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                    ShortUnique id for inter-element referencing
                                                    Control0..1
                                                    Typestring
                                                    Is Modifierfalse
                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                    Summaryfalse
                                                    8. Observation.meta.extension
                                                    Definition

                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                    ShortAdditional content defined by implementations
                                                    Comments

                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                    Control0..*
                                                    TypeExtension
                                                    Is Modifierfalse
                                                    Summaryfalse
                                                    Alternate Namesextensions, user content
                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                    SlicingThis element introduces a set of slices on Observation.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                    • value @ url
                                                    • 10. Observation.meta.versionId
                                                      Definition

                                                      The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

                                                      ShortVersion specific identifier
                                                      Comments

                                                      The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

                                                      Control0..1
                                                      Typeid
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      12. Observation.meta.lastUpdated
                                                      Definition

                                                      When the resource last changed - e.g. when the version changed.

                                                      ShortWhen the resource version last changed
                                                      Comments

                                                      This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

                                                      Control0..1
                                                      Typeinstant
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      14. Observation.meta.source
                                                      Definition

                                                      A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

                                                      ShortIdentifies where the resource comes from
                                                      Comments

                                                      In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

                                                      This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

                                                      Control0..1
                                                      Typeuri
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      16. Observation.meta.profile
                                                      Definition

                                                      A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

                                                      ShortProfiles this resource claims to conform to
                                                      Comments

                                                      It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

                                                      Control0..*
                                                      Typecanonical(StructureDefinition)
                                                      Is Modifierfalse
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Must Supporttrue
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      18. Observation.meta.security
                                                      Definition

                                                      Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

                                                      ShortSecurity Labels applied to this resource
                                                      Comments

                                                      The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

                                                      Control0..*
                                                      BindingUnless not suitable, these codes SHALL be taken from All Security Labels
                                                      (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)

                                                      Security Labels from the Healthcare Privacy and Security Classification System.

                                                      TypeCoding
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      20. Observation.meta.tag
                                                      Definition

                                                      Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

                                                      ShortTags applied to this resource
                                                      Comments

                                                      The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

                                                      Control0..*
                                                      BindingFor example codes, see CommonTags
                                                      (example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)

                                                      Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

                                                      TypeCoding
                                                      Is Modifierfalse
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      22. Observation.implicitRules
                                                      Definition

                                                      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                                                      ShortA set of rules under which this content was created
                                                      Comments

                                                      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      Typeuri
                                                      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Summarytrue
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      24. Observation.language
                                                      Definition

                                                      The base language in which the resource is written.

                                                      ShortLanguage of the resource content
                                                      Comments

                                                      Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      BindingThe codes SHOULD be taken from CommonLanguages
                                                      (preferred to http://hl7.org/fhir/ValueSet/languages)

                                                      A human language.

                                                      Additional BindingsPurpose
                                                      AllLanguagesMax Binding
                                                      Typecode
                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      26. Observation.text
                                                      Definition

                                                      A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                                                      ShortText summary of the resource, for human interpretation
                                                      Comments

                                                      Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                                                      Control0..1
                                                      This element is affected by the following invariants: ele-1
                                                      TypeNarrative
                                                      Alternate Namesnarrative, html, xhtml, display
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      28. Observation.contained
                                                      Definition

                                                      These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                                                      ShortContained, inline Resources
                                                      Comments

                                                      This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                                                      Control0..*
                                                      TypeResource
                                                      Alternate Namesinline resources, anonymous resources, contained resources
                                                      30. Observation.extension
                                                      Definition

                                                      May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                      ShortAdditional content defined by implementations
                                                      Comments

                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                      Control0..*
                                                      This element is affected by the following invariants: ele-1
                                                      TypeExtension
                                                      Alternate Namesextensions, user content
                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                      SlicingThis element introduces a set of slices on Observation.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                      • value @ url
                                                      • 32. Observation.extension:secondary-finding
                                                        Slice Namesecondary-finding
                                                        Definition

                                                        Secondary findings are genetic test results that provide information about variants in a gene unrelated to the primary purpose for the testing, most often discovered when Whole Exome Sequencing (WES) or Whole Genome Sequencing (WGS) is performed. This extension should be used to denote when a genetic finding is being shared as a secondary finding, and ideally refer to a corresponding guideline or policy statement.

                                                        For more detail, please see: https://ghr.nlm.nih.gov/primer/testing/secondaryfindings.

                                                        ShortSecondary findings are genetic test results that provide information about variants in a gene unrelated to the primary purpose for the testing, most often discovered when [Whole Exome Sequencing (WES)](https://en.wikipedia.org/wiki/Exome_sequencing) or [Whole Genome Sequencing (WGS)](https://en.wikipedia.org/wiki/Whole_genome_sequencing) is performed. This extension should be used to denote when a genetic finding is being shared as a secondary finding, and ideally refer to a corresponding guideline or policy statement. For more detail, please see: https://ghr.nlm.nih.gov/primer/testing/secondaryfindings
                                                        Comments

                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension(Observation Secondary Finding) (Extension Type: CodeableConcept)
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        34. Observation.extension:body-structure
                                                        Slice Namebody-structure
                                                        Definition

                                                        Record details about the anatomical location of a specimen or body part. This resource may be used when a coded concept does not provide the necessary detail needed for the use case.

                                                        ShortTarget anatomic location or structure
                                                        Comments

                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                        Control0..1
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension(BodyStructure Reference) (Extension Type: Reference(BodyStructure))
                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        36. Observation.modifierExtension
                                                        Definition

                                                        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                        ShortExtensions that cannot be ignored
                                                        Comments

                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                        Control0..*
                                                        This element is affected by the following invariants: ele-1
                                                        TypeExtension
                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                                        Requirements

                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                        Alternate Namesextensions, user content
                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                        SlicingThis element introduces a set of slices on Observation.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                        • value @ url
                                                        • 38. Observation.identifier
                                                          Definition

                                                          A unique identifier assigned to this observation.

                                                          ShortVariantenId innerhalb des NGS-Befundes
                                                          NoteThis is a business identifier, not a resource identifier (see discussion)
                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          TypeIdentifier
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Requirements

                                                          Allows observations to be distinguished and referenced.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          40. Observation.basedOn
                                                          Definition

                                                          A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.

                                                          ShortFulfills plan, proposal or order
                                                          Comments

                                                          References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          TypeReference(CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest)
                                                          Summarytrue
                                                          Requirements

                                                          Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

                                                          Alternate NamesFulfills
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ref-1: 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')))
                                                          42. Observation.partOf
                                                          Definition

                                                          A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.

                                                          ShortPart of referenced event
                                                          Comments

                                                          To link an Observation to an Encounter use encounter. See the Notes below for guidance on referencing another Observation.

                                                          Control0..*
                                                          This element is affected by the following invariants: ele-1
                                                          TypeReference(MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Immunization, ImagingStudy, Genomic Study)
                                                          Summarytrue
                                                          Alternate NamesContainer
                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          ref-1: 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')))
                                                          44. Observation.status
                                                          Definition

                                                          Status der Beobachtung

                                                          ShortStatus
                                                          Comments

                                                          This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

                                                          Control1..1
                                                          This element is affected by the following invariants: ele-1
                                                          BindingThe codes SHALL be taken from ObservationStatus
                                                          (required to http://hl7.org/fhir/ValueSet/observation-status|4.0.1)

                                                          Codes providing the status of an observation.

                                                          Typecode
                                                          Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                          Must Supporttrue
                                                          Summarytrue
                                                          Requirements

                                                          Need to track the status of individual results. Some results are finalized before the whole report is finalized.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          46. Observation.category
                                                          Definition

                                                          Klassifizierung der Beobachtungsart

                                                          ShortKategorie
                                                          Comments

                                                          In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

                                                          Control2..*
                                                          This element is affected by the following invariants: ele-1
                                                          BindingThe codes SHOULD be taken from ObservationCategoryCodes
                                                          (preferred to http://hl7.org/fhir/ValueSet/observation-category)

                                                          Codes for high level observation categories.

                                                          TypeCodeableConcept
                                                          Must Supporttrue
                                                          Requirements

                                                          Used for filtering what observations are retrieved and displayed.

                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                          SlicingThis element introduces a set of slices on Observation.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                          • value @ coding
                                                          • 48. Observation.category:labCategory
                                                            Slice NamelabCategory
                                                            Definition

                                                            A code that classifies the general type of observation being made.

                                                            ShortClassification of type of observation
                                                            Comments

                                                            In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

                                                            Control1..1
                                                            This element is affected by the following invariants: ele-1
                                                            BindingThe codes SHOULD be taken from ObservationCategoryCodes
                                                            (preferred to http://hl7.org/fhir/ValueSet/observation-category)

                                                            Codes for high level observation categories.

                                                            TypeCodeableConcept
                                                            Requirements

                                                            Used for filtering what observations are retrieved and displayed.

                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            50. Observation.category:labCategory.id
                                                            Definition

                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                            ShortUnique id for inter-element referencing
                                                            Control0..1
                                                            Typestring
                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                            52. Observation.category:labCategory.extension
                                                            Definition

                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                            ShortAdditional content defined by implementations
                                                            Comments

                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                            Control0..*
                                                            This element is affected by the following invariants: ele-1
                                                            TypeExtension
                                                            Alternate Namesextensions, user content
                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                            SlicingThis element introduces a set of slices on Observation.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                            • value @ url
                                                            • 54. Observation.category:labCategory.coding
                                                              Definition

                                                              A reference to a code defined by a terminology system.

                                                              ShortCode defined by a terminology system
                                                              Comments

                                                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                              Control1..1
                                                              This element is affected by the following invariants: ele-1
                                                              TypeCoding
                                                              Summarytrue
                                                              Requirements

                                                              Allows for alternative encodings within a code system, and translations to other code systems.

                                                              Pattern Value{
                                                                "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                                                                "code" : "laboratory"
                                                              }
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              56. Observation.category:labCategory.text
                                                              Definition

                                                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                              ShortPlain text representation of the concept
                                                              Comments

                                                              Very often the text is the same as a displayName of one of the codings.

                                                              Control0..1
                                                              This element is affected by the following invariants: ele-1
                                                              Typestring
                                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                              Summarytrue
                                                              Requirements

                                                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              58. Observation.category:geCategory
                                                              Slice NamegeCategory
                                                              Definition

                                                              A code that classifies the general type of observation being made.

                                                              ShortClassification of type of observation
                                                              Comments

                                                              In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

                                                              Control1..1
                                                              This element is affected by the following invariants: ele-1
                                                              BindingThe codes SHOULD be taken from ObservationCategoryCodes
                                                              (preferred to http://hl7.org/fhir/ValueSet/observation-category)

                                                              Codes for high level observation categories.

                                                              TypeCodeableConcept
                                                              Requirements

                                                              Used for filtering what observations are retrieved and displayed.

                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              60. Observation.category:geCategory.id
                                                              Definition

                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                              ShortUnique id for inter-element referencing
                                                              Control0..1
                                                              Typestring
                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                              62. Observation.category:geCategory.extension
                                                              Definition

                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                              ShortAdditional content defined by implementations
                                                              Comments

                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                              Control0..*
                                                              This element is affected by the following invariants: ele-1
                                                              TypeExtension
                                                              Alternate Namesextensions, user content
                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                              SlicingThis element introduces a set of slices on Observation.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                              • value @ url
                                                              • 64. Observation.category:geCategory.coding
                                                                Definition

                                                                A reference to a code defined by a terminology system.

                                                                ShortCode defined by a terminology system
                                                                Comments

                                                                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                                                Control1..1
                                                                This element is affected by the following invariants: ele-1
                                                                TypeCoding
                                                                Summarytrue
                                                                Requirements

                                                                Allows for alternative encodings within a code system, and translations to other code systems.

                                                                Pattern Value{
                                                                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
                                                                  "code" : "GE"
                                                                }
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                66. Observation.category:geCategory.text
                                                                Definition

                                                                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                                                ShortPlain text representation of the concept
                                                                Comments

                                                                Very often the text is the same as a displayName of one of the codings.

                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                Typestring
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Summarytrue
                                                                Requirements

                                                                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                68. Observation.code
                                                                Definition

                                                                Code zur Identifizierung der Varianten-Beobachtung

                                                                ShortCode
                                                                Comments

                                                                All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                Control1..1
                                                                This element is affected by the following invariants: ele-1
                                                                BindingFor example codes, see LOINCCodes
                                                                (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                Codes identifying names of simple observations.

                                                                TypeCodeableConcept
                                                                Must Supporttrue
                                                                Summarytrue
                                                                Requirements

                                                                Knowing what kind of observation is being made is essential to understanding the observation.

                                                                Alternate NamesName
                                                                Pattern Value{
                                                                  "coding" : [{
                                                                    "system" : "http://loinc.org",
                                                                    "code" : "69548-6"
                                                                  }]
                                                                }
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                70. Observation.subject
                                                                Definition

                                                                Der Patient oder die Gruppe auf die sich die Variante bezieht

                                                                ShortPatient oder Proband
                                                                Comments

                                                                One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

                                                                Control1..1
                                                                This element is affected by the following invariants: ele-1
                                                                TypeReference(Patient, Group)
                                                                Must Supporttrue
                                                                Must Support TypesNo must-support rules about the choice of types/profiles
                                                                Summarytrue
                                                                Requirements

                                                                Observations have no value if you don't know who or what they're about.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ref-1: 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')))
                                                                72. Observation.focus
                                                                Definition

                                                                The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

                                                                ShortWhat the observation is about, when it is not about the subject of record
                                                                Comments

                                                                Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use specimen if a reference to a specimen is required. If a code is required instead of a resource use either bodysite for bodysites or the standard extension focusCode.

                                                                Control0..*
                                                                This element is affected by the following invariants: ele-1
                                                                TypeReference(MII PR Onkologie Diagnose Primärtumor, MII PR MTB Diagnose Primärtumor)
                                                                Must Supporttrue
                                                                Must Support TypesNo must-support rules about the choice of types/profiles
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ref-1: 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')))
                                                                74. Observation.encounter
                                                                Definition

                                                                The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.

                                                                ShortHealthcare event during which this observation is made
                                                                Comments

                                                                This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                TypeReference(Encounter)
                                                                Summarytrue
                                                                Requirements

                                                                For some observations it may be important to know the link between an observation and a particular encounter.

                                                                Alternate NamesContext
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ref-1: 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')))
                                                                76. Observation.effective[x]
                                                                Definition

                                                                Klinisch relevanter Zeitpunkt oder Zeitraum der Beobachtung

                                                                ShortZeitpunkt der Beobachtung
                                                                Comments

                                                                At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                TypeChoice of: dateTime, Period, Timing, instant
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supporttrue
                                                                Must Support TypesNo must-support rules about the choice of types/profiles
                                                                Summarytrue
                                                                Requirements

                                                                Knowing when an observation was deemed true is important to its relevance as well as determining trends.

                                                                Alternate NamesOccurrence
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                78. Observation.issued
                                                                Definition

                                                                Datum und Uhrzeit der Freigabe der Beobachtung

                                                                ShortFreigabedatum
                                                                Comments

                                                                For Observations that don’t require review and verification, it may be the same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1
                                                                Typeinstant
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supporttrue
                                                                Summarytrue
                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                80. Observation.performer
                                                                Definition

                                                                Who was responsible for asserting the observed value as "true".

                                                                ShortWho is responsible for the observation
                                                                Comments

                                                                References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                                                                Control0..*
                                                                This element is affected by the following invariants: ele-1
                                                                TypeReference(Practitioner, PractitionerRole, Organization, CareTeam, Patient, RelatedPerson)
                                                                Summarytrue
                                                                Requirements

                                                                May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                ref-1: 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')))
                                                                82. Observation.value[x]
                                                                Definition

                                                                Das Ergebnis der Variantenanalyse - vorhanden oder abwesend

                                                                ShortErgebniswert
                                                                Comments

                                                                An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                Control0..1
                                                                This element is affected by the following invariants: ele-1, obs-7
                                                                TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                Must Supporttrue
                                                                Must Support TypesNo must-support rules about the choice of types/profiles
                                                                Summarytrue
                                                                Requirements

                                                                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                SlicingThis element introduces a set of slices on Observation.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                • type @ $this
                                                                • 84. Observation.value[x]:valueCodeableConcept
                                                                  Slice NamevalueCodeableConcept
                                                                  Definition

                                                                  The presence or absence of the variant described in the components. If not searching for specific variations and merely reporting what's found, the profile's value should be set to 'Present'.

                                                                  ShortIndeterminate | No call | Present | Absent.
                                                                  Comments

                                                                  See here for usage guidance.

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1, obs-7
                                                                  BindingThe codes SHALL be taken from LOINC Answer List LL1971-2
                                                                  (required to http://loinc.org/vs/LL1971-2)
                                                                  TypeCodeableConcept
                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                  Summarytrue
                                                                  Requirements

                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  86. Observation.dataAbsentReason
                                                                  Definition

                                                                  Provides a reason why the expected value in the element Observation.value[x] is missing.

                                                                  ShortWhy the result is missing
                                                                  Comments

                                                                  Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory".

                                                                  The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1, obs-6
                                                                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                  Codes specifying why the result (Observation.value[x]) is missing.

                                                                  TypeCodeableConcept
                                                                  Requirements

                                                                  For many results it is necessary to handle exceptional values in measurements.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  88. Observation.interpretation
                                                                  Definition

                                                                  A categorical assessment of an observation value. For example, high, low, normal.

                                                                  ShortHigh, low, normal, etc.
                                                                  Comments

                                                                  Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                  Control0..*
                                                                  This element is affected by the following invariants: ele-1
                                                                  BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                  (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                  Codes identifying interpretations of observations.

                                                                  TypeCodeableConcept
                                                                  Requirements

                                                                  For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                  Alternate NamesAbnormal Flag
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  90. Observation.note
                                                                  Definition

                                                                  A text note which also contains information about who made the statement and when.

                                                                  ShortComments about the Observation that also contain a coded type
                                                                  Comments

                                                                  May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation. The CodedAnnotation data type, while not allowing for or intending to make the content computable, does allow the author to indicate the type of note. This does not replace the use of interpretation, value, or component values. One important note is that Annotation is a FHIR data type, this is NOT about annotations in the genomic context.

                                                                  Control0..*
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeAnnotation(Coded Annotation)
                                                                  Requirements

                                                                  Need to be able to provide free text additional information. Notes SHALL NOT contain information which can be captured in a structured way.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  92. Observation.bodySite
                                                                  Definition

                                                                  Indicates the site on the subject's body where the observation was made (i.e. the target site).

                                                                  ShortObserved body part
                                                                  Comments

                                                                  Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

                                                                  If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  BindingFor example codes, see SNOMEDCTBodyStructures
                                                                  (example to http://hl7.org/fhir/ValueSet/body-site)

                                                                  Codes describing anatomical locations. May include laterality.

                                                                  TypeCodeableConcept
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  94. Observation.method
                                                                  Definition

                                                                  Die verwendete Untersuchungsmethode

                                                                  ShortMethode
                                                                  Comments

                                                                  Only used if not implicit in code for Observation.code.

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  BindingUnless not suitable, these codes SHALL be taken from LOINC Answer List LL4048-6
                                                                  (extensible to http://loinc.org/vs/LL4048-6)

                                                                  Methods for simple observations.

                                                                  TypeCodeableConcept
                                                                  Must Supporttrue
                                                                  Requirements

                                                                  In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  96. Observation.specimen
                                                                  Definition

                                                                  Die untersuchte Probe

                                                                  ShortProbe
                                                                  Comments

                                                                  Should only be used if not implicit in code found in Observation.code. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeReference(Specimen)
                                                                  Must Supporttrue
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ref-1: 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')))
                                                                  98. Observation.device
                                                                  Definition

                                                                  Das verwendete Analysegerät

                                                                  ShortGerät
                                                                  Comments

                                                                  Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.

                                                                  Control0..1
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeReference(Device, DeviceMetric)
                                                                  Must Supporttrue
                                                                  Must Support TypesNo must-support rules about the choice of types/profiles
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ref-1: 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')))
                                                                  100. Observation.referenceRange
                                                                  Definition

                                                                  Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two referenceRange elements would be used.

                                                                  ShortProvides guide for interpretation
                                                                  Comments

                                                                  Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                  Control0..*
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeBackboneElement
                                                                  Requirements

                                                                  Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  obs-3: Must have at least a low or a high or text (low.exists() or high.exists() or text.exists())
                                                                  102. Observation.referenceRange.id
                                                                  Definition

                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                  ShortUnique id for inter-element referencing
                                                                  Control0..1
                                                                  Typestring
                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                  104. Observation.referenceRange.extension
                                                                  Definition

                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                  ShortAdditional content defined by implementations
                                                                  Comments

                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                  Control0..*
                                                                  This element is affected by the following invariants: ele-1
                                                                  TypeExtension
                                                                  Alternate Namesextensions, user content
                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                  SlicingThis element introduces a set of slices on Observation.referenceRange.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                  • value @ url
                                                                  • 106. Observation.referenceRange.modifierExtension
                                                                    Definition

                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                    Comments

                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                    Control0..*
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypeExtension
                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                    Summarytrue
                                                                    Requirements

                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                    Alternate Namesextensions, user content, modifiers
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                    108. Observation.referenceRange.low
                                                                    Definition

                                                                    The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).

                                                                    ShortLow Range, if relevant
                                                                    Comments

                                                                    The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1, obs-3
                                                                    TypeQuantity(SimpleQuantity)
                                                                    Is Modifierfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                    sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                                    110. Observation.referenceRange.high
                                                                    Definition

                                                                    The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).

                                                                    ShortHigh Range, if relevant
                                                                    Comments

                                                                    The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1, obs-3
                                                                    TypeQuantity(SimpleQuantity)
                                                                    Is Modifierfalse
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    qty-3: If a code for the unit is present, the system SHALL also be present (code.empty() or system.exists())
                                                                    sqty-1: The comparator is not used on a SimpleQuantity (comparator.empty())
                                                                    112. Observation.referenceRange.type
                                                                    Definition

                                                                    Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

                                                                    ShortReference range qualifier
                                                                    Comments

                                                                    This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.

                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    BindingThe codes SHOULD be taken from ObservationReferenceRangeMeaningCodes
                                                                    (preferred to http://hl7.org/fhir/ValueSet/referencerange-meaning)

                                                                    Code for the meaning of a reference range.

                                                                    TypeCodeableConcept
                                                                    Requirements

                                                                    Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    114. Observation.referenceRange.appliesTo
                                                                    Definition

                                                                    Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple appliesTo are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

                                                                    ShortReference range population
                                                                    Comments

                                                                    This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.

                                                                    Control0..*
                                                                    This element is affected by the following invariants: ele-1
                                                                    BindingFor example codes, see ObservationReferenceRangeAppliesToCodes
                                                                    (example to http://hl7.org/fhir/ValueSet/referencerange-appliesto)

                                                                    Codes identifying the population the reference range applies to.

                                                                    TypeCodeableConcept
                                                                    Requirements

                                                                    Need to be able to identify the target population for proper interpretation.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    116. Observation.referenceRange.age
                                                                    Definition

                                                                    The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

                                                                    ShortApplicable age range, if relevant
                                                                    Comments

                                                                    The stated low and high value are assumed to have arbitrarily high precision when it comes to determining which values are in the range. I.e. 1.99 is not in the range 2 -> 3.

                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypeRange
                                                                    Requirements

                                                                    Some analytes vary greatly over age.

                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    rng-2: If present, low SHALL have a lower value than high (low.empty() or high.empty() or (low <= high))
                                                                    118. Observation.referenceRange.text
                                                                    Definition

                                                                    Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals".

                                                                    ShortText based reference range in an observation
                                                                    Comments

                                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                    Control0..1
                                                                    This element is affected by the following invariants: ele-1
                                                                    Typestring
                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    120. Observation.hasMember
                                                                    Definition

                                                                    This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.

                                                                    ShortRelated resource that belongs to the Observation group
                                                                    Comments

                                                                    When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.

                                                                    Control0..*
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypeReference(Observation, QuestionnaireResponse, MolecularSequence)
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ref-1: 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')))
                                                                    122. Observation.derivedFrom
                                                                    Definition

                                                                    The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

                                                                    ShortRelated measurements the observation is made from
                                                                    Comments

                                                                    All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.

                                                                    Control0..*
                                                                    This element is affected by the following invariants: ele-1
                                                                    TypeReference(DocumentReference, ImagingStudy, Media, QuestionnaireResponse, Observation, MolecularSequence)
                                                                    Summarytrue
                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                    ref-1: 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')))
                                                                    SlicingThis element introduces a set of slices on Observation.derivedFrom. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                    • profile @ resolve()
                                                                    • 124. Observation.component
                                                                      Definition

                                                                      Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                      ShortComponent results
                                                                      Comments

                                                                      For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                      Control10..*
                                                                      This element is affected by the following invariants: ele-1
                                                                      TypeBackboneElement
                                                                      Summarytrue
                                                                      Requirements

                                                                      Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                      SlicingThis element introduces a set of slices on Observation.component. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                      • value @ code
                                                                      • 126. Observation.component.id
                                                                        Definition

                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                        ShortUnique id for inter-element referencing
                                                                        Control0..1
                                                                        Typestring
                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                        128. Observation.component.extension
                                                                        Definition

                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                        ShortAdditional content defined by implementations
                                                                        Comments

                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                        Control0..*
                                                                        This element is affected by the following invariants: ele-1
                                                                        TypeExtension
                                                                        Alternate Namesextensions, user content
                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                        SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                        • value @ url
                                                                        • 130. Observation.component.modifierExtension
                                                                          Definition

                                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                          Comments

                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                          Control0..*
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeExtension
                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                          Summarytrue
                                                                          Requirements

                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                          Alternate Namesextensions, user content, modifiers
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          132. Observation.component.code
                                                                          Definition

                                                                          Describes what was observed. Sometimes this is called the observation "code".

                                                                          ShortType of component observation (code / type)
                                                                          Comments

                                                                          All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                          Control1..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          BindingFor example codes, see LOINCCodes
                                                                          (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                          Codes identifying names of simple observations.

                                                                          TypeCodeableConcept
                                                                          Summarytrue
                                                                          Requirements

                                                                          Knowing what kind of observation is being made is essential to understanding the observation.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          134. Observation.component.value[x]
                                                                          Definition

                                                                          The information determined as a result of making the observation, if the information has a simple value.

                                                                          ShortActual component result
                                                                          Comments

                                                                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                          Summarytrue
                                                                          Requirements

                                                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          136. Observation.component.dataAbsentReason
                                                                          Definition

                                                                          Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                          ShortWhy the component result is missing
                                                                          Comments

                                                                          "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                          The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1, obs-6
                                                                          BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                          (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                          Codes specifying why the result (Observation.value[x]) is missing.

                                                                          TypeCodeableConcept
                                                                          Requirements

                                                                          For many results it is necessary to handle exceptional values in measurements.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          138. Observation.component.interpretation
                                                                          Definition

                                                                          A categorical assessment of an observation value. For example, high, low, normal.

                                                                          ShortHigh, low, normal, etc.
                                                                          Comments

                                                                          Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                          Control0..*
                                                                          This element is affected by the following invariants: ele-1
                                                                          BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                          (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                          Codes identifying interpretations of observations.

                                                                          TypeCodeableConcept
                                                                          Requirements

                                                                          For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                          Alternate NamesAbnormal Flag
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          140. Observation.component.referenceRange
                                                                          Definition

                                                                          Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                          ShortProvides guide for interpretation of component result
                                                                          Comments

                                                                          Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                          Control0..*
                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                          Requirements

                                                                          Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                          142. Observation.component:conclusion-string
                                                                          Slice Nameconclusion-string
                                                                          Definition

                                                                          Textuelle Zusammenfassung oder Schlussfolgerung zur Variante

                                                                          ShortSchlussfolgerung - Text
                                                                          Comments

                                                                          An example would be the interpretative information, typically canned, about a variant identified in the patient.

                                                                          Control0..1
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeBackboneElement
                                                                          Must Supporttrue
                                                                          Summarytrue
                                                                          Requirements

                                                                          Need to be able to provide a conclusion that is not lost among the basic result data.

                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          144. Observation.component:conclusion-string.id
                                                                          Definition

                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                          ShortUnique id for inter-element referencing
                                                                          Control0..1
                                                                          Typestring
                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                          146. Observation.component:conclusion-string.extension
                                                                          Definition

                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                          ShortAdditional content defined by implementations
                                                                          Comments

                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                          Control0..*
                                                                          This element is affected by the following invariants: ele-1
                                                                          TypeExtension
                                                                          Alternate Namesextensions, user content
                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                          SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                          • value @ url
                                                                          • 148. Observation.component:conclusion-string.modifierExtension
                                                                            Definition

                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                            Comments

                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                            Control0..*
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypeExtension
                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                            Summarytrue
                                                                            Requirements

                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                            Alternate Namesextensions, user content, modifiers
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            150. Observation.component:conclusion-string.code
                                                                            Definition

                                                                            Describes what was observed. Sometimes this is called the observation "code".

                                                                            Shortconclusion-string
                                                                            Comments

                                                                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                            Control1..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            BindingFor example codes, see LOINCCodes
                                                                            (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                            Codes identifying names of simple observations.

                                                                            TypeCodeableConcept
                                                                            Summarytrue
                                                                            Requirements

                                                                            Knowing what kind of observation is being made is essential to understanding the observation.

                                                                            Pattern Value{
                                                                              "coding" : [{
                                                                                "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
                                                                                "code" : "conclusion-string"
                                                                              }]
                                                                            }
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            152. Observation.component:conclusion-string.value[x]
                                                                            Definition

                                                                            The information determined as a result of making the observation, if the information has a simple value.

                                                                            ShortSummary conclusion (interpretation/impression)
                                                                            Comments

                                                                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1
                                                                            Typestring
                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                            Summarytrue
                                                                            Requirements

                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            154. Observation.component:conclusion-string.dataAbsentReason
                                                                            Definition

                                                                            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                            ShortWhy the component result is missing
                                                                            Comments

                                                                            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                            Control0..1
                                                                            This element is affected by the following invariants: ele-1, obs-6
                                                                            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                            Codes specifying why the result (Observation.value[x]) is missing.

                                                                            TypeCodeableConcept
                                                                            Requirements

                                                                            For many results it is necessary to handle exceptional values in measurements.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            156. Observation.component:conclusion-string.interpretation
                                                                            Definition

                                                                            A categorical assessment of an observation value. For example, high, low, normal.

                                                                            ShortHigh, low, normal, etc.
                                                                            Comments

                                                                            Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                            Control0..*
                                                                            This element is affected by the following invariants: ele-1
                                                                            BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                            (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                            Codes identifying interpretations of observations.

                                                                            TypeCodeableConcept
                                                                            Requirements

                                                                            For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                            Alternate NamesAbnormal Flag
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            158. Observation.component:conclusion-string.referenceRange
                                                                            Definition

                                                                            Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                            ShortProvides guide for interpretation of component result
                                                                            Comments

                                                                            Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                            Control0..*
                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                            Requirements

                                                                            Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                            160. Observation.component:gene-studied
                                                                            Slice Namegene-studied
                                                                            Definition

                                                                            Das untersuchte Gen identifiziert durch HGNC-ID

                                                                            ShortUntersuchtes Gen
                                                                            Comments

                                                                            For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                            Control0..*
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypeBackboneElement
                                                                            Must Supporttrue
                                                                            Summarytrue
                                                                            Requirements

                                                                            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            162. Observation.component:gene-studied.id
                                                                            Definition

                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                            ShortUnique id for inter-element referencing
                                                                            Control0..1
                                                                            Typestring
                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                            164. Observation.component:gene-studied.extension
                                                                            Definition

                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                            ShortAdditional content defined by implementations
                                                                            Comments

                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                            Control0..*
                                                                            This element is affected by the following invariants: ele-1
                                                                            TypeExtension
                                                                            Alternate Namesextensions, user content
                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                            SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                            • value @ url
                                                                            • 166. Observation.component:gene-studied.modifierExtension
                                                                              Definition

                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                              Comments

                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                              Control0..*
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension
                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                              Summarytrue
                                                                              Requirements

                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                              Alternate Namesextensions, user content, modifiers
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              168. Observation.component:gene-studied.code
                                                                              Definition

                                                                              Describes what was observed. Sometimes this is called the observation "code".

                                                                              Short48018-6
                                                                              Comments

                                                                              All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                              Control1..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              BindingFor example codes, see LOINCCodes
                                                                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                              Codes identifying names of simple observations.

                                                                              TypeCodeableConcept
                                                                              Summarytrue
                                                                              Requirements

                                                                              Knowing what kind of observation is being made is essential to understanding the observation.

                                                                              Pattern Value{
                                                                                "coding" : [{
                                                                                  "system" : "http://loinc.org",
                                                                                  "code" : "48018-6"
                                                                                }]
                                                                              }
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              170. Observation.component:gene-studied.value[x]
                                                                              Definition

                                                                              The information determined as a result of making the observation, if the information has a simple value.

                                                                              ShortThe HGNC gene symbol is to be used as display text and the HGNC gene ID used as the code. If no HGNC code issued for this gene yet, NCBI gene IDs SHALL be used.
                                                                              Comments

                                                                              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                              Control1..1
                                                                              This element is affected by the following invariants: ele-1
                                                                              BindingUnless not suitable, these codes SHALL be taken from HUGO Gene Nomenclature Committee Gene Names (HGNC)
                                                                              (extensible to http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgnc-vs)
                                                                              TypeCodeableConcept
                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                              Summarytrue
                                                                              Requirements

                                                                              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              172. Observation.component:gene-studied.dataAbsentReason
                                                                              Definition

                                                                              Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                              ShortWhy the component result is missing
                                                                              Comments

                                                                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                              The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                              Control0..1
                                                                              This element is affected by the following invariants: ele-1, obs-6
                                                                              BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                              (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                              Codes specifying why the result (Observation.value[x]) is missing.

                                                                              TypeCodeableConcept
                                                                              Requirements

                                                                              For many results it is necessary to handle exceptional values in measurements.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              174. Observation.component:gene-studied.interpretation
                                                                              Definition

                                                                              A categorical assessment of an observation value. For example, high, low, normal.

                                                                              ShortHigh, low, normal, etc.
                                                                              Comments

                                                                              Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                              Control0..*
                                                                              This element is affected by the following invariants: ele-1
                                                                              BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                              Codes identifying interpretations of observations.

                                                                              TypeCodeableConcept
                                                                              Requirements

                                                                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                              Alternate NamesAbnormal Flag
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              176. Observation.component:gene-studied.referenceRange
                                                                              Definition

                                                                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                              ShortProvides guide for interpretation of component result
                                                                              Comments

                                                                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                              Control0..*
                                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                              Requirements

                                                                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                              178. Observation.component:cytogenetic-location
                                                                              Slice Namecytogenetic-location
                                                                              Definition

                                                                              Chromosomale Position der Variante in Bandennomenklatur

                                                                              ShortZytogenetische Lokalisation
                                                                              Comments

                                                                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                              Control0..*
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeBackboneElement
                                                                              Must Supporttrue
                                                                              Summarytrue
                                                                              Requirements

                                                                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              180. Observation.component:cytogenetic-location.id
                                                                              Definition

                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                              ShortUnique id for inter-element referencing
                                                                              Control0..1
                                                                              Typestring
                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                              182. Observation.component:cytogenetic-location.extension
                                                                              Definition

                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                              ShortAdditional content defined by implementations
                                                                              Comments

                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                              Control0..*
                                                                              This element is affected by the following invariants: ele-1
                                                                              TypeExtension
                                                                              Alternate Namesextensions, user content
                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                              SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                              • value @ url
                                                                              • 184. Observation.component:cytogenetic-location.modifierExtension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeExtension
                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                Summarytrue
                                                                                Requirements

                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                Alternate Namesextensions, user content, modifiers
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                186. Observation.component:cytogenetic-location.code
                                                                                Definition

                                                                                Describes what was observed. Sometimes this is called the observation "code".

                                                                                Short48001-2
                                                                                Comments

                                                                                All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                Control1..1
                                                                                This element is affected by the following invariants: ele-1
                                                                                BindingFor example codes, see LOINCCodes
                                                                                (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                Codes identifying names of simple observations.

                                                                                TypeCodeableConcept
                                                                                Summarytrue
                                                                                Requirements

                                                                                Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                Pattern Value{
                                                                                  "coding" : [{
                                                                                    "system" : "http://loinc.org",
                                                                                    "code" : "48001-2"
                                                                                  }]
                                                                                }
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                188. Observation.component:cytogenetic-location.value[x]
                                                                                Definition

                                                                                The information determined as a result of making the observation, if the information has a simple value.

                                                                                ShortExample: 1q21.1
                                                                                Comments

                                                                                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                Control1..1
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeCodeableConcept
                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                Summarytrue
                                                                                Requirements

                                                                                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                190. Observation.component:cytogenetic-location.dataAbsentReason
                                                                                Definition

                                                                                Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                ShortWhy the component result is missing
                                                                                Comments

                                                                                "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                Control0..1
                                                                                This element is affected by the following invariants: ele-1, obs-6
                                                                                BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                Codes specifying why the result (Observation.value[x]) is missing.

                                                                                TypeCodeableConcept
                                                                                Requirements

                                                                                For many results it is necessary to handle exceptional values in measurements.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                192. Observation.component:cytogenetic-location.interpretation
                                                                                Definition

                                                                                A categorical assessment of an observation value. For example, high, low, normal.

                                                                                ShortHigh, low, normal, etc.
                                                                                Comments

                                                                                Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                Control0..*
                                                                                This element is affected by the following invariants: ele-1
                                                                                BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                Codes identifying interpretations of observations.

                                                                                TypeCodeableConcept
                                                                                Requirements

                                                                                For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                Alternate NamesAbnormal Flag
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                194. Observation.component:cytogenetic-location.referenceRange
                                                                                Definition

                                                                                Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                ShortProvides guide for interpretation of component result
                                                                                Comments

                                                                                Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                Control0..*
                                                                                TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                Requirements

                                                                                Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                196. Observation.component:reference-sequence-assembly
                                                                                Slice Namereference-sequence-assembly
                                                                                Definition

                                                                                Die verwendete Referenzgenom-Version wie z.B. GRCh37 oder GRCh38

                                                                                ShortReferenzgenom-Assembly
                                                                                Comments

                                                                                For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                Control0..*
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeBackboneElement
                                                                                Must Supporttrue
                                                                                Summarytrue
                                                                                Requirements

                                                                                Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                198. Observation.component:reference-sequence-assembly.id
                                                                                Definition

                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                ShortUnique id for inter-element referencing
                                                                                Control0..1
                                                                                Typestring
                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                200. Observation.component:reference-sequence-assembly.extension
                                                                                Definition

                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                ShortAdditional content defined by implementations
                                                                                Comments

                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                Control0..*
                                                                                This element is affected by the following invariants: ele-1
                                                                                TypeExtension
                                                                                Alternate Namesextensions, user content
                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                • value @ url
                                                                                • 202. Observation.component:reference-sequence-assembly.modifierExtension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                  Comments

                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension
                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  204. Observation.component:reference-sequence-assembly.code
                                                                                  Definition

                                                                                  Describes what was observed. Sometimes this is called the observation "code".

                                                                                  Short62374-4
                                                                                  Comments

                                                                                  All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                  Control1..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  BindingFor example codes, see LOINCCodes
                                                                                  (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                  Codes identifying names of simple observations.

                                                                                  TypeCodeableConcept
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                  Pattern Value{
                                                                                    "coding" : [{
                                                                                      "system" : "http://loinc.org",
                                                                                      "code" : "62374-4"
                                                                                    }]
                                                                                  }
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  206. Observation.component:reference-sequence-assembly.value[x]
                                                                                  Definition

                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                  ShortGRCh37 | GRCh38 | ...
                                                                                  Comments

                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                  Control1..1
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  BindingUnless not suitable, these codes SHALL be taken from LOINC Answer List LL1040-6
                                                                                  (extensible to http://loinc.org/vs/LL1040-6)
                                                                                  TypeCodeableConcept
                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  208. Observation.component:reference-sequence-assembly.dataAbsentReason
                                                                                  Definition

                                                                                  Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                  ShortWhy the component result is missing
                                                                                  Comments

                                                                                  "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                  The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                  Control0..1
                                                                                  This element is affected by the following invariants: ele-1, obs-6
                                                                                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                  Codes specifying why the result (Observation.value[x]) is missing.

                                                                                  TypeCodeableConcept
                                                                                  Requirements

                                                                                  For many results it is necessary to handle exceptional values in measurements.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  210. Observation.component:reference-sequence-assembly.interpretation
                                                                                  Definition

                                                                                  A categorical assessment of an observation value. For example, high, low, normal.

                                                                                  ShortHigh, low, normal, etc.
                                                                                  Comments

                                                                                  Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                  (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                  Codes identifying interpretations of observations.

                                                                                  TypeCodeableConcept
                                                                                  Requirements

                                                                                  For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                  Alternate NamesAbnormal Flag
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  212. Observation.component:reference-sequence-assembly.referenceRange
                                                                                  Definition

                                                                                  Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                  ShortProvides guide for interpretation of component result
                                                                                  Comments

                                                                                  Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                  Control0..*
                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                  Requirements

                                                                                  Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                  214. Observation.component:chromosome-identifier
                                                                                  Slice Namechromosome-identifier
                                                                                  Definition

                                                                                  Das betroffene Chromosom

                                                                                  ShortChromosom
                                                                                  Comments

                                                                                  For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeBackboneElement
                                                                                  Must Supporttrue
                                                                                  Summarytrue
                                                                                  Requirements

                                                                                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  216. Observation.component:chromosome-identifier.id
                                                                                  Definition

                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                  ShortUnique id for inter-element referencing
                                                                                  Control0..1
                                                                                  Typestring
                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                  218. Observation.component:chromosome-identifier.extension
                                                                                  Definition

                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                  ShortAdditional content defined by implementations
                                                                                  Comments

                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                  Control0..*
                                                                                  This element is affected by the following invariants: ele-1
                                                                                  TypeExtension
                                                                                  Alternate Namesextensions, user content
                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                  SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                  • value @ url
                                                                                  • 220. Observation.component:chromosome-identifier.modifierExtension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                    Comments

                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeExtension
                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    222. Observation.component:chromosome-identifier.code
                                                                                    Definition

                                                                                    Describes what was observed. Sometimes this is called the observation "code".

                                                                                    Short48000-4
                                                                                    Comments

                                                                                    All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                    Control1..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingFor example codes, see LOINCCodes
                                                                                    (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                    Codes identifying names of simple observations.

                                                                                    TypeCodeableConcept
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                    Pattern Value{
                                                                                      "coding" : [{
                                                                                        "system" : "http://loinc.org",
                                                                                        "code" : "48000-4"
                                                                                      }]
                                                                                    }
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    224. Observation.component:chromosome-identifier.value[x]
                                                                                    Definition

                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                    ShortChromosome 1 | Chromosome 2 | ... | Chromosome 22 | Chromosome X | Chromosome Y
                                                                                    Comments

                                                                                    Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                    Control1..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingThe codes SHALL be taken from LOINC Answer List LL2938-0
                                                                                    (required to http://loinc.org/vs/LL2938-0)
                                                                                    TypeCodeableConcept
                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    226. Observation.component:chromosome-identifier.dataAbsentReason
                                                                                    Definition

                                                                                    Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                    ShortWhy the component result is missing
                                                                                    Comments

                                                                                    "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                    The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1, obs-6
                                                                                    BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                    (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                    Codes specifying why the result (Observation.value[x]) is missing.

                                                                                    TypeCodeableConcept
                                                                                    Requirements

                                                                                    For many results it is necessary to handle exceptional values in measurements.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    228. Observation.component:chromosome-identifier.interpretation
                                                                                    Definition

                                                                                    A categorical assessment of an observation value. For example, high, low, normal.

                                                                                    ShortHigh, low, normal, etc.
                                                                                    Comments

                                                                                    Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                    (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                    Codes identifying interpretations of observations.

                                                                                    TypeCodeableConcept
                                                                                    Requirements

                                                                                    For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                    Alternate NamesAbnormal Flag
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    230. Observation.component:chromosome-identifier.referenceRange
                                                                                    Definition

                                                                                    Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                    ShortProvides guide for interpretation of component result
                                                                                    Comments

                                                                                    Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                    Control0..*
                                                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                    Requirements

                                                                                    Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                    232. Observation.component:representative-coding-hgvs
                                                                                    Slice Namerepresentative-coding-hgvs
                                                                                    Definition

                                                                                    Die cDNA-Änderung in HGVS-Nomenklatur auf Transkriptebene

                                                                                    ShortDNA-Änderung c.HGVS
                                                                                    Comments

                                                                                    For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                    Control0..1
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeBackboneElement
                                                                                    Must Supporttrue
                                                                                    Summarytrue
                                                                                    Requirements

                                                                                    Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    234. Observation.component:representative-coding-hgvs.id
                                                                                    Definition

                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                    ShortUnique id for inter-element referencing
                                                                                    Control0..1
                                                                                    Typestring
                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                    236. Observation.component:representative-coding-hgvs.extension
                                                                                    Definition

                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                    ShortAdditional content defined by implementations
                                                                                    Comments

                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                    Control0..*
                                                                                    This element is affected by the following invariants: ele-1
                                                                                    TypeExtension
                                                                                    Alternate Namesextensions, user content
                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                    SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                    • value @ url
                                                                                    • 238. Observation.component:representative-coding-hgvs.modifierExtension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                      Comments

                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                      Control0..*
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeExtension
                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      240. Observation.component:representative-coding-hgvs.code
                                                                                      Definition

                                                                                      Describes what was observed. Sometimes this is called the observation "code".

                                                                                      Short48004-6
                                                                                      Comments

                                                                                      All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                      Control1..1
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      BindingFor example codes, see LOINCCodes
                                                                                      (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                      Codes identifying names of simple observations.

                                                                                      TypeCodeableConcept
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                      Pattern Value{
                                                                                        "coding" : [{
                                                                                          "system" : "http://loinc.org",
                                                                                          "code" : "48004-6"
                                                                                        }]
                                                                                      }
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      242. Observation.component:representative-coding-hgvs.value[x]
                                                                                      Definition

                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                      ShortA valid HGVS-formatted 'c.' string, e.g. NM_005228.5:c.2369C>T.
                                                                                      Comments

                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                      Control1..1
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      BindingThe codes SHALL be taken from Human Genome Variation Society (HGVS) Nomenclature
                                                                                      (required to http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgvs-vs)
                                                                                      TypeCodeableConcept
                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      244. Observation.component:representative-coding-hgvs.dataAbsentReason
                                                                                      Definition

                                                                                      Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                      ShortWhy the component result is missing
                                                                                      Comments

                                                                                      "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                      The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: ele-1, obs-6
                                                                                      BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                      (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                      Codes specifying why the result (Observation.value[x]) is missing.

                                                                                      TypeCodeableConcept
                                                                                      Requirements

                                                                                      For many results it is necessary to handle exceptional values in measurements.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      246. Observation.component:representative-coding-hgvs.interpretation
                                                                                      Definition

                                                                                      A categorical assessment of an observation value. For example, high, low, normal.

                                                                                      ShortHigh, low, normal, etc.
                                                                                      Comments

                                                                                      Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                      Control0..*
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                      (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                      Codes identifying interpretations of observations.

                                                                                      TypeCodeableConcept
                                                                                      Requirements

                                                                                      For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                      Alternate NamesAbnormal Flag
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      248. Observation.component:representative-coding-hgvs.referenceRange
                                                                                      Definition

                                                                                      Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                      ShortProvides guide for interpretation of component result
                                                                                      Comments

                                                                                      Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                      Control0..*
                                                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                      Requirements

                                                                                      Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                      250. Observation.component:genomic-hgvs
                                                                                      Slice Namegenomic-hgvs
                                                                                      Definition

                                                                                      Die genomische DNA-Änderung in HGVS-Nomenklatur

                                                                                      ShortGenomische DNA-Änderung g.HGVS
                                                                                      Comments

                                                                                      For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                      Control0..1
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeBackboneElement
                                                                                      Must Supporttrue
                                                                                      Summarytrue
                                                                                      Requirements

                                                                                      Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      252. Observation.component:genomic-hgvs.id
                                                                                      Definition

                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                      ShortUnique id for inter-element referencing
                                                                                      Control0..1
                                                                                      Typestring
                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                      254. Observation.component:genomic-hgvs.extension
                                                                                      Definition

                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                      ShortAdditional content defined by implementations
                                                                                      Comments

                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                      Control0..*
                                                                                      This element is affected by the following invariants: ele-1
                                                                                      TypeExtension
                                                                                      Alternate Namesextensions, user content
                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                      SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                      • value @ url
                                                                                      • 256. Observation.component:genomic-hgvs.modifierExtension
                                                                                        Definition

                                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                                        Comments

                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                        Control0..*
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        TypeExtension
                                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                        Summarytrue
                                                                                        Requirements

                                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                        Alternate Namesextensions, user content, modifiers
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                        258. Observation.component:genomic-hgvs.code
                                                                                        Definition

                                                                                        Describes what was observed. Sometimes this is called the observation "code".

                                                                                        Short81290-9
                                                                                        Comments

                                                                                        All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                        Control1..1
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        BindingFor example codes, see LOINCCodes
                                                                                        (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                        Codes identifying names of simple observations.

                                                                                        TypeCodeableConcept
                                                                                        Summarytrue
                                                                                        Requirements

                                                                                        Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                        Pattern Value{
                                                                                          "coding" : [{
                                                                                            "system" : "http://loinc.org",
                                                                                            "code" : "81290-9"
                                                                                          }]
                                                                                        }
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        260. Observation.component:genomic-hgvs.value[x]
                                                                                        Definition

                                                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                                                        ShortA valid HGVS-formatted 'g.' string, e.g. NC_000016.9:g.2124200_2138612dup
                                                                                        Comments

                                                                                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                        Control1..1
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        BindingThe codes SHALL be taken from Human Genome Variation Society (HGVS) Nomenclature
                                                                                        (required to http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgvs-vs)
                                                                                        TypeCodeableConcept
                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                        Summarytrue
                                                                                        Requirements

                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        262. Observation.component:genomic-hgvs.dataAbsentReason
                                                                                        Definition

                                                                                        Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                        ShortWhy the component result is missing
                                                                                        Comments

                                                                                        "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                        The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                        Control0..1
                                                                                        This element is affected by the following invariants: ele-1, obs-6
                                                                                        BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                        (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                        Codes specifying why the result (Observation.value[x]) is missing.

                                                                                        TypeCodeableConcept
                                                                                        Requirements

                                                                                        For many results it is necessary to handle exceptional values in measurements.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        264. Observation.component:genomic-hgvs.interpretation
                                                                                        Definition

                                                                                        A categorical assessment of an observation value. For example, high, low, normal.

                                                                                        ShortHigh, low, normal, etc.
                                                                                        Comments

                                                                                        Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                        Control0..*
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                        (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                        Codes identifying interpretations of observations.

                                                                                        TypeCodeableConcept
                                                                                        Requirements

                                                                                        For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                        Alternate NamesAbnormal Flag
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        266. Observation.component:genomic-hgvs.referenceRange
                                                                                        Definition

                                                                                        Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                        ShortProvides guide for interpretation of component result
                                                                                        Comments

                                                                                        Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                        Control0..*
                                                                                        TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                        Requirements

                                                                                        Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                        268. Observation.component:cytogenomic-nomenclature
                                                                                        Slice Namecytogenomic-nomenclature
                                                                                        Definition

                                                                                        Fully describes a variant with a single code. Typically a large variant such as a mosaic, abnormal chromosome numbers, etc.

                                                                                        ShortCytogenomic Nomenclature (ISCN)
                                                                                        Comments

                                                                                        For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                        Control0..1
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        TypeBackboneElement
                                                                                        Summarytrue
                                                                                        Requirements

                                                                                        Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        270. Observation.component:cytogenomic-nomenclature.id
                                                                                        Definition

                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                        ShortUnique id for inter-element referencing
                                                                                        Control0..1
                                                                                        Typestring
                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                        272. Observation.component:cytogenomic-nomenclature.extension
                                                                                        Definition

                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                        ShortAdditional content defined by implementations
                                                                                        Comments

                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                        Control0..*
                                                                                        This element is affected by the following invariants: ele-1
                                                                                        TypeExtension
                                                                                        Alternate Namesextensions, user content
                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                        SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                        • value @ url
                                                                                        • 274. Observation.component:cytogenomic-nomenclature.modifierExtension
                                                                                          Definition

                                                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                                          Comments

                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                          Control0..*
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          TypeExtension
                                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                          Alternate Namesextensions, user content, modifiers
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                          276. Observation.component:cytogenomic-nomenclature.code
                                                                                          Definition

                                                                                          Describes what was observed. Sometimes this is called the observation "code".

                                                                                          Short81291-7
                                                                                          Comments

                                                                                          All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                          Control1..1
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          BindingFor example codes, see LOINCCodes
                                                                                          (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                          Codes identifying names of simple observations.

                                                                                          TypeCodeableConcept
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                          Pattern Value{
                                                                                            "coding" : [{
                                                                                              "system" : "http://loinc.org",
                                                                                              "code" : "81291-7"
                                                                                            }]
                                                                                          }
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          278. Observation.component:cytogenomic-nomenclature.value[x]
                                                                                          Definition

                                                                                          The information determined as a result of making the observation, if the information has a simple value.

                                                                                          ShortActual component result
                                                                                          Comments

                                                                                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                          Control1..1
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          Binding

                                                                                          Binding not yet defined

                                                                                          TypeCodeableConcept
                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          280. Observation.component:cytogenomic-nomenclature.dataAbsentReason
                                                                                          Definition

                                                                                          Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                          ShortWhy the component result is missing
                                                                                          Comments

                                                                                          "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                          The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                          Control0..1
                                                                                          This element is affected by the following invariants: ele-1, obs-6
                                                                                          BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                          (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                          Codes specifying why the result (Observation.value[x]) is missing.

                                                                                          TypeCodeableConcept
                                                                                          Requirements

                                                                                          For many results it is necessary to handle exceptional values in measurements.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          282. Observation.component:cytogenomic-nomenclature.interpretation
                                                                                          Definition

                                                                                          A categorical assessment of an observation value. For example, high, low, normal.

                                                                                          ShortHigh, low, normal, etc.
                                                                                          Comments

                                                                                          Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                          Control0..*
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                          (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                          Codes identifying interpretations of observations.

                                                                                          TypeCodeableConcept
                                                                                          Requirements

                                                                                          For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                          Alternate NamesAbnormal Flag
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          284. Observation.component:cytogenomic-nomenclature.referenceRange
                                                                                          Definition

                                                                                          Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                          ShortProvides guide for interpretation of component result
                                                                                          Comments

                                                                                          Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                          Control0..*
                                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                          Requirements

                                                                                          Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                          286. Observation.component:genomic-ref-seq
                                                                                          Slice Namegenomic-ref-seq
                                                                                          Definition

                                                                                          Die genomische Referenzsequenz-ID wie z.B. NC_000007.14

                                                                                          ShortGenomische Referenzsequenz
                                                                                          Comments

                                                                                          For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                          Control0..1
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          TypeBackboneElement
                                                                                          Must Supporttrue
                                                                                          Summarytrue
                                                                                          Requirements

                                                                                          Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          288. Observation.component:genomic-ref-seq.id
                                                                                          Definition

                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                          ShortUnique id for inter-element referencing
                                                                                          Control0..1
                                                                                          Typestring
                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                          290. Observation.component:genomic-ref-seq.extension
                                                                                          Definition

                                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                          ShortAdditional content defined by implementations
                                                                                          Comments

                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                          Control0..*
                                                                                          This element is affected by the following invariants: ele-1
                                                                                          TypeExtension
                                                                                          Alternate Namesextensions, user content
                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                          SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                          • value @ url
                                                                                          • 292. Observation.component:genomic-ref-seq.modifierExtension
                                                                                            Definition

                                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                                            Comments

                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                            Control0..*
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            TypeExtension
                                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                            Alternate Namesextensions, user content, modifiers
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                            294. Observation.component:genomic-ref-seq.code
                                                                                            Definition

                                                                                            Describes what was observed. Sometimes this is called the observation "code".

                                                                                            Short48013-7
                                                                                            Comments

                                                                                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                            Control1..1
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            BindingFor example codes, see LOINCCodes
                                                                                            (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                            Codes identifying names of simple observations.

                                                                                            TypeCodeableConcept
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                            Pattern Value{
                                                                                              "coding" : [{
                                                                                                "system" : "http://loinc.org",
                                                                                                "code" : "48013-7"
                                                                                              }]
                                                                                            }
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            296. Observation.component:genomic-ref-seq.value[x]
                                                                                            Definition

                                                                                            The information determined as a result of making the observation, if the information has a simple value.

                                                                                            ShortVersioned genomic reference sequence identifier
                                                                                            Comments

                                                                                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                            Control1..1
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            Binding

                                                                                            Multiple bindings acceptable (NCBI or LRG)

                                                                                            TypeCodeableConcept
                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            298. Observation.component:genomic-ref-seq.dataAbsentReason
                                                                                            Definition

                                                                                            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                            ShortWhy the component result is missing
                                                                                            Comments

                                                                                            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                            Control0..1
                                                                                            This element is affected by the following invariants: ele-1, obs-6
                                                                                            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                            Codes specifying why the result (Observation.value[x]) is missing.

                                                                                            TypeCodeableConcept
                                                                                            Requirements

                                                                                            For many results it is necessary to handle exceptional values in measurements.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            300. Observation.component:genomic-ref-seq.interpretation
                                                                                            Definition

                                                                                            A categorical assessment of an observation value. For example, high, low, normal.

                                                                                            ShortHigh, low, normal, etc.
                                                                                            Comments

                                                                                            Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                            Control0..*
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                            (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                            Codes identifying interpretations of observations.

                                                                                            TypeCodeableConcept
                                                                                            Requirements

                                                                                            For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                            Alternate NamesAbnormal Flag
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            302. Observation.component:genomic-ref-seq.referenceRange
                                                                                            Definition

                                                                                            Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                            ShortProvides guide for interpretation of component result
                                                                                            Comments

                                                                                            Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                            Control0..*
                                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                            Requirements

                                                                                            Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                            304. Observation.component:representative-protein-ref-seq
                                                                                            Slice Namerepresentative-protein-ref-seq
                                                                                            Definition

                                                                                            ID of the protein reference sequence, which includes transcribed and non transcribed stretches. It covers the entire protein described.

                                                                                            ShortProtein Reference Sequence
                                                                                            Comments

                                                                                            For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                            Control0..1
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            TypeBackboneElement
                                                                                            Summarytrue
                                                                                            Requirements

                                                                                            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            306. Observation.component:representative-protein-ref-seq.id
                                                                                            Definition

                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                            ShortUnique id for inter-element referencing
                                                                                            Control0..1
                                                                                            Typestring
                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                            308. Observation.component:representative-protein-ref-seq.extension
                                                                                            Definition

                                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                            ShortAdditional content defined by implementations
                                                                                            Comments

                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                            Control0..*
                                                                                            This element is affected by the following invariants: ele-1
                                                                                            TypeExtension
                                                                                            Alternate Namesextensions, user content
                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                            SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                            • value @ url
                                                                                            • 310. Observation.component:representative-protein-ref-seq.modifierExtension
                                                                                              Definition

                                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                              Comments

                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                              Control0..*
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              TypeExtension
                                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                              Summarytrue
                                                                                              Requirements

                                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                              Alternate Namesextensions, user content, modifiers
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                              312. Observation.component:representative-protein-ref-seq.code
                                                                                              Definition

                                                                                              Describes what was observed. Sometimes this is called the observation "code".

                                                                                              Shortprotein-ref-seq
                                                                                              Comments

                                                                                              All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                              Control1..1
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              BindingFor example codes, see LOINCCodes
                                                                                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                              Codes identifying names of simple observations.

                                                                                              TypeCodeableConcept
                                                                                              Summarytrue
                                                                                              Requirements

                                                                                              Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                              Pattern Value{
                                                                                                "coding" : [{
                                                                                                  "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
                                                                                                  "code" : "protein-ref-seq"
                                                                                                }]
                                                                                              }
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              314. Observation.component:representative-protein-ref-seq.value[x]
                                                                                              Definition

                                                                                              The information determined as a result of making the observation, if the information has a simple value.

                                                                                              ShortVersioned protein reference sequence identifier
                                                                                              Comments

                                                                                              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                              Control1..1
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              Binding

                                                                                              Multiple bindings acceptable (NCBI or LRG)

                                                                                              TypeCodeableConcept
                                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                              Summarytrue
                                                                                              Requirements

                                                                                              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              316. Observation.component:representative-protein-ref-seq.dataAbsentReason
                                                                                              Definition

                                                                                              Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                              ShortWhy the component result is missing
                                                                                              Comments

                                                                                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                              The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                              Control0..1
                                                                                              This element is affected by the following invariants: ele-1, obs-6
                                                                                              BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                              (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                              Codes specifying why the result (Observation.value[x]) is missing.

                                                                                              TypeCodeableConcept
                                                                                              Requirements

                                                                                              For many results it is necessary to handle exceptional values in measurements.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              318. Observation.component:representative-protein-ref-seq.interpretation
                                                                                              Definition

                                                                                              A categorical assessment of an observation value. For example, high, low, normal.

                                                                                              ShortHigh, low, normal, etc.
                                                                                              Comments

                                                                                              Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                              Control0..*
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                              Codes identifying interpretations of observations.

                                                                                              TypeCodeableConcept
                                                                                              Requirements

                                                                                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                              Alternate NamesAbnormal Flag
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              320. Observation.component:representative-protein-ref-seq.referenceRange
                                                                                              Definition

                                                                                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                              ShortProvides guide for interpretation of component result
                                                                                              Comments

                                                                                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                              Control0..*
                                                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                              Requirements

                                                                                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                              322. Observation.component:representative-transcript-ref-seq
                                                                                              Slice Namerepresentative-transcript-ref-seq
                                                                                              Definition

                                                                                              Die Transkript-Referenzsequenz-ID wie z.B. NM_004333.4

                                                                                              ShortTranskript-Referenzsequenz
                                                                                              Comments

                                                                                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                              Control0..1
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              TypeBackboneElement
                                                                                              Must Supporttrue
                                                                                              Summarytrue
                                                                                              Requirements

                                                                                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              324. Observation.component:representative-transcript-ref-seq.id
                                                                                              Definition

                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                              ShortUnique id for inter-element referencing
                                                                                              Control0..1
                                                                                              Typestring
                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                              326. Observation.component:representative-transcript-ref-seq.extension
                                                                                              Definition

                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                              ShortAdditional content defined by implementations
                                                                                              Comments

                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                              Control0..*
                                                                                              This element is affected by the following invariants: ele-1
                                                                                              TypeExtension
                                                                                              Alternate Namesextensions, user content
                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                              SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                              • value @ url
                                                                                              • 328. Observation.component:representative-transcript-ref-seq.modifierExtension
                                                                                                Definition

                                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                                Comments

                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeExtension
                                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                Alternate Namesextensions, user content, modifiers
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                330. Observation.component:representative-transcript-ref-seq.code
                                                                                                Definition

                                                                                                Describes what was observed. Sometimes this is called the observation "code".

                                                                                                Short51958-7
                                                                                                Comments

                                                                                                All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                Control1..1
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                BindingFor example codes, see LOINCCodes
                                                                                                (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                Codes identifying names of simple observations.

                                                                                                TypeCodeableConcept
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                Pattern Value{
                                                                                                  "coding" : [{
                                                                                                    "system" : "http://loinc.org",
                                                                                                    "code" : "51958-7"
                                                                                                  }]
                                                                                                }
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                332. Observation.component:representative-transcript-ref-seq.value[x]
                                                                                                Definition

                                                                                                The information determined as a result of making the observation, if the information has a simple value.

                                                                                                ShortVersioned transcript reference sequence identifier
                                                                                                Comments

                                                                                                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                Control1..1
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                Binding

                                                                                                Multiple bindings acceptable (NCBI or LRG)

                                                                                                TypeCodeableConcept
                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                334. Observation.component:representative-transcript-ref-seq.dataAbsentReason
                                                                                                Definition

                                                                                                Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                ShortWhy the component result is missing
                                                                                                Comments

                                                                                                "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                Control0..1
                                                                                                This element is affected by the following invariants: ele-1, obs-6
                                                                                                BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                TypeCodeableConcept
                                                                                                Requirements

                                                                                                For many results it is necessary to handle exceptional values in measurements.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                336. Observation.component:representative-transcript-ref-seq.interpretation
                                                                                                Definition

                                                                                                A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                ShortHigh, low, normal, etc.
                                                                                                Comments

                                                                                                Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                Codes identifying interpretations of observations.

                                                                                                TypeCodeableConcept
                                                                                                Requirements

                                                                                                For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                Alternate NamesAbnormal Flag
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                338. Observation.component:representative-transcript-ref-seq.referenceRange
                                                                                                Definition

                                                                                                Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                ShortProvides guide for interpretation of component result
                                                                                                Comments

                                                                                                Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                Control0..*
                                                                                                TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                Requirements

                                                                                                Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                340. Observation.component:exact-start-end
                                                                                                Slice Nameexact-start-end
                                                                                                Definition

                                                                                                Die exakten genomischen Koordinaten der Variante - Start und Ende

                                                                                                ShortExakte Start-End-Position
                                                                                                Comments

                                                                                                For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                Control0..1
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeBackboneElement
                                                                                                Must Supporttrue
                                                                                                Summarytrue
                                                                                                Requirements

                                                                                                Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                342. Observation.component:exact-start-end.id
                                                                                                Definition

                                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                ShortUnique id for inter-element referencing
                                                                                                Control0..1
                                                                                                Typestring
                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                344. Observation.component:exact-start-end.extension
                                                                                                Definition

                                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                ShortAdditional content defined by implementations
                                                                                                Comments

                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                Control0..*
                                                                                                This element is affected by the following invariants: ele-1
                                                                                                TypeExtension
                                                                                                Alternate Namesextensions, user content
                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                • value @ url
                                                                                                • 346. Observation.component:exact-start-end.modifierExtension
                                                                                                  Definition

                                                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                                  Comments

                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                  Control0..*
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeExtension
                                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                  348. Observation.component:exact-start-end.code
                                                                                                  Definition

                                                                                                  Describes what was observed. Sometimes this is called the observation "code".

                                                                                                  Short81254-5
                                                                                                  Comments

                                                                                                  All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                  Control1..1
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  BindingFor example codes, see LOINCCodes
                                                                                                  (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                  Codes identifying names of simple observations.

                                                                                                  TypeCodeableConcept
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                  Pattern Value{
                                                                                                    "coding" : [{
                                                                                                      "system" : "http://loinc.org",
                                                                                                      "code" : "81254-5"
                                                                                                    }]
                                                                                                  }
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  350. Observation.component:exact-start-end.value[x]
                                                                                                  Definition

                                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                                  ShortRange in question. 'High' can be omitted for single nucleotide variants.
                                                                                                  Comments

                                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                  Control0..1
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeRange
                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  352. Observation.component:exact-start-end.dataAbsentReason
                                                                                                  Definition

                                                                                                  Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                  ShortWhy the component result is missing
                                                                                                  Comments

                                                                                                  "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                  The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                  Control0..1
                                                                                                  This element is affected by the following invariants: ele-1, obs-6
                                                                                                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                  Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                  TypeCodeableConcept
                                                                                                  Requirements

                                                                                                  For many results it is necessary to handle exceptional values in measurements.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  354. Observation.component:exact-start-end.interpretation
                                                                                                  Definition

                                                                                                  A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                  ShortHigh, low, normal, etc.
                                                                                                  Comments

                                                                                                  Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                  Control0..*
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                  (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                  Codes identifying interpretations of observations.

                                                                                                  TypeCodeableConcept
                                                                                                  Requirements

                                                                                                  For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                  Alternate NamesAbnormal Flag
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  356. Observation.component:exact-start-end.referenceRange
                                                                                                  Definition

                                                                                                  Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                  ShortProvides guide for interpretation of component result
                                                                                                  Comments

                                                                                                  Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                  Control0..*
                                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                  Requirements

                                                                                                  Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                  358. Observation.component:inner-start-end
                                                                                                  Slice Nameinner-start-end
                                                                                                  Definition

                                                                                                  Der innere Bereich bei strukturellen Varianten

                                                                                                  ShortInnere Start-End-Position
                                                                                                  Comments

                                                                                                  For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                  Control0..1
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeBackboneElement
                                                                                                  Must Supporttrue
                                                                                                  Summarytrue
                                                                                                  Requirements

                                                                                                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  360. Observation.component:inner-start-end.id
                                                                                                  Definition

                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                  ShortUnique id for inter-element referencing
                                                                                                  Control0..1
                                                                                                  Typestring
                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                  362. Observation.component:inner-start-end.extension
                                                                                                  Definition

                                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                  ShortAdditional content defined by implementations
                                                                                                  Comments

                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                  Control0..*
                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                  TypeExtension
                                                                                                  Alternate Namesextensions, user content
                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                  SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                  • value @ url
                                                                                                  • 364. Observation.component:inner-start-end.modifierExtension
                                                                                                    Definition

                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                    Comments

                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    TypeExtension
                                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    366. Observation.component:inner-start-end.code
                                                                                                    Definition

                                                                                                    Describes what was observed. Sometimes this is called the observation "code".

                                                                                                    Short81302-2
                                                                                                    Comments

                                                                                                    All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                    Control1..1
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    BindingFor example codes, see LOINCCodes
                                                                                                    (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                    Codes identifying names of simple observations.

                                                                                                    TypeCodeableConcept
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                    Pattern Value{
                                                                                                      "coding" : [{
                                                                                                        "system" : "http://loinc.org",
                                                                                                        "code" : "81302-2"
                                                                                                      }]
                                                                                                    }
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    368. Observation.component:inner-start-end.value[x]
                                                                                                    Definition

                                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                                    ShortImprecise variant inner-bounding range
                                                                                                    Comments

                                                                                                    Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                    Control0..1
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    TypeRange
                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    370. Observation.component:inner-start-end.dataAbsentReason
                                                                                                    Definition

                                                                                                    Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                    ShortWhy the component result is missing
                                                                                                    Comments

                                                                                                    "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                    The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                    Control0..1
                                                                                                    This element is affected by the following invariants: ele-1, obs-6
                                                                                                    BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                    (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                    Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                    TypeCodeableConcept
                                                                                                    Requirements

                                                                                                    For many results it is necessary to handle exceptional values in measurements.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    372. Observation.component:inner-start-end.interpretation
                                                                                                    Definition

                                                                                                    A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                    ShortHigh, low, normal, etc.
                                                                                                    Comments

                                                                                                    Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                    (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                    Codes identifying interpretations of observations.

                                                                                                    TypeCodeableConcept
                                                                                                    Requirements

                                                                                                    For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                    Alternate NamesAbnormal Flag
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    374. Observation.component:inner-start-end.referenceRange
                                                                                                    Definition

                                                                                                    Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                    ShortProvides guide for interpretation of component result
                                                                                                    Comments

                                                                                                    Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                    Control0..*
                                                                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                    Requirements

                                                                                                    Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                    376. Observation.component:outer-start-end
                                                                                                    Slice Nameouter-start-end
                                                                                                    Definition

                                                                                                    Der äußere Bereich bei strukturellen Varianten

                                                                                                    ShortÄußere Start-End-Position
                                                                                                    Comments

                                                                                                    For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                    Control0..1
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    TypeBackboneElement
                                                                                                    Must Supporttrue
                                                                                                    Summarytrue
                                                                                                    Requirements

                                                                                                    Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    378. Observation.component:outer-start-end.id
                                                                                                    Definition

                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                    ShortUnique id for inter-element referencing
                                                                                                    Control0..1
                                                                                                    Typestring
                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                    380. Observation.component:outer-start-end.extension
                                                                                                    Definition

                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                    ShortAdditional content defined by implementations
                                                                                                    Comments

                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                    Control0..*
                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                    TypeExtension
                                                                                                    Alternate Namesextensions, user content
                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                    SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                    • value @ url
                                                                                                    • 382. Observation.component:outer-start-end.modifierExtension
                                                                                                      Definition

                                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                      Comments

                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                      Control0..*
                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                      TypeExtension
                                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                      384. Observation.component:outer-start-end.code
                                                                                                      Definition

                                                                                                      Describes what was observed. Sometimes this is called the observation "code".

                                                                                                      Short81301-4
                                                                                                      Comments

                                                                                                      All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                      Control1..1
                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                      BindingFor example codes, see LOINCCodes
                                                                                                      (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                      Codes identifying names of simple observations.

                                                                                                      TypeCodeableConcept
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                      Pattern Value{
                                                                                                        "coding" : [{
                                                                                                          "system" : "http://loinc.org",
                                                                                                          "code" : "81301-4"
                                                                                                        }]
                                                                                                      }
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      386. Observation.component:outer-start-end.value[x]
                                                                                                      Definition

                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                      ShortImprecise variant outer-bounding range
                                                                                                      Comments

                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                      Control0..1
                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                      TypeRange
                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      388. Observation.component:outer-start-end.dataAbsentReason
                                                                                                      Definition

                                                                                                      Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                      ShortWhy the component result is missing
                                                                                                      Comments

                                                                                                      "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                      The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                      Control0..1
                                                                                                      This element is affected by the following invariants: ele-1, obs-6
                                                                                                      BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                      Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                      TypeCodeableConcept
                                                                                                      Requirements

                                                                                                      For many results it is necessary to handle exceptional values in measurements.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      390. Observation.component:outer-start-end.interpretation
                                                                                                      Definition

                                                                                                      A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                      ShortHigh, low, normal, etc.
                                                                                                      Comments

                                                                                                      Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                      Control0..*
                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                      BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                      Codes identifying interpretations of observations.

                                                                                                      TypeCodeableConcept
                                                                                                      Requirements

                                                                                                      For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                      Alternate NamesAbnormal Flag
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      392. Observation.component:outer-start-end.referenceRange
                                                                                                      Definition

                                                                                                      Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                      ShortProvides guide for interpretation of component result
                                                                                                      Comments

                                                                                                      Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                      Control0..*
                                                                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                      Requirements

                                                                                                      Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                      394. Observation.component:coordinate-system
                                                                                                      Slice Namecoordinate-system
                                                                                                      Definition

                                                                                                      These are different ways of identifying nucleotides or amino acids within a sequence. In the 1-based system, the first unit of the polymer (e.g. the first nucleotide) is counted as number 1. In the 0-based system, the number 0 designates the location before the first nucleotide. Different databases and file types may use different systems.

                                                                                                      ShortCoordinate System
                                                                                                      Comments

                                                                                                      For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                      Control0..1
                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                      TypeBackboneElement
                                                                                                      Summarytrue
                                                                                                      Requirements

                                                                                                      Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      396. Observation.component:coordinate-system.id
                                                                                                      Definition

                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                      ShortUnique id for inter-element referencing
                                                                                                      Control0..1
                                                                                                      Typestring
                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                      398. Observation.component:coordinate-system.extension
                                                                                                      Definition

                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                      ShortAdditional content defined by implementations
                                                                                                      Comments

                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                      Control0..*
                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                      TypeExtension
                                                                                                      Alternate Namesextensions, user content
                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                      SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                      • value @ url
                                                                                                      • 400. Observation.component:coordinate-system.modifierExtension
                                                                                                        Definition

                                                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                                                        Comments

                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                        Control0..*
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        TypeExtension
                                                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                        Alternate Namesextensions, user content, modifiers
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                        402. Observation.component:coordinate-system.code
                                                                                                        Definition

                                                                                                        Describes what was observed. Sometimes this is called the observation "code".

                                                                                                        Short92822-6
                                                                                                        Comments

                                                                                                        All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                        Control1..1
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        BindingFor example codes, see LOINCCodes
                                                                                                        (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                        Codes identifying names of simple observations.

                                                                                                        TypeCodeableConcept
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                        Pattern Value{
                                                                                                          "coding" : [{
                                                                                                            "system" : "http://loinc.org",
                                                                                                            "code" : "92822-6"
                                                                                                          }]
                                                                                                        }
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        404. Observation.component:coordinate-system.value[x]
                                                                                                        Definition

                                                                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                                                                        Short0-based interval counting | 0-based character counting | 1-based character counting
                                                                                                        Comments

                                                                                                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                        Control1..1
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        BindingUnless not suitable, these codes SHALL be taken from LOINC Answer List LL5323-2
                                                                                                        (extensible to http://loinc.org/vs/LL5323-2)
                                                                                                        TypeCodeableConcept
                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        406. Observation.component:coordinate-system.dataAbsentReason
                                                                                                        Definition

                                                                                                        Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                        ShortWhy the component result is missing
                                                                                                        Comments

                                                                                                        "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                        The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                        Control0..1
                                                                                                        This element is affected by the following invariants: ele-1, obs-6
                                                                                                        BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                        (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                        Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                        TypeCodeableConcept
                                                                                                        Requirements

                                                                                                        For many results it is necessary to handle exceptional values in measurements.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        408. Observation.component:coordinate-system.interpretation
                                                                                                        Definition

                                                                                                        A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                        ShortHigh, low, normal, etc.
                                                                                                        Comments

                                                                                                        Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                        Control0..*
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                        (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                        Codes identifying interpretations of observations.

                                                                                                        TypeCodeableConcept
                                                                                                        Requirements

                                                                                                        For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                        Alternate NamesAbnormal Flag
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        410. Observation.component:coordinate-system.referenceRange
                                                                                                        Definition

                                                                                                        Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                        ShortProvides guide for interpretation of component result
                                                                                                        Comments

                                                                                                        Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                        Control0..*
                                                                                                        TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                        Requirements

                                                                                                        Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                        412. Observation.component:ref-allele
                                                                                                        Slice Nameref-allele
                                                                                                        Definition

                                                                                                        Die Nukleotidsequenz des Referenz-Allels

                                                                                                        ShortReferenz-Allel
                                                                                                        Comments

                                                                                                        For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                        Control0..1
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        TypeBackboneElement
                                                                                                        Must Supporttrue
                                                                                                        Summarytrue
                                                                                                        Requirements

                                                                                                        Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        414. Observation.component:ref-allele.id
                                                                                                        Definition

                                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                        ShortUnique id for inter-element referencing
                                                                                                        Control0..1
                                                                                                        Typestring
                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                        416. Observation.component:ref-allele.extension
                                                                                                        Definition

                                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                        ShortAdditional content defined by implementations
                                                                                                        Comments

                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                        Control0..*
                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                        TypeExtension
                                                                                                        Alternate Namesextensions, user content
                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                        SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                        • value @ url
                                                                                                        • 418. Observation.component:ref-allele.modifierExtension
                                                                                                          Definition

                                                                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                                                          Comments

                                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                          Control0..*
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          TypeExtension
                                                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                          Alternate Namesextensions, user content, modifiers
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                          420. Observation.component:ref-allele.code
                                                                                                          Definition

                                                                                                          Describes what was observed. Sometimes this is called the observation "code".

                                                                                                          Short69547-8
                                                                                                          Comments

                                                                                                          All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                          Control1..1
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          BindingFor example codes, see LOINCCodes
                                                                                                          (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                          Codes identifying names of simple observations.

                                                                                                          TypeCodeableConcept
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                          Pattern Value{
                                                                                                            "coding" : [{
                                                                                                              "system" : "http://loinc.org",
                                                                                                              "code" : "69547-8"
                                                                                                            }]
                                                                                                          }
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          422. Observation.component:ref-allele.value[x]
                                                                                                          Definition

                                                                                                          The information determined as a result of making the observation, if the information has a simple value.

                                                                                                          ShortNormalized string per the VCF format.
                                                                                                          Comments

                                                                                                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                          Control0..1
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          Typestring
                                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          424. Observation.component:ref-allele.dataAbsentReason
                                                                                                          Definition

                                                                                                          Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                          ShortWhy the component result is missing
                                                                                                          Comments

                                                                                                          "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                          The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                          Control0..1
                                                                                                          This element is affected by the following invariants: ele-1, obs-6
                                                                                                          BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                          (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                          Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                          TypeCodeableConcept
                                                                                                          Requirements

                                                                                                          For many results it is necessary to handle exceptional values in measurements.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          426. Observation.component:ref-allele.interpretation
                                                                                                          Definition

                                                                                                          A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                          ShortHigh, low, normal, etc.
                                                                                                          Comments

                                                                                                          Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                          Control0..*
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                          (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                          Codes identifying interpretations of observations.

                                                                                                          TypeCodeableConcept
                                                                                                          Requirements

                                                                                                          For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                          Alternate NamesAbnormal Flag
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          428. Observation.component:ref-allele.referenceRange
                                                                                                          Definition

                                                                                                          Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                          ShortProvides guide for interpretation of component result
                                                                                                          Comments

                                                                                                          Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                          Control0..*
                                                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                          Requirements

                                                                                                          Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                          430. Observation.component:alt-allele
                                                                                                          Slice Namealt-allele
                                                                                                          Definition

                                                                                                          Die Nukleotidsequenz des alternativen - mutierten - Allels

                                                                                                          ShortAlternatives Allel
                                                                                                          Comments

                                                                                                          For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                          Control0..1
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          TypeBackboneElement
                                                                                                          Must Supporttrue
                                                                                                          Summarytrue
                                                                                                          Requirements

                                                                                                          Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          432. Observation.component:alt-allele.id
                                                                                                          Definition

                                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                          ShortUnique id for inter-element referencing
                                                                                                          Control0..1
                                                                                                          Typestring
                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                          434. Observation.component:alt-allele.extension
                                                                                                          Definition

                                                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                          ShortAdditional content defined by implementations
                                                                                                          Comments

                                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                          Control0..*
                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                          TypeExtension
                                                                                                          Alternate Namesextensions, user content
                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                          SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                          • value @ url
                                                                                                          • 436. Observation.component:alt-allele.modifierExtension
                                                                                                            Definition

                                                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                                                            Comments

                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                            Control0..*
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            TypeExtension
                                                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                            Alternate Namesextensions, user content, modifiers
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                            438. Observation.component:alt-allele.code
                                                                                                            Definition

                                                                                                            Describes what was observed. Sometimes this is called the observation "code".

                                                                                                            Short69551-0
                                                                                                            Comments

                                                                                                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                            Control1..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            BindingFor example codes, see LOINCCodes
                                                                                                            (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                            Codes identifying names of simple observations.

                                                                                                            TypeCodeableConcept
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                            Pattern Value{
                                                                                                              "coding" : [{
                                                                                                                "system" : "http://loinc.org",
                                                                                                                "code" : "69551-0"
                                                                                                              }]
                                                                                                            }
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            440. Observation.component:alt-allele.value[x]
                                                                                                            Definition

                                                                                                            The information determined as a result of making the observation, if the information has a simple value.

                                                                                                            ShortNormalized string per the VCF format.
                                                                                                            Comments

                                                                                                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                            Control0..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            Typestring
                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            442. Observation.component:alt-allele.dataAbsentReason
                                                                                                            Definition

                                                                                                            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                            ShortWhy the component result is missing
                                                                                                            Comments

                                                                                                            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                            Control0..1
                                                                                                            This element is affected by the following invariants: ele-1, obs-6
                                                                                                            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                            Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                            TypeCodeableConcept
                                                                                                            Requirements

                                                                                                            For many results it is necessary to handle exceptional values in measurements.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            444. Observation.component:alt-allele.interpretation
                                                                                                            Definition

                                                                                                            A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                            ShortHigh, low, normal, etc.
                                                                                                            Comments

                                                                                                            Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                            Control0..*
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                            (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                            Codes identifying interpretations of observations.

                                                                                                            TypeCodeableConcept
                                                                                                            Requirements

                                                                                                            For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                            Alternate NamesAbnormal Flag
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            446. Observation.component:alt-allele.referenceRange
                                                                                                            Definition

                                                                                                            Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                            ShortProvides guide for interpretation of component result
                                                                                                            Comments

                                                                                                            Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                            Control0..*
                                                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                            Requirements

                                                                                                            Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                            448. Observation.component:coding-change-type
                                                                                                            Slice Namecoding-change-type
                                                                                                            Definition

                                                                                                            Der Typ der DNA-Änderung wie z.B. Substitution oder Deletion

                                                                                                            ShortDNA-Änderungstyp
                                                                                                            Comments

                                                                                                            For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                            Control0..1
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            TypeBackboneElement
                                                                                                            Must Supporttrue
                                                                                                            Summarytrue
                                                                                                            Requirements

                                                                                                            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            450. Observation.component:coding-change-type.id
                                                                                                            Definition

                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                            ShortUnique id for inter-element referencing
                                                                                                            Control0..1
                                                                                                            Typestring
                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                            452. Observation.component:coding-change-type.extension
                                                                                                            Definition

                                                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                            ShortAdditional content defined by implementations
                                                                                                            Comments

                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                            Control0..*
                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                            TypeExtension
                                                                                                            Alternate Namesextensions, user content
                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                            SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                            • value @ url
                                                                                                            • 454. Observation.component:coding-change-type.modifierExtension
                                                                                                              Definition

                                                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                              Comments

                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                              Control0..*
                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                              TypeExtension
                                                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                              Alternate Namesextensions, user content, modifiers
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                              456. Observation.component:coding-change-type.code
                                                                                                              Definition

                                                                                                              Describes what was observed. Sometimes this is called the observation "code".

                                                                                                              Short48019-4
                                                                                                              Comments

                                                                                                              All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                              Control1..1
                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                              BindingFor example codes, see LOINCCodes
                                                                                                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                              Codes identifying names of simple observations.

                                                                                                              TypeCodeableConcept
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                              Pattern Value{
                                                                                                                "coding" : [{
                                                                                                                  "system" : "http://loinc.org",
                                                                                                                  "code" : "48019-4"
                                                                                                                }]
                                                                                                              }
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              458. Observation.component:coding-change-type.value[x]
                                                                                                              Definition

                                                                                                              The information determined as a result of making the observation, if the information has a simple value.

                                                                                                              Shortdeletion | insertion | delins | SNV | copy_number_gain | copy_number_loss | ... (many)
                                                                                                              Comments

                                                                                                              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                              Control1..1
                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                              BindingUnless not suitable, these codes SHALL be taken from DNA Change Type
                                                                                                              (extensible to http://hl7.org/fhir/uv/genomics-reporting/ValueSet/dna-change-type-vs)

                                                                                                              Concepts in sequence ontology under SO:0002072

                                                                                                              TypeCodeableConcept
                                                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              460. Observation.component:coding-change-type.dataAbsentReason
                                                                                                              Definition

                                                                                                              Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                              ShortWhy the component result is missing
                                                                                                              Comments

                                                                                                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                              The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                              Control0..1
                                                                                                              This element is affected by the following invariants: ele-1, obs-6
                                                                                                              BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                              (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                              Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                              TypeCodeableConcept
                                                                                                              Requirements

                                                                                                              For many results it is necessary to handle exceptional values in measurements.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              462. Observation.component:coding-change-type.interpretation
                                                                                                              Definition

                                                                                                              A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                              ShortHigh, low, normal, etc.
                                                                                                              Comments

                                                                                                              Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                              Control0..*
                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                              BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                              Codes identifying interpretations of observations.

                                                                                                              TypeCodeableConcept
                                                                                                              Requirements

                                                                                                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                              Alternate NamesAbnormal Flag
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              464. Observation.component:coding-change-type.referenceRange
                                                                                                              Definition

                                                                                                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                              ShortProvides guide for interpretation of component result
                                                                                                              Comments

                                                                                                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                              Control0..*
                                                                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                              Requirements

                                                                                                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                              466. Observation.component:genomic-source-class
                                                                                                              Slice Namegenomic-source-class
                                                                                                              Definition

                                                                                                              Die Herkunft der Variante wie z.B. somatisch oder Keimbahn

                                                                                                              ShortGenomische Herkunftsklasse
                                                                                                              Comments

                                                                                                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                              Control0..1
                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                              TypeBackboneElement
                                                                                                              Must Supporttrue
                                                                                                              Summarytrue
                                                                                                              Requirements

                                                                                                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              468. Observation.component:genomic-source-class.id
                                                                                                              Definition

                                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                              ShortUnique id for inter-element referencing
                                                                                                              Control0..1
                                                                                                              Typestring
                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                              470. Observation.component:genomic-source-class.extension
                                                                                                              Definition

                                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                              ShortAdditional content defined by implementations
                                                                                                              Comments

                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                              Control0..*
                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                              TypeExtension
                                                                                                              Alternate Namesextensions, user content
                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                              SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                              • value @ url
                                                                                                              • 472. Observation.component:genomic-source-class.modifierExtension
                                                                                                                Definition

                                                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                Comments

                                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                Control0..*
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                TypeExtension
                                                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                Alternate Namesextensions, user content, modifiers
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                474. Observation.component:genomic-source-class.code
                                                                                                                Definition

                                                                                                                Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                Short48002-0
                                                                                                                Comments

                                                                                                                All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                Control1..1
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                BindingFor example codes, see LOINCCodes
                                                                                                                (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                Codes identifying names of simple observations.

                                                                                                                TypeCodeableConcept
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                Pattern Value{
                                                                                                                  "coding" : [{
                                                                                                                    "system" : "http://loinc.org",
                                                                                                                    "code" : "48002-0"
                                                                                                                  }]
                                                                                                                }
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                476. Observation.component:genomic-source-class.value[x]
                                                                                                                Definition

                                                                                                                The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                ShortGermline | Somatic | Fetal | Likely germline | Likely somatic | Likely fetal | Unknown genomic origin | De novo
                                                                                                                Comments

                                                                                                                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                Control1..1
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                BindingUnless not suitable, these codes SHALL be taken from LOINC Answer List LL378-1
                                                                                                                (extensible to http://loinc.org/vs/LL378-1)
                                                                                                                TypeCodeableConcept
                                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                478. Observation.component:genomic-source-class.dataAbsentReason
                                                                                                                Definition

                                                                                                                Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                ShortWhy the component result is missing
                                                                                                                Comments

                                                                                                                "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                Control0..1
                                                                                                                This element is affected by the following invariants: ele-1, obs-6
                                                                                                                BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                TypeCodeableConcept
                                                                                                                Requirements

                                                                                                                For many results it is necessary to handle exceptional values in measurements.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                480. Observation.component:genomic-source-class.interpretation
                                                                                                                Definition

                                                                                                                A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                ShortHigh, low, normal, etc.
                                                                                                                Comments

                                                                                                                Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                Control0..*
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                Codes identifying interpretations of observations.

                                                                                                                TypeCodeableConcept
                                                                                                                Requirements

                                                                                                                For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                Alternate NamesAbnormal Flag
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                482. Observation.component:genomic-source-class.referenceRange
                                                                                                                Definition

                                                                                                                Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                ShortProvides guide for interpretation of component result
                                                                                                                Comments

                                                                                                                Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                Control0..*
                                                                                                                TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                Requirements

                                                                                                                Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                484. Observation.component:sample-allelic-frequency
                                                                                                                Slice Namesample-allelic-frequency
                                                                                                                Definition

                                                                                                                Die Häufigkeit des varianten Allels in der untersuchten Probe

                                                                                                                ShortAllelfrequenz in der Probe
                                                                                                                Comments

                                                                                                                For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                Control0..1
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                TypeBackboneElement
                                                                                                                Must Supporttrue
                                                                                                                Summarytrue
                                                                                                                Requirements

                                                                                                                Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                486. Observation.component:sample-allelic-frequency.id
                                                                                                                Definition

                                                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                ShortUnique id for inter-element referencing
                                                                                                                Control0..1
                                                                                                                Typestring
                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                488. Observation.component:sample-allelic-frequency.extension
                                                                                                                Definition

                                                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                ShortAdditional content defined by implementations
                                                                                                                Comments

                                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                Control0..*
                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                TypeExtension
                                                                                                                Alternate Namesextensions, user content
                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                • value @ url
                                                                                                                • 490. Observation.component:sample-allelic-frequency.modifierExtension
                                                                                                                  Definition

                                                                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                  Comments

                                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                  Control0..*
                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                  TypeExtension
                                                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                  Summarytrue
                                                                                                                  Requirements

                                                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                  492. Observation.component:sample-allelic-frequency.code
                                                                                                                  Definition

                                                                                                                  Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                  Short81258-6
                                                                                                                  Comments

                                                                                                                  All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                  Control1..1
                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                  BindingFor example codes, see LOINCCodes
                                                                                                                  (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                  Codes identifying names of simple observations.

                                                                                                                  TypeCodeableConcept
                                                                                                                  Summarytrue
                                                                                                                  Requirements

                                                                                                                  Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                  Pattern Value{
                                                                                                                    "coding" : [{
                                                                                                                      "system" : "http://loinc.org",
                                                                                                                      "code" : "81258-6"
                                                                                                                    }]
                                                                                                                  }
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  494. Observation.component:sample-allelic-frequency.value[x]
                                                                                                                  Definition

                                                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                  ShortRelative frequency in the sample
                                                                                                                  Comments

                                                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                  Control0..1
                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                  TypeQuantity
                                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                  Summarytrue
                                                                                                                  Requirements

                                                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  496. Observation.component:sample-allelic-frequency.value[x].id
                                                                                                                  Definition

                                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                  ShortUnique id for inter-element referencing
                                                                                                                  Control0..1
                                                                                                                  Typestring
                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                  498. Observation.component:sample-allelic-frequency.value[x].extension
                                                                                                                  Definition

                                                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                  ShortAdditional content defined by implementations
                                                                                                                  Comments

                                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                  Control0..*
                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                  TypeExtension
                                                                                                                  Alternate Namesextensions, user content
                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                  SlicingThis element introduces a set of slices on Observation.component.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                  • value @ url
                                                                                                                  • 500. Observation.component:sample-allelic-frequency.value[x].value
                                                                                                                    Definition

                                                                                                                    The value of the measured amount. The value includes an implicit precision in the presentation of the value.

                                                                                                                    ShortNumerical value (with implicit precision)
                                                                                                                    Comments

                                                                                                                    The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                    Typedecimal
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Summarytrue
                                                                                                                    Requirements

                                                                                                                    Precision is handled implicitly in almost all cases of measurement.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    502. Observation.component:sample-allelic-frequency.value[x].comparator
                                                                                                                    Definition

                                                                                                                    How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value.

                                                                                                                    Short< | <= | >= | > - how to understand the value
                                                                                                                    Comments

                                                                                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                    BindingThe codes SHALL be taken from QuantityComparator
                                                                                                                    (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)

                                                                                                                    How the Quantity should be understood and represented.

                                                                                                                    Typecode
                                                                                                                    Is Modifiertrue because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Summarytrue
                                                                                                                    Requirements

                                                                                                                    Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

                                                                                                                    Meaning if MissingIf there is no comparator, then there is no modification of the value
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    504. Observation.component:sample-allelic-frequency.value[x].unit
                                                                                                                    Definition

                                                                                                                    A human-readable form of the unit.

                                                                                                                    ShortUnit representation
                                                                                                                    Comments

                                                                                                                    Note that FHIR strings SHALL NOT exceed 1MB in size

                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                    Typestring
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Summarytrue
                                                                                                                    Requirements

                                                                                                                    There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    506. Observation.component:sample-allelic-frequency.value[x].system
                                                                                                                    Definition

                                                                                                                    The identification of the system that provides the coded form of the unit.

                                                                                                                    ShortSystem that defines coded unit form
                                                                                                                    Comments

                                                                                                                    see http://en.wikipedia.org/wiki/Uniform_resource_identifier

                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: ele-1, qty-3
                                                                                                                    Typeuri
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Summarytrue
                                                                                                                    Requirements

                                                                                                                    Need to know the system that defines the coded form of the unit.

                                                                                                                    Pattern Valuehttp://unitsofmeasure.org
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    508. Observation.component:sample-allelic-frequency.value[x].code
                                                                                                                    Definition

                                                                                                                    A computer processable form of the unit in some unit representation system.

                                                                                                                    ShortCoded form of the unit
                                                                                                                    Comments

                                                                                                                    The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                    Typecode
                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                    Summarytrue
                                                                                                                    Requirements

                                                                                                                    Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    510. Observation.component:sample-allelic-frequency.dataAbsentReason
                                                                                                                    Definition

                                                                                                                    Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                    ShortWhy the component result is missing
                                                                                                                    Comments

                                                                                                                    "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                    The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: ele-1, obs-6
                                                                                                                    BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                    (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                    Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                    TypeCodeableConcept
                                                                                                                    Requirements

                                                                                                                    For many results it is necessary to handle exceptional values in measurements.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    512. Observation.component:sample-allelic-frequency.interpretation
                                                                                                                    Definition

                                                                                                                    A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                    ShortHigh, low, normal, etc.
                                                                                                                    Comments

                                                                                                                    Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                    Control0..*
                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                    BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                    (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                    Codes identifying interpretations of observations.

                                                                                                                    TypeCodeableConcept
                                                                                                                    Requirements

                                                                                                                    For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                    Alternate NamesAbnormal Flag
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    514. Observation.component:sample-allelic-frequency.referenceRange
                                                                                                                    Definition

                                                                                                                    Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                    ShortProvides guide for interpretation of component result
                                                                                                                    Comments

                                                                                                                    Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                    Control0..*
                                                                                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                    Requirements

                                                                                                                    Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                    516. Observation.component:allelic-read-depth
                                                                                                                    Slice Nameallelic-read-depth
                                                                                                                    Definition

                                                                                                                    Die Anzahl der Reads die das Allel unterstützen

                                                                                                                    ShortNumber reported reads
                                                                                                                    Comments

                                                                                                                    See here for usage guidance.

                                                                                                                    Control0..1
                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                    TypeBackboneElement
                                                                                                                    Must Supporttrue
                                                                                                                    Summarytrue
                                                                                                                    Requirements

                                                                                                                    Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    518. Observation.component:allelic-read-depth.id
                                                                                                                    Definition

                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                    Control0..1
                                                                                                                    Typestring
                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                    520. Observation.component:allelic-read-depth.extension
                                                                                                                    Definition

                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                    ShortAdditional content defined by implementations
                                                                                                                    Comments

                                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                    Control0..*
                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                    TypeExtension
                                                                                                                    Alternate Namesextensions, user content
                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                    SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                    • value @ url
                                                                                                                    • 522. Observation.component:allelic-read-depth.modifierExtension
                                                                                                                      Definition

                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                      Comments

                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                      Control0..*
                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                      TypeExtension
                                                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                      Summarytrue
                                                                                                                      Requirements

                                                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                      524. Observation.component:allelic-read-depth.code
                                                                                                                      Definition

                                                                                                                      Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                      Short82121-5
                                                                                                                      Comments

                                                                                                                      All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                      Control1..1
                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                      BindingFor example codes, see LOINCCodes
                                                                                                                      (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                      Codes identifying names of simple observations.

                                                                                                                      TypeCodeableConcept
                                                                                                                      Must Supporttrue
                                                                                                                      Summarytrue
                                                                                                                      Requirements

                                                                                                                      Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                      Pattern Value{
                                                                                                                        "coding" : [{
                                                                                                                          "system" : "http://loinc.org",
                                                                                                                          "code" : "82121-5"
                                                                                                                        }]
                                                                                                                      }
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      526. Observation.component:allelic-read-depth.value[x]
                                                                                                                      Definition

                                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                      ShortUnfiltered count of supporting reads
                                                                                                                      Comments

                                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                      Control0..1
                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                      TypeQuantity
                                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                      Must Supporttrue
                                                                                                                      Summarytrue
                                                                                                                      Requirements

                                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      528. Observation.component:allelic-read-depth.dataAbsentReason
                                                                                                                      Definition

                                                                                                                      Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                      ShortWhy the component result is missing
                                                                                                                      Comments

                                                                                                                      "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                      The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                      Control0..1
                                                                                                                      This element is affected by the following invariants: ele-1, obs-6
                                                                                                                      BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                      Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                      TypeCodeableConcept
                                                                                                                      Requirements

                                                                                                                      For many results it is necessary to handle exceptional values in measurements.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      530. Observation.component:allelic-read-depth.interpretation
                                                                                                                      Definition

                                                                                                                      A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                      ShortHigh, low, normal, etc.
                                                                                                                      Comments

                                                                                                                      Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                      Control0..*
                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                      BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                      Codes identifying interpretations of observations.

                                                                                                                      TypeCodeableConcept
                                                                                                                      Requirements

                                                                                                                      For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                      Alternate NamesAbnormal Flag
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      532. Observation.component:allelic-read-depth.referenceRange
                                                                                                                      Definition

                                                                                                                      Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                      ShortProvides guide for interpretation of component result
                                                                                                                      Comments

                                                                                                                      Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                      Control0..*
                                                                                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                      Requirements

                                                                                                                      Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                      534. Observation.component:allelic-state
                                                                                                                      Slice Nameallelic-state
                                                                                                                      Definition

                                                                                                                      Der Allelstatus wie z.B. heterozygot oder homozygot

                                                                                                                      ShortAllelstatus
                                                                                                                      Comments

                                                                                                                      For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                      Control0..1
                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                      TypeBackboneElement
                                                                                                                      Must Supporttrue
                                                                                                                      Summarytrue
                                                                                                                      Requirements

                                                                                                                      Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      536. Observation.component:allelic-state.id
                                                                                                                      Definition

                                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                      ShortUnique id for inter-element referencing
                                                                                                                      Control0..1
                                                                                                                      Typestring
                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                      538. Observation.component:allelic-state.extension
                                                                                                                      Definition

                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                      Comments

                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                      Control0..*
                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                      TypeExtension
                                                                                                                      Alternate Namesextensions, user content
                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                      SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                      • value @ url
                                                                                                                      • 540. Observation.component:allelic-state.modifierExtension
                                                                                                                        Definition

                                                                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                        Comments

                                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                        Control0..*
                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                        TypeExtension
                                                                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                        Summarytrue
                                                                                                                        Requirements

                                                                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                        Alternate Namesextensions, user content, modifiers
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                        542. Observation.component:allelic-state.code
                                                                                                                        Definition

                                                                                                                        Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                        Short53034-5
                                                                                                                        Comments

                                                                                                                        All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                        Control1..1
                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                        BindingFor example codes, see LOINCCodes
                                                                                                                        (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                        Codes identifying names of simple observations.

                                                                                                                        TypeCodeableConcept
                                                                                                                        Summarytrue
                                                                                                                        Requirements

                                                                                                                        Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                        Pattern Value{
                                                                                                                          "coding" : [{
                                                                                                                            "system" : "http://loinc.org",
                                                                                                                            "code" : "53034-5"
                                                                                                                          }]
                                                                                                                        }
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        544. Observation.component:allelic-state.value[x]
                                                                                                                        Definition

                                                                                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                        ShortHeteroplasmic | Homoplasmic | Homozygous | Heterozygous | Hemizygous
                                                                                                                        Comments

                                                                                                                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                        Control1..1
                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                        BindingUnless not suitable, these codes SHALL be taken from LOINC Answer List LL381-5
                                                                                                                        (extensible to http://loinc.org/vs/LL381-5)
                                                                                                                        TypeCodeableConcept
                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                        Summarytrue
                                                                                                                        Requirements

                                                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        546. Observation.component:allelic-state.dataAbsentReason
                                                                                                                        Definition

                                                                                                                        Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                        ShortWhy the component result is missing
                                                                                                                        Comments

                                                                                                                        "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                        The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                        Control0..1
                                                                                                                        This element is affected by the following invariants: ele-1, obs-6
                                                                                                                        BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                        (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                        Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                        TypeCodeableConcept
                                                                                                                        Requirements

                                                                                                                        For many results it is necessary to handle exceptional values in measurements.

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        548. Observation.component:allelic-state.interpretation
                                                                                                                        Definition

                                                                                                                        A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                        ShortHigh, low, normal, etc.
                                                                                                                        Comments

                                                                                                                        Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                        Control0..*
                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                        BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                        (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                        Codes identifying interpretations of observations.

                                                                                                                        TypeCodeableConcept
                                                                                                                        Requirements

                                                                                                                        For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                        Alternate NamesAbnormal Flag
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        550. Observation.component:allelic-state.referenceRange
                                                                                                                        Definition

                                                                                                                        Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                        ShortProvides guide for interpretation of component result
                                                                                                                        Comments

                                                                                                                        Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                        Control0..*
                                                                                                                        TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                        Requirements

                                                                                                                        Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                        552. Observation.component:variant-inheritance
                                                                                                                        Slice Namevariant-inheritance
                                                                                                                        Definition

                                                                                                                        Die Vererbungsart der Variante wie z.B. maternal oder paternal

                                                                                                                        ShortVarianten-Vererbung
                                                                                                                        Comments

                                                                                                                        For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                        Control0..1
                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                        TypeBackboneElement
                                                                                                                        Must Supporttrue
                                                                                                                        Summarytrue
                                                                                                                        Requirements

                                                                                                                        Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        554. Observation.component:variant-inheritance.id
                                                                                                                        Definition

                                                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                        ShortUnique id for inter-element referencing
                                                                                                                        Control0..1
                                                                                                                        Typestring
                                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                        556. Observation.component:variant-inheritance.extension
                                                                                                                        Definition

                                                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                        ShortAdditional content defined by implementations
                                                                                                                        Comments

                                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                        Control0..*
                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                        TypeExtension
                                                                                                                        Alternate Namesextensions, user content
                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                        SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                        • value @ url
                                                                                                                        • 558. Observation.component:variant-inheritance.modifierExtension
                                                                                                                          Definition

                                                                                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                          Comments

                                                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                          Control0..*
                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                          TypeExtension
                                                                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                          Summarytrue
                                                                                                                          Requirements

                                                                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                          Alternate Namesextensions, user content, modifiers
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                          560. Observation.component:variant-inheritance.code
                                                                                                                          Definition

                                                                                                                          Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                          Short94186-4
                                                                                                                          Comments

                                                                                                                          All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                          Control1..1
                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                          BindingFor example codes, see LOINCCodes
                                                                                                                          (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                          Codes identifying names of simple observations.

                                                                                                                          TypeCodeableConcept
                                                                                                                          Summarytrue
                                                                                                                          Requirements

                                                                                                                          Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                          Pattern Value{
                                                                                                                            "coding" : [{
                                                                                                                              "system" : "http://loinc.org",
                                                                                                                              "code" : "94186-4"
                                                                                                                            }]
                                                                                                                          }
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          562. Observation.component:variant-inheritance.value[x]
                                                                                                                          Definition

                                                                                                                          The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                          ShortMaternal | Paternal | Unknown
                                                                                                                          Comments

                                                                                                                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                          Control1..1
                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                          BindingUnless not suitable, these codes SHALL be taken from LOINC Answer List LL5489-1
                                                                                                                          (extensible to http://loinc.org/vs/LL5489-1)
                                                                                                                          TypeCodeableConcept
                                                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                          Summarytrue
                                                                                                                          Requirements

                                                                                                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          564. Observation.component:variant-inheritance.dataAbsentReason
                                                                                                                          Definition

                                                                                                                          Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                          ShortWhy the component result is missing
                                                                                                                          Comments

                                                                                                                          "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                          The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                          Control0..1
                                                                                                                          This element is affected by the following invariants: ele-1, obs-6
                                                                                                                          BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                          (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                          Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                          TypeCodeableConcept
                                                                                                                          Requirements

                                                                                                                          For many results it is necessary to handle exceptional values in measurements.

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          566. Observation.component:variant-inheritance.interpretation
                                                                                                                          Definition

                                                                                                                          A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                          ShortHigh, low, normal, etc.
                                                                                                                          Comments

                                                                                                                          Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                          Control0..*
                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                          BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                          (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                          Codes identifying interpretations of observations.

                                                                                                                          TypeCodeableConcept
                                                                                                                          Requirements

                                                                                                                          For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                          Alternate NamesAbnormal Flag
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          568. Observation.component:variant-inheritance.referenceRange
                                                                                                                          Definition

                                                                                                                          Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                          ShortProvides guide for interpretation of component result
                                                                                                                          Comments

                                                                                                                          Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                          Control0..*
                                                                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                          Requirements

                                                                                                                          Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                          570. Observation.component:variant-inheritance-basis
                                                                                                                          Slice Namevariant-inheritance-basis
                                                                                                                          Definition

                                                                                                                          The method by which the variant inheritance is determined.

                                                                                                                          ShortEvidential basis for variant inheritance
                                                                                                                          Comments

                                                                                                                          For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                          Control0..1
                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                          TypeBackboneElement
                                                                                                                          Summarytrue
                                                                                                                          Requirements

                                                                                                                          Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          572. Observation.component:variant-inheritance-basis.id
                                                                                                                          Definition

                                                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                          ShortUnique id for inter-element referencing
                                                                                                                          Control0..1
                                                                                                                          Typestring
                                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                          574. Observation.component:variant-inheritance-basis.extension
                                                                                                                          Definition

                                                                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                          ShortAdditional content defined by implementations
                                                                                                                          Comments

                                                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                          Control0..*
                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                          TypeExtension
                                                                                                                          Alternate Namesextensions, user content
                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                          SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                          • value @ url
                                                                                                                          • 576. Observation.component:variant-inheritance-basis.modifierExtension
                                                                                                                            Definition

                                                                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                            Comments

                                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                            Control0..*
                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                            TypeExtension
                                                                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                            Summarytrue
                                                                                                                            Requirements

                                                                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                            Alternate Namesextensions, user content, modifiers
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                            578. Observation.component:variant-inheritance-basis.code
                                                                                                                            Definition

                                                                                                                            Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                            ShortBasis for allelic phase
                                                                                                                            Comments

                                                                                                                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                            Control1..1
                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                            BindingFor example codes, see LOINCCodes
                                                                                                                            (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                            Codes identifying names of simple observations.

                                                                                                                            TypeCodeableConcept
                                                                                                                            Summarytrue
                                                                                                                            Requirements

                                                                                                                            Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                            Pattern Value{
                                                                                                                              "coding" : [{
                                                                                                                                "system" : "http://loinc.org",
                                                                                                                                "code" : "82309-6"
                                                                                                                              }]
                                                                                                                            }
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            580. Observation.component:variant-inheritance-basis.value[x]
                                                                                                                            Definition

                                                                                                                            The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                            ShortDirectly measured | Family DNA | Family history | Inferred from population data
                                                                                                                            Comments

                                                                                                                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                            Control1..1
                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                            BindingUnless not suitable, these codes SHALL be taken from LOINC Answer List LL4050-2
                                                                                                                            (extensible to http://loinc.org/vs/LL4050-2)
                                                                                                                            TypeCodeableConcept
                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                            Summarytrue
                                                                                                                            Requirements

                                                                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            582. Observation.component:variant-inheritance-basis.dataAbsentReason
                                                                                                                            Definition

                                                                                                                            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                            ShortWhy the component result is missing
                                                                                                                            Comments

                                                                                                                            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                            Control0..1
                                                                                                                            This element is affected by the following invariants: ele-1, obs-6
                                                                                                                            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                            Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                            TypeCodeableConcept
                                                                                                                            Requirements

                                                                                                                            For many results it is necessary to handle exceptional values in measurements.

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            584. Observation.component:variant-inheritance-basis.interpretation
                                                                                                                            Definition

                                                                                                                            A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                            ShortHigh, low, normal, etc.
                                                                                                                            Comments

                                                                                                                            Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                            Control0..*
                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                            BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                            (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                            Codes identifying interpretations of observations.

                                                                                                                            TypeCodeableConcept
                                                                                                                            Requirements

                                                                                                                            For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                            Alternate NamesAbnormal Flag
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            586. Observation.component:variant-inheritance-basis.referenceRange
                                                                                                                            Definition

                                                                                                                            Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                            ShortProvides guide for interpretation of component result
                                                                                                                            Comments

                                                                                                                            Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                            Control0..*
                                                                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                            Requirements

                                                                                                                            Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                            588. Observation.component:variation-code
                                                                                                                            Slice Namevariation-code
                                                                                                                            Definition

                                                                                                                            Eindeutiger Identifikator der Variante aus externen Datenbanken wie z.B. ClinVar oder dbSNP

                                                                                                                            ShortVariant database ID (e.g. COSMIC)
                                                                                                                            Comments

                                                                                                                            For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                            Control0..*
                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                            TypeBackboneElement
                                                                                                                            Must Supporttrue
                                                                                                                            Summarytrue
                                                                                                                            Requirements

                                                                                                                            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            590. Observation.component:variation-code.id
                                                                                                                            Definition

                                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                            ShortUnique id for inter-element referencing
                                                                                                                            Control0..1
                                                                                                                            Typestring
                                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                            592. Observation.component:variation-code.extension
                                                                                                                            Definition

                                                                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                            ShortAdditional content defined by implementations
                                                                                                                            Comments

                                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                            Control0..*
                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                            TypeExtension
                                                                                                                            Alternate Namesextensions, user content
                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                            SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                            • value @ url
                                                                                                                            • 594. Observation.component:variation-code.modifierExtension
                                                                                                                              Definition

                                                                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                              Comments

                                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                              Control0..*
                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                              TypeExtension
                                                                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                              Summarytrue
                                                                                                                              Requirements

                                                                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                              Alternate Namesextensions, user content, modifiers
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                              596. Observation.component:variation-code.code
                                                                                                                              Definition

                                                                                                                              Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                              Short81252-9
                                                                                                                              Comments

                                                                                                                              All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                              Control1..1
                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                              BindingFor example codes, see LOINCCodes
                                                                                                                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                              Codes identifying names of simple observations.

                                                                                                                              TypeCodeableConcept
                                                                                                                              Summarytrue
                                                                                                                              Requirements

                                                                                                                              Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                              Pattern Value{
                                                                                                                                "coding" : [{
                                                                                                                                  "system" : "http://loinc.org",
                                                                                                                                  "code" : "81252-9"
                                                                                                                                }]
                                                                                                                              }
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              598. Observation.component:variation-code.value[x]
                                                                                                                              Definition

                                                                                                                              The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                              ShortClinVar ID or similar
                                                                                                                              Comments

                                                                                                                              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                              Control1..1
                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                              Binding

                                                                                                                              Multiple bindings acceptable

                                                                                                                              TypeCodeableConcept
                                                                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                              Summarytrue
                                                                                                                              Requirements

                                                                                                                              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              600. Observation.component:variation-code.dataAbsentReason
                                                                                                                              Definition

                                                                                                                              Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                              ShortWhy the component result is missing
                                                                                                                              Comments

                                                                                                                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                              The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                              Control0..1
                                                                                                                              This element is affected by the following invariants: ele-1, obs-6
                                                                                                                              BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                              (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                              Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                              TypeCodeableConcept
                                                                                                                              Requirements

                                                                                                                              For many results it is necessary to handle exceptional values in measurements.

                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              602. Observation.component:variation-code.interpretation
                                                                                                                              Definition

                                                                                                                              A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                              ShortHigh, low, normal, etc.
                                                                                                                              Comments

                                                                                                                              Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                              Control0..*
                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                              BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                              Codes identifying interpretations of observations.

                                                                                                                              TypeCodeableConcept
                                                                                                                              Requirements

                                                                                                                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                              Alternate NamesAbnormal Flag
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              604. Observation.component:variation-code.referenceRange
                                                                                                                              Definition

                                                                                                                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                              ShortProvides guide for interpretation of component result
                                                                                                                              Comments

                                                                                                                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                              Control0..*
                                                                                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                              Requirements

                                                                                                                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                              606. Observation.component:representative-protein-hgvs
                                                                                                                              Slice Namerepresentative-protein-hgvs
                                                                                                                              Definition

                                                                                                                              Die Aminosäure-Änderung in HGVS-Nomenklatur auf Proteinebene

                                                                                                                              ShortAminosäure-Änderung p.HGVS
                                                                                                                              Comments

                                                                                                                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                              Control0..1
                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                              TypeBackboneElement
                                                                                                                              Must Supporttrue
                                                                                                                              Summarytrue
                                                                                                                              Requirements

                                                                                                                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              608. Observation.component:representative-protein-hgvs.id
                                                                                                                              Definition

                                                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                              ShortUnique id for inter-element referencing
                                                                                                                              Control0..1
                                                                                                                              Typestring
                                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                              610. Observation.component:representative-protein-hgvs.extension
                                                                                                                              Definition

                                                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                              ShortAdditional content defined by implementations
                                                                                                                              Comments

                                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                              Control0..*
                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                              TypeExtension
                                                                                                                              Alternate Namesextensions, user content
                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                              SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                              • value @ url
                                                                                                                              • 612. Observation.component:representative-protein-hgvs.modifierExtension
                                                                                                                                Definition

                                                                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                Comments

                                                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                Control0..*
                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                TypeExtension
                                                                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                Summarytrue
                                                                                                                                Requirements

                                                                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                Alternate Namesextensions, user content, modifiers
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                614. Observation.component:representative-protein-hgvs.code
                                                                                                                                Definition

                                                                                                                                Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                Short48005-3
                                                                                                                                Comments

                                                                                                                                All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                Control1..1
                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                BindingFor example codes, see LOINCCodes
                                                                                                                                (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                Codes identifying names of simple observations.

                                                                                                                                TypeCodeableConcept
                                                                                                                                Summarytrue
                                                                                                                                Requirements

                                                                                                                                Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                Pattern Value{
                                                                                                                                  "coding" : [{
                                                                                                                                    "system" : "http://loinc.org",
                                                                                                                                    "code" : "48005-3"
                                                                                                                                  }]
                                                                                                                                }
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                616. Observation.component:representative-protein-hgvs.value[x]
                                                                                                                                Definition

                                                                                                                                The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                ShortA valid HGVS-formatted 'p.' string, e.g. NP_000050.2:p.(Asn1836Lys)
                                                                                                                                Comments

                                                                                                                                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                Control1..1
                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                BindingThe codes SHALL be taken from Human Genome Variation Society (HGVS) Nomenclature
                                                                                                                                (required to http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgvs-vs)
                                                                                                                                TypeCodeableConcept
                                                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                Summarytrue
                                                                                                                                Requirements

                                                                                                                                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                618. Observation.component:representative-protein-hgvs.dataAbsentReason
                                                                                                                                Definition

                                                                                                                                Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                ShortWhy the component result is missing
                                                                                                                                Comments

                                                                                                                                "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                Control0..1
                                                                                                                                This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                TypeCodeableConcept
                                                                                                                                Requirements

                                                                                                                                For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                620. Observation.component:representative-protein-hgvs.interpretation
                                                                                                                                Definition

                                                                                                                                A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                ShortHigh, low, normal, etc.
                                                                                                                                Comments

                                                                                                                                Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                Control0..*
                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                Codes identifying interpretations of observations.

                                                                                                                                TypeCodeableConcept
                                                                                                                                Requirements

                                                                                                                                For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                Alternate NamesAbnormal Flag
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                622. Observation.component:representative-protein-hgvs.referenceRange
                                                                                                                                Definition

                                                                                                                                Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                ShortProvides guide for interpretation of component result
                                                                                                                                Comments

                                                                                                                                Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                Control0..*
                                                                                                                                TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                Requirements

                                                                                                                                Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                624. Observation.component:copy-number
                                                                                                                                Slice Namecopy-number
                                                                                                                                Definition

                                                                                                                                Die Anzahl der Kopien eines genomischen Abschnitts

                                                                                                                                ShortKopienzahl
                                                                                                                                Comments

                                                                                                                                Copy number variants are often described with a single copy number value. However, due to the nature of assays, such as qPCR and microarray, it can be difficult to assign an exact copy number. Therefore, labs sometimes report a range instead of an exact copy number. They may alternatively choose to report decimal numbers, even if whole numbers are biologically correct.

                                                                                                                                In general, it can be difficult to estimate a copy number from measurements taken on a heterogenous population of cells, such as a tumor. As indicated in the ISCN 2020 specifications, it is appropriate to express the measurements using a range. Furthermore, regardless of cell population, many assays use fluorescent probes to detect copy number. These testing methodologies do not always provide an exact, discrete value for this data point.

                                                                                                                                Control0..1
                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                TypeBackboneElement
                                                                                                                                Must Supporttrue
                                                                                                                                Summarytrue
                                                                                                                                Requirements

                                                                                                                                There SHALL be a code with a value of '1' if there is a value. If system is present, it SHALL be UCUM.

                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                626. Observation.component:copy-number.id
                                                                                                                                Definition

                                                                                                                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                ShortUnique id for inter-element referencing
                                                                                                                                Control0..1
                                                                                                                                Typestring
                                                                                                                                XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                628. Observation.component:copy-number.extension
                                                                                                                                Definition

                                                                                                                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                ShortAdditional content defined by implementations
                                                                                                                                Comments

                                                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                Control0..*
                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                TypeExtension
                                                                                                                                Alternate Namesextensions, user content
                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                • value @ url
                                                                                                                                • 630. Observation.component:copy-number.modifierExtension
                                                                                                                                  Definition

                                                                                                                                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                  ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                  Comments

                                                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                  Control0..*
                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                  TypeExtension
                                                                                                                                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                  Summarytrue
                                                                                                                                  Requirements

                                                                                                                                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                  Alternate Namesextensions, user content, modifiers
                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                  632. Observation.component:copy-number.code
                                                                                                                                  Definition

                                                                                                                                  Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                  Short82155-3
                                                                                                                                  Comments

                                                                                                                                  All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                  Control1..1
                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                  BindingFor example codes, see LOINCCodes
                                                                                                                                  (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                  Codes identifying names of simple observations.

                                                                                                                                  TypeCodeableConcept
                                                                                                                                  Summarytrue
                                                                                                                                  Requirements

                                                                                                                                  Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                  Pattern Value{
                                                                                                                                    "coding" : [{
                                                                                                                                      "system" : "http://loinc.org",
                                                                                                                                      "code" : "82155-3"
                                                                                                                                    }]
                                                                                                                                  }
                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  634. Observation.component:copy-number.value[x]
                                                                                                                                  Definition

                                                                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                  ShortActual component result
                                                                                                                                  Comments

                                                                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                  Control0..1
                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                  TypeChoice of: Quantity, Range
                                                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                  Summarytrue
                                                                                                                                  Requirements

                                                                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  636. Observation.component:copy-number.dataAbsentReason
                                                                                                                                  Definition

                                                                                                                                  Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                  ShortWhy the component result is missing
                                                                                                                                  Comments

                                                                                                                                  "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                  The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                  Control0..1
                                                                                                                                  This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                  Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                  TypeCodeableConcept
                                                                                                                                  Requirements

                                                                                                                                  For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  638. Observation.component:copy-number.interpretation
                                                                                                                                  Definition

                                                                                                                                  A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                  ShortHigh, low, normal, etc.
                                                                                                                                  Comments

                                                                                                                                  Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                  Control0..*
                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                  BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                  (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                  Codes identifying interpretations of observations.

                                                                                                                                  TypeCodeableConcept
                                                                                                                                  Requirements

                                                                                                                                  For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                  Alternate NamesAbnormal Flag
                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  640. Observation.component:copy-number.referenceRange
                                                                                                                                  Definition

                                                                                                                                  Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                  ShortProvides guide for interpretation of component result
                                                                                                                                  Comments

                                                                                                                                  Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                  Control0..*
                                                                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                  Requirements

                                                                                                                                  Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                  642. Observation.component:variant-confidence-status
                                                                                                                                  Slice Namevariant-confidence-status
                                                                                                                                  Definition

                                                                                                                                  Der Vertrauensstatus der Variantendetektion

                                                                                                                                  ShortKonfidenzstatus der Variante
                                                                                                                                  Comments

                                                                                                                                  See here for usage guidance.

                                                                                                                                  Control0..1
                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                  TypeBackboneElement
                                                                                                                                  Must Supporttrue
                                                                                                                                  Summarytrue
                                                                                                                                  Requirements

                                                                                                                                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  644. Observation.component:variant-confidence-status.id
                                                                                                                                  Definition

                                                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                  ShortUnique id for inter-element referencing
                                                                                                                                  Control0..1
                                                                                                                                  Typestring
                                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                  646. Observation.component:variant-confidence-status.extension
                                                                                                                                  Definition

                                                                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                  ShortAdditional content defined by implementations
                                                                                                                                  Comments

                                                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                  Control0..*
                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                  TypeExtension
                                                                                                                                  Alternate Namesextensions, user content
                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                  SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                  • value @ url
                                                                                                                                  • 648. Observation.component:variant-confidence-status.modifierExtension
                                                                                                                                    Definition

                                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                    Comments

                                                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                    Control0..*
                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                    TypeExtension
                                                                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                    Summarytrue
                                                                                                                                    Requirements

                                                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                    650. Observation.component:variant-confidence-status.code
                                                                                                                                    Definition

                                                                                                                                    Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                    Shortvariant-confidence-status
                                                                                                                                    Comments

                                                                                                                                    All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                    Control1..1
                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                    BindingFor example codes, see LOINCCodes
                                                                                                                                    (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                    Codes identifying names of simple observations.

                                                                                                                                    TypeCodeableConcept
                                                                                                                                    Summarytrue
                                                                                                                                    Requirements

                                                                                                                                    Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                    Pattern Value{
                                                                                                                                      "coding" : [{
                                                                                                                                        "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
                                                                                                                                        "code" : "variant-confidence-status"
                                                                                                                                      }]
                                                                                                                                    }
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    652. Observation.component:variant-confidence-status.value[x]
                                                                                                                                    Definition

                                                                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                    ShortHigh | Intermediate | Low
                                                                                                                                    Comments

                                                                                                                                    Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                    Control1..1
                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                    BindingThe codes SHALL be taken from Variant Confidence Status
                                                                                                                                    (required to http://hl7.org/fhir/uv/genomics-reporting/ValueSet/variant-confidence-status-vs)
                                                                                                                                    TypeCodeableConcept
                                                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                    Summarytrue
                                                                                                                                    Requirements

                                                                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    654. Observation.component:variant-confidence-status.dataAbsentReason
                                                                                                                                    Definition

                                                                                                                                    Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                    ShortWhy the component result is missing
                                                                                                                                    Comments

                                                                                                                                    "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                    The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                    Control0..1
                                                                                                                                    This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                    BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                    (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                    Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                    TypeCodeableConcept
                                                                                                                                    Requirements

                                                                                                                                    For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    656. Observation.component:variant-confidence-status.interpretation
                                                                                                                                    Definition

                                                                                                                                    A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                    ShortHigh, low, normal, etc.
                                                                                                                                    Comments

                                                                                                                                    Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                    Control0..*
                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                    BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                    (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                    Codes identifying interpretations of observations.

                                                                                                                                    TypeCodeableConcept
                                                                                                                                    Requirements

                                                                                                                                    For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                    Alternate NamesAbnormal Flag
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    658. Observation.component:variant-confidence-status.referenceRange
                                                                                                                                    Definition

                                                                                                                                    Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                    ShortProvides guide for interpretation of component result
                                                                                                                                    Comments

                                                                                                                                    Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                    Control0..*
                                                                                                                                    TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                    Requirements

                                                                                                                                    Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                    660. Observation.component:repeat-motif
                                                                                                                                    Slice Namerepeat-motif
                                                                                                                                    Definition

                                                                                                                                    Nucleotides of a repeat expansion motif.

                                                                                                                                    ShortRepeat Motif
                                                                                                                                    Comments

                                                                                                                                    For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                    Control0..*
                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                    TypeBackboneElement
                                                                                                                                    Summarytrue
                                                                                                                                    Requirements

                                                                                                                                    Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    662. Observation.component:repeat-motif.id
                                                                                                                                    Definition

                                                                                                                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                    ShortUnique id for inter-element referencing
                                                                                                                                    Control0..1
                                                                                                                                    Typestring
                                                                                                                                    XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                    664. Observation.component:repeat-motif.extension
                                                                                                                                    Definition

                                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                    ShortAdditional content defined by implementations
                                                                                                                                    Comments

                                                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                    Control0..*
                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                    TypeExtension
                                                                                                                                    Alternate Namesextensions, user content
                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                    SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                    • value @ url
                                                                                                                                    • 666. Observation.component:repeat-motif.extension:repeat-motif-order
                                                                                                                                      Slice Namerepeat-motif-order
                                                                                                                                      Definition

                                                                                                                                      Use to group and order repeat expansion motifs.

                                                                                                                                      ShortRepeat Motif Order
                                                                                                                                      Comments

                                                                                                                                      If there are multiple repeat expansion pairs, this must be used both to indicate the sequence position of a given repeat-motif and repeat-number pair and to group the related components together. Components with the same extension value describe the same motif.

                                                                                                                                      Control0..1
                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                      TypeExtension(Repeat Motif Order) (Extension Type: positiveInt)
                                                                                                                                      Requirements

                                                                                                                                      The value must be a natural number starting from 1 and increasing sequentially

                                                                                                                                      Alternate Namesextensions, user content
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                      668. Observation.component:repeat-motif.modifierExtension
                                                                                                                                      Definition

                                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                      ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                      Comments

                                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                      Control0..*
                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                      TypeExtension
                                                                                                                                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                      Summarytrue
                                                                                                                                      Requirements

                                                                                                                                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                      Alternate Namesextensions, user content, modifiers
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                      670. Observation.component:repeat-motif.code
                                                                                                                                      Definition

                                                                                                                                      Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                      Shortrepeat-motif
                                                                                                                                      Comments

                                                                                                                                      All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                      Control1..1
                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                      BindingFor example codes, see LOINCCodes
                                                                                                                                      (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                      Codes identifying names of simple observations.

                                                                                                                                      TypeCodeableConcept
                                                                                                                                      Summarytrue
                                                                                                                                      Requirements

                                                                                                                                      Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                      Pattern Value{
                                                                                                                                        "coding" : [{
                                                                                                                                          "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
                                                                                                                                          "code" : "repeat-motif"
                                                                                                                                        }]
                                                                                                                                      }
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      672. Observation.component:repeat-motif.value[x]
                                                                                                                                      Definition

                                                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                      ShortCAG
                                                                                                                                      Comments

                                                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                      Control1..1
                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                      Typestring
                                                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                      Summarytrue
                                                                                                                                      Requirements

                                                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      674. Observation.component:repeat-motif.dataAbsentReason
                                                                                                                                      Definition

                                                                                                                                      Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                      ShortWhy the component result is missing
                                                                                                                                      Comments

                                                                                                                                      "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                      The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                      Control0..1
                                                                                                                                      This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                      BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                      Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                      TypeCodeableConcept
                                                                                                                                      Requirements

                                                                                                                                      For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      676. Observation.component:repeat-motif.interpretation
                                                                                                                                      Definition

                                                                                                                                      A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                      ShortHigh, low, normal, etc.
                                                                                                                                      Comments

                                                                                                                                      Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                      Control0..*
                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                      BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                      Codes identifying interpretations of observations.

                                                                                                                                      TypeCodeableConcept
                                                                                                                                      Requirements

                                                                                                                                      For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                      Alternate NamesAbnormal Flag
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      678. Observation.component:repeat-motif.referenceRange
                                                                                                                                      Definition

                                                                                                                                      Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                      ShortProvides guide for interpretation of component result
                                                                                                                                      Comments

                                                                                                                                      Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                      Control0..*
                                                                                                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                      Requirements

                                                                                                                                      Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                      680. Observation.component:repeat-number
                                                                                                                                      Slice Namerepeat-number
                                                                                                                                      Definition

                                                                                                                                      Number of repeats of a repeat expansion.

                                                                                                                                      ShortRepeat Number
                                                                                                                                      Comments

                                                                                                                                      For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                      Control0..*
                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                      TypeBackboneElement
                                                                                                                                      Summarytrue
                                                                                                                                      Requirements

                                                                                                                                      Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      682. Observation.component:repeat-number.id
                                                                                                                                      Definition

                                                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                      ShortUnique id for inter-element referencing
                                                                                                                                      Control0..1
                                                                                                                                      Typestring
                                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                      684. Observation.component:repeat-number.extension
                                                                                                                                      Definition

                                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                                      Comments

                                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                      Control0..*
                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                      TypeExtension
                                                                                                                                      Alternate Namesextensions, user content
                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                      SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                      • value @ url
                                                                                                                                      • 686. Observation.component:repeat-number.extension:repeat-motif-order
                                                                                                                                        Slice Namerepeat-motif-order
                                                                                                                                        Definition

                                                                                                                                        Use to group and order repeat expansion motifs.

                                                                                                                                        ShortRepeat Motif Order
                                                                                                                                        Comments

                                                                                                                                        If there are multiple repeat expansion pairs, this must be used both to indicate the sequence position of a given repeat-motif and repeat-number pair and to group the related components together. Components with the same extension value describe the same motif.

                                                                                                                                        Control0..1
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        TypeExtension(Repeat Motif Order) (Extension Type: positiveInt)
                                                                                                                                        Requirements

                                                                                                                                        The value must be a natural number starting from 1 and increasing sequentially

                                                                                                                                        Alternate Namesextensions, user content
                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                        688. Observation.component:repeat-number.modifierExtension
                                                                                                                                        Definition

                                                                                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                        Comments

                                                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                        Control0..*
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        TypeExtension
                                                                                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                        Summarytrue
                                                                                                                                        Requirements

                                                                                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                        Alternate Namesextensions, user content, modifiers
                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                        690. Observation.component:repeat-number.code
                                                                                                                                        Definition

                                                                                                                                        Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                        Shortrepeat-number
                                                                                                                                        Comments

                                                                                                                                        All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                        Control1..1
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        BindingFor example codes, see LOINCCodes
                                                                                                                                        (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                        Codes identifying names of simple observations.

                                                                                                                                        TypeCodeableConcept
                                                                                                                                        Summarytrue
                                                                                                                                        Requirements

                                                                                                                                        Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                        Pattern Value{
                                                                                                                                          "coding" : [{
                                                                                                                                            "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
                                                                                                                                            "code" : "repeat-number"
                                                                                                                                          }]
                                                                                                                                        }
                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        692. Observation.component:repeat-number.value[x]
                                                                                                                                        Definition

                                                                                                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                        Short40
                                                                                                                                        Comments

                                                                                                                                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                        Control1..1
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        TypeQuantity
                                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                        Summarytrue
                                                                                                                                        Requirements

                                                                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        694. Observation.component:repeat-number.dataAbsentReason
                                                                                                                                        Definition

                                                                                                                                        Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                        ShortWhy the component result is missing
                                                                                                                                        Comments

                                                                                                                                        "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                        The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                        Control0..1
                                                                                                                                        This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                        BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                        (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                        Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                        TypeCodeableConcept
                                                                                                                                        Requirements

                                                                                                                                        For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        696. Observation.component:repeat-number.interpretation
                                                                                                                                        Definition

                                                                                                                                        A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                        ShortHigh, low, normal, etc.
                                                                                                                                        Comments

                                                                                                                                        Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                        Control0..*
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                        (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                        Codes identifying interpretations of observations.

                                                                                                                                        TypeCodeableConcept
                                                                                                                                        Requirements

                                                                                                                                        For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                        Alternate NamesAbnormal Flag
                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        698. Observation.component:repeat-number.referenceRange
                                                                                                                                        Definition

                                                                                                                                        Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                        ShortProvides guide for interpretation of component result
                                                                                                                                        Comments

                                                                                                                                        Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                        Control0..*
                                                                                                                                        TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                        Requirements

                                                                                                                                        Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                        700. Observation.component:dna-region
                                                                                                                                        Slice Namedna-region
                                                                                                                                        Definition

                                                                                                                                        Ein lesbarer Name für die untersuchte Region. Typischerweise Exon # oder Intron # oder andere.

                                                                                                                                        ShortDNA-Regionsname
                                                                                                                                        Comments

                                                                                                                                        For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                        Control0..*
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        TypeBackboneElement
                                                                                                                                        Must Supporttrue
                                                                                                                                        Summarytrue
                                                                                                                                        Requirements

                                                                                                                                        Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        702. Observation.component:dna-region.id
                                                                                                                                        Definition

                                                                                                                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                        ShortUnique id for inter-element referencing
                                                                                                                                        Control0..1
                                                                                                                                        Typestring
                                                                                                                                        XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                        704. Observation.component:dna-region.extension
                                                                                                                                        Definition

                                                                                                                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                        ShortAdditional content defined by implementations
                                                                                                                                        Comments

                                                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                        Control0..*
                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                        TypeExtension
                                                                                                                                        Alternate Namesextensions, user content
                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                        SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                        • value @ url
                                                                                                                                        • 706. Observation.component:dna-region.modifierExtension
                                                                                                                                          Definition

                                                                                                                                          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                          ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                          Comments

                                                                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                          Control0..*
                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                          TypeExtension
                                                                                                                                          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                          Summarytrue
                                                                                                                                          Requirements

                                                                                                                                          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                          Alternate Namesextensions, user content, modifiers
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                          708. Observation.component:dna-region.code
                                                                                                                                          Definition

                                                                                                                                          Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                          Short47999-8
                                                                                                                                          Comments

                                                                                                                                          All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                          Control1..1
                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                          BindingFor example codes, see LOINCCodes
                                                                                                                                          (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                          Codes identifying names of simple observations.

                                                                                                                                          TypeCodeableConcept
                                                                                                                                          Summarytrue
                                                                                                                                          Requirements

                                                                                                                                          Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                          Pattern Value{
                                                                                                                                            "coding" : [{
                                                                                                                                              "system" : "http://loinc.org",
                                                                                                                                              "code" : "47999-8"
                                                                                                                                            }]
                                                                                                                                          }
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          710. Observation.component:dna-region.value[x]
                                                                                                                                          Definition

                                                                                                                                          The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                          ShortActual component result
                                                                                                                                          Comments

                                                                                                                                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                          Control1..1
                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                          Typestring
                                                                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                          Summarytrue
                                                                                                                                          Requirements

                                                                                                                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          712. Observation.component:dna-region.dataAbsentReason
                                                                                                                                          Definition

                                                                                                                                          Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                          ShortWhy the component result is missing
                                                                                                                                          Comments

                                                                                                                                          "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                          The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                          Control0..1
                                                                                                                                          This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                          BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                          (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                          Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                          TypeCodeableConcept
                                                                                                                                          Requirements

                                                                                                                                          For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          714. Observation.component:dna-region.interpretation
                                                                                                                                          Definition

                                                                                                                                          A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                          ShortHigh, low, normal, etc.
                                                                                                                                          Comments

                                                                                                                                          Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                          Control0..*
                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                          BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                          (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                          Codes identifying interpretations of observations.

                                                                                                                                          TypeCodeableConcept
                                                                                                                                          Requirements

                                                                                                                                          For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                          Alternate NamesAbnormal Flag
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          716. Observation.component:dna-region.referenceRange
                                                                                                                                          Definition

                                                                                                                                          Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                          ShortProvides guide for interpretation of component result
                                                                                                                                          Comments

                                                                                                                                          Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                          Control0..*
                                                                                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                          Requirements

                                                                                                                                          Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                          718. Observation.component:gene-fusion
                                                                                                                                          Slice Namegene-fusion
                                                                                                                                          Definition

                                                                                                                                          Details zur Genfusion in Blut oder Gewebe mittels molekulargenetischer Methode

                                                                                                                                          ShortGenfusion
                                                                                                                                          Comments

                                                                                                                                          For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                          Control0..1
                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                          TypeBackboneElement
                                                                                                                                          Must Supporttrue
                                                                                                                                          Summarytrue
                                                                                                                                          Requirements

                                                                                                                                          Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          720. Observation.component:gene-fusion.id
                                                                                                                                          Definition

                                                                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                          ShortUnique id for inter-element referencing
                                                                                                                                          Control0..1
                                                                                                                                          Typestring
                                                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                          722. Observation.component:gene-fusion.extension
                                                                                                                                          Definition

                                                                                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                          ShortAdditional content defined by implementations
                                                                                                                                          Comments

                                                                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                          Control0..*
                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                          TypeExtension
                                                                                                                                          Alternate Namesextensions, user content
                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                          SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                          • value @ url
                                                                                                                                          • 724. Observation.component:gene-fusion.modifierExtension
                                                                                                                                            Definition

                                                                                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                            Comments

                                                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                            Control0..*
                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                            TypeExtension
                                                                                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                            Summarytrue
                                                                                                                                            Requirements

                                                                                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                            Alternate Namesextensions, user content, modifiers
                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                            726. Observation.component:gene-fusion.code
                                                                                                                                            Definition

                                                                                                                                            Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                            ShortType of component observation (code / type)
                                                                                                                                            Comments

                                                                                                                                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                            Control1..1
                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                            BindingFor example codes, see LOINCCodes
                                                                                                                                            (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                            Codes identifying names of simple observations.

                                                                                                                                            TypeCodeableConcept
                                                                                                                                            Summarytrue
                                                                                                                                            Requirements

                                                                                                                                            Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                            Pattern Value{
                                                                                                                                              "coding" : [{
                                                                                                                                                "system" : "http://loinc.org",
                                                                                                                                                "code" : "95123-6"
                                                                                                                                              }]
                                                                                                                                            }
                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                            728. Observation.component:gene-fusion.value[x]
                                                                                                                                            Definition

                                                                                                                                            The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                            ShortHGNC-Format für Genfusionen GENESYMBOL1::GENESYMBOL2 und Readthrough-Transkripte GENESYMBOL1-GENESYMBOL2
                                                                                                                                            Comments

                                                                                                                                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                            Control1..1
                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                            BindingUnless not suitable, these codes SHALL be taken from HUGO Gene Nomenclature Committee Gene Names (HGNC)
                                                                                                                                            (extensible to http://hl7.org/fhir/uv/genomics-reporting/ValueSet/hgnc-vs)
                                                                                                                                            TypeCodeableConcept
                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                            Summarytrue
                                                                                                                                            Requirements

                                                                                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                            730. Observation.component:gene-fusion.dataAbsentReason
                                                                                                                                            Definition

                                                                                                                                            Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                            ShortWhy the component result is missing
                                                                                                                                            Comments

                                                                                                                                            "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                            The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                            Control0..1
                                                                                                                                            This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                            BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                            (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                            Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                            TypeCodeableConcept
                                                                                                                                            Requirements

                                                                                                                                            For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                            732. Observation.component:gene-fusion.interpretation
                                                                                                                                            Definition

                                                                                                                                            A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                            ShortHigh, low, normal, etc.
                                                                                                                                            Comments

                                                                                                                                            Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                            Control0..*
                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                            BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                            (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                            Codes identifying interpretations of observations.

                                                                                                                                            TypeCodeableConcept
                                                                                                                                            Requirements

                                                                                                                                            For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                            Alternate NamesAbnormal Flag
                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                            734. Observation.component:gene-fusion.referenceRange
                                                                                                                                            Definition

                                                                                                                                            Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                            ShortProvides guide for interpretation of component result
                                                                                                                                            Comments

                                                                                                                                            Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                            Control0..*
                                                                                                                                            TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                            Requirements

                                                                                                                                            Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                            736. Observation.component:detection-limit
                                                                                                                                            Slice Namedetection-limit
                                                                                                                                            Definition

                                                                                                                                            Die Nachweisgrenze des Laborgeräts

                                                                                                                                            ShortNachweisgrenze
                                                                                                                                            Comments

                                                                                                                                            For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                            Control0..1
                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                            TypeBackboneElement
                                                                                                                                            Must Supporttrue
                                                                                                                                            Summarytrue
                                                                                                                                            Requirements

                                                                                                                                            Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                            738. Observation.component:detection-limit.id
                                                                                                                                            Definition

                                                                                                                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                            ShortUnique id for inter-element referencing
                                                                                                                                            Control0..1
                                                                                                                                            Typestring
                                                                                                                                            XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                            740. Observation.component:detection-limit.extension
                                                                                                                                            Definition

                                                                                                                                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                            ShortAdditional content defined by implementations
                                                                                                                                            Comments

                                                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                            Control0..*
                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                            TypeExtension
                                                                                                                                            Alternate Namesextensions, user content
                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                            SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                            • value @ url
                                                                                                                                            • 742. Observation.component:detection-limit.modifierExtension
                                                                                                                                              Definition

                                                                                                                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                              ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                              Comments

                                                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                              Control0..*
                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                              TypeExtension
                                                                                                                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                              Summarytrue
                                                                                                                                              Requirements

                                                                                                                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                              Alternate Namesextensions, user content, modifiers
                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                              744. Observation.component:detection-limit.code
                                                                                                                                              Definition

                                                                                                                                              Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                              ShortType of component observation (code / type)
                                                                                                                                              Comments

                                                                                                                                              All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                              Control1..1
                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                              BindingFor example codes, see LOINCCodes
                                                                                                                                              (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                              Codes identifying names of simple observations.

                                                                                                                                              TypeCodeableConcept
                                                                                                                                              Summarytrue
                                                                                                                                              Requirements

                                                                                                                                              Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                              Pattern Value{
                                                                                                                                                "coding" : [{
                                                                                                                                                  "system" : "http://loinc.org",
                                                                                                                                                  "code" : "87706-8"
                                                                                                                                                }]
                                                                                                                                              }
                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              746. Observation.component:detection-limit.value[x]
                                                                                                                                              Definition

                                                                                                                                              The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                              ShortWird üblicherweise als Prozentsatz angegeben
                                                                                                                                              Comments

                                                                                                                                              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                              Control0..1
                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                              TypeQuantity
                                                                                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                              Summarytrue
                                                                                                                                              Requirements

                                                                                                                                              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              748. Observation.component:detection-limit.dataAbsentReason
                                                                                                                                              Definition

                                                                                                                                              Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                              ShortWhy the component result is missing
                                                                                                                                              Comments

                                                                                                                                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                              The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                              Control0..1
                                                                                                                                              This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                              BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                              (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                              Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                              TypeCodeableConcept
                                                                                                                                              Requirements

                                                                                                                                              For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              750. Observation.component:detection-limit.interpretation
                                                                                                                                              Definition

                                                                                                                                              A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                              ShortHigh, low, normal, etc.
                                                                                                                                              Comments

                                                                                                                                              Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                              Control0..*
                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                              BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                              Codes identifying interpretations of observations.

                                                                                                                                              TypeCodeableConcept
                                                                                                                                              Requirements

                                                                                                                                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                              Alternate NamesAbnormal Flag
                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              752. Observation.component:detection-limit.referenceRange
                                                                                                                                              Definition

                                                                                                                                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                              ShortProvides guide for interpretation of component result
                                                                                                                                              Comments

                                                                                                                                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                              Control0..*
                                                                                                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                              Requirements

                                                                                                                                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                              754. Observation.component:five-prime-gene
                                                                                                                                              Slice Namefive-prime-gene
                                                                                                                                              Definition

                                                                                                                                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                                                              Short5' Domain - Gene
                                                                                                                                              Comments

                                                                                                                                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                              Control1..1
                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                              TypeBackboneElement
                                                                                                                                              Must Supporttrue
                                                                                                                                              Summarytrue
                                                                                                                                              Requirements

                                                                                                                                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              756. Observation.component:five-prime-gene.id
                                                                                                                                              Definition

                                                                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                              ShortUnique id for inter-element referencing
                                                                                                                                              Control0..1
                                                                                                                                              Typestring
                                                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                              758. Observation.component:five-prime-gene.extension
                                                                                                                                              Definition

                                                                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                              ShortAdditional content defined by implementations
                                                                                                                                              Comments

                                                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                              Control0..*
                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                              TypeExtension
                                                                                                                                              Alternate Namesextensions, user content
                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                              SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                              • value @ url
                                                                                                                                              • 760. Observation.component:five-prime-gene.modifierExtension
                                                                                                                                                Definition

                                                                                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                Comments

                                                                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                Control0..*
                                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                                TypeExtension
                                                                                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                Summarytrue
                                                                                                                                                Requirements

                                                                                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                                Alternate Namesextensions, user content, modifiers
                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                762. Observation.component:five-prime-gene.code
                                                                                                                                                Definition

                                                                                                                                                Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                                ShortType of component observation (code / type)
                                                                                                                                                Comments

                                                                                                                                                All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                                Control1..1
                                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                                BindingFor example codes, see LOINCCodes
                                                                                                                                                (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                                Codes identifying names of simple observations.

                                                                                                                                                TypeCodeableConcept
                                                                                                                                                Summarytrue
                                                                                                                                                Requirements

                                                                                                                                                Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                                Pattern Value{
                                                                                                                                                  "coding" : [{
                                                                                                                                                    "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                                                                                                                                    "code" : "five-prime-gene"
                                                                                                                                                  }]
                                                                                                                                                }
                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                764. Observation.component:five-prime-gene.value[x]
                                                                                                                                                Definition

                                                                                                                                                The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                ShortActual component result
                                                                                                                                                Comments

                                                                                                                                                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                Control0..1
                                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                                TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                Summarytrue
                                                                                                                                                Requirements

                                                                                                                                                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                • type @ $this
                                                                                                                                                • 766. Observation.component:five-prime-gene.value[x]:valueCodeableConcept
                                                                                                                                                  Slice NamevalueCodeableConcept
                                                                                                                                                  Definition

                                                                                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                  ShortActual component result
                                                                                                                                                  Comments

                                                                                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                  Control0..1
                                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                  Must Supporttrue
                                                                                                                                                  Summarytrue
                                                                                                                                                  Requirements

                                                                                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                  768. Observation.component:five-prime-gene.dataAbsentReason
                                                                                                                                                  Definition

                                                                                                                                                  Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                                  ShortWhy the component result is missing
                                                                                                                                                  Comments

                                                                                                                                                  "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                                  The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                                  Control0..1
                                                                                                                                                  This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                                  Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                  Requirements

                                                                                                                                                  For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                  770. Observation.component:five-prime-gene.interpretation
                                                                                                                                                  Definition

                                                                                                                                                  A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                                  ShortHigh, low, normal, etc.
                                                                                                                                                  Comments

                                                                                                                                                  Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                                  Control0..*
                                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                                  BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                                  (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                                  Codes identifying interpretations of observations.

                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                  Requirements

                                                                                                                                                  For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                                  Alternate NamesAbnormal Flag
                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                  772. Observation.component:five-prime-gene.referenceRange
                                                                                                                                                  Definition

                                                                                                                                                  Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                                  ShortProvides guide for interpretation of component result
                                                                                                                                                  Comments

                                                                                                                                                  Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                                  Control0..*
                                                                                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                                  Requirements

                                                                                                                                                  Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                                  774. Observation.component:five-prime-transcript-id
                                                                                                                                                  Slice Namefive-prime-transcript-id
                                                                                                                                                  Definition

                                                                                                                                                  Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                                                                  Short5' Transcript - Identifier
                                                                                                                                                  Comments

                                                                                                                                                  For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                                  Control1..1
                                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                                  TypeBackboneElement
                                                                                                                                                  Must Supporttrue
                                                                                                                                                  Summarytrue
                                                                                                                                                  Requirements

                                                                                                                                                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                  776. Observation.component:five-prime-transcript-id.id
                                                                                                                                                  Definition

                                                                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                  ShortUnique id for inter-element referencing
                                                                                                                                                  Control0..1
                                                                                                                                                  Typestring
                                                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                  778. Observation.component:five-prime-transcript-id.extension
                                                                                                                                                  Definition

                                                                                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                                  ShortAdditional content defined by implementations
                                                                                                                                                  Comments

                                                                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                  Control0..*
                                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                                  TypeExtension
                                                                                                                                                  Alternate Namesextensions, user content
                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                  SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                  • value @ url
                                                                                                                                                  • 780. Observation.component:five-prime-transcript-id.modifierExtension
                                                                                                                                                    Definition

                                                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                    Comments

                                                                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                    Control0..*
                                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                                    TypeExtension
                                                                                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                    Summarytrue
                                                                                                                                                    Requirements

                                                                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                    782. Observation.component:five-prime-transcript-id.code
                                                                                                                                                    Definition

                                                                                                                                                    Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                                    ShortType of component observation (code / type)
                                                                                                                                                    Comments

                                                                                                                                                    All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                                    Control1..1
                                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                                    BindingFor example codes, see LOINCCodes
                                                                                                                                                    (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                                    Codes identifying names of simple observations.

                                                                                                                                                    TypeCodeableConcept
                                                                                                                                                    Summarytrue
                                                                                                                                                    Requirements

                                                                                                                                                    Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                                    Pattern Value{
                                                                                                                                                      "coding" : [{
                                                                                                                                                        "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                                                                                                                                        "code" : "five-prime-transcript-id"
                                                                                                                                                      }]
                                                                                                                                                    }
                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    784. Observation.component:five-prime-transcript-id.value[x]
                                                                                                                                                    Definition

                                                                                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                    ShortActual component result
                                                                                                                                                    Comments

                                                                                                                                                    Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                    Control0..1
                                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                                    TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                    Summarytrue
                                                                                                                                                    Requirements

                                                                                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                    SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                    • type @ $this
                                                                                                                                                    • 786. Observation.component:five-prime-transcript-id.value[x]:valueCodeableConcept
                                                                                                                                                      Slice NamevalueCodeableConcept
                                                                                                                                                      Definition

                                                                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                      ShortActual component result
                                                                                                                                                      Comments

                                                                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                      Control0..1
                                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                                      TypeCodeableConcept
                                                                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                      Must Supporttrue
                                                                                                                                                      Summarytrue
                                                                                                                                                      Requirements

                                                                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      788. Observation.component:five-prime-transcript-id.dataAbsentReason
                                                                                                                                                      Definition

                                                                                                                                                      Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                                      ShortWhy the component result is missing
                                                                                                                                                      Comments

                                                                                                                                                      "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                                      The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                                      Control0..1
                                                                                                                                                      This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                                      BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                                      Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                                      TypeCodeableConcept
                                                                                                                                                      Requirements

                                                                                                                                                      For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      790. Observation.component:five-prime-transcript-id.interpretation
                                                                                                                                                      Definition

                                                                                                                                                      A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                                      ShortHigh, low, normal, etc.
                                                                                                                                                      Comments

                                                                                                                                                      Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                                      Control0..*
                                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                                      BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                                      Codes identifying interpretations of observations.

                                                                                                                                                      TypeCodeableConcept
                                                                                                                                                      Requirements

                                                                                                                                                      For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                                      Alternate NamesAbnormal Flag
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      792. Observation.component:five-prime-transcript-id.referenceRange
                                                                                                                                                      Definition

                                                                                                                                                      Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                                      ShortProvides guide for interpretation of component result
                                                                                                                                                      Comments

                                                                                                                                                      Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                                      Control0..*
                                                                                                                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                                      Requirements

                                                                                                                                                      Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                                      794. Observation.component:five-prime-exon-id
                                                                                                                                                      Slice Namefive-prime-exon-id
                                                                                                                                                      Definition

                                                                                                                                                      Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                                                                      Short5' Exon - Identifier
                                                                                                                                                      Comments

                                                                                                                                                      For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                                      Control1..1
                                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                                      TypeBackboneElement
                                                                                                                                                      Must Supporttrue
                                                                                                                                                      Summarytrue
                                                                                                                                                      Requirements

                                                                                                                                                      Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      796. Observation.component:five-prime-exon-id.id
                                                                                                                                                      Definition

                                                                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                      ShortUnique id for inter-element referencing
                                                                                                                                                      Control0..1
                                                                                                                                                      Typestring
                                                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                      798. Observation.component:five-prime-exon-id.extension
                                                                                                                                                      Definition

                                                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                                                      Comments

                                                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                      Control0..*
                                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                                      TypeExtension
                                                                                                                                                      Alternate Namesextensions, user content
                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                      SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                      • value @ url
                                                                                                                                                      • 800. Observation.component:five-prime-exon-id.modifierExtension
                                                                                                                                                        Definition

                                                                                                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                        Comments

                                                                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                        Control0..*
                                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                                        TypeExtension
                                                                                                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                        Summarytrue
                                                                                                                                                        Requirements

                                                                                                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                                        Alternate Namesextensions, user content, modifiers
                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                        802. Observation.component:five-prime-exon-id.code
                                                                                                                                                        Definition

                                                                                                                                                        Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                                        ShortType of component observation (code / type)
                                                                                                                                                        Comments

                                                                                                                                                        All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                                        Control1..1
                                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                                        BindingFor example codes, see LOINCCodes
                                                                                                                                                        (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                                        Codes identifying names of simple observations.

                                                                                                                                                        TypeCodeableConcept
                                                                                                                                                        Summarytrue
                                                                                                                                                        Requirements

                                                                                                                                                        Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                                        Pattern Value{
                                                                                                                                                          "coding" : [{
                                                                                                                                                            "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                                                                                                                                            "code" : "five-prime-exon-id"
                                                                                                                                                          }]
                                                                                                                                                        }
                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        804. Observation.component:five-prime-exon-id.value[x]
                                                                                                                                                        Definition

                                                                                                                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                        ShortActual component result
                                                                                                                                                        Comments

                                                                                                                                                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                        Control0..1
                                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                                        TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                        Summarytrue
                                                                                                                                                        Requirements

                                                                                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                        SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                        • type @ $this
                                                                                                                                                        • 806. Observation.component:five-prime-exon-id.value[x]:valueCodeableConcept
                                                                                                                                                          Slice NamevalueCodeableConcept
                                                                                                                                                          Definition

                                                                                                                                                          The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                          ShortActual component result
                                                                                                                                                          Comments

                                                                                                                                                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                          Control0..1
                                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                                          TypeCodeableConcept
                                                                                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                          Must Supporttrue
                                                                                                                                                          Summarytrue
                                                                                                                                                          Requirements

                                                                                                                                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          808. Observation.component:five-prime-exon-id.dataAbsentReason
                                                                                                                                                          Definition

                                                                                                                                                          Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                                          ShortWhy the component result is missing
                                                                                                                                                          Comments

                                                                                                                                                          "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                                          The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                                          Control0..1
                                                                                                                                                          This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                                          BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                                          (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                                          Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                                          TypeCodeableConcept
                                                                                                                                                          Requirements

                                                                                                                                                          For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          810. Observation.component:five-prime-exon-id.interpretation
                                                                                                                                                          Definition

                                                                                                                                                          A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                                          ShortHigh, low, normal, etc.
                                                                                                                                                          Comments

                                                                                                                                                          Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                                          Control0..*
                                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                                          BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                                          (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                                          Codes identifying interpretations of observations.

                                                                                                                                                          TypeCodeableConcept
                                                                                                                                                          Requirements

                                                                                                                                                          For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                                          Alternate NamesAbnormal Flag
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          812. Observation.component:five-prime-exon-id.referenceRange
                                                                                                                                                          Definition

                                                                                                                                                          Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                                          ShortProvides guide for interpretation of component result
                                                                                                                                                          Comments

                                                                                                                                                          Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                                          Control0..*
                                                                                                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                                          Requirements

                                                                                                                                                          Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                                          814. Observation.component:five-prime-position
                                                                                                                                                          Slice Namefive-prime-position
                                                                                                                                                          Definition

                                                                                                                                                          Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                                                                          Short5' Domain - Position
                                                                                                                                                          Comments

                                                                                                                                                          For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                                          Control1..1
                                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                                          TypeBackboneElement
                                                                                                                                                          Must Supporttrue
                                                                                                                                                          Summarytrue
                                                                                                                                                          Requirements

                                                                                                                                                          Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          816. Observation.component:five-prime-position.id
                                                                                                                                                          Definition

                                                                                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                          ShortUnique id for inter-element referencing
                                                                                                                                                          Control0..1
                                                                                                                                                          Typestring
                                                                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                          818. Observation.component:five-prime-position.extension
                                                                                                                                                          Definition

                                                                                                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                                          ShortAdditional content defined by implementations
                                                                                                                                                          Comments

                                                                                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                          Control0..*
                                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                                          TypeExtension
                                                                                                                                                          Alternate Namesextensions, user content
                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                          SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                          • value @ url
                                                                                                                                                          • 820. Observation.component:five-prime-position.modifierExtension
                                                                                                                                                            Definition

                                                                                                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                            Comments

                                                                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                            Control0..*
                                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                                            TypeExtension
                                                                                                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                            Summarytrue
                                                                                                                                                            Requirements

                                                                                                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                                            Alternate Namesextensions, user content, modifiers
                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                            822. Observation.component:five-prime-position.code
                                                                                                                                                            Definition

                                                                                                                                                            Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                                            ShortType of component observation (code / type)
                                                                                                                                                            Comments

                                                                                                                                                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                                            Control1..1
                                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                                            BindingFor example codes, see LOINCCodes
                                                                                                                                                            (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                                            Codes identifying names of simple observations.

                                                                                                                                                            TypeCodeableConcept
                                                                                                                                                            Summarytrue
                                                                                                                                                            Requirements

                                                                                                                                                            Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                                            Pattern Value{
                                                                                                                                                              "coding" : [{
                                                                                                                                                                "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                                                                                                                                                "code" : "five-prime-position"
                                                                                                                                                              }]
                                                                                                                                                            }
                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                            824. Observation.component:five-prime-position.value[x]
                                                                                                                                                            Definition

                                                                                                                                                            The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                            ShortActual component result
                                                                                                                                                            Comments

                                                                                                                                                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                            Control0..1
                                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                                            TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                            Summarytrue
                                                                                                                                                            Requirements

                                                                                                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                            SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                            • type @ $this
                                                                                                                                                            • 826. Observation.component:five-prime-position.value[x]:valueRange
                                                                                                                                                              Slice NamevalueRange
                                                                                                                                                              Definition

                                                                                                                                                              The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                              ShortActual component result
                                                                                                                                                              Comments

                                                                                                                                                              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                              Control0..1
                                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                                              TypeRange
                                                                                                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                              Must Supporttrue
                                                                                                                                                              Summarytrue
                                                                                                                                                              Requirements

                                                                                                                                                              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              828. Observation.component:five-prime-position.dataAbsentReason
                                                                                                                                                              Definition

                                                                                                                                                              Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                                              ShortWhy the component result is missing
                                                                                                                                                              Comments

                                                                                                                                                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                                              The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                                              Control0..1
                                                                                                                                                              This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                                              BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                                              (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                                              Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                                              TypeCodeableConcept
                                                                                                                                                              Requirements

                                                                                                                                                              For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              830. Observation.component:five-prime-position.interpretation
                                                                                                                                                              Definition

                                                                                                                                                              A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                                              ShortHigh, low, normal, etc.
                                                                                                                                                              Comments

                                                                                                                                                              Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                                              Control0..*
                                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                                              BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                                              Codes identifying interpretations of observations.

                                                                                                                                                              TypeCodeableConcept
                                                                                                                                                              Requirements

                                                                                                                                                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                                              Alternate NamesAbnormal Flag
                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              832. Observation.component:five-prime-position.referenceRange
                                                                                                                                                              Definition

                                                                                                                                                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                                              ShortProvides guide for interpretation of component result
                                                                                                                                                              Comments

                                                                                                                                                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                                              Control0..*
                                                                                                                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                                              Requirements

                                                                                                                                                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                                              834. Observation.component:five-prime-strand
                                                                                                                                                              Slice Namefive-prime-strand
                                                                                                                                                              Definition

                                                                                                                                                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                                                                              Short5' Strand
                                                                                                                                                              Comments

                                                                                                                                                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                                              Control1..1
                                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                                              TypeBackboneElement
                                                                                                                                                              Must Supporttrue
                                                                                                                                                              Summarytrue
                                                                                                                                                              Requirements

                                                                                                                                                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              836. Observation.component:five-prime-strand.id
                                                                                                                                                              Definition

                                                                                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                              ShortUnique id for inter-element referencing
                                                                                                                                                              Control0..1
                                                                                                                                                              Typestring
                                                                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                              838. Observation.component:five-prime-strand.extension
                                                                                                                                                              Definition

                                                                                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                                              ShortAdditional content defined by implementations
                                                                                                                                                              Comments

                                                                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                              Control0..*
                                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                                              TypeExtension
                                                                                                                                                              Alternate Namesextensions, user content
                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                              SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                              • value @ url
                                                                                                                                                              • 840. Observation.component:five-prime-strand.modifierExtension
                                                                                                                                                                Definition

                                                                                                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                Comments

                                                                                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                                Control0..*
                                                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                                                TypeExtension
                                                                                                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                                Summarytrue
                                                                                                                                                                Requirements

                                                                                                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                                                Alternate Namesextensions, user content, modifiers
                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                842. Observation.component:five-prime-strand.code
                                                                                                                                                                Definition

                                                                                                                                                                Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                                                ShortType of component observation (code / type)
                                                                                                                                                                Comments

                                                                                                                                                                All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                                                Control1..1
                                                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                                                BindingFor example codes, see LOINCCodes
                                                                                                                                                                (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                                                Codes identifying names of simple observations.

                                                                                                                                                                TypeCodeableConcept
                                                                                                                                                                Summarytrue
                                                                                                                                                                Requirements

                                                                                                                                                                Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                                                Pattern Value{
                                                                                                                                                                  "coding" : [{
                                                                                                                                                                    "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                                                                                                                                                    "code" : "five-prime-strand"
                                                                                                                                                                  }]
                                                                                                                                                                }
                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                844. Observation.component:five-prime-strand.value[x]
                                                                                                                                                                Definition

                                                                                                                                                                The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                ShortActual component result
                                                                                                                                                                Comments

                                                                                                                                                                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                Control0..1
                                                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                                                TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                Summarytrue
                                                                                                                                                                Requirements

                                                                                                                                                                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                • type @ $this
                                                                                                                                                                • 846. Observation.component:five-prime-strand.value[x]:valueCodeableConcept
                                                                                                                                                                  Slice NamevalueCodeableConcept
                                                                                                                                                                  Definition

                                                                                                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                  ShortActual component result
                                                                                                                                                                  Comments

                                                                                                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                  Control0..1
                                                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                  Must Supporttrue
                                                                                                                                                                  Summarytrue
                                                                                                                                                                  Requirements

                                                                                                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                  848. Observation.component:five-prime-strand.dataAbsentReason
                                                                                                                                                                  Definition

                                                                                                                                                                  Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                                                  ShortWhy the component result is missing
                                                                                                                                                                  Comments

                                                                                                                                                                  "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                                                  The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                                                  Control0..1
                                                                                                                                                                  This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                                                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                                                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                                                  Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                                  Requirements

                                                                                                                                                                  For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                  850. Observation.component:five-prime-strand.interpretation
                                                                                                                                                                  Definition

                                                                                                                                                                  A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                                                  ShortHigh, low, normal, etc.
                                                                                                                                                                  Comments

                                                                                                                                                                  Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                                                  Control0..*
                                                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                                                  BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                                                  (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                                                  Codes identifying interpretations of observations.

                                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                                  Requirements

                                                                                                                                                                  For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                                                  Alternate NamesAbnormal Flag
                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                  852. Observation.component:five-prime-strand.referenceRange
                                                                                                                                                                  Definition

                                                                                                                                                                  Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                                                  ShortProvides guide for interpretation of component result
                                                                                                                                                                  Comments

                                                                                                                                                                  Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                                                  Control0..*
                                                                                                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                                                  Requirements

                                                                                                                                                                  Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                                                  854. Observation.component:three-prime-gene
                                                                                                                                                                  Slice Namethree-prime-gene
                                                                                                                                                                  Definition

                                                                                                                                                                  Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                                                                                  Short3' Domain - Gene
                                                                                                                                                                  Comments

                                                                                                                                                                  For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                                                  Control1..1
                                                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                                                  TypeBackboneElement
                                                                                                                                                                  Must Supporttrue
                                                                                                                                                                  Summarytrue
                                                                                                                                                                  Requirements

                                                                                                                                                                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                  856. Observation.component:three-prime-gene.id
                                                                                                                                                                  Definition

                                                                                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                  ShortUnique id for inter-element referencing
                                                                                                                                                                  Control0..1
                                                                                                                                                                  Typestring
                                                                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                  858. Observation.component:three-prime-gene.extension
                                                                                                                                                                  Definition

                                                                                                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                                                  ShortAdditional content defined by implementations
                                                                                                                                                                  Comments

                                                                                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                                  Control0..*
                                                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                                                  TypeExtension
                                                                                                                                                                  Alternate Namesextensions, user content
                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                  SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                  • value @ url
                                                                                                                                                                  • 860. Observation.component:three-prime-gene.modifierExtension
                                                                                                                                                                    Definition

                                                                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                    Comments

                                                                                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                                    Control0..*
                                                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                                                    TypeExtension
                                                                                                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                                    Summarytrue
                                                                                                                                                                    Requirements

                                                                                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                    862. Observation.component:three-prime-gene.code
                                                                                                                                                                    Definition

                                                                                                                                                                    Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                                                    ShortType of component observation (code / type)
                                                                                                                                                                    Comments

                                                                                                                                                                    All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                                                    Control1..1
                                                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                                                    BindingFor example codes, see LOINCCodes
                                                                                                                                                                    (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                                                    Codes identifying names of simple observations.

                                                                                                                                                                    TypeCodeableConcept
                                                                                                                                                                    Summarytrue
                                                                                                                                                                    Requirements

                                                                                                                                                                    Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                                                    Pattern Value{
                                                                                                                                                                      "coding" : [{
                                                                                                                                                                        "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                                                                                                                                                        "code" : "three-prime-gene"
                                                                                                                                                                      }]
                                                                                                                                                                    }
                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                    864. Observation.component:three-prime-gene.value[x]
                                                                                                                                                                    Definition

                                                                                                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                    ShortActual component result
                                                                                                                                                                    Comments

                                                                                                                                                                    Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                    Control0..1
                                                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                                                    TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                    Summarytrue
                                                                                                                                                                    Requirements

                                                                                                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                    SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                    • type @ $this
                                                                                                                                                                    • 866. Observation.component:three-prime-gene.value[x]:valueCodeableConcept
                                                                                                                                                                      Slice NamevalueCodeableConcept
                                                                                                                                                                      Definition

                                                                                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                      ShortActual component result
                                                                                                                                                                      Comments

                                                                                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                      Control0..1
                                                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                                                      TypeCodeableConcept
                                                                                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                      Must Supporttrue
                                                                                                                                                                      Summarytrue
                                                                                                                                                                      Requirements

                                                                                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                      868. Observation.component:three-prime-gene.dataAbsentReason
                                                                                                                                                                      Definition

                                                                                                                                                                      Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                                                      ShortWhy the component result is missing
                                                                                                                                                                      Comments

                                                                                                                                                                      "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                                                      The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                                                      Control0..1
                                                                                                                                                                      This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                                                      BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                                                      Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                                                      TypeCodeableConcept
                                                                                                                                                                      Requirements

                                                                                                                                                                      For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                      870. Observation.component:three-prime-gene.interpretation
                                                                                                                                                                      Definition

                                                                                                                                                                      A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                                                      ShortHigh, low, normal, etc.
                                                                                                                                                                      Comments

                                                                                                                                                                      Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                                                      Control0..*
                                                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                                                      BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                                                      Codes identifying interpretations of observations.

                                                                                                                                                                      TypeCodeableConcept
                                                                                                                                                                      Requirements

                                                                                                                                                                      For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                                                      Alternate NamesAbnormal Flag
                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                      872. Observation.component:three-prime-gene.referenceRange
                                                                                                                                                                      Definition

                                                                                                                                                                      Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                                                      ShortProvides guide for interpretation of component result
                                                                                                                                                                      Comments

                                                                                                                                                                      Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                                                      Control0..*
                                                                                                                                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                                                      Requirements

                                                                                                                                                                      Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                                                      874. Observation.component:three-prime-transcript-id
                                                                                                                                                                      Slice Namethree-prime-transcript-id
                                                                                                                                                                      Definition

                                                                                                                                                                      Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                                                                                      Short3' Transcript - Identifier
                                                                                                                                                                      Comments

                                                                                                                                                                      For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                                                      Control1..1
                                                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                                                      TypeBackboneElement
                                                                                                                                                                      Must Supporttrue
                                                                                                                                                                      Summarytrue
                                                                                                                                                                      Requirements

                                                                                                                                                                      Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                      876. Observation.component:three-prime-transcript-id.id
                                                                                                                                                                      Definition

                                                                                                                                                                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                      ShortUnique id for inter-element referencing
                                                                                                                                                                      Control0..1
                                                                                                                                                                      Typestring
                                                                                                                                                                      XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                      878. Observation.component:three-prime-transcript-id.extension
                                                                                                                                                                      Definition

                                                                                                                                                                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                                                      ShortAdditional content defined by implementations
                                                                                                                                                                      Comments

                                                                                                                                                                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                                      Control0..*
                                                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                                                      TypeExtension
                                                                                                                                                                      Alternate Namesextensions, user content
                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                      SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                      • value @ url
                                                                                                                                                                      • 880. Observation.component:three-prime-transcript-id.modifierExtension
                                                                                                                                                                        Definition

                                                                                                                                                                        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                                                        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                                                        ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                        Comments

                                                                                                                                                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                                        Control0..*
                                                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                                                        TypeExtension
                                                                                                                                                                        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                                        Summarytrue
                                                                                                                                                                        Requirements

                                                                                                                                                                        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                                                        Alternate Namesextensions, user content, modifiers
                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                        882. Observation.component:three-prime-transcript-id.code
                                                                                                                                                                        Definition

                                                                                                                                                                        Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                                                        ShortType of component observation (code / type)
                                                                                                                                                                        Comments

                                                                                                                                                                        All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                                                        Control1..1
                                                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                                                        BindingFor example codes, see LOINCCodes
                                                                                                                                                                        (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                                                        Codes identifying names of simple observations.

                                                                                                                                                                        TypeCodeableConcept
                                                                                                                                                                        Summarytrue
                                                                                                                                                                        Requirements

                                                                                                                                                                        Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                                                        Pattern Value{
                                                                                                                                                                          "coding" : [{
                                                                                                                                                                            "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                                                                                                                                                            "code" : "three-prime-transcript-id"
                                                                                                                                                                          }]
                                                                                                                                                                        }
                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                        884. Observation.component:three-prime-transcript-id.value[x]
                                                                                                                                                                        Definition

                                                                                                                                                                        The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                        ShortActual component result
                                                                                                                                                                        Comments

                                                                                                                                                                        Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                        Control0..1
                                                                                                                                                                        This element is affected by the following invariants: ele-1
                                                                                                                                                                        TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                                                                                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                        Summarytrue
                                                                                                                                                                        Requirements

                                                                                                                                                                        An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                        SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                        • type @ $this
                                                                                                                                                                        • 886. Observation.component:three-prime-transcript-id.value[x]:valueCodeableConcept
                                                                                                                                                                          Slice NamevalueCodeableConcept
                                                                                                                                                                          Definition

                                                                                                                                                                          The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                          ShortActual component result
                                                                                                                                                                          Comments

                                                                                                                                                                          Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                          Control0..1
                                                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                                                          TypeCodeableConcept
                                                                                                                                                                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                          Must Supporttrue
                                                                                                                                                                          Summarytrue
                                                                                                                                                                          Requirements

                                                                                                                                                                          An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                          888. Observation.component:three-prime-transcript-id.dataAbsentReason
                                                                                                                                                                          Definition

                                                                                                                                                                          Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                                                          ShortWhy the component result is missing
                                                                                                                                                                          Comments

                                                                                                                                                                          "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                                                          The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                                                          Control0..1
                                                                                                                                                                          This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                                                          BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                                                          (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                                                          Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                                                          TypeCodeableConcept
                                                                                                                                                                          Requirements

                                                                                                                                                                          For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                          890. Observation.component:three-prime-transcript-id.interpretation
                                                                                                                                                                          Definition

                                                                                                                                                                          A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                                                          ShortHigh, low, normal, etc.
                                                                                                                                                                          Comments

                                                                                                                                                                          Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                                                          Control0..*
                                                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                                                          BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                                                          (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                                                          Codes identifying interpretations of observations.

                                                                                                                                                                          TypeCodeableConcept
                                                                                                                                                                          Requirements

                                                                                                                                                                          For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                                                          Alternate NamesAbnormal Flag
                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                          892. Observation.component:three-prime-transcript-id.referenceRange
                                                                                                                                                                          Definition

                                                                                                                                                                          Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                                                          ShortProvides guide for interpretation of component result
                                                                                                                                                                          Comments

                                                                                                                                                                          Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                                                          Control0..*
                                                                                                                                                                          TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                                                          Requirements

                                                                                                                                                                          Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                                                          894. Observation.component:three-prime-exon-id
                                                                                                                                                                          Slice Namethree-prime-exon-id
                                                                                                                                                                          Definition

                                                                                                                                                                          Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                                                                                          Short3' Exon - Identifier
                                                                                                                                                                          Comments

                                                                                                                                                                          For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                                                          Control1..1
                                                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                                                          TypeBackboneElement
                                                                                                                                                                          Must Supporttrue
                                                                                                                                                                          Summarytrue
                                                                                                                                                                          Requirements

                                                                                                                                                                          Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                          896. Observation.component:three-prime-exon-id.id
                                                                                                                                                                          Definition

                                                                                                                                                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                          ShortUnique id for inter-element referencing
                                                                                                                                                                          Control0..1
                                                                                                                                                                          Typestring
                                                                                                                                                                          XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                          898. Observation.component:three-prime-exon-id.extension
                                                                                                                                                                          Definition

                                                                                                                                                                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                                                          ShortAdditional content defined by implementations
                                                                                                                                                                          Comments

                                                                                                                                                                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                                          Control0..*
                                                                                                                                                                          This element is affected by the following invariants: ele-1
                                                                                                                                                                          TypeExtension
                                                                                                                                                                          Alternate Namesextensions, user content
                                                                                                                                                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                          SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                          • value @ url
                                                                                                                                                                          • 900. Observation.component:three-prime-exon-id.modifierExtension
                                                                                                                                                                            Definition

                                                                                                                                                                            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                                                            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                                                            ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                            Comments

                                                                                                                                                                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                                            Control0..*
                                                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                                                            TypeExtension
                                                                                                                                                                            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                                            Summarytrue
                                                                                                                                                                            Requirements

                                                                                                                                                                            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                                                            Alternate Namesextensions, user content, modifiers
                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                            902. Observation.component:three-prime-exon-id.code
                                                                                                                                                                            Definition

                                                                                                                                                                            Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                                                            ShortType of component observation (code / type)
                                                                                                                                                                            Comments

                                                                                                                                                                            All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                                                            Control1..1
                                                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                                                            BindingFor example codes, see LOINCCodes
                                                                                                                                                                            (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                                                            Codes identifying names of simple observations.

                                                                                                                                                                            TypeCodeableConcept
                                                                                                                                                                            Summarytrue
                                                                                                                                                                            Requirements

                                                                                                                                                                            Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                                                            Pattern Value{
                                                                                                                                                                              "coding" : [{
                                                                                                                                                                                "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                                                                                                                                                                "code" : "three-prime-exon-id"
                                                                                                                                                                              }]
                                                                                                                                                                            }
                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            904. Observation.component:three-prime-exon-id.value[x]
                                                                                                                                                                            Definition

                                                                                                                                                                            The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                            ShortActual component result
                                                                                                                                                                            Comments

                                                                                                                                                                            Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                            Control0..1
                                                                                                                                                                            This element is affected by the following invariants: ele-1
                                                                                                                                                                            TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                                                                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                            Summarytrue
                                                                                                                                                                            Requirements

                                                                                                                                                                            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                            SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                            • type @ $this
                                                                                                                                                                            • 906. Observation.component:three-prime-exon-id.value[x]:valueCodeableConcept
                                                                                                                                                                              Slice NamevalueCodeableConcept
                                                                                                                                                                              Definition

                                                                                                                                                                              The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                              ShortActual component result
                                                                                                                                                                              Comments

                                                                                                                                                                              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                              Control0..1
                                                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                                                              TypeCodeableConcept
                                                                                                                                                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                              Must Supporttrue
                                                                                                                                                                              Summarytrue
                                                                                                                                                                              Requirements

                                                                                                                                                                              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                              908. Observation.component:three-prime-exon-id.dataAbsentReason
                                                                                                                                                                              Definition

                                                                                                                                                                              Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                                                              ShortWhy the component result is missing
                                                                                                                                                                              Comments

                                                                                                                                                                              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                                                              The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                                                              Control0..1
                                                                                                                                                                              This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                                                              BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                                                              (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                                                              Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                                                              TypeCodeableConcept
                                                                                                                                                                              Requirements

                                                                                                                                                                              For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                              910. Observation.component:three-prime-exon-id.interpretation
                                                                                                                                                                              Definition

                                                                                                                                                                              A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                                                              ShortHigh, low, normal, etc.
                                                                                                                                                                              Comments

                                                                                                                                                                              Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                                                              Control0..*
                                                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                                                              BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                                                              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                                                              Codes identifying interpretations of observations.

                                                                                                                                                                              TypeCodeableConcept
                                                                                                                                                                              Requirements

                                                                                                                                                                              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                                                              Alternate NamesAbnormal Flag
                                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                              912. Observation.component:three-prime-exon-id.referenceRange
                                                                                                                                                                              Definition

                                                                                                                                                                              Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                                                              ShortProvides guide for interpretation of component result
                                                                                                                                                                              Comments

                                                                                                                                                                              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                                                              Control0..*
                                                                                                                                                                              TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                                                              Requirements

                                                                                                                                                                              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                                                              914. Observation.component:three-prime-position
                                                                                                                                                                              Slice Namethree-prime-position
                                                                                                                                                                              Definition

                                                                                                                                                                              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                                                                                              Short3' Domain - Position
                                                                                                                                                                              Comments

                                                                                                                                                                              For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                                                              Control1..1
                                                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                                                              TypeBackboneElement
                                                                                                                                                                              Must Supporttrue
                                                                                                                                                                              Summarytrue
                                                                                                                                                                              Requirements

                                                                                                                                                                              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                              916. Observation.component:three-prime-position.id
                                                                                                                                                                              Definition

                                                                                                                                                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                              ShortUnique id for inter-element referencing
                                                                                                                                                                              Control0..1
                                                                                                                                                                              Typestring
                                                                                                                                                                              XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                              918. Observation.component:three-prime-position.extension
                                                                                                                                                                              Definition

                                                                                                                                                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                                                              ShortAdditional content defined by implementations
                                                                                                                                                                              Comments

                                                                                                                                                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                                              Control0..*
                                                                                                                                                                              This element is affected by the following invariants: ele-1
                                                                                                                                                                              TypeExtension
                                                                                                                                                                              Alternate Namesextensions, user content
                                                                                                                                                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                              SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                              • value @ url
                                                                                                                                                                              • 920. Observation.component:three-prime-position.modifierExtension
                                                                                                                                                                                Definition

                                                                                                                                                                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                                                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                                                                ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                Comments

                                                                                                                                                                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                                                Control0..*
                                                                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                                                                TypeExtension
                                                                                                                                                                                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                                                Summarytrue
                                                                                                                                                                                Requirements

                                                                                                                                                                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                                                                Alternate Namesextensions, user content, modifiers
                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                                922. Observation.component:three-prime-position.code
                                                                                                                                                                                Definition

                                                                                                                                                                                Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                                                                ShortType of component observation (code / type)
                                                                                                                                                                                Comments

                                                                                                                                                                                All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                                                                Control1..1
                                                                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                                                                BindingFor example codes, see LOINCCodes
                                                                                                                                                                                (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                                                                Codes identifying names of simple observations.

                                                                                                                                                                                TypeCodeableConcept
                                                                                                                                                                                Summarytrue
                                                                                                                                                                                Requirements

                                                                                                                                                                                Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                                                                Pattern Value{
                                                                                                                                                                                  "coding" : [{
                                                                                                                                                                                    "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                                                                                                                                                                    "code" : "three-prime-position"
                                                                                                                                                                                  }]
                                                                                                                                                                                }
                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                924. Observation.component:three-prime-position.value[x]
                                                                                                                                                                                Definition

                                                                                                                                                                                The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                                ShortActual component result
                                                                                                                                                                                Comments

                                                                                                                                                                                Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                                Control0..1
                                                                                                                                                                                This element is affected by the following invariants: ele-1
                                                                                                                                                                                TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                                                                                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                Summarytrue
                                                                                                                                                                                Requirements

                                                                                                                                                                                An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                • type @ $this
                                                                                                                                                                                • 926. Observation.component:three-prime-position.value[x]:valueRange
                                                                                                                                                                                  Slice NamevalueRange
                                                                                                                                                                                  Definition

                                                                                                                                                                                  The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                                  ShortActual component result
                                                                                                                                                                                  Comments

                                                                                                                                                                                  Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                                  Control0..1
                                                                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                                                                  TypeRange
                                                                                                                                                                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                                  Must Supporttrue
                                                                                                                                                                                  Summarytrue
                                                                                                                                                                                  Requirements

                                                                                                                                                                                  An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  928. Observation.component:three-prime-position.dataAbsentReason
                                                                                                                                                                                  Definition

                                                                                                                                                                                  Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                                                                  ShortWhy the component result is missing
                                                                                                                                                                                  Comments

                                                                                                                                                                                  "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                                                                  The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                                                                  Control0..1
                                                                                                                                                                                  This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                                                                  BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                                                                  (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                                                                  Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                                                  Requirements

                                                                                                                                                                                  For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  930. Observation.component:three-prime-position.interpretation
                                                                                                                                                                                  Definition

                                                                                                                                                                                  A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                                                                  ShortHigh, low, normal, etc.
                                                                                                                                                                                  Comments

                                                                                                                                                                                  Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                                                                  Control0..*
                                                                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                                                                  BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                                                                  (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                                                                  Codes identifying interpretations of observations.

                                                                                                                                                                                  TypeCodeableConcept
                                                                                                                                                                                  Requirements

                                                                                                                                                                                  For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                                                                  Alternate NamesAbnormal Flag
                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  932. Observation.component:three-prime-position.referenceRange
                                                                                                                                                                                  Definition

                                                                                                                                                                                  Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                                                                  ShortProvides guide for interpretation of component result
                                                                                                                                                                                  Comments

                                                                                                                                                                                  Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                                                                  Control0..*
                                                                                                                                                                                  TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                                                                  Requirements

                                                                                                                                                                                  Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

                                                                                                                                                                                  934. Observation.component:three-prime-strand
                                                                                                                                                                                  Slice Namethree-prime-strand
                                                                                                                                                                                  Definition

                                                                                                                                                                                  Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

                                                                                                                                                                                  Short3' Strand
                                                                                                                                                                                  Comments

                                                                                                                                                                                  For a discussion on the ways Observations can be assembled in groups together see Notes below.

                                                                                                                                                                                  Control1..1
                                                                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                                                                  TypeBackboneElement
                                                                                                                                                                                  Must Supporttrue
                                                                                                                                                                                  Summarytrue
                                                                                                                                                                                  Requirements

                                                                                                                                                                                  Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  936. Observation.component:three-prime-strand.id
                                                                                                                                                                                  Definition

                                                                                                                                                                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                                                                                                                                                                  ShortUnique id for inter-element referencing
                                                                                                                                                                                  Control0..1
                                                                                                                                                                                  Typestring
                                                                                                                                                                                  XML FormatIn the XML format, this property is represented as an attribute.
                                                                                                                                                                                  938. Observation.component:three-prime-strand.extension
                                                                                                                                                                                  Definition

                                                                                                                                                                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                                                                                                                                                                  ShortAdditional content defined by implementations
                                                                                                                                                                                  Comments

                                                                                                                                                                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                                                  Control0..*
                                                                                                                                                                                  This element is affected by the following invariants: ele-1
                                                                                                                                                                                  TypeExtension
                                                                                                                                                                                  Alternate Namesextensions, user content
                                                                                                                                                                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                                  SlicingThis element introduces a set of slices on Observation.component.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                  • value @ url
                                                                                                                                                                                  • 940. Observation.component:three-prime-strand.modifierExtension
                                                                                                                                                                                    Definition

                                                                                                                                                                                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                                                                                                                                                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                                                                                                                                                                    ShortExtensions that cannot be ignored even if unrecognized
                                                                                                                                                                                    Comments

                                                                                                                                                                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                                                                                                                                                                    Control0..*
                                                                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                                                                    TypeExtension
                                                                                                                                                                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                                                                                                                                                                    Summarytrue
                                                                                                                                                                                    Requirements

                                                                                                                                                                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                                                                                                                                                                    Alternate Namesextensions, user content, modifiers
                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                                                                                                                                                                    942. Observation.component:three-prime-strand.code
                                                                                                                                                                                    Definition

                                                                                                                                                                                    Describes what was observed. Sometimes this is called the observation "code".

                                                                                                                                                                                    ShortType of component observation (code / type)
                                                                                                                                                                                    Comments

                                                                                                                                                                                    All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

                                                                                                                                                                                    Control1..1
                                                                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                                                                    BindingFor example codes, see LOINCCodes
                                                                                                                                                                                    (example to http://hl7.org/fhir/ValueSet/observation-codes)

                                                                                                                                                                                    Codes identifying names of simple observations.

                                                                                                                                                                                    TypeCodeableConcept
                                                                                                                                                                                    Summarytrue
                                                                                                                                                                                    Requirements

                                                                                                                                                                                    Knowing what kind of observation is being made is essential to understanding the observation.

                                                                                                                                                                                    Pattern Value{
                                                                                                                                                                                      "coding" : [{
                                                                                                                                                                                        "system" : "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-molekulare-biomarker",
                                                                                                                                                                                        "code" : "three-prime-strand"
                                                                                                                                                                                      }]
                                                                                                                                                                                    }
                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                    944. Observation.component:three-prime-strand.value[x]
                                                                                                                                                                                    Definition

                                                                                                                                                                                    The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                                    ShortActual component result
                                                                                                                                                                                    Comments

                                                                                                                                                                                    Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                                    Control0..1
                                                                                                                                                                                    This element is affected by the following invariants: ele-1
                                                                                                                                                                                    TypeChoice of: Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
                                                                                                                                                                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                                                                                                                                                                    Summarytrue
                                                                                                                                                                                    Requirements

                                                                                                                                                                                    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                    SlicingThis element introduces a set of slices on Observation.component.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                                                                                                                                                                    • type @ $this
                                                                                                                                                                                    • 946. Observation.component:three-prime-strand.value[x]:valueCodeableConcept
                                                                                                                                                                                      Slice NamevalueCodeableConcept
                                                                                                                                                                                      Definition

                                                                                                                                                                                      The information determined as a result of making the observation, if the information has a simple value.

                                                                                                                                                                                      ShortActual component result
                                                                                                                                                                                      Comments

                                                                                                                                                                                      Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

                                                                                                                                                                                      Control0..1
                                                                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                                                                      TypeCodeableConcept
                                                                                                                                                                                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                                                                                                                                                                      Must Supporttrue
                                                                                                                                                                                      Summarytrue
                                                                                                                                                                                      Requirements

                                                                                                                                                                                      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

                                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                      948. Observation.component:three-prime-strand.dataAbsentReason
                                                                                                                                                                                      Definition

                                                                                                                                                                                      Provides a reason why the expected value in the element Observation.component.value[x] is missing.

                                                                                                                                                                                      ShortWhy the component result is missing
                                                                                                                                                                                      Comments

                                                                                                                                                                                      "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

                                                                                                                                                                                      The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

                                                                                                                                                                                      Control0..1
                                                                                                                                                                                      This element is affected by the following invariants: ele-1, obs-6
                                                                                                                                                                                      BindingUnless not suitable, these codes SHALL be taken from DataAbsentReason
                                                                                                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason)

                                                                                                                                                                                      Codes specifying why the result (Observation.value[x]) is missing.

                                                                                                                                                                                      TypeCodeableConcept
                                                                                                                                                                                      Requirements

                                                                                                                                                                                      For many results it is necessary to handle exceptional values in measurements.

                                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                      950. Observation.component:three-prime-strand.interpretation
                                                                                                                                                                                      Definition

                                                                                                                                                                                      A categorical assessment of an observation value. For example, high, low, normal.

                                                                                                                                                                                      ShortHigh, low, normal, etc.
                                                                                                                                                                                      Comments

                                                                                                                                                                                      Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

                                                                                                                                                                                      Control0..*
                                                                                                                                                                                      This element is affected by the following invariants: ele-1
                                                                                                                                                                                      BindingUnless not suitable, these codes SHALL be taken from ObservationInterpretationCodes
                                                                                                                                                                                      (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation)

                                                                                                                                                                                      Codes identifying interpretations of observations.

                                                                                                                                                                                      TypeCodeableConcept
                                                                                                                                                                                      Requirements

                                                                                                                                                                                      For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

                                                                                                                                                                                      Alternate NamesAbnormal Flag
                                                                                                                                                                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                                                                                                                                                                      952. Observation.component:three-prime-strand.referenceRange
                                                                                                                                                                                      Definition

                                                                                                                                                                                      Guidance on how to interpret the value by comparison to a normal or recommended range.

                                                                                                                                                                                      ShortProvides guide for interpretation of component result
                                                                                                                                                                                      Comments

                                                                                                                                                                                      Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

                                                                                                                                                                                      Control0..*
                                                                                                                                                                                      TypeSeettp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
                                                                                                                                                                                      Requirements

                                                                                                                                                                                      Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.