CodeX Radiation Therapy, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/codex-radiation-therapy/ and changes regularly. See the Directory of published versions

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Resource Profile: Radiotherapy Disease Status

Disease Status Reported by Radiation Oncologist

Usage:

• Examples for this Resource Profile: Observation/cancer-disease-status-22B

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from CancerDiseaseStatus

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	CancerDiseaseStatus	Measurements and simple assertions
Slices for extension				Content/Rules for all slices
radiotherapyVolume		0..*	Reference(Radiotherapy Volume)	Radiotherapy Volume Extension URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-volume-extension
value[x]	C	0..1	CodeableConcept	Actual result RestrictDiseaseProgressionQualifier: Only allow qualifier for one value status
Slices for extension				Content/Rules for all slices
diseaseProgressionQualifier		0..*	CodeableConcept	Progression Qualifier URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-disease-progression-qualifier Binding: Disease Progression Qualifier Value Set (required)
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
RestrictDiseaseProgressionQualifier	error	Observation.value[x]	Only allow qualifier for one value status : coding.exists(code = '271299001').not() implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-disease-progression-qualifier').not()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CancerDiseaseStatus	Measurements and simple assertions dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present 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
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
evidenceType	S	0..*	CodeableConcept	Cancer Disease Status Evidence Type Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status-evidence-type Binding: Cancer Disease Status Evidence Type Value Set (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
radiotherapyVolume		0..*	Reference(Radiotherapy Volume)	Radiotherapy Volume Extension URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-volume-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. ele-1: All FHIR elements must have a @value or children
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 97509-4
subject	SΣ	1..1	Reference(Cancer Patient Profile)	Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children
focus	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile | Tumor Profile | Radiotherapy Volume Profile)	What the observation is about, when it is not about the subject of record ele-1: All FHIR elements must have a @value or children
effective[x]	SΣ	0..1	dateTime	Clinically relevant time/time-period for observation ele-1: All FHIR elements must have a @value or children
value[x]	SΣC	0..1	CodeableConcept	Actual result Binding: Condition Status Trend Value Set (preferred) Additional Bindings Purpose Condition Status Trend Maximum Value Set Max Binding ele-1: All FHIR elements must have a @value or children RestrictDiseaseProgressionQualifier: Only allow qualifier for one value status
Slices for extension				Content/Rules for all slices
diseaseProgressionQualifier		0..*	CodeableConcept	Progression Qualifier URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-disease-progression-qualifier Binding: Disease Progression Qualifier Value Set (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.code	example	Pattern: LOINC Code 97509-4 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]	preferred	ConditionStatusTrendVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-condition-status-trend-vs Additional Bindings Purpose Condition Status Trend Maximum Value Set Max Binding

Constraints

Id	Grade	Path(s)	Details	Requirements
RestrictDiseaseProgressionQualifier	error	Observation.value[x]	Only allow qualifier for one value status : coding.exists(code = '271299001').not() implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-disease-progression-qualifier').not()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CancerDiseaseStatus	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present 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
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
evidenceType	S	0..*	CodeableConcept	Cancer Disease Status Evidence Type Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status-evidence-type Binding: Cancer Disease Status Evidence Type Value Set (required)
radiotherapyVolume		0..*	Reference(Radiotherapy Volume)	Radiotherapy Volume Extension URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-volume-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 97509-4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(Cancer Patient Profile)	Who and/or what the observation is about
focus	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile | Tumor Profile | Radiotherapy Volume Profile)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣ	0..1	dateTime	Clinically relevant time/time-period for observation
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(US Core Practitioner Profile)	Who is responsible for the observation
value[x]	SΣC	0..1	CodeableConcept	Actual result Binding: Condition Status Trend Value Set (preferred) Additional Bindings Purpose Condition Status Trend Maximum Value Set Max Binding RestrictDiseaseProgressionQualifier: Only allow qualifier for one value status
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
diseaseProgressionQualifier		0..*	CodeableConcept	Progression Qualifier URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-disease-progression-qualifier Binding: Disease Progression Qualifier Value Set (required)
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Not used in this profile
device		0..1	Reference(Device | DeviceMetric)	Not used in this profile
referenceRange	C	0..*	BackboneElement	Not used in this profile obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Not used in this profile
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	Σ	0..*	BackboneElement	Not used in this profile
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	Pattern: LOINC Code 97509-4 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]	preferred	ConditionStatusTrendVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-condition-status-trend-vs Additional Bindings Purpose Condition Status Trend Maximum Value Set Max Binding
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
RestrictDiseaseProgressionQualifier	error	Observation.value[x]	Only allow qualifier for one value status : coding.exists(code = '271299001').not() implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-disease-progression-qualifier').not()

This structure is derived from CancerDiseaseStatus

Summary

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-volume-extension
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-disease-progression-qualifier

Differential View

This structure is derived from CancerDiseaseStatus

Name	Flags	Card.	Type	Description & Constraints
Observation		0..*	CancerDiseaseStatus	Measurements and simple assertions
Slices for extension				Content/Rules for all slices
radiotherapyVolume		0..*	Reference(Radiotherapy Volume)	Radiotherapy Volume Extension URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-volume-extension
value[x]	C	0..1	CodeableConcept	Actual result RestrictDiseaseProgressionQualifier: Only allow qualifier for one value status
Slices for extension				Content/Rules for all slices
diseaseProgressionQualifier		0..*	CodeableConcept	Progression Qualifier URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-disease-progression-qualifier Binding: Disease Progression Qualifier Value Set (required)
Documentation for this format

Constraints

Id	Grade	Path(s)	Details	Requirements
RestrictDiseaseProgressionQualifier	error	Observation.value[x]	Only allow qualifier for one value status : coding.exists(code = '271299001').not() implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-disease-progression-qualifier').not()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CancerDiseaseStatus	Measurements and simple assertions dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources 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 dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present 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
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
evidenceType	S	0..*	CodeableConcept	Cancer Disease Status Evidence Type Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status-evidence-type Binding: Cancer Disease Status Evidence Type Value Set (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
radiotherapyVolume		0..*	Reference(Radiotherapy Volume)	Radiotherapy Volume Extension URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-volume-extension ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. ele-1: All FHIR elements must have a @value or children
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. ele-1: All FHIR elements must have a @value or children Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 97509-4
subject	SΣ	1..1	Reference(Cancer Patient Profile)	Who and/or what the observation is about ele-1: All FHIR elements must have a @value or children
focus	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile | Tumor Profile | Radiotherapy Volume Profile)	What the observation is about, when it is not about the subject of record ele-1: All FHIR elements must have a @value or children
effective[x]	SΣ	0..1	dateTime	Clinically relevant time/time-period for observation ele-1: All FHIR elements must have a @value or children
value[x]	SΣC	0..1	CodeableConcept	Actual result Binding: Condition Status Trend Value Set (preferred) Additional Bindings Purpose Condition Status Trend Maximum Value Set Max Binding ele-1: All FHIR elements must have a @value or children RestrictDiseaseProgressionQualifier: Only allow qualifier for one value status
Slices for extension				Content/Rules for all slices
diseaseProgressionQualifier		0..*	CodeableConcept	Progression Qualifier URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-disease-progression-qualifier Binding: Disease Progression Qualifier Value Set (required) ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.code	example	Pattern: LOINC Code 97509-4 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]	preferred	ConditionStatusTrendVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-condition-status-trend-vs Additional Bindings Purpose Condition Status Trend Maximum Value Set Max Binding

Constraints

Id	Grade	Path(s)	Details	Requirements
RestrictDiseaseProgressionQualifier	error	Observation.value[x]	Only allow qualifier for one value status : coding.exists(code = '271299001').not() implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-disease-progression-qualifier').not()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	CancerDiseaseStatus	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present 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
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
evidenceType	S	0..*	CodeableConcept	Cancer Disease Status Evidence Type Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status-evidence-type Binding: Cancer Disease Status Evidence Type Value Set (required)
radiotherapyVolume		0..*	Reference(Radiotherapy Volume)	Radiotherapy Volume Extension URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-volume-extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 97509-4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(Cancer Patient Profile)	Who and/or what the observation is about
focus	SΣ	0..*	Reference(US Core Condition Problems and Health Concerns Profile | Tumor Profile | Radiotherapy Volume Profile)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣ	0..1	dateTime	Clinically relevant time/time-period for observation
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(US Core Practitioner Profile)	Who is responsible for the observation
value[x]	SΣC	0..1	CodeableConcept	Actual result Binding: Condition Status Trend Value Set (preferred) Additional Bindings Purpose Condition Status Trend Maximum Value Set Max Binding RestrictDiseaseProgressionQualifier: Only allow qualifier for one value status
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
diseaseProgressionQualifier		0..*	CodeableConcept	Progression Qualifier URL: http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-disease-progression-qualifier Binding: Disease Progression Qualifier Value Set (required)
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Not used in this profile
device		0..1	Reference(Device | DeviceMetric)	Not used in this profile
referenceRange	C	0..*	BackboneElement	Not used in this profile obs-3: Must have at least a low or a high or text
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Not used in this profile
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	Σ	0..*	BackboneElement	Not used in this profile
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	preferred	ObservationCategoryCodes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	Pattern: LOINC Code 97509-4 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]	preferred	ConditionStatusTrendVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-condition-status-trend-vs Additional Bindings Purpose Condition Status Trend Maximum Value Set Max Binding
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
RestrictDiseaseProgressionQualifier	error	Observation.value[x]	Only allow qualifier for one value status : coding.exists(code = '271299001').not() implies extension.exists(url = 'http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-disease-progression-qualifier').not()

This structure is derived from CancerDiseaseStatus

Summary

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-volume-extension
• http://hl7.org/fhir/us/codex-radiation-therapy/StructureDefinition/codexrt-radiotherapy-disease-progression-qualifier

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