DICOM® SR to FHIR Resource Mapping IG
1.0.0 - International flag

DICOM® SR to FHIR Resource Mapping IG, published by HL7 International / Imaging Integration. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/dicom-sr/ and changes regularly. See the Directory of published versions

Resource Profile: Observation - DICOM SR Imaging Qualitative Evaluation Mapping to Observation

Official URL: http://hl7.org/fhir/uv/dicom-sr/StructureDefinition/imaging-qualitative-evaluation Version: 1.0.0
Standards status: Trial-use Active as of 2025-10-29 Maturity Level: 2 Computable Name: ImagingQualitativeEvaluation
Other Identifiers: OID:2.16.840.1.113883.4.642.40.39.42.14

DICOM® SR Imaging Qualitative Evaluation Mapping to Observation

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* ImagingObservationProfile Measurements and simple assertions
Constraints: obs-6, obs-7, obs-8
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
.... identifier:observationUID SΣ 0..* Identifier The unique identifier for the observation.
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 1..1 CodeableConcept Description of identifier
Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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://hl7.org/fhir/uv/dicom-sr/CodeSystem/dicom-identifier-type
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: observation-uid
....... display 1..1 string Representation defined by the system
Fixed Value: Observation UID
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... system Σ 0..1 uri The namespace for the identifier value
Required Pattern: urn:dicom:uid
..... value ΣC 1..1 string The value that is unique
Example General: 123456
... Slices for basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
Slice: Unordered, Open by type:reference
.... basedOn:serviceRequestRef SΣ 0..1 Reference(ServiceRequest) Description of the related ServiceRequest
..... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
... Slices for partOf Σ 1..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy) Part of referenced event
Slice: Unordered, Open by type:reference
.... partOf:imagingStudyRef SΣ 1..1 Reference(ImagingStudy) Related ImagingStudy
..... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
... category S 1..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

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://terminology.hl7.org/CodeSystem/umls
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: C0034375
..... display 1..1 string Representation defined by the system
Fixed Value: Qualitative Evaluations
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... code SΣC 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
... Slices for focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
Slice: Unordered, Open by profile:resolve()
.... focus:trackingIdentifiers SΣ 0..1 Reference(Body Structure - DICOM SR Observation Tracking Identifier Mapping) What the observation is about, when it is not about the subject of record
.... focus:imageRegion2d SΣ 0..1 Reference(Imaging Selection - DICOM SR 2D Image Region Mapping) 2D Image Region
.... focus:imageRegion3d SΣ 0..1 Reference(Imaging Selection - DICOM SR Image 3D Region Mapping) 3D Image Region
.... focus:referencedSegment SΣ 0..1 Reference(Imaging Selection - DICOM SR Referenced Segment Mapping) Referenced Segment
.... focus:referencedSegmentationFrame SΣ 0..1 Reference(Imaging Selection - DICOM SR Referenced Segmentation Frame Mapping) Referenced Segmentation Frame
.... focus:regionInSpace SΣ 0..1 Reference(Imaging Selection - DICOM SR Region In Space) RegionInSpace
.... focus:volumeSurface SΣ 0..1 Reference(Imaging Selection - DICOM SR Image Volume Surface Mapping) Volume Surface
.... focus:realWorldValueMap SΣ 0..1 Reference(Imaging Selection - DICOM SR Real World Value Map) Real World Value Map
.... focus:illustrationOfRoi SΣ 0..1 Reference(Imaging Selection - DICOM SR Illustration Of ROI Mapping) Illustration of ROI
.... focus:visualExplanation SΣ 0..1 Reference(Imaging Selection - DICOM SR Visual Explanation Mapping) VisualExplanation
... issued SΣ 1..1 instant Observation Date Time
... Slices for value[x] ΣC 1..1 CodeableConcept Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueCodeableConcept SΣC 1..1 CodeableConcept Actual result
... interpretation S 0..* CodeableConcept High, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... bodyStructure SC 0..1 Reference(Body Structure - DICOM SR Finding Site Mapping) Observed body structure
... device S 1..1 Reference(Device - DICOM SR Algorithm Identification Mapping | Device - DICOM General Equipment Mapping | Device - DICOM Participant Device Mapping) A reference to the device that generates the measurements or the device settings for the device

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.identifier:observationUID.​use Base required IdentifierUse 📍5.0.0 FHIR Std.
Observation.identifier:observationUID.​type Base extensible Identifier Type Codes 📍5.0.0 FHIR Std.
Observation.status Base required Observation Status 📍5.0.0 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍5.0.0 FHIR Std.
Observation.code Base example LOINC Codes 📍5.0.0 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍5.0.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
obs-8 error Observation bodyStructure SHALL only be present if Observation.bodySite is not present bodySite.exists() implies bodyStructure.empty()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* ImagingObservationProfile Measurements and simple assertions
... Slices for identifier Content/Rules for all slices
.... identifier:observationUID 0..* Identifier The unique identifier for the observation.
... category 1..* CodeableConcept Classification of type of observation
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://terminology.hl7.org/CodeSystem/umls
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: C0034375
..... display 1..1 string Representation defined by the system
Fixed Value: Qualitative Evaluations
... code 1..1 CodeableConcept Type of observation (code / type)
... issued 1..1 instant Observation Date Time
... Slices for value[x] 1..1 CodeableConcept Actual result
Slice: Unordered, Open by type:$this
.... value[x]:valueCodeableConcept S 1..1 CodeableConcept Actual result

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* ImagingObservationProfile Measurements and simple assertions
Constraints: obs-6, obs-7, obs-8
... 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: AllLanguages (required): IETF language tag for a human language
Additional BindingsPurpose
CommonLanguages Starter
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... Slices for identifier Σ 0..* Identifier Business Identifier for observation
Slice: Unordered, Open by value:type
.... identifier:observationUID SΣ 0..* Identifier The unique identifier for the observation.
..... id 0..1 id Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 1..1 CodeableConcept Description of identifier
Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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://hl7.org/fhir/uv/dicom-sr/CodeSystem/dicom-identifier-type
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: observation-uid
....... display 1..1 string Representation defined by the system
Fixed Value: Observation UID
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... system Σ 0..1 uri The namespace for the identifier value
Required Pattern: urn:dicom:uid
..... value ΣC 1..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... instantiates[x] Σ 0..1 canonical(ObservationDefinition), Reference(ObservationDefinition) Instantiates FHIR ObservationDefinition
... Slices for basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
Slice: Unordered, Open by type:reference
.... basedOn:serviceRequestRef SΣ 0..1 Reference(ServiceRequest) Description of the related ServiceRequest
..... id 0..1 id Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
..... type Σ 0..1 uri Type the reference refers to (e.g. "Patient") - must be a resource in resources
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
..... identifier ΣC 0..1 Identifier The accession number related to the performed study
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
...... type Σ 1..1 CodeableConcept Description of identifier
Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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://terminology.hl7.org/CodeSystem/v2-0203
........ version 0..1 string Version of the system - if relevant
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: ACSN
........ display 1..1 string Representation defined by the system
Fixed Value: Accession ID
........ userSelected 0..1 boolean If this coding was chosen directly by the user
....... text 0..1 string Plain text representation of the concept
...... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
...... value ΣC 1..1 string The value that is unique
Example General: 123456
...... period Σ 0..1 Period Time period when id is/was valid for use
...... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
..... display ΣC 0..1 string Text alternative for the resource
... triggeredBy 0..* BackboneElement Triggering observation(s)
.... 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
.... observation Σ 1..1 Reference(Observation) Triggering observation
.... type Σ 1..1 code reflex | repeat | re-run
Binding: TriggeredBytype (required): The type of TriggeredBy Observation.
.... reason 0..1 string Reason that the observation was triggered
... Slices for partOf Σ 1..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy) Part of referenced event
Slice: Unordered, Open by type:reference
.... partOf:imagingStudyRef SΣ 1..1 Reference(ImagingStudy) Related ImagingStudy
..... id 0..1 id Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
..... type Σ 0..1 uri Type the reference refers to (e.g. "Patient") - must be a resource in resources
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
..... identifier ΣC 0..1 Identifier Identifier related to Study Instance UID
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
...... type Σ 1..1 CodeableConcept Description of identifier
Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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://dicom.nema.org/resources/ontology/DCM
........ version 0..1 string Version of the system - if relevant
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: 110180
........ display 1..1 string Representation defined by the system
Fixed Value: Study Instance UID
........ userSelected 0..1 boolean If this coding was chosen directly by the user
....... text 0..1 string Plain text representation of the concept
...... system Σ 0..1 uri The namespace for the identifier value
Required Pattern: urn:dicom:uid
...... value ΣC 1..1 string The value that is unique
Example General: 123456
...... period Σ 0..1 Period Time period when id is/was valid for use
...... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
..... display ΣC 0..1 string Text alternative for the resource
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
... category S 1..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

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://terminology.hl7.org/CodeSystem/umls
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: C0034375
..... display 1..1 string Representation defined by the system
Fixed Value: Qualitative Evaluations
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... code SΣC 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
... Slices for focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
Slice: Unordered, Open by profile:resolve()
.... focus:trackingIdentifiers SΣ 0..1 Reference(Body Structure - DICOM SR Observation Tracking Identifier Mapping) What the observation is about, when it is not about the subject of record
.... focus:imageRegion2d SΣ 0..1 Reference(Imaging Selection - DICOM SR 2D Image Region Mapping) 2D Image Region
.... focus:imageRegion3d SΣ 0..1 Reference(Imaging Selection - DICOM SR Image 3D Region Mapping) 3D Image Region
.... focus:referencedSegment SΣ 0..1 Reference(Imaging Selection - DICOM SR Referenced Segment Mapping) Referenced Segment
.... focus:referencedSegmentationFrame SΣ 0..1 Reference(Imaging Selection - DICOM SR Referenced Segmentation Frame Mapping) Referenced Segmentation Frame
.... focus:regionInSpace SΣ 0..1 Reference(Imaging Selection - DICOM SR Region In Space) RegionInSpace
.... focus:volumeSurface SΣ 0..1 Reference(Imaging Selection - DICOM SR Image Volume Surface Mapping) Volume Surface
.... focus:realWorldValueMap SΣ 0..1 Reference(Imaging Selection - DICOM SR Real World Value Map) Real World Value Map
.... focus:illustrationOfRoi SΣ 0..1 Reference(Imaging Selection - DICOM SR Illustration Of ROI Mapping) Illustration of ROI
.... focus:visualExplanation SΣ 0..1 Reference(Imaging Selection - DICOM SR Visual Explanation Mapping) VisualExplanation
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] Σ 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... issued SΣ 1..1 instant Observation Date Time
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... Slices for value[x] ΣC 1..1 CodeableConcept Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueCodeableConcept SΣC 1..1 CodeableConcept Actual result
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation S 0..* CodeableConcept High, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note 0..* Annotation Comments about the observation
... bodySite C 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
... bodyStructure SC 0..1 Reference(Body Structure - DICOM SR Finding Site Mapping) Observed body structure
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
... specimen C 0..1 Reference(Specimen | Group) Specimen used for this observation
Constraints: obs-9
... device S 1..1 Reference(Device - DICOM SR Algorithm Identification Mapping | Device - DICOM General Equipment Mapping | Device - DICOM Participant Device Mapping) A reference to the device that generates the measurements or the device settings for the device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity(5.0.0) Low Range, if relevant
.... high C 0..1 SimpleQuantity(5.0.0) High Range, if relevant
.... normalValue 0..1 CodeableConcept Normal value, if relevant
Binding: ObservationReferenceRangeNormalValueCodes (extensible): Codes identifying the normal value of the observation.
.... 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 C 0..1 markdown Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | ImagingSelection | QuestionnaireResponse | Observation | MolecularSequence | GenomicStudy) Related resource from which the observation is made
... component ΣC 0..* BackboneElement Component results
.... 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 ΣC 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
..... valueAttachment Attachment
..... valueReference Reference(MolecularSequence)
.... dataAbsentReason 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base required All Languages 📍5.0.0 FHIR Std.
Observation.identifier:observationUID.​use Base required IdentifierUse 📍5.0.0 FHIR Std.
Observation.identifier:observationUID.​type Base extensible Identifier Type Codes 📍5.0.0 FHIR Std.
Observation.basedOn:serviceRequestRef.​type Base extensible Resource Types 📍5.0.0 FHIR Std.
Observation.basedOn:serviceRequestRef.​identifier.use Base required IdentifierUse 📍5.0.0 FHIR Std.
Observation.basedOn:serviceRequestRef.​identifier.type Base extensible Identifier Type Codes 📍5.0.0 FHIR Std.
Observation.triggeredBy.​type Base required triggered Bytype 📍5.0.0 FHIR Std.
Observation.partOf:imagingStudyRef.​type Base extensible Resource Types 📍5.0.0 FHIR Std.
Observation.partOf:imagingStudyRef.​identifier.use Base required IdentifierUse 📍5.0.0 FHIR Std.
Observation.partOf:imagingStudyRef.​identifier.type Base extensible Identifier Type Codes 📍5.0.0 FHIR Std.
Observation.status Base required Observation Status 📍5.0.0 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍5.0.0 FHIR Std.
Observation.code Base example LOINC Codes 📍5.0.0 FHIR Std.
Observation.dataAbsentReason Base extensible Data Absent Reason 📍5.0.0 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍5.0.0 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍5.0.0 FHIR Std.
Observation.method Base example Observation Methods 📍5.0.0 FHIR Std.
Observation.referenceRange.​normalValue Base extensible Observation Reference Range Normal Value Codes 📍5.0.0 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍5.0.0 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍5.0.0 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍5.0.0 FHIR Std.
Observation.component.​dataAbsentReason Base extensible Data Absent Reason 📍5.0.0 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍5.0.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
obs-8 error Observation bodyStructure SHALL only be present if Observation.bodySite is not present bodySite.exists() implies bodyStructure.empty()
obs-9 error Observation.specimen If Observation.specimen is a reference to Group, the group can only have specimens (reference.resolve().exists() and reference.resolve() is Group) implies reference.resolve().member.entity.resolve().all($this is Specimen)

Summary

Mandatory: 3 elements
Must-Support: 1 element

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.value[x]

Maturity: 2

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* ImagingObservationProfile Measurements and simple assertions
Constraints: obs-6, obs-7, obs-8
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
.... identifier:observationUID SΣ 0..* Identifier The unique identifier for the observation.
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 1..1 CodeableConcept Description of identifier
Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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://hl7.org/fhir/uv/dicom-sr/CodeSystem/dicom-identifier-type
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: observation-uid
....... display 1..1 string Representation defined by the system
Fixed Value: Observation UID
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... system Σ 0..1 uri The namespace for the identifier value
Required Pattern: urn:dicom:uid
..... value ΣC 1..1 string The value that is unique
Example General: 123456
... Slices for basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
Slice: Unordered, Open by type:reference
.... basedOn:serviceRequestRef SΣ 0..1 Reference(ServiceRequest) Description of the related ServiceRequest
..... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
... Slices for partOf Σ 1..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy) Part of referenced event
Slice: Unordered, Open by type:reference
.... partOf:imagingStudyRef SΣ 1..1 Reference(ImagingStudy) Related ImagingStudy
..... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
... category S 1..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

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://terminology.hl7.org/CodeSystem/umls
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: C0034375
..... display 1..1 string Representation defined by the system
Fixed Value: Qualitative Evaluations
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... code SΣC 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
... Slices for focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
Slice: Unordered, Open by profile:resolve()
.... focus:trackingIdentifiers SΣ 0..1 Reference(Body Structure - DICOM SR Observation Tracking Identifier Mapping) What the observation is about, when it is not about the subject of record
.... focus:imageRegion2d SΣ 0..1 Reference(Imaging Selection - DICOM SR 2D Image Region Mapping) 2D Image Region
.... focus:imageRegion3d SΣ 0..1 Reference(Imaging Selection - DICOM SR Image 3D Region Mapping) 3D Image Region
.... focus:referencedSegment SΣ 0..1 Reference(Imaging Selection - DICOM SR Referenced Segment Mapping) Referenced Segment
.... focus:referencedSegmentationFrame SΣ 0..1 Reference(Imaging Selection - DICOM SR Referenced Segmentation Frame Mapping) Referenced Segmentation Frame
.... focus:regionInSpace SΣ 0..1 Reference(Imaging Selection - DICOM SR Region In Space) RegionInSpace
.... focus:volumeSurface SΣ 0..1 Reference(Imaging Selection - DICOM SR Image Volume Surface Mapping) Volume Surface
.... focus:realWorldValueMap SΣ 0..1 Reference(Imaging Selection - DICOM SR Real World Value Map) Real World Value Map
.... focus:illustrationOfRoi SΣ 0..1 Reference(Imaging Selection - DICOM SR Illustration Of ROI Mapping) Illustration of ROI
.... focus:visualExplanation SΣ 0..1 Reference(Imaging Selection - DICOM SR Visual Explanation Mapping) VisualExplanation
... issued SΣ 1..1 instant Observation Date Time
... Slices for value[x] ΣC 1..1 CodeableConcept Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueCodeableConcept SΣC 1..1 CodeableConcept Actual result
... interpretation S 0..* CodeableConcept High, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... bodyStructure SC 0..1 Reference(Body Structure - DICOM SR Finding Site Mapping) Observed body structure
... device S 1..1 Reference(Device - DICOM SR Algorithm Identification Mapping | Device - DICOM General Equipment Mapping | Device - DICOM Participant Device Mapping) A reference to the device that generates the measurements or the device settings for the device

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.identifier:observationUID.​use Base required IdentifierUse 📍5.0.0 FHIR Std.
Observation.identifier:observationUID.​type Base extensible Identifier Type Codes 📍5.0.0 FHIR Std.
Observation.status Base required Observation Status 📍5.0.0 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍5.0.0 FHIR Std.
Observation.code Base example LOINC Codes 📍5.0.0 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍5.0.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
obs-8 error Observation bodyStructure SHALL only be present if Observation.bodySite is not present bodySite.exists() implies bodyStructure.empty()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* ImagingObservationProfile Measurements and simple assertions
... Slices for identifier Content/Rules for all slices
.... identifier:observationUID 0..* Identifier The unique identifier for the observation.
... category 1..* CodeableConcept Classification of type of observation
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://terminology.hl7.org/CodeSystem/umls
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: C0034375
..... display 1..1 string Representation defined by the system
Fixed Value: Qualitative Evaluations
... code 1..1 CodeableConcept Type of observation (code / type)
... issued 1..1 instant Observation Date Time
... Slices for value[x] 1..1 CodeableConcept Actual result
Slice: Unordered, Open by type:$this
.... value[x]:valueCodeableConcept S 1..1 CodeableConcept Actual result

doco Documentation for this format

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* ImagingObservationProfile Measurements and simple assertions
Constraints: obs-6, obs-7, obs-8
... 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: AllLanguages (required): IETF language tag for a human language
Additional BindingsPurpose
CommonLanguages Starter
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... Slices for identifier Σ 0..* Identifier Business Identifier for observation
Slice: Unordered, Open by value:type
.... identifier:observationUID SΣ 0..* Identifier The unique identifier for the observation.
..... id 0..1 id Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
..... type Σ 1..1 CodeableConcept Description of identifier
Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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://hl7.org/fhir/uv/dicom-sr/CodeSystem/dicom-identifier-type
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: observation-uid
....... display 1..1 string Representation defined by the system
Fixed Value: Observation UID
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text 0..1 string Plain text representation of the concept
..... system Σ 0..1 uri The namespace for the identifier value
Required Pattern: urn:dicom:uid
..... value ΣC 1..1 string The value that is unique
Example General: 123456
..... period Σ 0..1 Period Time period when id is/was valid for use
..... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
... instantiates[x] Σ 0..1 canonical(ObservationDefinition), Reference(ObservationDefinition) Instantiates FHIR ObservationDefinition
... Slices for basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
Slice: Unordered, Open by type:reference
.... basedOn:serviceRequestRef SΣ 0..1 Reference(ServiceRequest) Description of the related ServiceRequest
..... id 0..1 id Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
..... type Σ 0..1 uri Type the reference refers to (e.g. "Patient") - must be a resource in resources
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
..... identifier ΣC 0..1 Identifier The accession number related to the performed study
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
...... type Σ 1..1 CodeableConcept Description of identifier
Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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://terminology.hl7.org/CodeSystem/v2-0203
........ version 0..1 string Version of the system - if relevant
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: ACSN
........ display 1..1 string Representation defined by the system
Fixed Value: Accession ID
........ userSelected 0..1 boolean If this coding was chosen directly by the user
....... text 0..1 string Plain text representation of the concept
...... system Σ 0..1 uri The namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
...... value ΣC 1..1 string The value that is unique
Example General: 123456
...... period Σ 0..1 Period Time period when id is/was valid for use
...... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
..... display ΣC 0..1 string Text alternative for the resource
... triggeredBy 0..* BackboneElement Triggering observation(s)
.... 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
.... observation Σ 1..1 Reference(Observation) Triggering observation
.... type Σ 1..1 code reflex | repeat | re-run
Binding: TriggeredBytype (required): The type of TriggeredBy Observation.
.... reason 0..1 string Reason that the observation was triggered
... Slices for partOf Σ 1..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy) Part of referenced event
Slice: Unordered, Open by type:reference
.... partOf:imagingStudyRef SΣ 1..1 Reference(ImagingStudy) Related ImagingStudy
..... id 0..1 id Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
..... type Σ 0..1 uri Type the reference refers to (e.g. "Patient") - must be a resource in resources
Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
..... identifier ΣC 0..1 Identifier Identifier related to Study Instance UID
...... id 0..1 id Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
...... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
...... type Σ 1..1 CodeableConcept Description of identifier
Binding: IdentifierTypeCodes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
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://dicom.nema.org/resources/ontology/DCM
........ version 0..1 string Version of the system - if relevant
........ code 1..1 code Symbol in syntax defined by the system
Fixed Value: 110180
........ display 1..1 string Representation defined by the system
Fixed Value: Study Instance UID
........ userSelected 0..1 boolean If this coding was chosen directly by the user
....... text 0..1 string Plain text representation of the concept
...... system Σ 0..1 uri The namespace for the identifier value
Required Pattern: urn:dicom:uid
...... value ΣC 1..1 string The value that is unique
Example General: 123456
...... period Σ 0..1 Period Time period when id is/was valid for use
...... assigner Σ 0..1 Reference(Organization) Organization that issued id (may be just text)
..... display ΣC 0..1 string Text alternative for the resource
... status ?!Σ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
... category S 1..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

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://terminology.hl7.org/CodeSystem/umls
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: C0034375
..... display 1..1 string Representation defined by the system
Fixed Value: Qualitative Evaluations
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... code SΣC 1..1 CodeableConcept Type of observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
... Slices for focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
Slice: Unordered, Open by profile:resolve()
.... focus:trackingIdentifiers SΣ 0..1 Reference(Body Structure - DICOM SR Observation Tracking Identifier Mapping) What the observation is about, when it is not about the subject of record
.... focus:imageRegion2d SΣ 0..1 Reference(Imaging Selection - DICOM SR 2D Image Region Mapping) 2D Image Region
.... focus:imageRegion3d SΣ 0..1 Reference(Imaging Selection - DICOM SR Image 3D Region Mapping) 3D Image Region
.... focus:referencedSegment SΣ 0..1 Reference(Imaging Selection - DICOM SR Referenced Segment Mapping) Referenced Segment
.... focus:referencedSegmentationFrame SΣ 0..1 Reference(Imaging Selection - DICOM SR Referenced Segmentation Frame Mapping) Referenced Segmentation Frame
.... focus:regionInSpace SΣ 0..1 Reference(Imaging Selection - DICOM SR Region In Space) RegionInSpace
.... focus:volumeSurface SΣ 0..1 Reference(Imaging Selection - DICOM SR Image Volume Surface Mapping) Volume Surface
.... focus:realWorldValueMap SΣ 0..1 Reference(Imaging Selection - DICOM SR Real World Value Map) Real World Value Map
.... focus:illustrationOfRoi SΣ 0..1 Reference(Imaging Selection - DICOM SR Illustration Of ROI Mapping) Illustration of ROI
.... focus:visualExplanation SΣ 0..1 Reference(Imaging Selection - DICOM SR Visual Explanation Mapping) VisualExplanation
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] Σ 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... issued SΣ 1..1 instant Observation Date Time
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... Slices for value[x] ΣC 1..1 CodeableConcept Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueCodeableConcept SΣC 1..1 CodeableConcept Actual result
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation S 0..* CodeableConcept High, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note 0..* Annotation Comments about the observation
... bodySite C 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
... bodyStructure SC 0..1 Reference(Body Structure - DICOM SR Finding Site Mapping) Observed body structure
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
... specimen C 0..1 Reference(Specimen | Group) Specimen used for this observation
Constraints: obs-9
... device S 1..1 Reference(Device - DICOM SR Algorithm Identification Mapping | Device - DICOM General Equipment Mapping | Device - DICOM Participant Device Mapping) A reference to the device that generates the measurements or the device settings for the device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity(5.0.0) Low Range, if relevant
.... high C 0..1 SimpleQuantity(5.0.0) High Range, if relevant
.... normalValue 0..1 CodeableConcept Normal value, if relevant
Binding: ObservationReferenceRangeNormalValueCodes (extensible): Codes identifying the normal value of the observation.
.... 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 C 0..1 markdown Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | ImagingSelection | QuestionnaireResponse | Observation | MolecularSequence | GenomicStudy) Related resource from which the observation is made
... component ΣC 0..* BackboneElement Component results
.... 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 ΣC 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
..... valueAttachment Attachment
..... valueReference Reference(MolecularSequence)
.... dataAbsentReason 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base required All Languages 📍5.0.0 FHIR Std.
Observation.identifier:observationUID.​use Base required IdentifierUse 📍5.0.0 FHIR Std.
Observation.identifier:observationUID.​type Base extensible Identifier Type Codes 📍5.0.0 FHIR Std.
Observation.basedOn:serviceRequestRef.​type Base extensible Resource Types 📍5.0.0 FHIR Std.
Observation.basedOn:serviceRequestRef.​identifier.use Base required IdentifierUse 📍5.0.0 FHIR Std.
Observation.basedOn:serviceRequestRef.​identifier.type Base extensible Identifier Type Codes 📍5.0.0 FHIR Std.
Observation.triggeredBy.​type Base required triggered Bytype 📍5.0.0 FHIR Std.
Observation.partOf:imagingStudyRef.​type Base extensible Resource Types 📍5.0.0 FHIR Std.
Observation.partOf:imagingStudyRef.​identifier.use Base required IdentifierUse 📍5.0.0 FHIR Std.
Observation.partOf:imagingStudyRef.​identifier.type Base extensible Identifier Type Codes 📍5.0.0 FHIR Std.
Observation.status Base required Observation Status 📍5.0.0 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍5.0.0 FHIR Std.
Observation.code Base example LOINC Codes 📍5.0.0 FHIR Std.
Observation.dataAbsentReason Base extensible Data Absent Reason 📍5.0.0 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍5.0.0 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍5.0.0 FHIR Std.
Observation.method Base example Observation Methods 📍5.0.0 FHIR Std.
Observation.referenceRange.​normalValue Base extensible Observation Reference Range Normal Value Codes 📍5.0.0 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍5.0.0 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍5.0.0 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍5.0.0 FHIR Std.
Observation.component.​dataAbsentReason Base extensible Data Absent Reason 📍5.0.0 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍5.0.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
obs-8 error Observation bodyStructure SHALL only be present if Observation.bodySite is not present bodySite.exists() implies bodyStructure.empty()
obs-9 error Observation.specimen If Observation.specimen is a reference to Group, the group can only have specimens (reference.resolve().exists() and reference.resolve() is Group) implies reference.resolve().member.entity.resolve().all($this is Specimen)

Summary

Mandatory: 3 elements
Must-Support: 1 element

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.value[x]

Maturity: 2

 

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