minimal Common Oncology Data Elements (mCODE) Implementation Guide
4.0.0 - STU4 United States of America flag

minimal Common Oncology Data Elements (mCODE) Implementation Guide, published by HL7 International / Clinical Interoperability Council. This guide is not an authorized publication; it is the continuous build for version 4.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-mCODE-ig/ and changes regularly. See the Directory of published versions

Resource Profile: Cancer Stage Profile

Official URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-stage Version: 4.0.0
Active as of 2024-12-03 Computable Name: CancerStage
Other Identifiers: OID:2.16.840.1.113883.4.642.40.15.42.12

Profile for observations regarding cancer stage, grade, or classification. The stage is an assessment of the extent of the cancer in the body, according to a given cancer staging classification system. The key elements are the code, method, value, and optionally, prognostic factors referenced in the hasMember (if the prognostic factor is captured in a different profile) or component (if the prognostic factor is not captured in a different profile) element.

Usage

Rather than offer a separate staging profiles for each type of cancer staging (also called domain – e.g., gynecologic FIGO stage, leukemia Binet stage, Melanoma Breslow stage, etc.), this profile can support many different staging categories. The Staging Domain can be specified in a CodeableConcept in the CancerStage.category slice. Based on the code selected for CancerStage.code slice, the Table below provides the valuesets to use for CancerStage.method and CancerStage.value[x] along with their bindings (e.g., required or extensible). If the value for CancerStage.method is "N/A", it means no specific method values have been identified.

Lymphoma and TNM staging are handled separately in Lymphoma Stage Profile and TNM Stage Group Profile, respectively.

Cancer Staging Domains

Cancer stage definitions are disease specific. Specific guidance is provided below on each stage type to provide development teams an understanding of what to look for in source systems, how to setup tests, etc.

Domain CancerStage.code CancerStage.value CancerStage.method
Gynecologic FIGO Stage system: http://snomed.info/sct
code: 385361009		 FIGO Stage Value Set (extensible) FIGO Staging Method Value Set (extensible)
Leukemia Binet Stage system: http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl
code: C141212		 Binet Stage Value Set (extensible) N/A
Leukemia RAI Stage system: http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl
code: C141207		 Rai Stage Value Set (extensible) Rai Staging System Value Set (required)
Melanoma Breslow Stage system: http://snomed.info/sct
code: 106243009		 Breslow Depth Stage Value Set (required) N/A
Melanoma Clark Level system: http://snomed.info/sct
code: 103419001		 Clark Level Value Set (required) N/A
Myeloma ISS Stage system: http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl
code: C139007		 International Staging System (ISS) for Myeloma Stage Value Set (extensible) N/A
Myeloma RISS Stage system: http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl
code: C141392		 Revised International Staging System (ISS) for Multiple Myeloma Stage Value Set (extensible) N/A
Neuroblastoma INSS Stage system: http://snomed.info/sct
code: 409720004		 International Neuroblastoma Staging System (INSS) for Neuroblastoma Stage Value Set (required) N/A
Neuroblastoma INRGSS Stage system: http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl
code: C133427		 International Neuroblastoma Risk Group Staging System (INRGSS) for Neuroblastoma Risk Assessment Value Set (extensible) N/A
Prostate Gleason Stage system: http://snomed.info/sct
code: 385377005		 Gleason Grade Value Set (required) N/A
Rhabdomyosarcoma Clinical Group Stage system: http://snomed.info/sct
code: 405916000		 Rhabdomyosarcoma Clinical Group Value Set N/A
Wilms Tumor Stage system: http://snomed.info/sct
code: 405931009		 Wilms Tumor Stage Value Set (required) Wilms Tumor Body Site Value Set (extensible)

Usage:

Changes since version true:

  • No changes

    • Formal Views of Profile Content

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

    This structure is derived from USCoreSimpleObservationProfile

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation USCoreSimpleObservationProfile
    ... code 1..1 CodeableConcept The type of stage information reported.
    Binding: Cancer Stage Type Value Set (preferred)
    ... subject 1..1 Reference(Cancer Patient Profile) (USCDI) Who and/or what the observation is about
    ... focus S 0..* Reference(Primary Cancer Condition Profile) The cancer condition associated with staging assessment.
    ... method S 0..1 CodeableConcept The staging system used.
    Binding: Cancer Staging Method Value Set (preferred)
    ... device 0..1 Reference(Device | DeviceMetric) Not used in this profile
    ... referenceRange 0..* BackboneElement Not used in this profile
    ... hasMember 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Prognostic factors contributing to stage determination.
    ... component
    .... code 1..1 CodeableConcept Type of prognostic factor
    Binding: Cancer Staging Prognostic Factors Types (preferred)
    .... value[x] 0..1 CodeableConcept Prognostic factor value
    Binding: Cancer Staging Prognostic Factors Value (preferred)

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Observation.codepreferredCancerStageTypeVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-stage-type-vs
    from this IG
    Observation.value[x]preferredCancerStageValueVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-stage-value-vs
    from this IG
    Observation.methodpreferredCancerStagingMethodVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-method-vs
    from this IG
    Observation.component.codepreferredCancerStagingPrognosticFactorTypeVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-prognostic-factor-type-vs
    from this IG
    Observation.component.value[x]preferredCancerStagingPrognosticFactorValueVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-prognostic-factor-value-vs
    from this IG
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* USCoreSimpleObservationProfile assessment observation
    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
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... status ?!SΣ 1..1 code (USCDI) registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    .... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
    Binding: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


    ... code SΣ 1..1 CodeableConcept The type of stage information reported.
    Binding: Cancer Stage Type Value Set (preferred)
    ... subject SΣ 1..1 Reference(Cancer Patient Profile) (USCDI) Who and/or what the observation is about
    ... focus SΣ 0..* Reference(Primary Cancer Condition Profile) The cancer condition associated with staging assessment.
    ... effective[x] SΣ 0..1 (USCDI) Clinically relevant time/time-period for observation
    .... effectiveDateTime dateTime
    ... performer SΣ 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile) (USCDI) Who is responsible for the observation
    ... value[x] SΣC 0..1 CodeableConcept The value of the stage
    Binding: Cancer Stage Value Set (preferred)
    ... method S 0..1 CodeableConcept The staging system used.
    Binding: Cancer Staging Method Value Set (preferred)
    ... 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
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Prognostic factors contributing to stage determination.

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:us-corerequiredUSCoreSimpleObservationCategory
    http://hl7.org/fhir/us/core/ValueSet/us-core-simple-observation-category
    Observation.codepreferredCancerStageTypeVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-stage-type-vs
    from this IG
    Observation.value[x]preferredCancerStageValueVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-stage-value-vs
    from this IG
    Observation.methodpreferredCancerStagingMethodVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-method-vs
    from this IG
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* USCoreSimpleObservationProfile assessment observation
    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 BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... 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 (USCDI) registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    ... Slices for category S 1..* CodeableConcept (USCDI) Classification of type of observation
    Slice: Unordered, Open by pattern:$this
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    .... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
    Binding: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


    ... code SΣ 1..1 CodeableConcept The type of stage information reported.
    Binding: Cancer Stage Type Value Set (preferred)
    ... subject SΣ 1..1 Reference(Cancer Patient Profile) (USCDI) Who and/or what the observation is about
    ... focus SΣ 0..* Reference(Primary Cancer Condition Profile) The cancer condition associated with staging assessment.
    ... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
    ... effective[x] SΣ 0..1 (USCDI) Clinically relevant time/time-period for observation
    .... effectiveDateTime dateTime S
    .... effectivePeriod Period
    .... effectiveTiming Timing
    .... effectiveInstant instant
    ... issued Σ 0..1 instant Date/Time this version was made available
    ... performer SΣ 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile) (USCDI) Who is responsible for the observation
    ... value[x] SΣC 0..1 CodeableConcept S The value of the stage
    Binding: Cancer Stage Value Set (preferred)
    ... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    ... interpretation 0..* CodeableConcept High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


    ... note 0..* Annotation Comments about the observation
    ... bodySite 0..1 CodeableConcept Observed body part
    Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

    ... method S 0..1 CodeableConcept The staging system used.
    Binding: Cancer Staging Method Value Set (preferred)
    ... specimen 0..1 Reference(Specimen) Specimen used for this observation
    ... 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) Prognostic factors contributing to stage determination.
    ... derivedFrom Σ 0..* Reference(Observation | US Core DocumentReference Profile | US Core QuestionnaireResponse Profile | ImagingStudy | Media | MolecularSequence) (USCDI) US Core Profiles or other resource the observation is made from
    ... component Σ 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 Σ 1..1 CodeableConcept Type of prognostic factor
    Binding: Cancer Staging Prognostic Factors Types (preferred)
    .... value[x] Σ 0..1 CodeableConcept Prognostic factor value
    Binding: Cancer Staging Prognostic Factors Value (preferred)
    .... 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

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    Observation.languagepreferredCommonLanguages
    Additional Bindings Purpose
    AllLanguages Max Binding
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:us-corerequiredUSCoreSimpleObservationCategory
    http://hl7.org/fhir/us/core/ValueSet/us-core-simple-observation-category
    Observation.codepreferredCancerStageTypeVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-stage-type-vs
    from this IG
    Observation.value[x]preferredCancerStageValueVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-stage-value-vs
    from this IG
    Observation.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.bodySiteexampleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Observation.methodpreferredCancerStagingMethodVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-method-vs
    from this IG
    Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
    http://hl7.org/fhir/ValueSet/referencerange-meaning
    from the FHIR Standard
    Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
    http://hl7.org/fhir/ValueSet/referencerange-appliesto
    from the FHIR Standard
    Observation.component.codepreferredCancerStagingPrognosticFactorTypeVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-prognostic-factor-type-vs
    from this IG
    Observation.component.value[x]preferredCancerStagingPrognosticFactorValueVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-prognostic-factor-value-vs
    from this IG
    Observation.component.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard

    Differential View

    This structure is derived from USCoreSimpleObservationProfile

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation USCoreSimpleObservationProfile
    ... code 1..1 CodeableConcept The type of stage information reported.
    Binding: Cancer Stage Type Value Set (preferred)
    ... subject 1..1 Reference(Cancer Patient Profile) (USCDI) Who and/or what the observation is about
    ... focus S 0..* Reference(Primary Cancer Condition Profile) The cancer condition associated with staging assessment.
    ... method S 0..1 CodeableConcept The staging system used.
    Binding: Cancer Staging Method Value Set (preferred)
    ... device 0..1 Reference(Device | DeviceMetric) Not used in this profile
    ... referenceRange 0..* BackboneElement Not used in this profile
    ... hasMember 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Prognostic factors contributing to stage determination.
    ... component
    .... code 1..1 CodeableConcept Type of prognostic factor
    Binding: Cancer Staging Prognostic Factors Types (preferred)
    .... value[x] 0..1 CodeableConcept Prognostic factor value
    Binding: Cancer Staging Prognostic Factors Value (preferred)

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Observation.codepreferredCancerStageTypeVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-stage-type-vs
    from this IG
    Observation.value[x]preferredCancerStageValueVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-stage-value-vs
    from this IG
    Observation.methodpreferredCancerStagingMethodVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-method-vs
    from this IG
    Observation.component.codepreferredCancerStagingPrognosticFactorTypeVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-prognostic-factor-type-vs
    from this IG
    Observation.component.value[x]preferredCancerStagingPrognosticFactorValueVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-prognostic-factor-value-vs
    from this IG

    Key Elements View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* USCoreSimpleObservationProfile assessment observation
    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
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... status ?!SΣ 1..1 code (USCDI) registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    .... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
    Binding: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


    ... code SΣ 1..1 CodeableConcept The type of stage information reported.
    Binding: Cancer Stage Type Value Set (preferred)
    ... subject SΣ 1..1 Reference(Cancer Patient Profile) (USCDI) Who and/or what the observation is about
    ... focus SΣ 0..* Reference(Primary Cancer Condition Profile) The cancer condition associated with staging assessment.
    ... effective[x] SΣ 0..1 (USCDI) Clinically relevant time/time-period for observation
    .... effectiveDateTime dateTime
    ... performer SΣ 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile) (USCDI) Who is responsible for the observation
    ... value[x] SΣC 0..1 CodeableConcept The value of the stage
    Binding: Cancer Stage Value Set (preferred)
    ... method S 0..1 CodeableConcept The staging system used.
    Binding: Cancer Staging Method Value Set (preferred)
    ... 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
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Prognostic factors contributing to stage determination.

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:us-corerequiredUSCoreSimpleObservationCategory
    http://hl7.org/fhir/us/core/ValueSet/us-core-simple-observation-category
    Observation.codepreferredCancerStageTypeVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-stage-type-vs
    from this IG
    Observation.value[x]preferredCancerStageValueVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-stage-value-vs
    from this IG
    Observation.methodpreferredCancerStagingMethodVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-method-vs
    from this IG

    Snapshot View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* USCoreSimpleObservationProfile assessment observation
    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 BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... 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 (USCDI) registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    ... Slices for category S 1..* CodeableConcept (USCDI) Classification of type of observation
    Slice: Unordered, Open by pattern:$this
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    .... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
    Binding: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


    ... code SΣ 1..1 CodeableConcept The type of stage information reported.
    Binding: Cancer Stage Type Value Set (preferred)
    ... subject SΣ 1..1 Reference(Cancer Patient Profile) (USCDI) Who and/or what the observation is about
    ... focus SΣ 0..* Reference(Primary Cancer Condition Profile) The cancer condition associated with staging assessment.
    ... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
    ... effective[x] SΣ 0..1 (USCDI) Clinically relevant time/time-period for observation
    .... effectiveDateTime dateTime S
    .... effectivePeriod Period
    .... effectiveTiming Timing
    .... effectiveInstant instant
    ... issued Σ 0..1 instant Date/Time this version was made available
    ... performer SΣ 0..* Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile) (USCDI) Who is responsible for the observation
    ... value[x] SΣC 0..1 CodeableConcept S The value of the stage
    Binding: Cancer Stage Value Set (preferred)
    ... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    ... interpretation 0..* CodeableConcept High, low, normal, etc.
    Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


    ... note 0..* Annotation Comments about the observation
    ... bodySite 0..1 CodeableConcept Observed body part
    Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

    ... method S 0..1 CodeableConcept The staging system used.
    Binding: Cancer Staging Method Value Set (preferred)
    ... specimen 0..1 Reference(Specimen) Specimen used for this observation
    ... 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) Prognostic factors contributing to stage determination.
    ... derivedFrom Σ 0..* Reference(Observation | US Core DocumentReference Profile | US Core QuestionnaireResponse Profile | ImagingStudy | Media | MolecularSequence) (USCDI) US Core Profiles or other resource the observation is made from
    ... component Σ 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 Σ 1..1 CodeableConcept Type of prognostic factor
    Binding: Cancer Staging Prognostic Factors Types (preferred)
    .... value[x] Σ 0..1 CodeableConcept Prognostic factor value
    Binding: Cancer Staging Prognostic Factors Value (preferred)
    .... 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

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSetURI
    Observation.languagepreferredCommonLanguages
    Additional Bindings Purpose
    AllLanguages Max Binding
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:us-corerequiredUSCoreSimpleObservationCategory
    http://hl7.org/fhir/us/core/ValueSet/us-core-simple-observation-category
    Observation.codepreferredCancerStageTypeVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-stage-type-vs
    from this IG
    Observation.value[x]preferredCancerStageValueVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-stage-value-vs
    from this IG
    Observation.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard
    Observation.bodySiteexampleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Observation.methodpreferredCancerStagingMethodVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-method-vs
    from this IG
    Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
    http://hl7.org/fhir/ValueSet/referencerange-meaning
    from the FHIR Standard
    Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
    http://hl7.org/fhir/ValueSet/referencerange-appliesto
    from the FHIR Standard
    Observation.component.codepreferredCancerStagingPrognosticFactorTypeVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-prognostic-factor-type-vs
    from this IG
    Observation.component.value[x]preferredCancerStagingPrognosticFactorValueVS
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-staging-prognostic-factor-value-vs
    from this IG
    Observation.component.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard

     

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