minimal Common Oncology Data Elements (mCODE) Implementation Guide
4.0.0-ballot - STU4 Ballot 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-ballot 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 Disease Status Profile

Official URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status Version: 4.0.0-ballot
Active as of 2024-04-03 Maturity Level: 3 Computable Name: CancerDiseaseStatus
Other Identifiers: OID:2.16.840.1.113883.4.642.40.15.42.6

A clinician’s qualitative judgment on the current trend of the cancer, e.g., whether it is stable, worsening (progressing), or improving (responding). The judgment may be based a single type or multiple kinds of evidence, such as imaging data, assessment of symptoms, tumor markers, laboratory data, etc.

Conformance

Observation resources associated with an in-scope patient with Observation.code LOINC 97509-4 SHALL conform to this profile. Beyond this requirement, a producer of resources SHOULD ensure that any resource instance associated with an in-scope patient that would reasonably be expected to conform to this profile SHOULD be published in this form.

In some cases, multiple values for Cancer Disease Status may be true at the same time. For example, a patient’s condition may have improved AND the patient is in partial remission. However, this profile is derived from the Observation resource, which restricts value[x] to one value. If a patient has experienced multiple values for Cancer Disease Status, multiple instances should be created.

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 Observation

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation 0..*ObservationMeasurements and simple assertions
    ... Slices for extension 0..*ExtensionExtension
    Slice: Unordered, Open by value:url
    ... evidenceType S0..*CodeableConceptCancer Disease Status Evidence Type Extension
    URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status-evidence-type
    Binding: Cancer Disease Status Evidence Type Value Set (required)
    ... status S1..1coderegistered | preliminary | final | amended +
    .... coding1..*CodingCode defined by a terminology system
    Fixed Value: (complex)
    ..... system1..1uriIdentity of the terminology system
    Fixed Value: http://loinc.org
    ..... code1..1codeSymbol in syntax defined by the system
    Fixed Value: 97509-4
    ... subject S1..1Reference(Cancer Patient Profile)Who and/or what the observation is about
    ... focus S0..*Reference(US Core Condition Problems and Health Concerns Profile | Tumor Profile | Radiotherapy Volume Profile)What the observation is about, when it is not about the subject of record
    ... effective[x] S0..1dateTimeClinically relevant time/time-period for observation
    ... performer 0..*Reference(US Core Practitioner Profile)Who is responsible for the observation
    ... value[x] S0..1CodeableConceptActual result
    Binding: Condition Status Trend Value Set (preferred)
    Additional BindingsPurpose
    Condition Status Trend Maximum Value SetMax Binding
    ... specimen 0..1Reference(Specimen)Not used in this profile
    ... device 0..1Reference(Device | DeviceMetric)Not used in this profile
    ... referenceRange 0..*BackboneElementNot used in this profile
    ... hasMember 0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Not used in this profile
    ... component 0..*BackboneElementNot used in this profile

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Observation.value[x]preferredConditionStatusTrendVS
    Additional Bindings Purpose
    Condition Status Trend Maximum Value Set Max Binding
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-condition-status-trend-vs
    from this IG
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C0..*ObservationMeasurements and simple assertions
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    ... implicitRules ?!Σ0..1uriA set of rules under which this content was created
    ... Slices for extension 0..*ExtensionExtension
    Slice: Unordered, Open by value:url
    ... evidenceType S0..*CodeableConceptCancer Disease Status Evidence Type Extension
    URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status-evidence-type
    Binding: Cancer Disease Status Evidence Type Value Set (required)
    ... status ?!SΣ1..1coderegistered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    ... code SΣ1..1CodeableConceptType of observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    .... coding1..*CodingCode defined by a terminology system
    Fixed Value: (complex)
    ..... system1..1uriIdentity of the terminology system
    Fixed Value: http://loinc.org
    ..... code1..1codeSymbol in syntax defined by the system
    Fixed Value: 97509-4
    ... subject SΣ1..1Reference(Cancer Patient Profile)Who and/or what the observation is about
    ... focus SΣ0..*Reference(US Core Condition Problems and Health Concerns Profile | Tumor Profile | Radiotherapy Volume Profile)What the observation is about, when it is not about the subject of record
    ... effective[x] SΣ0..1dateTimeClinically relevant time/time-period for observation
    ... performer Σ0..*Reference(US Core Practitioner Profile)Who is responsible for the observation
    ... value[x] SΣC0..1CodeableConceptActual result
    Binding: Condition Status Trend Value Set (preferred)
    Additional BindingsPurpose
    Condition Status Trend Maximum Value SetMax Binding
    ... specimen 0..1Reference(Specimen)Not used in this profile
    ... device 0..1Reference(Device | DeviceMetric)Not used in this profile
    ... referenceRange C0..*BackboneElementNot used in this profile
    obs-3: Must have at least a low or a high or text
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    ... hasMember Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Not used in this profile
    ... component Σ0..*BackboneElementNot used in this profile
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... code Σ1..1CodeableConceptType of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.codeexamplePattern: LOINC code 97509-4
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.value[x]preferredConditionStatusTrendVS
    Additional Bindings Purpose
    Condition Status Trend Maximum Value Set Max Binding
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-condition-status-trend-vs
    from this IG
    Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C0..*ObservationMeasurements and simple assertions
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    ... id Σ0..1idLogical id of this artifact
    ... meta Σ0..1MetaMetadata about the resource
    ... implicitRules ?!Σ0..1uriA set of rules under which this content was created
    ... language 0..1codeLanguage of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguagesMax Binding
    ... text 0..1NarrativeText summary of the resource, for human interpretation
    ... contained 0..*ResourceContained, inline Resources
    ... Slices for extension 0..*ExtensionExtension
    Slice: Unordered, Open by value:url
    ... evidenceType S0..*CodeableConceptCancer Disease Status Evidence Type Extension
    URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status-evidence-type
    Binding: Cancer Disease Status Evidence Type Value Set (required)
    ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
    ... identifier Σ0..*IdentifierBusiness Identifier for observation
    ... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
    ... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
    ... status ?!SΣ1..1coderegistered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    ... category 0..*CodeableConceptClassification of type of observation
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    ... code SΣ1..1CodeableConceptType of observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    .... id0..1stringUnique id for inter-element referencing
    .... extension0..*ExtensionAdditional content defined by implementations
    .... coding1..*CodingCode defined by a terminology system
    Fixed Value: (complex)
    ..... id0..1stringUnique id for inter-element referencing
    ..... extension0..*ExtensionAdditional content defined by implementations
    ..... system1..1uriIdentity of the terminology system
    Fixed Value: http://loinc.org
    ..... version0..1stringVersion of the system - if relevant
    ..... code1..1codeSymbol in syntax defined by the system
    Fixed Value: 97509-4
    ..... display0..1stringRepresentation defined by the system
    ..... userSelected0..1booleanIf this coding was chosen directly by the user
    .... text0..1stringPlain text representation of the concept
    ... subject SΣ1..1Reference(Cancer Patient Profile)Who and/or what the observation is about
    ... focus SΣ0..*Reference(US Core Condition Problems and Health Concerns Profile | Tumor Profile | Radiotherapy Volume Profile)What the observation is about, when it is not about the subject of record
    ... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
    ... effective[x] SΣ0..1dateTimeClinically relevant time/time-period for observation
    ... issued Σ0..1instantDate/Time this version was made available
    ... performer Σ0..*Reference(US Core Practitioner Profile)Who is responsible for the observation
    ... value[x] SΣC0..1CodeableConceptActual result
    Binding: Condition Status Trend Value Set (preferred)
    Additional BindingsPurpose
    Condition Status Trend Maximum Value SetMax Binding
    ... dataAbsentReason C0..1CodeableConceptWhy the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

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


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

    ... method 0..1CodeableConceptHow it was done
    Binding: ObservationMethods (example): Methods for simple observations.

    ... specimen 0..1Reference(Specimen)Not used in this profile
    ... device 0..1Reference(Device | DeviceMetric)Not used in this profile
    ... referenceRange C0..*BackboneElementNot used in this profile
    obs-3: Must have at least a low or a high or text
    .... id 0..1stringUnique id for inter-element referencing
    .... extension 0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... low C0..1SimpleQuantityLow Range, if relevant
    .... high C0..1SimpleQuantityHigh Range, if relevant
    .... type 0..1CodeableConceptReference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

    .... appliesTo 0..*CodeableConceptReference range population
    Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


    .... age 0..1RangeApplicable age range, if relevant
    .... text 0..1stringText based reference range in an observation
    ... hasMember Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Not used in this profile
    ... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from
    ... component Σ0..*BackboneElementNot used in this profile
    .... id 0..1stringUnique id for inter-element referencing
    .... extension 0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... code Σ1..1CodeableConceptType of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.

    .... value[x] Σ0..1Actual component result
    ..... valueQuantityQuantity
    ..... valueCodeableConceptCodeableConcept
    ..... valueStringstring
    ..... valueBooleanboolean
    ..... valueIntegerinteger
    ..... valueRangeRange
    ..... valueRatioRatio
    ..... valueSampledDataSampledData
    ..... valueTimetime
    ..... valueDateTimedateTime
    ..... valuePeriodPeriod
    .... dataAbsentReason C0..1CodeableConceptWhy the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    .... interpretation 0..*CodeableConceptHigh, 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

    PathConformanceValueSet / CodeURI
    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.codeexamplePattern: LOINC code 97509-4
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.value[x]preferredConditionStatusTrendVS
    Additional Bindings Purpose
    Condition Status Trend Maximum Value Set Max Binding
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-condition-status-trend-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.methodexampleObservationMethods
    http://hl7.org/fhir/ValueSet/observation-methods
    from the FHIR Standard
    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.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    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 Observation

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation 0..*ObservationMeasurements and simple assertions
    ... Slices for extension 0..*ExtensionExtension
    Slice: Unordered, Open by value:url
    ... evidenceType S0..*CodeableConceptCancer Disease Status Evidence Type Extension
    URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status-evidence-type
    Binding: Cancer Disease Status Evidence Type Value Set (required)
    ... status S1..1coderegistered | preliminary | final | amended +
    .... coding1..*CodingCode defined by a terminology system
    Fixed Value: (complex)
    ..... system1..1uriIdentity of the terminology system
    Fixed Value: http://loinc.org
    ..... code1..1codeSymbol in syntax defined by the system
    Fixed Value: 97509-4
    ... subject S1..1Reference(Cancer Patient Profile)Who and/or what the observation is about
    ... focus S0..*Reference(US Core Condition Problems and Health Concerns Profile | Tumor Profile | Radiotherapy Volume Profile)What the observation is about, when it is not about the subject of record
    ... effective[x] S0..1dateTimeClinically relevant time/time-period for observation
    ... performer 0..*Reference(US Core Practitioner Profile)Who is responsible for the observation
    ... value[x] S0..1CodeableConceptActual result
    Binding: Condition Status Trend Value Set (preferred)
    Additional BindingsPurpose
    Condition Status Trend Maximum Value SetMax Binding
    ... specimen 0..1Reference(Specimen)Not used in this profile
    ... device 0..1Reference(Device | DeviceMetric)Not used in this profile
    ... referenceRange 0..*BackboneElementNot used in this profile
    ... hasMember 0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Not used in this profile
    ... component 0..*BackboneElementNot used in this profile

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Observation.value[x]preferredConditionStatusTrendVS
    Additional Bindings Purpose
    Condition Status Trend Maximum Value Set Max Binding
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-condition-status-trend-vs
    from this IG

    Key Elements View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C0..*ObservationMeasurements and simple assertions
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    ... implicitRules ?!Σ0..1uriA set of rules under which this content was created
    ... Slices for extension 0..*ExtensionExtension
    Slice: Unordered, Open by value:url
    ... evidenceType S0..*CodeableConceptCancer Disease Status Evidence Type Extension
    URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status-evidence-type
    Binding: Cancer Disease Status Evidence Type Value Set (required)
    ... status ?!SΣ1..1coderegistered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    ... code SΣ1..1CodeableConceptType of observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    .... coding1..*CodingCode defined by a terminology system
    Fixed Value: (complex)
    ..... system1..1uriIdentity of the terminology system
    Fixed Value: http://loinc.org
    ..... code1..1codeSymbol in syntax defined by the system
    Fixed Value: 97509-4
    ... subject SΣ1..1Reference(Cancer Patient Profile)Who and/or what the observation is about
    ... focus SΣ0..*Reference(US Core Condition Problems and Health Concerns Profile | Tumor Profile | Radiotherapy Volume Profile)What the observation is about, when it is not about the subject of record
    ... effective[x] SΣ0..1dateTimeClinically relevant time/time-period for observation
    ... performer Σ0..*Reference(US Core Practitioner Profile)Who is responsible for the observation
    ... value[x] SΣC0..1CodeableConceptActual result
    Binding: Condition Status Trend Value Set (preferred)
    Additional BindingsPurpose
    Condition Status Trend Maximum Value SetMax Binding
    ... specimen 0..1Reference(Specimen)Not used in this profile
    ... device 0..1Reference(Device | DeviceMetric)Not used in this profile
    ... referenceRange C0..*BackboneElementNot used in this profile
    obs-3: Must have at least a low or a high or text
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    ... hasMember Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Not used in this profile
    ... component Σ0..*BackboneElementNot used in this profile
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... code Σ1..1CodeableConceptType of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.codeexamplePattern: LOINC code 97509-4
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.value[x]preferredConditionStatusTrendVS
    Additional Bindings Purpose
    Condition Status Trend Maximum Value Set Max Binding
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-condition-status-trend-vs
    from this IG
    Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard

    Snapshot View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C0..*ObservationMeasurements and simple assertions
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    ... id Σ0..1idLogical id of this artifact
    ... meta Σ0..1MetaMetadata about the resource
    ... implicitRules ?!Σ0..1uriA set of rules under which this content was created
    ... language 0..1codeLanguage of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguagesMax Binding
    ... text 0..1NarrativeText summary of the resource, for human interpretation
    ... contained 0..*ResourceContained, inline Resources
    ... Slices for extension 0..*ExtensionExtension
    Slice: Unordered, Open by value:url
    ... evidenceType S0..*CodeableConceptCancer Disease Status Evidence Type Extension
    URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status-evidence-type
    Binding: Cancer Disease Status Evidence Type Value Set (required)
    ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
    ... identifier Σ0..*IdentifierBusiness Identifier for observation
    ... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
    ... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
    ... status ?!SΣ1..1coderegistered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    ... category 0..*CodeableConceptClassification of type of observation
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    ... code SΣ1..1CodeableConceptType of observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    Required Pattern: At least the following
    .... id0..1stringUnique id for inter-element referencing
    .... extension0..*ExtensionAdditional content defined by implementations
    .... coding1..*CodingCode defined by a terminology system
    Fixed Value: (complex)
    ..... id0..1stringUnique id for inter-element referencing
    ..... extension0..*ExtensionAdditional content defined by implementations
    ..... system1..1uriIdentity of the terminology system
    Fixed Value: http://loinc.org
    ..... version0..1stringVersion of the system - if relevant
    ..... code1..1codeSymbol in syntax defined by the system
    Fixed Value: 97509-4
    ..... display0..1stringRepresentation defined by the system
    ..... userSelected0..1booleanIf this coding was chosen directly by the user
    .... text0..1stringPlain text representation of the concept
    ... subject SΣ1..1Reference(Cancer Patient Profile)Who and/or what the observation is about
    ... focus SΣ0..*Reference(US Core Condition Problems and Health Concerns Profile | Tumor Profile | Radiotherapy Volume Profile)What the observation is about, when it is not about the subject of record
    ... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
    ... effective[x] SΣ0..1dateTimeClinically relevant time/time-period for observation
    ... issued Σ0..1instantDate/Time this version was made available
    ... performer Σ0..*Reference(US Core Practitioner Profile)Who is responsible for the observation
    ... value[x] SΣC0..1CodeableConceptActual result
    Binding: Condition Status Trend Value Set (preferred)
    Additional BindingsPurpose
    Condition Status Trend Maximum Value SetMax Binding
    ... dataAbsentReason C0..1CodeableConceptWhy the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

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


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

    ... method 0..1CodeableConceptHow it was done
    Binding: ObservationMethods (example): Methods for simple observations.

    ... specimen 0..1Reference(Specimen)Not used in this profile
    ... device 0..1Reference(Device | DeviceMetric)Not used in this profile
    ... referenceRange C0..*BackboneElementNot used in this profile
    obs-3: Must have at least a low or a high or text
    .... id 0..1stringUnique id for inter-element referencing
    .... extension 0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... low C0..1SimpleQuantityLow Range, if relevant
    .... high C0..1SimpleQuantityHigh Range, if relevant
    .... type 0..1CodeableConceptReference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

    .... appliesTo 0..*CodeableConceptReference range population
    Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


    .... age 0..1RangeApplicable age range, if relevant
    .... text 0..1stringText based reference range in an observation
    ... hasMember Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Not used in this profile
    ... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from
    ... component Σ0..*BackboneElementNot used in this profile
    .... id 0..1stringUnique id for inter-element referencing
    .... extension 0..*ExtensionAdditional content defined by implementations
    .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
    .... code Σ1..1CodeableConceptType of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.

    .... value[x] Σ0..1Actual component result
    ..... valueQuantityQuantity
    ..... valueCodeableConceptCodeableConcept
    ..... valueStringstring
    ..... valueBooleanboolean
    ..... valueIntegerinteger
    ..... valueRangeRange
    ..... valueRatioRatio
    ..... valueSampledDataSampledData
    ..... valueTimetime
    ..... valueDateTimedateTime
    ..... valuePeriodPeriod
    .... dataAbsentReason C0..1CodeableConceptWhy the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    .... interpretation 0..*CodeableConceptHigh, 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

    PathConformanceValueSet / CodeURI
    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.codeexamplePattern: LOINC code 97509-4
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.value[x]preferredConditionStatusTrendVS
    Additional Bindings Purpose
    Condition Status Trend Maximum Value Set Max Binding
    http://hl7.org/fhir/us/mcode/ValueSet/mcode-condition-status-trend-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.methodexampleObservationMethods
    http://hl7.org/fhir/ValueSet/observation-methods
    from the FHIR Standard
    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.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    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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