Mandatory Data Elements

The following data elements must always be present or must be supported if the data is present in the sending system (Must Support definition). They are presented below with a simple human-readable explanation. Profile specific guidance and examples are provided as well. The Formal Profile Definition below provides the formal summary, definitions, and terminology requirements.

Each Symptom SHALL Have:

1. a status
2. a category - one repetition must be set to 'symptom'
3. a code (LOINC: 75325-1) that indicates this is a Symptom observation
4. a patient
5. a dateTime or period detailing when the symptom was note present
6. a performer of either the Patient or a RelatedPerson who provided the information about the symptom
7. a valueCodeableConcept that provides the code identifying the specific symptom

Each Symptom SHALL support:

1. bodySite - a code representing where the patient feels the symptom in the body

Each Symptom SHALL NOT provide:

1. a data absent reason - if there is no data about the symptom, then just do not provide information about that symptom
2. an interpretation code or a reference range - those apply to observations in general but not to symptom observations
3. a specimen or device - those do not apply to symptom observations

Other Important Data Elements

In a normal profile, we would indicate the remaining data elements using the Must Support flag. But since the expected use of this IG is that other IGs would further constrain the Symptoms profile for their own use, we have intentionally not used the Must Support flag so as not to imply any additionally required conformance statements. Instead, we have indicated data elements that were considered important to convey. These elements are the following:

1. issued - when the symptoms information was recorded. This is different from the effective dateTime or period.
2. note - a text description of the symptom provided by the patient or caregiver
3. associatedSymptom extension - used to associate other symptoms with this symptom for arbitrary groupings
4. associatedCondition extension - used to indicate a relationship between this symptom and a condition, eg. a symptom known to be due to a patient's condition

Component Observations of the Symptom

A lot of the structured information of the Symptom is profiled in the component observations. These component observations do not have a life of their own but are tied to the symptom itself. Every component observation has a note extension and does not allow a data absent reason, interpretation, or reference range element.

The following component observations allow for an assessment scale code or reference to an asssessment scale collection observation to be provided:

1. Quality - a patient's internal perception of the symptom. This is represented by the LOINC code 56823-8 and a value that is the quality.
2. Severity - the intensity with which the patient experiences the symptom. This is represented by the LOINC code 64750-3 and a value that is the severity.

The following component observations have no assessment scale attached to them:

1. Functional Impact - How the symptom affects the patient's daily activities. This is represented by a code taken from the WHO's International Classification of Functioning, Disability and Health code system. As well, a Functional Assessment Collection can be provided to give more details of the functional impact.
2. Clinical Course - the character of the symptom onset. This is represented by the LOINC code 89261-2 and a value that is the clinical course.
3. Trend - whether a symptom is improving, worsening, stable, or resolved. This is represented by the LOINC code 89253-9 and a value that is the trend.
4. Affective Grade - the emotional or mental impact of the symptom. This is represented by the SNOMED code 279116004 (Affective response to pain) and a value that is the affective grade.
5. Triggers or Exacerbating Factors - these are factors which either trigger the symptom or exacerbate the symptom. This is represented by the LOINC code 100752-5 and a value that is the factor. It also provides an extension to indicate a medication that is believed to cause or exacerbate the symptom.
6. Alleviating Factors - patient-reported actions, conditions, events, or other factors that decrease the symptoms. This is represented by the LOINC code 100753-3 and a value that is the factor. It also provides an extension to indicate a medication that is believed to alleviate the symptom.
7. Other Events - this is a catch-all to report other events that were occurring at the time of the symptom onset but were not considered triggers. This is represented by the code OTHEREVENTS and a value that is the event.
8. Frequency - how often the patient experiences the symptom. This is represented by the LOINC code 104156-5 and either a code that represents the frequency or a Ratio to express frequencies such as 2x/day.
9. Speed Of Onset - the rate at which the symptom becomes apparent. This is represented by the LOINC code 99495-4 and a value that is the speed of onset.

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: obs-6, obs-7
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:associatedSymptom		0..*	(Complex)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo"
value[x]		1..1	Reference(Symptom Observation | Symptom Absent Observation)	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Other symptoms associated with this symptom
extension:associatedCondition		0..*	(Complex)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo"
value[x]		1..1	Reference(Condition)	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Conditions with some relationship to this symptom
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:symptomCode	S	1..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://hl7.org/fhir/uv/symptoms/CodeSystem/SymptomTemporary
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: symptom
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 75325-1
display		1..1	string	Representation defined by the system Fixed Value: Symptom
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(Patient)	The patient who is experiencing the symptom
effective[x]	SΣ	1..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Instant when symptom recorded
performer	SΣ	1..1	Reference(Patient | RelatedPerson)	The person who is reporting the symptom information
value[x]	SΣC	1..1	CodeableConcept	Coded description of symptom Binding: Common Set of Symptom Codes (preferred) Additional Bindings Purpose SNOMEDCTClinicalFindings Max Binding
note		0..*	Annotation	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient or caregiver description of symptom
bodySite	S	0..1	CodeableConcept	Where the patient feels the symptom in the body Binding: SNOMEDCTBodyStructures (preferred)
Slices for component	Σ	0..*	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Various information about the symptom Slice: Unordered, Open by value:code
component:All Slices				Content/Rules for all slices
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	Annotation	Additional notes that apply to this resource or element. URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	1..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
component:quality	Σ	0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 The patient's internal perception of the symptom
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the symptom quality URL: http://hl7.org/fhir/StructureDefinition/note
extension:scaleCode		0..1	CodeableConcept, Reference(Assessment Scale Collection Observation)	Assessment Scale Information URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/AssessmentScaleInformation
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 56823-8
display		1..1	string	Representation defined by the system Fixed Value: Problem quality or description
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Code that represents the symptom quality Binding: Quality Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL4459-5 Preferred LOINC binding when SNOMED is unavailable
component:severity	Σ	0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 The intensity with which the patient experiences the symptom
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the symptom severity URL: http://hl7.org/fhir/StructureDefinition/note
extension:scaleCode		0..1	CodeableConcept, Reference(Assessment Scale Collection Observation)	Assessment Scale Information URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/AssessmentScaleInformation
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 64750-3
display		1..1	string	Representation defined by the system Fixed Value: Severity of symptoms
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Actual component result Binding: Severity Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL1156-0 Preferred LOINC binding when SNOMED is unavailable
component:functionalImpact	Σ	0..*	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How the symptom affects the patient's daily activities
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the impact URL: http://hl7.org/fhir/StructureDefinition/note
extension:functionalAssessment		0..1	Reference(Functional Assessment Collection)	Functional Assessment URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/FunctionalAssessment
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Code for the functional impact being described Binding: Functional Classification Codes (required)
value[x]	Σ	1..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
component:clinicalCourse	Σ	0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Character of symptom onset
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the clinical course of the symptom URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 89261-2
display		1..1	string	Representation defined by the system Fixed Value: Clinical course
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Actual component result Binding: Clinical Course Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL4997-4 Preferred LOINC binding when SNOMED is unavailable
component:trend	Σ	0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Whether a condition is improving, worsening, stable, or resolved.
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the symptom trend URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 89253-9
display		1..1	string	Representation defined by the system Fixed Value: Trend
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Actual component result Binding: Trend Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL4938-8 Preferred LOINC binding when SNOMED is unavailable
component:affectiveGrade	Σ	0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Emotional or mental impact of a symptom
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the impact of the symptom URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 279116004
display		1..1	string	Representation defined by the system Fixed Value: Affective response to pain
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Code that represents the affective grade Binding: Affective Grade (preferred)
component:triggersOrExacerbatingFactors	Σ	0..*	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient reported actions, conditions, events, physical objects or other factors that initiate, increase or worsen symptoms
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the event URL: http://hl7.org/fhir/StructureDefinition/note
extension:relatedMedication		0..*	Reference(MedicationStatement)	Surrounding Event Medication URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/SurroundingEventMedication
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Code for the specific type of event Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 100752-5
display		1..1	string	Representation defined by the system Fixed Value: Exacerbating factors - Reported
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Code or string describing the specific event Binding: Triggers or Exacerbating Factor Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL6278-7 Preferred LOINC binding when SNOMED is unavailable
component:alleviatingFactors	Σ	0..*	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient-reported actions, conditions, events, or other factors that decrease the symptoms or condition
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the event URL: http://hl7.org/fhir/StructureDefinition/note
extension:relatedMedication		0..*	Reference(MedicationStatement)	Surrounding Event Medication URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/SurroundingEventMedication
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Code for the specific type of event Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 100753-3
display		1..1	string	Representation defined by the system Fixed Value: Alleviating factors - Reported
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Code or string describing the specific event Binding: Alleviating Factor Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL6279-5 Preferred LOINC binding when SNOMED is unavailable
component:otherEvents	Σ	0..*	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient-reported actions that were occuring at time of symptom onset
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the event URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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/symptoms/CodeSystem/SymptomTemporary
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: OTHEREVENT
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Code or string describing the specific event Binding: Other Event Codes (example)
component:frequency	Σ	0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How often the patient experiences the symptom.
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the reported frequency URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 104156-5
display		1..1	string	Representation defined by the system Fixed Value: Condition frequency - Reported
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for value[x]	Σ	1..1		Actual component result Slice: Unordered, Closed by type:$this
valueCodeableConcept			CodeableConcept
valueRatio			Ratio
value[x]:valueCodeableConcept	Σ	0..1	CodeableConcept	Actual component result Binding: Frequency Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL6514-5 Preferred LOINC binding when SNOMED is unavailable
value[x]:valueRatio	Σ	0..1	Ratio	Actual component result
component:speedOfOnset	Σ	0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 The rate at which a physiological symptom became apparent.
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the reported speed of onset URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 99495-4
display		1..1	string	Representation defined by the system Fixed Value: Speed of condition onset
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Actual component result Binding: Speed of Onset (preferred)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:symptomCode	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.value[x]	Base	preferred	Common Set of Symptom Codes	📦0.1.0	This IG
Observation.bodySite	Base	preferred	SNOMED CT Body Structures	📦4.0.1	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:quality.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:quality.​value[x]	Base	preferred	Quality Codes	📦0.1.0	This IG
Observation.component:severity.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:severity.​value[x]	Base	preferred	Severity Codes	📦0.1.0	This IG
Observation.component:functionalImpact.​code	Base	required	Functional Classification Codes	📦0.1.0	This IG
Observation.component:clinicalCourse.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:clinicalCourse.​value[x]	Base	preferred	Clinical Course Codes	📦0.1.0	This IG
Observation.component:trend.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:trend.​value[x]	Base	preferred	Trend Codes	📦0.1.0	This IG
Observation.component:affectiveGrade.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:affectiveGrade.​value[x]	Base	preferred	Affective Grade	📦0.1.0	This IG
Observation.component:triggersOrExacerbatingFactors.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:triggersOrExacerbatingFactors.​value[x]	Base	preferred	Triggers or Exacerbating Factor Codes	📦0.1.0	This IG
Observation.component:alleviatingFactors.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:alleviatingFactors.​value[x]	Base	preferred	Alleviating Factor Codes	📦0.1.0	This IG
Observation.component:otherEvents.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:otherEvents.​value[x]	Base	example	Other Event Codes	📦0.1.0	This IG
Observation.component:frequency.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:frequency.​value[x]:valueCodeableConcept	Base	preferred	Frequency Codes	📦0.1.0	This IG
Observation.component:speedOfOnset.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:speedOfOnset.​value[x]	Base	preferred	Speed of Onset	📦0.1.0	This IG

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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-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.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

This structure is derived from Observation

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation		0..*	Observation	Measurements and simple assertions
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:associatedSymptom		0..*	(Complex)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
value[x]		1..1	Reference(Symptom Observation | Symptom Absent Observation)	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Other symptoms associated with this symptom
extension:associatedCondition		0..*	(Complex)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
value[x]		1..1	Reference(Condition)	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Conditions with some relationship to this symptom
status	S	1..1	code	registered | preliminary | final | amended +
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:$this
category:symptomCode	S	1..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://hl7.org/fhir/uv/symptoms/CodeSystem/SymptomTemporary
code		1..1	code	Symbol in syntax defined by the system Fixed Value: symptom
code	S	1..1	CodeableConcept	Type of observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 75325-1
display		1..1	string	Representation defined by the system Fixed Value: Symptom
subject	S	1..1	Reference(Patient)	The patient who is experiencing the symptom
effective[x]	S	1..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
issued		0..1	instant	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Instant when symptom recorded
performer	S	1..1	Reference(Patient | RelatedPerson)	The person who is reporting the symptom information
value[x]	S	1..1	CodeableConcept	Coded description of symptom Binding: Common Set of Symptom Codes (preferred) Additional Bindings Purpose SNOMEDCTClinicalFindings Max Binding
dataAbsentReason		0..0
interpretation		0..0
note		0..*	Annotation	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient or caregiver description of symptom
bodySite	S	0..1	CodeableConcept	Where the patient feels the symptom in the body Binding: SNOMEDCTBodyStructures (preferred)
specimen		0..0
device		0..0
referenceRange		0..0
Slices for component		0..*	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Various information about the symptom Slice: Unordered, Open by value:code
component:All Slices				Content/Rules for all slices
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	Annotation	Additional notes that apply to this resource or element. URL: http://hl7.org/fhir/StructureDefinition/note
value[x]		1..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual component result
dataAbsentReason		0..0
interpretation		0..0
referenceRange		0..0
component:quality		0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 The patient's internal perception of the symptom
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the symptom quality URL: http://hl7.org/fhir/StructureDefinition/note
extension:scaleCode		0..1	CodeableConcept, Reference(Assessment Scale Collection Observation)	Assessment Scale Information URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/AssessmentScaleInformation
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 56823-8
display		1..1	string	Representation defined by the system Fixed Value: Problem quality or description
value[x]		1..1	CodeableConcept	Code that represents the symptom quality Binding: Quality Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL4459-5 Preferred LOINC binding when SNOMED is unavailable
component:severity		0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 The intensity with which the patient experiences the symptom
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the symptom severity URL: http://hl7.org/fhir/StructureDefinition/note
extension:scaleCode		0..1	CodeableConcept, Reference(Assessment Scale Collection Observation)	Assessment Scale Information URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/AssessmentScaleInformation
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 64750-3
display		1..1	string	Representation defined by the system Fixed Value: Severity of symptoms
value[x]		1..1	CodeableConcept	Actual component result Binding: Severity Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL1156-0 Preferred LOINC binding when SNOMED is unavailable
component:functionalImpact		0..*	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How the symptom affects the patient's daily activities
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the impact URL: http://hl7.org/fhir/StructureDefinition/note
extension:functionalAssessment		0..1	Reference(Functional Assessment Collection)	Functional Assessment URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/FunctionalAssessment
code		1..1	CodeableConcept	Code for the functional impact being described Binding: Functional Classification Codes (required)
component:clinicalCourse		0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Character of symptom onset
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the clinical course of the symptom URL: http://hl7.org/fhir/StructureDefinition/note
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 89261-2
display		1..1	string	Representation defined by the system Fixed Value: Clinical course
value[x]		1..1	CodeableConcept	Actual component result Binding: Clinical Course Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL4997-4 Preferred LOINC binding when SNOMED is unavailable
component:trend		0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Whether a condition is improving, worsening, stable, or resolved.
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the symptom trend URL: http://hl7.org/fhir/StructureDefinition/note
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 89253-9
display		1..1	string	Representation defined by the system Fixed Value: Trend
value[x]		1..1	CodeableConcept	Actual component result Binding: Trend Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL4938-8 Preferred LOINC binding when SNOMED is unavailable
component:affectiveGrade		0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Emotional or mental impact of a symptom
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the impact of the symptom URL: http://hl7.org/fhir/StructureDefinition/note
code		1..1	CodeableConcept	Type of component observation (code / type) 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://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 279116004
display		1..1	string	Representation defined by the system Fixed Value: Affective response to pain
value[x]		1..1	CodeableConcept	Code that represents the affective grade Binding: Affective Grade (preferred)
component:triggersOrExacerbatingFactors		0..*	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient reported actions, conditions, events, physical objects or other factors that initiate, increase or worsen symptoms
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the event URL: http://hl7.org/fhir/StructureDefinition/note
extension:relatedMedication		0..*	Reference(MedicationStatement)	Surrounding Event Medication URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/SurroundingEventMedication
code		1..1	CodeableConcept	Code for the specific type of event Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 100752-5
display		1..1	string	Representation defined by the system Fixed Value: Exacerbating factors - Reported
value[x]		1..1	CodeableConcept	Code or string describing the specific event Binding: Triggers or Exacerbating Factor Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL6278-7 Preferred LOINC binding when SNOMED is unavailable
component:alleviatingFactors		0..*	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient-reported actions, conditions, events, or other factors that decrease the symptoms or condition
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the event URL: http://hl7.org/fhir/StructureDefinition/note
extension:relatedMedication		0..*	Reference(MedicationStatement)	Surrounding Event Medication URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/SurroundingEventMedication
code		1..1	CodeableConcept	Code for the specific type of event Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 100753-3
display		1..1	string	Representation defined by the system Fixed Value: Alleviating factors - Reported
value[x]		1..1	CodeableConcept	Code or string describing the specific event Binding: Alleviating Factor Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL6279-5 Preferred LOINC binding when SNOMED is unavailable
component:otherEvents		0..*	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient-reported actions that were occuring at time of symptom onset
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the event URL: http://hl7.org/fhir/StructureDefinition/note
code		1..1	CodeableConcept	Type of component observation (code / type) 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://hl7.org/fhir/uv/symptoms/CodeSystem/SymptomTemporary
code		1..1	code	Symbol in syntax defined by the system Fixed Value: OTHEREVENT
value[x]		1..1	CodeableConcept	Code or string describing the specific event Binding: Other Event Codes (example)
component:frequency		0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How often the patient experiences the symptom.
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the reported frequency URL: http://hl7.org/fhir/StructureDefinition/note
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 104156-5
display		1..1	string	Representation defined by the system Fixed Value: Condition frequency - Reported
Slices for value[x]		1..1		Actual component result Slice: Unordered, Open by type:$this
valueCodeableConcept			CodeableConcept
valueRatio			Ratio
value[x]:valueCodeableConcept		0..1	CodeableConcept	Actual component result Binding: Frequency Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL6514-5 Preferred LOINC binding when SNOMED is unavailable
value[x]:valueRatio		0..1	Ratio	Actual component result
denominator
unit		0..1	string	Unit representation Binding: CommonUCUMCodesForDuration (required)
component:speedOfOnset		0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 The rate at which a physiological symptom became apparent.
Slices for extension				Content/Rules for all slices
extension:text		0..1	Annotation	Textual description of the reported speed of onset URL: http://hl7.org/fhir/StructureDefinition/note
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 99495-4
display		1..1	string	Representation defined by the system Fixed Value: Speed of condition onset
value[x]		1..1	CodeableConcept	Actual component result Binding: Speed of Onset (preferred)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.value[x]	Base	preferred	Common Set of Symptom Codes	📦0.1.0	This IG
Observation.bodySite	Base	preferred	SNOMED CT Body Structures	📦4.0.1	FHIR Std.
Observation.component:quality.​value[x]	Base	preferred	Quality Codes	📦0.1.0	This IG
Observation.component:severity.​value[x]	Base	preferred	Severity Codes	📦0.1.0	This IG
Observation.component:functionalImpact.​code	Base	required	Functional Classification Codes	📦0.1.0	This IG
Observation.component:clinicalCourse.​value[x]	Base	preferred	Clinical Course Codes	📦0.1.0	This IG
Observation.component:trend.​value[x]	Base	preferred	Trend Codes	📦0.1.0	This IG
Observation.component:affectiveGrade.​value[x]	Base	preferred	Affective Grade	📦0.1.0	This IG
Observation.component:triggersOrExacerbatingFactors.​value[x]	Base	preferred	Triggers or Exacerbating Factor Codes	📦0.1.0	This IG
Observation.component:alleviatingFactors.​value[x]	Base	preferred	Alleviating Factor Codes	📦0.1.0	This IG
Observation.component:otherEvents.​value[x]	Base	example	Other Event Codes	📦0.1.0	This IG
Observation.component:frequency.​value[x]:valueCodeableConcept	Base	preferred	Frequency Codes	📦0.1.0	This IG
Observation.component:frequency.​value[x]:valueRatio.​denominator.unit	Base	required	Common UCUM Codes for Duration	📦4.0.1	FHIR Std.
Observation.component:speedOfOnset.​value[x]	Base	preferred	Speed of Onset	📦0.1.0	This IG

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	Observation	Measurements and simple assertions Constraints: obs-6, obs-7
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:associatedSymptom		0..*	(Complex)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo"
value[x]		1..1	Reference(Symptom Observation | Symptom Absent Observation)	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Other symptoms associated with this symptom
extension:associatedCondition		0..*	(Complex)	Other information that may be relevant to this event. URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo"
value[x]		1..1	Reference(Condition)	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Conditions with some relationship to this symptom
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	1..*	CodeableConcept	Classification of type of observation Slice: Unordered, Open by value:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:symptomCode	S	1..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://hl7.org/fhir/uv/symptoms/CodeSystem/SymptomTemporary
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: symptom
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 75325-1
display		1..1	string	Representation defined by the system Fixed Value: Symptom
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(Patient)	The patient who is experiencing the symptom
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣ	1..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
issued	Σ	0..1	instant	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Instant when symptom recorded
performer	SΣ	1..1	Reference(Patient | RelatedPerson)	The person who is reporting the symptom information
value[x]	SΣC	1..1	CodeableConcept	Coded description of symptom Binding: Common Set of Symptom Codes (preferred) Additional Bindings Purpose SNOMEDCTClinicalFindings Max Binding
note		0..*	Annotation	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient or caregiver description of symptom
bodySite	S	0..1	CodeableConcept	Where the patient feels the symptom in the body Binding: SNOMEDCTBodyStructures (preferred)
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
Slices for component	Σ	0..*	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Various information about the symptom Slice: Unordered, Open by value:code
component:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	Annotation	Additional notes that apply to this resource or element. URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	1..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
component:quality	Σ	0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 The patient's internal perception of the symptom
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	Annotation	Textual description of the symptom quality URL: http://hl7.org/fhir/StructureDefinition/note
extension:scaleCode		0..1	CodeableConcept, Reference(Assessment Scale Collection Observation)	Assessment Scale Information URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/AssessmentScaleInformation
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 56823-8
display		1..1	string	Representation defined by the system Fixed Value: Problem quality or description
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Code that represents the symptom quality Binding: Quality Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL4459-5 Preferred LOINC binding when SNOMED is unavailable
component:severity	Σ	0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 The intensity with which the patient experiences the symptom
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	Annotation	Textual description of the symptom severity URL: http://hl7.org/fhir/StructureDefinition/note
extension:scaleCode		0..1	CodeableConcept, Reference(Assessment Scale Collection Observation)	Assessment Scale Information URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/AssessmentScaleInformation
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 64750-3
display		1..1	string	Representation defined by the system Fixed Value: Severity of symptoms
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Actual component result Binding: Severity Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL1156-0 Preferred LOINC binding when SNOMED is unavailable
component:functionalImpact	Σ	0..*	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How the symptom affects the patient's daily activities
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	Annotation	Textual description of the impact URL: http://hl7.org/fhir/StructureDefinition/note
extension:functionalAssessment		0..1	Reference(Functional Assessment Collection)	Functional Assessment URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/FunctionalAssessment
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Code for the functional impact being described Binding: Functional Classification Codes (required)
value[x]	Σ	1..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
component:clinicalCourse	Σ	0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Character of symptom onset
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	Annotation	Textual description of the clinical course of the symptom URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 89261-2
display		1..1	string	Representation defined by the system Fixed Value: Clinical course
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Actual component result Binding: Clinical Course Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL4997-4 Preferred LOINC binding when SNOMED is unavailable
component:trend	Σ	0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Whether a condition is improving, worsening, stable, or resolved.
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	Annotation	Textual description of the symptom trend URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 89253-9
display		1..1	string	Representation defined by the system Fixed Value: Trend
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Actual component result Binding: Trend Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL4938-8 Preferred LOINC binding when SNOMED is unavailable
component:affectiveGrade	Σ	0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Emotional or mental impact of a symptom
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	Annotation	Textual description of the impact of the symptom URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 279116004
display		1..1	string	Representation defined by the system Fixed Value: Affective response to pain
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Code that represents the affective grade Binding: Affective Grade (preferred)
component:triggersOrExacerbatingFactors	Σ	0..*	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient reported actions, conditions, events, physical objects or other factors that initiate, increase or worsen symptoms
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	Annotation	Textual description of the event URL: http://hl7.org/fhir/StructureDefinition/note
extension:relatedMedication		0..*	Reference(MedicationStatement)	Surrounding Event Medication URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/SurroundingEventMedication
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Code for the specific type of event Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 100752-5
display		1..1	string	Representation defined by the system Fixed Value: Exacerbating factors - Reported
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Code or string describing the specific event Binding: Triggers or Exacerbating Factor Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL6278-7 Preferred LOINC binding when SNOMED is unavailable
component:alleviatingFactors	Σ	0..*	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient-reported actions, conditions, events, or other factors that decrease the symptoms or condition
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	Annotation	Textual description of the event URL: http://hl7.org/fhir/StructureDefinition/note
extension:relatedMedication		0..*	Reference(MedicationStatement)	Surrounding Event Medication URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/SurroundingEventMedication
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Code for the specific type of event Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 100753-3
display		1..1	string	Representation defined by the system Fixed Value: Alleviating factors - Reported
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Code or string describing the specific event Binding: Alleviating Factor Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL6279-5 Preferred LOINC binding when SNOMED is unavailable
component:otherEvents	Σ	0..*	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient-reported actions that were occuring at time of symptom onset
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	Annotation	Textual description of the event URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. 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/symptoms/CodeSystem/SymptomTemporary
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: OTHEREVENT
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Code or string describing the specific event Binding: Other Event Codes (example)
component:frequency	Σ	0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How often the patient experiences the symptom.
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	Annotation	Textual description of the reported frequency URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 104156-5
display		1..1	string	Representation defined by the system Fixed Value: Condition frequency - Reported
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for value[x]	Σ	1..1		Actual component result Slice: Unordered, Closed by type:$this
valueCodeableConcept			CodeableConcept
valueRatio			Ratio
value[x]:valueCodeableConcept	Σ	0..1	CodeableConcept	Actual component result Binding: Frequency Codes (preferred) Additional Bindings Purpose Documentation LOINC Answer List LL6514-5 Preferred LOINC binding when SNOMED is unavailable
value[x]:valueRatio	Σ	0..1	Ratio	Actual component result
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
numerator	Σ	0..1	Quantity	Numerator value
denominator	Σ	0..1	Quantity	Denominator value
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Binding: CommonUCUMCodesForDuration (required)
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
component:speedOfOnset	Σ	0..1	BackboneElement	𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 The rate at which a physiological symptom became apparent.
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:text		0..1	Annotation	Textual description of the reported speed of onset URL: http://hl7.org/fhir/StructureDefinition/note
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 99495-4
display		1..1	string	Representation defined by the system Fixed Value: Speed of condition onset
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	Σ	1..1	CodeableConcept	Actual component result Binding: Speed of Onset (preferred)
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.category:symptomCode	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.value[x]	Base	preferred	Common Set of Symptom Codes	📦0.1.0	This IG
Observation.bodySite	Base	preferred	SNOMED CT Body Structures	📦4.0.1	FHIR Std.
Observation.method	Base	example	Observation Methods	📍4.0.1	FHIR Std.
Observation.referenceRange.​type	Base	preferred	Observation Reference Range Meaning Codes	📍4.0.1	FHIR Std.
Observation.referenceRange.​appliesTo	Base	example	Observation Reference Range Applies To Codes	📍4.0.1	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:quality.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:quality.​value[x]	Base	preferred	Quality Codes	📦0.1.0	This IG
Observation.component:severity.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:severity.​value[x]	Base	preferred	Severity Codes	📦0.1.0	This IG
Observation.component:functionalImpact.​code	Base	required	Functional Classification Codes	📦0.1.0	This IG
Observation.component:clinicalCourse.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:clinicalCourse.​value[x]	Base	preferred	Clinical Course Codes	📦0.1.0	This IG
Observation.component:trend.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:trend.​value[x]	Base	preferred	Trend Codes	📦0.1.0	This IG
Observation.component:affectiveGrade.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:affectiveGrade.​value[x]	Base	preferred	Affective Grade	📦0.1.0	This IG
Observation.component:triggersOrExacerbatingFactors.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:triggersOrExacerbatingFactors.​value[x]	Base	preferred	Triggers or Exacerbating Factor Codes	📦0.1.0	This IG
Observation.component:alleviatingFactors.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:alleviatingFactors.​value[x]	Base	preferred	Alleviating Factor Codes	📦0.1.0	This IG
Observation.component:otherEvents.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:otherEvents.​value[x]	Base	example	Other Event Codes	📦0.1.0	This IG
Observation.component:frequency.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:frequency.​value[x]:valueCodeableConcept	Base	preferred	Frequency Codes	📦0.1.0	This IG
Observation.component:frequency.​value[x]:valueRatio.​denominator.comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Observation.component:frequency.​value[x]:valueRatio.​denominator.unit	Base	required	Common UCUM Codes for Duration	📦4.0.1	FHIR Std.
Observation.component:speedOfOnset.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:speedOfOnset.​value[x]	Base	preferred	Speed of Onset	📦0.1.0	This IG

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().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-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.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present	value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()