Generated Narrative: StructureDefinition SymptomLogicalModel Name Flags Card. Type Description & Constraints <a href="StructureDefinition-SymptomLogicalModel-definitions.html#SymptomLogicalModel" title="The FHIR Symptoms Logical Model defines the conceptual representation of symptom data, independent of any particular FHIR resource. It specifies the key elements needed to describe symptoms, including onset, severity, course, body site, and qualitative descriptors. This logical model captures the semantics of symptoms and provides a consistent structure for implementers and modelers.">SymptomLogicalModel 0..* Element Symptom Logical Model Elements defined in Ancestors:@id, <a href="http://hl7.org/fhir/R4/datatypes.html#Element" title="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.">extension #xD; identifier 1..1 string A unique string that identifies this instance of a symptom #xD; symptomCode 1..1 code Coded description of symptom #xD; presentFlag 1..1 boolean Whether the symptom is present or absent #xD; affectedPatient 1..1 Patient The patient who is experiencing the symptom #xD; reporter[x] 1..1 The person who is reporting the symptom information #xD; reporterPatient Patient #xD; reporterRelatedPerson RelatedPerson #xD; symptomDescription 0..* Annotation Textual description of symptom as provided by patient or related person #xD; associatedSymptoms 0..* SymptomLogicalModel Other symptoms associated with this symptom. Used when a patient or caregiver reports multiple symptoms in an encounter and a system wants to link all of them together #xD; associatedConditions 0..* Condition Condition associated with this symptom. Used when a patient, caregiver, or clinician wants to link a symptom to a new or existing Condition. #xD; keyFeatures 1..1 BackboneElement Key Features #xD; location 0..* BackboneElement Where the patient feels the symptom in the body. #xD; code 1..1 code Coded description of the location. #xD; qualifier 0..* string Qualifers of the location, eg. radiating down my leg #xD; quality 0..* BackboneElement The patient's internal perception of the symptom. #xD; note 0..1 Annotation Textual description of the symptom quality #xD; scaleCode 0..1 code Code for the specific scale or assessment (if any) used to determine the quality #xD; value 1..1 code Code that represents the symptom quality #xD; severity 0..1 BackboneElement The intensity with which the patient experiences the symptom. #xD; note 0..1 Annotation Textual description of the symptom severity #xD; scaleCode 0..1 code Code for the specific scale or assessment if any used to determine the severity #xD; value 1..1 code Code that represents the symptom severity #xD; impact 0..* BackboneElement How the symptom is affecting the patient, either emotionally, mentally, or physically. #xD; note 0..1 Annotation Textual description of the impact #xD; scaleCode 0..1 code Code for the specific scale or assessment (if any) used to determine the impact #xD; value 1..1 code Code that represents the impact #xD; surroundingEvents 0..1 BackboneElement Events or circumstances related to symptom onset or intensity. #xD; triggerOrExacerbatingFactors 0..* BackboneElement #xD; factor 1..1 code Reference to the factor #xD; relatedMedication[x] 0..* Medication that patient suggests/reports triggers or exacerbates the symptom #xD; <span title="A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains. #xA;#xA;The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information.">relatedMedicationMedicationStatement MedicationStatement #xD; relatedMedicationMedicationAdministration MedicationAdministration #xD; note 0..1 Annotation Information given about actions, conditions, events, or other factors #xD; alleviatingFactors 0..* BackboneElement #xD; factor 1..1 code Reference to the factor #xD; note 0..1 Annotation Information given about actions, conditions, events, or other factors #xD; relatedMedication[x] 0..* Medication that patient suggests/reports alleviating the symptom #xD; <span title="A record of a medication that is being consumed by a patient. A MedicationStatement may indicate that the patient may be taking the medication now or has taken the medication in the past or will be taking the medication in the future. The source of this information can be the patient, significant other (such as a family member or spouse), or a clinician. A common scenario where this information is captured is during the history taking process during a patient visit or stay. The medication information may come from sources such as the patient's memory, from a prescription bottle, or from a list of medications the patient, clinician or other party maintains. #xA;#xA;The primary difference between a medication statement and a medication administration is that the medication administration has complete administration information and is based on actual administration information from the person who administered the medication. A medication statement is often, if not always, less specific. There is no required date/time when the medication was administered, in fact we only know that a source has reported the patient is taking this medication, where details such as time, quantity, or rate or even medication product may be incomplete or missing or less precise. As stated earlier, the medication statement information may come from the patient's memory, from a prescription bottle or from a list of medications the patient, clinician or other party maintains. Medication administration is more formal and is not missing detailed information.">relatedMedicationMedicationStatement MedicationStatement #xD; relatedMedicationMedicationAdministration MedicationAdministration #xD; otherEvents 0..* code Patient-reported actions that were occuring at time of symptom onset #xD; frequency 0..1 BackboneElement How often the patient experiences the symptom i.e. expressed as 3x/day or 2x/week. #xD; quality 0..1 string A qualitative expression of the frequency, eg. often #xD; quantity 0..1 Quantity A quantitative expression of the frequency #xD; timing 0..1 BackboneElement #xD; speedOfOnset 0..1 code Qualitative expression of how the patient perceived the rate of the symptom to become apparent. #xD; onset[x] 0..1 Clinically relevant time or period for the symptom since first occurence. #xD; onsetDateTime dateTime #xD; onsetPeriod Period #xD; note 0..1 Annotation Information given by the patient about the overall timing of the symptom. #xD; duration 0..1 Duration The length of time the symptom persists in this instance of occurence. #xD; clinicalCourse 0..1 code Character of symptom onset. #xD; trend 0..1 code Intensity of symptom over time #xD; metadata 1..1 BackboneElement Non clinical information about the symptom #xD; documentationDate 1..1 dateTime Date when symptom was documented in the system #xD; issued 1..1 dateTime Date/time when the current version was made available. #xD; Documentation for this format
HL7 International / Clinical Interoperability Council
The FHIR Symptoms Logical Model defines the conceptual representation of symptom data, independent of any particular FHIR resource. It specifies the key elements needed to describe symptoms, including onset, severity, course, body site, and qualitative descriptors. This logical model captures the semantics of symptoms and provides a consistent structure for implementers and modelers.
Symptom Logical Model mapping to Symptom Observation
This table maps the Symptom Observation elements to the Symptom Logical Model
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
A unique string that identifies this instance of a symptom
Whether the symptom is present or absent
The patient who is experiencing the symptom
The person who is reporting the symptom information
Textual description of symptom as provided by patient or related person
Other symptoms associated with this symptom. Used when a patient or caregiver reports multiple symptoms in an encounter and a system wants to link all of them together
Condition associated with this symptom. Used when a patient, caregiver, or clinician wants to link a symptom to a new or existing Condition.
Extensions that cannot be ignored even if unrecognized
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Where the patient feels the symptom in the body.
Qualifers of the location, eg. radiating down my leg
The patient's internal perception of the symptom.
Textual description of the symptom quality
Code for the specific scale or assessment (if any) used to determine the quality
Code that represents the symptom quality
The intensity with which the patient experiences the symptom.
Textual description of the symptom severity
Code for the specific scale or assessment if any used to determine the severity
Code that represents the symptom severity
How the symptom is affecting the patient, either emotionally, mentally, or physically.
Code for the specific scale or assessment (if any) used to determine the impact
Events or circumstances related to symptom onset or intensity.
Patient reported actions, conditions, events, physical objects or other factors that initiate or worsen symptoms or the condition of interest (pain, nausea, dyspnea, dizziness, or other).
Medication that patient suggests/reports triggers or exacerbates the symptom
Information given about actions, conditions, events, or other factors
Patient-reported actions, conditions, events, or other factors that decrease the symptoms or condition
Medication that patient suggests/reports alleviating the symptom
Patient-reported actions that were occuring at time of symptom onset
How often the patient experiences the symptom i.e. expressed as 3x/day or 2x/week.
A qualitative expression of the frequency, eg. often
A quantitative expression of the frequency
Timing includes the actual or estimated date/time of onset, character of onset, how often the patient experiences the symptom, and the length of time the symptom persists.
Qualitative expression of how the patient perceived the rate of the symptom to become apparent.
Clinically relevant time or period for the symptom since first occurence.
Information given by the patient about the overall timing of the symptom.
The length of time the symptom persists in this instance of occurence.
Qualitative expression of how the patient perceived the course or duration of the symptom.
Whether a condition is improving, worsening, stable, or resolved.
Non clinical information about the symptom
Date when symptom was documented in the system
Date when symptom was documented in the system.
Date/time when the current version was made available.