FHIR R4 Symptoms Implementation Guide
1.0.0 - STU 1 International flag

FHIR R4 Symptoms Implementation Guide, published by HL7 International / Clinical Interoperability Council. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-symptoms-ig/ and changes regularly. See the Directory of published versions

Resource Profile: Symptom Observation

Official URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/SymptomObservation Version: 1.0.0
Standards status: Trial-use Active as of 2026-03-31 Maturity Level: 2 Computable Name: SymptomObservation

Used to record the presence of a Symptom as reported by the patient or a patient's caregiver. The Symptom observation contains all information given about a patient's symptom.

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 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. workflow-supportingInfo extension - used to associate other symptoms with this symptom for arbitrary groupings as well as indicating 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.
  3. Impact - How the symptom is affecting the patient, either emotionally, mentally, or physically. 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.

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

  1. 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.
  2. 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.
  3. Triggers or Exacerbating Factors - patient reported actions, conditions, events, physical objects or other factors that initiate, increase or worsen symptoms. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* 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:associatedSymptomOrCondition 0..* (Complex) Other information that may be relevant to this event.
URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo"
..... value[x] 1..1 Reference(Symptom Observation | Symptom Absent Observation | Condition) 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Other symptoms or conditions that are associated with this symptom
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... 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 this version of the symptom information was 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 BindingsPurpose
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 extension Content/Rules for all slices
..... extension:locationQualifier 0..* string Location Qualifier
URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/LocationQualifier
... 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..* 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 BindingsPurposeDocumentation
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 BindingsPurposeDocumentation
LOINC Answer List LL1156-0 Preferred
LOINC binding when SNOMED is unavailable
.... component:impact Σ 0..* BackboneElement 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How the symptom is affecting the patient, either emotionally, mentally, or physically
..... 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 CodeableConcept, 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 impact being described
Binding: Functional Classification Codes (required)
..... value[x] Σ 1..1 CodeableConcept Code that represents the affective grade
Binding: LOINC Answer List LL4997-4 (example)
.... 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 BindingsPurposeDocumentation
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 BindingsPurposeDocumentation
LOINC Answer List LL4938-8 Preferred
LOINC binding when SNOMED is unavailable
.... 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 | MedicationAdministration) 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 BindingsPurposeDocumentation
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 | MedicationAdministration) 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 BindingsPurposeDocumentation
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..* BackboneElement 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How often the patient experiences the symptom. Use multiple repetitions to provide both qualitative and quantitative frequencies.
..... 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 BindingsPurposeDocumentation
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 Qualitative expression of how the patient perceived the rate of the symptom to become 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)

doco 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 📦1.0.0 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 📦1.0.0 This IG
Observation.component:severity.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component:severity.​value[x] Base preferred Severity Codes 📦1.0.0 This IG
Observation.component:impact.​code Base required Functional Classification Codes 📦1.0.0 This IG
Observation.component:impact.​value[x] Base example LOINC Answer Codes for LL4997-4 ∅ unknown?
Observation.component:clinicalCourse.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component:clinicalCourse.​value[x] Base preferred Clinical Course Codes 📦1.0.0 This IG
Observation.component:trend.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component:trend.​value[x] Base preferred Trend Codes 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* Observation Measurements and simple assertions
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:associatedSymptomOrCondition 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 | Condition) 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Other symptoms or conditions that are associated with 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
.... 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 this version of the symptom information was 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 BindingsPurpose
SNOMEDCTClinicalFindings Max Binding
... dataAbsentReason 0..0 Why the result is missing
... interpretation 0..0 High, low, normal, etc.
... 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 extension Content/Rules for all slices
..... extension:locationQualifier 0..* string Location Qualifier
URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/LocationQualifier
... specimen 0..0 Specimen used for this observation
... device 0..0 (Measurement) Device
... referenceRange 0..0 Provides guide for interpretation
... 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 Why the component result is missing
..... interpretation 0..0 High, low, normal, etc.
..... referenceRange 0..0 Provides guide for interpretation of component result
.... component:quality 0..* 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 BindingsPurposeDocumentation
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 BindingsPurposeDocumentation
LOINC Answer List LL1156-0 Preferred
LOINC binding when SNOMED is unavailable
.... component:impact 0..* BackboneElement 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How the symptom is affecting the patient, either emotionally, mentally, or physically
..... 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 CodeableConcept, Reference(Functional Assessment Collection) Functional Assessment
URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/FunctionalAssessment
..... code 1..1 CodeableConcept Code for the impact being described
Binding: Functional Classification Codes (required)
..... value[x] 1..1 CodeableConcept Code that represents the affective grade
Binding: LOINC Answer List LL4997-4 (example)
.... 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 BindingsPurposeDocumentation
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 BindingsPurposeDocumentation
LOINC Answer List LL4938-8 Preferred
LOINC binding when SNOMED is unavailable
.... 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 | MedicationAdministration) 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 BindingsPurposeDocumentation
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 | MedicationAdministration) 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 BindingsPurposeDocumentation
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..* BackboneElement 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How often the patient experiences the symptom. Use multiple repetitions to provide both qualitative and quantitative frequencies.
..... 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 BindingsPurposeDocumentation
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 Qualitative expression of how the patient perceived the rate of the symptom to become 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)

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.value[x] Base preferred Common Set of Symptom Codes 📦1.0.0 This IG
Observation.bodySite Base preferred SNOMED CT Body Structures 📦4.0.1 FHIR Std.
Observation.component:quality.​value[x] Base preferred Quality Codes 📦1.0.0 This IG
Observation.component:severity.​value[x] Base preferred Severity Codes 📦1.0.0 This IG
Observation.component:impact.​code Base required Functional Classification Codes 📦1.0.0 This IG
Observation.component:impact.​value[x] Base example LOINC Answer Codes for LL4997-4 ∅ unknown?
Observation.component:clinicalCourse.​value[x] Base preferred Clinical Course Codes 📦1.0.0 This IG
Observation.component:trend.​value[x] Base preferred Trend Codes 📦1.0.0 This IG
Observation.component:triggersOrExacerbatingFactors.​value[x] Base preferred Triggers or Exacerbating Factor Codes 📦1.0.0 This IG
Observation.component:alleviatingFactors.​value[x] Base preferred Alleviating Factor Codes 📦1.0.0 This IG
Observation.component:otherEvents.​value[x] Base example Other Event Codes 📦1.0.0 This IG
Observation.component:frequency.​value[x]:valueCodeableConcept Base preferred Frequency Codes 📦1.0.0 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 📦1.0.0 This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. 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 BindingsPurpose
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:associatedSymptomOrCondition 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 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo"
..... value[x] 1..1 Reference(Symptom Observation | Symptom Absent Observation | Condition) 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Other symptoms or conditions that are associated with 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 this version of the symptom information was 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 BindingsPurpose
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)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:locationQualifier 0..* string Location Qualifier
URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/LocationQualifier
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... 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..* 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 BindingsPurposeDocumentation
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 BindingsPurposeDocumentation
LOINC Answer List LL1156-0 Preferred
LOINC binding when SNOMED is unavailable
.... component:impact Σ 0..* BackboneElement 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How the symptom is affecting the patient, either emotionally, mentally, or physically
..... 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 CodeableConcept, 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 impact being described
Binding: Functional Classification Codes (required)
..... value[x] Σ 1..1 CodeableConcept Code that represents the affective grade
Binding: LOINC Answer List LL4997-4 (example)
.... 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 BindingsPurposeDocumentation
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 BindingsPurposeDocumentation
LOINC Answer List LL4938-8 Preferred
LOINC binding when SNOMED is unavailable
.... 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 | MedicationAdministration) 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 BindingsPurposeDocumentation
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 | MedicationAdministration) 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 BindingsPurposeDocumentation
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..* BackboneElement 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How often the patient experiences the symptom. Use multiple repetitions to provide both qualitative and quantitative frequencies.
..... 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 BindingsPurposeDocumentation
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 Qualitative expression of how the patient perceived the rate of the symptom to become 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)

doco 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 📦1.0.0 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 📦1.0.0 This IG
Observation.component:severity.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component:severity.​value[x] Base preferred Severity Codes 📦1.0.0 This IG
Observation.component:impact.​code Base required Functional Classification Codes 📦1.0.0 This IG
Observation.component:impact.​value[x] Base example LOINC Answer Codes for LL4997-4 ∅ unknown?
Observation.component:clinicalCourse.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component:clinicalCourse.​value[x] Base preferred Clinical Course Codes 📦1.0.0 This IG
Observation.component:trend.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component:trend.​value[x] Base preferred Trend Codes 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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()
.Data
..Classification of type of observation
Cardinality: 1..*
CodeableConcept
 A code that classifies the general type of observation being made.

 value is bound to Observation Category Codes (10 codes)
..Classification of type of observation
Cardinality: 1..1
CodeableConcept
 A code that classifies the general type of observation being made.

 value must match Temporary Symptom Codes: symptom("Symptom") from Observation Category Codes (10 codes)
..Type of observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "name".

 value must match LOINC: 75325-1 "Symptom" from LOINC Codes (>1000 codes)
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Instant when this version of the symptom information was recorded
Cardinality: 0..1
instant
 The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.
..Coded description of symptom
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Common Set of Symptom Codes (52 codes)
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient or caregiver description of symptom
Cardinality: 0..*
Annotation
 Comments about the observation or the results.
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Various information about the symptom
Cardinality: 0..*
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Additional notes that apply to this resource or element.
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Actual component result
Cardinality: 1..1
Choice
 The information determined as a result of making the observation, if the information has a simple value.

 value is a choice of:
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 The patient's internal perception of the symptom
Cardinality: 0..*
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the symptom quality
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Assessment Scale Information
Cardinality: 0..1
Extension
 Information about the specific scale or assessment used to determine the value. This can be either just a code that represents the assessment scale or can be a reference to an Assessment Scale Collection.

 value must be a Assessment Scale Information
...Type of component observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 56823-8 "Problem quality or description" from LOINC Codes (>1000 codes)
...Code that represents the symptom quality
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Quality Codes (19 codes)
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 The intensity with which the patient experiences the symptom
Cardinality: 0..1
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the symptom severity
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Assessment Scale Information
Cardinality: 0..1
Extension
 Information about the specific scale or assessment used to determine the value. This can be either just a code that represents the assessment scale or can be a reference to an Assessment Scale Collection.

 value must be a Assessment Scale Information
...Type of component observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 64750-3 "Severity of symptoms" from LOINC Codes (>1000 codes)
...Actual component result
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Severity Codes (7 codes)
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How the symptom is affecting the patient, either emotionally, mentally, or physically
Cardinality: 0..*
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the impact
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Functional Assessment
Cardinality: 0..1
Extension
 Information about the specific functional scale or assessment used to determine the value. This can be either just a code that represents the assessment scale or can be a reference to an Functional Assessment Collection.

 value must be a Functional Assessment
...Code for the impact being described
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value is bound to Functional Classification Codes (>1000 codes)
...Code that represents the affective grade
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to LOINC Answer Codes for LL4997-4. Codes:
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Character of symptom onset
Cardinality: 0..1
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

Comment: Term to represent both the course and onset of a disease. Many conditions with an acute (sudden) onset also have an acute (short duration) course.
...Textual description of the clinical course of the symptom
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Type of component observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 89261-2 "Clinical course" from LOINC Codes (>1000 codes)
...Actual component result
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Clinical Course Codes. Codes:
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Whether a condition is improving, worsening, stable, or resolved.
Cardinality: 0..1
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the symptom trend
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Type of component observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 89253-9 "Trend" from LOINC Codes (>1000 codes)
...Actual component result
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Trend Codes (8 codes)
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient reported actions, conditions, events, physical objects or other factors that initiate, increase or worsen symptoms
Cardinality: 0..*
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the event
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Surrounding Event Medication
Cardinality: 0..*
Extension
 Medication that when taken affects the symptom

 value must be a Surrounding Event Medication
...Code for the specific type of event
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 100752-5 "Exacerbating factors - Reported" from LOINC Codes (>1000 codes)
...Code or string describing the specific event
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Triggers or Exacerbating Factor Codes (17 codes)
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient-reported actions, conditions, events, or other factors that decrease the symptoms or condition
Cardinality: 0..*
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the event
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Surrounding Event Medication
Cardinality: 0..*
Extension
 Medication that when taken affects the symptom

 value must be a Surrounding Event Medication
...Code for the specific type of event
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 100753-3 "Alleviating factors - Reported" from LOINC Codes (>1000 codes)
...Code or string describing the specific event
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Alleviating Factor Codes (28 codes)
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient-reported actions that were occuring at time of symptom onset
Cardinality: 0..*
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the event
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Type of component observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match Temporary Symptom Codes: OTHEREVENT("Other Events") from LOINC Codes (>1000 codes)
...Code or string describing the specific event
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Other Event Codes. Codes:
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How often the patient experiences the symptom. Use multiple repetitions to provide both qualitative and quantitative frequencies.
Cardinality: 0..*
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the reported frequency
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Type of component observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 104156-5 "Condition frequency - Reported" from LOINC Codes (>1000 codes)
...Actual component result
Cardinality: 1..1
Choice
 The information determined as a result of making the observation, if the information has a simple value.

Comment: Frequency can be expressed as either a specific time frame i.e. 3x/day or 2x/week (preferred) or bound to the LOINC code answer set 104156-5

 value is a choice of:
...Actual component result
Cardinality: 0..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Frequency Codes. Codes:
...Actual component result
Cardinality: 0..1
Ratio
 The information determined as a result of making the observation, if the information has a simple value.
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Qualitative expression of how the patient perceived the rate of the symptom to become apparent.
Cardinality: 0..1
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the reported speed of onset
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Type of component observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 99495-4 "Speed of condition onset" from LOINC Codes (>1000 codes)
...Actual component result
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Speed of Onset. Codes:
.Protocol
..The person who is reporting the symptom information
Cardinality: 1..1
Reference
 Who was responsible for asserting the observed value as "true".

 value must point to one of Patient or RelatedPerson
..Where the patient feels the symptom in the body
Cardinality: 0..1
CodeableConcept
 Indicates the site on the subject's body where the observation was made (i.e. the target site).

 value is bound to SNOMED CT Body Structures (>1000 codes)
.Context
..The patient who is experiencing the symptom
Cardinality: 1..1
Reference
 The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

 value must point to a Patient
.Other Data
..Other information that may be relevant to this event.
Cardinality: 0..*
Extension
 Other resources from the patient record that may be relevant to the event. The information from these resources was either used to create the instance or is provided to help with its interpretation. This extension should not be used if more specific inline elements or extensions are available. For example, use Observation.hasMember instead of supportingInformation for representing the members of an Observation panel.

 value must be a Supporting info
extensionhas cardinality: 0..0
url is fixed to Supporting info
value[x]has cardinality: 1..1

doco Documentation for this format

Summary

Mandatory: 6 elements(1 nested mandatory element)
Must-Support: 9 elements
Prohibited: 8 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

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

Maturity: 2

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. 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:associatedSymptomOrCondition 0..* (Complex) Other information that may be relevant to this event.
URL: http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo"
..... value[x] 1..1 Reference(Symptom Observation | Symptom Absent Observation | Condition) 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Other symptoms or conditions that are associated with this symptom
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... 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 this version of the symptom information was 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 BindingsPurpose
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 extension Content/Rules for all slices
..... extension:locationQualifier 0..* string Location Qualifier
URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/LocationQualifier
... 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..* 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 BindingsPurposeDocumentation
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 BindingsPurposeDocumentation
LOINC Answer List LL1156-0 Preferred
LOINC binding when SNOMED is unavailable
.... component:impact Σ 0..* BackboneElement 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How the symptom is affecting the patient, either emotionally, mentally, or physically
..... 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 CodeableConcept, 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 impact being described
Binding: Functional Classification Codes (required)
..... value[x] Σ 1..1 CodeableConcept Code that represents the affective grade
Binding: LOINC Answer List LL4997-4 (example)
.... 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 BindingsPurposeDocumentation
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 BindingsPurposeDocumentation
LOINC Answer List LL4938-8 Preferred
LOINC binding when SNOMED is unavailable
.... 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 | MedicationAdministration) 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 BindingsPurposeDocumentation
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 | MedicationAdministration) 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 BindingsPurposeDocumentation
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..* BackboneElement 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How often the patient experiences the symptom. Use multiple repetitions to provide both qualitative and quantitative frequencies.
..... 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 BindingsPurposeDocumentation
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 Qualitative expression of how the patient perceived the rate of the symptom to become 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)

doco 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 📦1.0.0 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 📦1.0.0 This IG
Observation.component:severity.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component:severity.​value[x] Base preferred Severity Codes 📦1.0.0 This IG
Observation.component:impact.​code Base required Functional Classification Codes 📦1.0.0 This IG
Observation.component:impact.​value[x] Base example LOINC Answer Codes for LL4997-4 ∅ unknown?
Observation.component:clinicalCourse.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component:clinicalCourse.​value[x] Base preferred Clinical Course Codes 📦1.0.0 This IG
Observation.component:trend.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component:trend.​value[x] Base preferred Trend Codes 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* Observation Measurements and simple assertions
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:associatedSymptomOrCondition 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 | Condition) 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Other symptoms or conditions that are associated with 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
.... 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 this version of the symptom information was 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 BindingsPurpose
SNOMEDCTClinicalFindings Max Binding
... dataAbsentReason 0..0 Why the result is missing
... interpretation 0..0 High, low, normal, etc.
... 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 extension Content/Rules for all slices
..... extension:locationQualifier 0..* string Location Qualifier
URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/LocationQualifier
... specimen 0..0 Specimen used for this observation
... device 0..0 (Measurement) Device
... referenceRange 0..0 Provides guide for interpretation
... 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 Why the component result is missing
..... interpretation 0..0 High, low, normal, etc.
..... referenceRange 0..0 Provides guide for interpretation of component result
.... component:quality 0..* 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 BindingsPurposeDocumentation
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 BindingsPurposeDocumentation
LOINC Answer List LL1156-0 Preferred
LOINC binding when SNOMED is unavailable
.... component:impact 0..* BackboneElement 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How the symptom is affecting the patient, either emotionally, mentally, or physically
..... 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 CodeableConcept, Reference(Functional Assessment Collection) Functional Assessment
URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/FunctionalAssessment
..... code 1..1 CodeableConcept Code for the impact being described
Binding: Functional Classification Codes (required)
..... value[x] 1..1 CodeableConcept Code that represents the affective grade
Binding: LOINC Answer List LL4997-4 (example)
.... 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 BindingsPurposeDocumentation
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 BindingsPurposeDocumentation
LOINC Answer List LL4938-8 Preferred
LOINC binding when SNOMED is unavailable
.... 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 | MedicationAdministration) 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 BindingsPurposeDocumentation
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 | MedicationAdministration) 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 BindingsPurposeDocumentation
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..* BackboneElement 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How often the patient experiences the symptom. Use multiple repetitions to provide both qualitative and quantitative frequencies.
..... 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 BindingsPurposeDocumentation
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 Qualitative expression of how the patient perceived the rate of the symptom to become 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)

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.value[x] Base preferred Common Set of Symptom Codes 📦1.0.0 This IG
Observation.bodySite Base preferred SNOMED CT Body Structures 📦4.0.1 FHIR Std.
Observation.component:quality.​value[x] Base preferred Quality Codes 📦1.0.0 This IG
Observation.component:severity.​value[x] Base preferred Severity Codes 📦1.0.0 This IG
Observation.component:impact.​code Base required Functional Classification Codes 📦1.0.0 This IG
Observation.component:impact.​value[x] Base example LOINC Answer Codes for LL4997-4 ∅ unknown?
Observation.component:clinicalCourse.​value[x] Base preferred Clinical Course Codes 📦1.0.0 This IG
Observation.component:trend.​value[x] Base preferred Trend Codes 📦1.0.0 This IG
Observation.component:triggersOrExacerbatingFactors.​value[x] Base preferred Triggers or Exacerbating Factor Codes 📦1.0.0 This IG
Observation.component:alleviatingFactors.​value[x] Base preferred Alleviating Factor Codes 📦1.0.0 This IG
Observation.component:otherEvents.​value[x] Base example Other Event Codes 📦1.0.0 This IG
Observation.component:frequency.​value[x]:valueCodeableConcept Base preferred Frequency Codes 📦1.0.0 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 📦1.0.0 This IG

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. 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 BindingsPurpose
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:associatedSymptomOrCondition 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 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "http://hl7.org/fhir/StructureDefinition/workflow-supportingInfo"
..... value[x] 1..1 Reference(Symptom Observation | Symptom Absent Observation | Condition) 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Other symptoms or conditions that are associated with 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 this version of the symptom information was 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 BindingsPurpose
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)
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... extension:locationQualifier 0..* string Location Qualifier
URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/LocationQualifier
.... coding Σ 0..* Coding Code defined by a terminology system
.... text Σ 0..1 string Plain text representation of the concept
... 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..* 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 BindingsPurposeDocumentation
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 BindingsPurposeDocumentation
LOINC Answer List LL1156-0 Preferred
LOINC binding when SNOMED is unavailable
.... component:impact Σ 0..* BackboneElement 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How the symptom is affecting the patient, either emotionally, mentally, or physically
..... 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 CodeableConcept, 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 impact being described
Binding: Functional Classification Codes (required)
..... value[x] Σ 1..1 CodeableConcept Code that represents the affective grade
Binding: LOINC Answer List LL4997-4 (example)
.... 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 BindingsPurposeDocumentation
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 BindingsPurposeDocumentation
LOINC Answer List LL4938-8 Preferred
LOINC binding when SNOMED is unavailable
.... 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 | MedicationAdministration) 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 BindingsPurposeDocumentation
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 | MedicationAdministration) 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 BindingsPurposeDocumentation
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..* BackboneElement 𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How often the patient experiences the symptom. Use multiple repetitions to provide both qualitative and quantitative frequencies.
..... 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 BindingsPurposeDocumentation
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 Qualitative expression of how the patient perceived the rate of the symptom to become 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)

doco 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 📦1.0.0 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 📦1.0.0 This IG
Observation.component:severity.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component:severity.​value[x] Base preferred Severity Codes 📦1.0.0 This IG
Observation.component:impact.​code Base required Functional Classification Codes 📦1.0.0 This IG
Observation.component:impact.​value[x] Base example LOINC Answer Codes for LL4997-4 ∅ unknown?
Observation.component:clinicalCourse.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component:clinicalCourse.​value[x] Base preferred Clinical Course Codes 📦1.0.0 This IG
Observation.component:trend.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component:trend.​value[x] Base preferred Trend Codes 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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 📦1.0.0 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()

openEHR View

.Data
..Classification of type of observation
Cardinality: 1..*
CodeableConcept
 A code that classifies the general type of observation being made.

 value is bound to Observation Category Codes (10 codes)
..Classification of type of observation
Cardinality: 1..1
CodeableConcept
 A code that classifies the general type of observation being made.

 value must match Temporary Symptom Codes: symptom("Symptom") from Observation Category Codes (10 codes)
..Type of observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "name".

 value must match LOINC: 75325-1 "Symptom" from LOINC Codes (>1000 codes)
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Instant when this version of the symptom information was recorded
Cardinality: 0..1
instant
 The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.
..Coded description of symptom
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Common Set of Symptom Codes (52 codes)
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient or caregiver description of symptom
Cardinality: 0..*
Annotation
 Comments about the observation or the results.
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Various information about the symptom
Cardinality: 0..*
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Additional notes that apply to this resource or element.
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Actual component result
Cardinality: 1..1
Choice
 The information determined as a result of making the observation, if the information has a simple value.

 value is a choice of:
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 The patient's internal perception of the symptom
Cardinality: 0..*
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the symptom quality
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Assessment Scale Information
Cardinality: 0..1
Extension
 Information about the specific scale or assessment used to determine the value. This can be either just a code that represents the assessment scale or can be a reference to an Assessment Scale Collection.

 value must be a Assessment Scale Information
...Type of component observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 56823-8 "Problem quality or description" from LOINC Codes (>1000 codes)
...Code that represents the symptom quality
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Quality Codes (19 codes)
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 The intensity with which the patient experiences the symptom
Cardinality: 0..1
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the symptom severity
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Assessment Scale Information
Cardinality: 0..1
Extension
 Information about the specific scale or assessment used to determine the value. This can be either just a code that represents the assessment scale or can be a reference to an Assessment Scale Collection.

 value must be a Assessment Scale Information
...Type of component observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 64750-3 "Severity of symptoms" from LOINC Codes (>1000 codes)
...Actual component result
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Severity Codes (7 codes)
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How the symptom is affecting the patient, either emotionally, mentally, or physically
Cardinality: 0..*
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the impact
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Functional Assessment
Cardinality: 0..1
Extension
 Information about the specific functional scale or assessment used to determine the value. This can be either just a code that represents the assessment scale or can be a reference to an Functional Assessment Collection.

 value must be a Functional Assessment
...Code for the impact being described
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value is bound to Functional Classification Codes (>1000 codes)
...Code that represents the affective grade
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to LOINC Answer Codes for LL4997-4. Codes:
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Character of symptom onset
Cardinality: 0..1
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

Comment: Term to represent both the course and onset of a disease. Many conditions with an acute (sudden) onset also have an acute (short duration) course.
...Textual description of the clinical course of the symptom
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Type of component observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 89261-2 "Clinical course" from LOINC Codes (>1000 codes)
...Actual component result
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Clinical Course Codes. Codes:
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Whether a condition is improving, worsening, stable, or resolved.
Cardinality: 0..1
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the symptom trend
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Type of component observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 89253-9 "Trend" from LOINC Codes (>1000 codes)
...Actual component result
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Trend Codes (8 codes)
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient reported actions, conditions, events, physical objects or other factors that initiate, increase or worsen symptoms
Cardinality: 0..*
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the event
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Surrounding Event Medication
Cardinality: 0..*
Extension
 Medication that when taken affects the symptom

 value must be a Surrounding Event Medication
...Code for the specific type of event
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 100752-5 "Exacerbating factors - Reported" from LOINC Codes (>1000 codes)
...Code or string describing the specific event
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Triggers or Exacerbating Factor Codes (17 codes)
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient-reported actions, conditions, events, or other factors that decrease the symptoms or condition
Cardinality: 0..*
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the event
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Surrounding Event Medication
Cardinality: 0..*
Extension
 Medication that when taken affects the symptom

 value must be a Surrounding Event Medication
...Code for the specific type of event
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 100753-3 "Alleviating factors - Reported" from LOINC Codes (>1000 codes)
...Code or string describing the specific event
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Alleviating Factor Codes (28 codes)
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Patient-reported actions that were occuring at time of symptom onset
Cardinality: 0..*
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the event
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Type of component observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match Temporary Symptom Codes: OTHEREVENT("Other Events") from LOINC Codes (>1000 codes)
...Code or string describing the specific event
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Other Event Codes. Codes:
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 How often the patient experiences the symptom. Use multiple repetitions to provide both qualitative and quantitative frequencies.
Cardinality: 0..*
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the reported frequency
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Type of component observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 104156-5 "Condition frequency - Reported" from LOINC Codes (>1000 codes)
...Actual component result
Cardinality: 1..1
Choice
 The information determined as a result of making the observation, if the information has a simple value.

Comment: Frequency can be expressed as either a specific time frame i.e. 3x/day or 2x/week (preferred) or bound to the LOINC code answer set 104156-5

 value is a choice of:
...Actual component result
Cardinality: 0..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Frequency Codes. Codes:
...Actual component result
Cardinality: 0..1
Ratio
 The information determined as a result of making the observation, if the information has a simple value.
..𝗦𝗛𝗢𝗨𝗟𝗗 𝗦𝗨𝗣𝗣𝗢𝗥𝗧 Qualitative expression of how the patient perceived the rate of the symptom to become apparent.
Cardinality: 0..1
Group
 Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.
...Textual description of the reported speed of onset
Cardinality: 0..1
Extension
 Additional notes that apply to this resource or element.

 value must be a Note
...Type of component observation (code / type)
Cardinality: 1..1
CodeableConcept
 Describes what was observed. Sometimes this is called the observation "code".

 value must match LOINC: 99495-4 "Speed of condition onset" from LOINC Codes (>1000 codes)
...Actual component result
Cardinality: 1..1
CodeableConcept
 The information determined as a result of making the observation, if the information has a simple value.

 value is bound to Speed of Onset. Codes:
.Protocol
..The person who is reporting the symptom information
Cardinality: 1..1
Reference
 Who was responsible for asserting the observed value as "true".

 value must point to one of Patient or RelatedPerson
..Where the patient feels the symptom in the body
Cardinality: 0..1
CodeableConcept
 Indicates the site on the subject's body where the observation was made (i.e. the target site).

 value is bound to SNOMED CT Body Structures (>1000 codes)
.Context
..The patient who is experiencing the symptom
Cardinality: 1..1
Reference
 The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

 value must point to a Patient
.Other Data
..Other information that may be relevant to this event.
Cardinality: 0..*
Extension
 Other resources from the patient record that may be relevant to the event. The information from these resources was either used to create the instance or is provided to help with its interpretation. This extension should not be used if more specific inline elements or extensions are available. For example, use Observation.hasMember instead of supportingInformation for representing the members of an Observation panel.

 value must be a Supporting info
extensionhas cardinality: 0..0
url is fixed to Supporting info
value[x]has cardinality: 1..1

doco Documentation for this format

Summary

Mandatory: 6 elements(1 nested mandatory element)
Must-Support: 9 elements
Prohibited: 8 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

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

Maturity: 2

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Mandatory Search Parameters:

The following search parameters and search parameter combinations SHALL be supported:

  1. SHALL support searching using the combination of the patient and category search parameters:

    GET [base]/Observation?patient={Type/}[id]&category={system|}[code]

    Example:

    1. GET [base]/Observation?patient=1134281&category=http://terminology.hl7.org/CodeSystem/observation-category|symptom

    Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and a category code = symptom (how to search by reference and how to search by token)

  2. SHALL support searching using the combination of the patient and code search parameters: GET [base]/Observation?patient={Type/}[id]&code={system|}[code]

    Example:

    1. GET [base]/Observation?patient=1134281&code=http://loinc.org|75325-1

    Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and observation code (how to search by reference and how to search by token)

  3. SHALL support searching using the combination of the patient and code-value-concept search parameters: GET [base]/Observation?patient={Type/}[id]&code-value-concept={system|}[code]${system|}[code]

    Example:

    1. GET [base]/Observation?patient=1134281&code-value-concept=http://loinc.org|75325-1$http://www.snomed.info/sct/ 51197009

    Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and observation code and symptom code (how to search by reference and how to search by composite)

  4. SHALL support searching using the combination of the patient and code-value-concept and date search parameters:

    • including support for these date comparators: gt,lt,ge,le
    • including optional support for AND search on date (e.g.date=[date]&date=[date]]&...)

    GET [base]/Observation?patient={Type/}[id]&code-value-concept={system|}[code]${system|}[code]&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

    Example:

    1. GET [base]Observation?patient=555580&code-value-concept=http://loinc.org|75325-1$http://www.snomed.info/sct/ 51197009&date=ge2018-03-14T00:00:00Z

    Implementation Notes: Fetches a bundle of all Observation resources for the specified patient and date and observation code and symptom code (how to search by reference and how to search by composite and how to search by date)