FHIR R4 Symptoms Implementation Guide
1.0.0-ballot - STU 1 Ballot 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-ballot 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

Logical Model: ExclusionSymptomSignV0

Official URL: http://hl7.org/fhir/uv/symptoms/StructureDefinition/openEHR-EHR-CLUSTER.exclusion-symptom-sign.v0 Version: 1.0.0-ballot
Standards status: Trial-use Draft as of 2025-12-17 Maturity Level: 1 Computable Name: ExclusionSymptomSignV0
Keywords: symptom, absence, exclusion

Copyright/Legal: © openEHR Foundation. This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/.

Use to record a positive statement to explicitly record that a symptom or sign was reported as not present. Use to record exlicitly that a symptom or sign was absolutely not present. If this is not absolutely required, consider use of the 'Nil significant' data element within the CLUSTER.symptom_sign archetype.

This archetype has been specifically designed to be used in the 'Structured detail' SLOT within the OBSERVATION.story archetype, but can also be used within other OBSERVATION or CLUSTER archetypes, where clinically appropriate.

Symptom Exclusion Archetype Diagram
Symptom Exclusion Archetype Elements

Original Source: specifications.openehr.org

Usages:

  • This Logical Model Profile is not used by any profiles in this Implementation Guide

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
.. CLUSTER 0..* CLUSTER Exclusion of a symptom or sign
... Slices for items 1..* ITEM Ordered list of items - `CLUSTER` or `ELEMENT` objects - under this `CLUSTER`.
Slice: Unordered, Closed by profile:$this
.... items:at0001 0..1 ELEMENT Exclusion Statement
..... value 0..1 DV_TEXT Property representing leaf value object of `ELEMENT`.
.... items:at0002 0..1 ELEMENT Excluded Symptom
..... Slices for value 0..1 DATA_VALUE Property representing leaf value object of `ELEMENT`.
Slice: Unordered, Closed by type:$this
...... value:DV_TEXT 0..1 DV_TEXT Property representing leaf value object of `ELEMENT`.
...... value:DV_CODED_TEXT 0..1 DV_CODED_TEXT Property representing leaf value object of `ELEMENT`.
Binding: Excluded Symptom ValueSet (required)

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
CLUSTER.items:at0002.​value:DV_CODED_TEXT Base required Excluded Symptom ValueSet 📦1.0.0-ballot This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CLUSTER C 0..* CLUSTER Exclusion of a symptom or sign
Constraints: Links_valid, Archetyped_valid, Archetype_node_id_valid
... name 1..1 DV_TEXT Runtime name of this fragment, used to build runtime paths.
... archetype_node_id 1..1 string Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths.
... uid 0..1 UID_BASED_ID Optional globally unique object identifier for root points of archetyped structures.
... archetype_details 0..1 ARCHETYPED Details of archetyping used on this node.
... feeder_audit 0..1 FEEDER_AUDIT Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.
... Slices for items 1..* ITEM Ordered list of items - `CLUSTER` or `ELEMENT` objects - under this `CLUSTER`.
Slice: Unordered, Closed by profile:$this
.... items:at0001 0..1 ELEMENT Exclusion Statement
..... name 1..1 DV_TEXT Runtime name of this fragment, used to build runtime paths.
..... archetype_node_id 1..1 string Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths.
..... uid 0..1 UID_BASED_ID Optional globally unique object identifier for root points of archetyped structures.
..... links 0..* LINK Links to other archetyped structures (data whose root object inherits from `ARCHETYPED`, such as `ENTRY`, `SECTION` and so on).
..... archetype_details 0..1 ARCHETYPED Details of archetyping used on this node.
..... feeder_audit 0..1 FEEDER_AUDIT Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.
..... null_flavour 0..1 DV_CODED_TEXT Flavour of null value, e.
..... value 0..1 DV_TEXT Property representing leaf value object of `ELEMENT`.
..... null_reason 0..1 DV_TEXT Optional specific reason for null value; if set, `_null_flavour_` must be set.
.... items:at0002 0..1 ELEMENT Excluded Symptom
..... name 1..1 DV_TEXT Runtime name of this fragment, used to build runtime paths.
..... archetype_node_id 1..1 string Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths.
..... uid 0..1 UID_BASED_ID Optional globally unique object identifier for root points of archetyped structures.
..... links 0..* LINK Links to other archetyped structures (data whose root object inherits from `ARCHETYPED`, such as `ENTRY`, `SECTION` and so on).
..... archetype_details 0..1 ARCHETYPED Details of archetyping used on this node.
..... feeder_audit 0..1 FEEDER_AUDIT Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.
..... null_flavour 0..1 DV_CODED_TEXT Flavour of null value, e.
..... Slices for value 0..1 DATA_VALUE Property representing leaf value object of `ELEMENT`.
Slice: Unordered, Closed by type:$this
...... value:DV_TEXT 0..1 DV_TEXT Property representing leaf value object of `ELEMENT`.
...... value:DV_CODED_TEXT 0..1 DV_CODED_TEXT Property representing leaf value object of `ELEMENT`.
..... null_reason 0..1 DV_TEXT Optional specific reason for null value; if set, `_null_flavour_` must be set.

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
Archetype_node_id_valid error CLUSTER Archetype node id valid must not be empty archetype_node_id.empty().not()
Archetyped_valid error CLUSTER Archetyped valid must satisfy exclusive conditions is_archetype_root() xor archetype_details .empty()
Links_valid error CLUSTER Links valid must be present links.exists() implies links.empty().not()
.Items
..Exclusion Statement
Optional
DV_TEXT
 A statement about the exclusion of known symptoms in the health record.
..Excluded Symptom
Optional
DV_TEXT
 Identification of the specific symptom to which the Exclusion Statement applies.
..Excluded Symptom
Optional
DV_CODED_TEXT
 Identification of the specific symptom to which the Exclusion Statement applies.

doco Documentation for this format
archetype (adl_version=1.4; rm_release=1.1.0; uid=659df819-b8da-4489-9b7e-0a20074f543c)
	openEHR-EHR-CLUSTER.exclusion_symptom_sign.v0

concept
	[at0000]	-- Exclusion of a symptom or sign
language
	original_language = <[ISO_639-1::en]>
	translations = <
		["nb"] = <
			language = <[ISO_639-1::nb]>
			author = <
				["name"] = <"Lars Bitsch-Larsen">
				["organisation"] = <"Haukeland University Hospital of Bergen, Norway">
			>
			accreditation = <"MD, DEAA, MBA, spec in anesthesia, spec in tropical medicine.">
		>
	>
description
	original_author = <
		["name"] = <"Heather Leslie">
		["organisation"] = <"Ocean Informatics">
		["email"] = <"heather.leslie@oceaninformatics.com">
		["date"] = <"2015-06-26">
	>
	details = <
		["nb"] = <
			language = <[ISO_639-1::nb]>
			purpose = <"Anvendes for registrering av fravær av et spesifikk symptom som definert i \"openEHR-EHR-CLUSTER.symptom.v1 archetype\".">
			use = <"">
			keywords = <"Symptom", "fravær", "eksklusjon">
			misuse = <"">
			copyright = <"© openEHR Foundation">
		>
		["en"] = <
			language = <[ISO_639-1::en]>
			purpose = <"To record a positive statement to explicitly record that a symptom or sign was reported as not present.">
			use = <"Use to record a positive statement to explicitly record that a symptom or sign was reported as not present.
Use to record exlicitly that a symptom or sign was absolutely not present. If this is not absolutely required, consider use of the 'Nil significant' data element within the CLUSTER.symptom_sign archetype.

This archetype has been specifically designed to be used in the 'Structured detail' SLOT within the OBSERVATION.story archetype, but can also be used within other OBSERVATION or CLUSTER archetypes, where clinically appropriate.">
			keywords = <"symptom, absence, exclusion", ...>
			misuse = <"">
			copyright = <"© openEHR Foundation">
		>
	>
	lifecycle_state = <"in_development">
	other_contributors = <>
	other_details = <
		["licence"] = <"This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/.">
		["custodian_organisation"] = <"openEHR Foundation">
		["current_contact"] = <"Heather Leslie, Ocean Informatics<heather.leslie@oceaninformatics.com>">
		["original_namespace"] = <"org.openehr">
		["original_publisher"] = <"openEHR Foundation">
		["custodian_namespace"] = <"org.openehr">
		["MD5-CAM-1.0.1"] = <"4C7933C02F879864FC54A31737ABEBD3">
		["build_uid"] = <"e1d694db-a6eb-48c3-a4d1-f4fef9f65b75">
		["revision"] = <"0.0.1-alpha">
	>

definition
	CLUSTER[at0000] matches {	-- Exclusion of a symptom or sign
		items cardinality matches {1..*; unordered} matches {
			ELEMENT[at0001] occurrences matches {0..1} matches {	-- Exclusion Statement
				value matches {
					DV_TEXT matches {*}
				}
			}
			ELEMENT[at0002] occurrences matches {0..1} matches {	-- Excluded Symptom
				value matches {
					DV_TEXT matches {*}
					DV_CODED_TEXT matches {
						defining_code matches {[local::]}
					}
				}
			}
		}
	}


ontology
	term_definitions = <
		["en"] = <
			items = <
				["at0000"] = <
					text = <"Exclusion of a symptom or sign">
					description = <"Statement to explicitly record that a symptom or signe was reported as not present.">
				>
				["at0001"] = <
					text = <"Exclusion Statement">
					description = <"A statement about the exclusion of known symptoms in the health record.">
					comment = <"For example: \"No significant symptoms\".">
				>
				["at0002"] = <
					text = <"Excluded Symptom">
					description = <"Identification of the specific symptom to which the Exclusion Statement applies.">
					comment = <"Coding of the Symptom with a terminology is desirable, where possible.">
				>
			>
		>
		["nb"] = <
			items = <
				["at0000"] = <
					text = <"*Exclusion of a symptom or sign(en)">
					description = <"*Statement to explicitly record that a symptom or signe was reported as not present.(en)">
				>
				["at0001"] = <
					text = <"*Exclusion Statement(en)">
					description = <"*A statement about the exclusion of known symptoms in the health record.(en)">
					comment = <"*For example: \"No significant symptoms\".(en)">
				>
				["at0002"] = <
					text = <"*Excluded Symptom(en)">
					description = <"*Identification of the specific symptom to which the Exclusion Statement applies.(en)">
					comment = <"*Coding of the Symptom with a terminology is desirable, where possible.(en)">
				>
			>
		>
	>

Summary

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of CLUSTER.items (Closed)
  • The element 1 is sliced based on the value of CLUSTER.items.value (Closed)

Maturity: 1

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CLUSTER 0..* CLUSTER Exclusion of a symptom or sign
... Slices for items 1..* ITEM Ordered list of items - `CLUSTER` or `ELEMENT` objects - under this `CLUSTER`.
Slice: Unordered, Closed by profile:$this
.... items:at0001 0..1 ELEMENT Exclusion Statement
..... value 0..1 DV_TEXT Property representing leaf value object of `ELEMENT`.
.... items:at0002 0..1 ELEMENT Excluded Symptom
..... Slices for value 0..1 DATA_VALUE Property representing leaf value object of `ELEMENT`.
Slice: Unordered, Closed by type:$this
...... value:DV_TEXT 0..1 DV_TEXT Property representing leaf value object of `ELEMENT`.
...... value:DV_CODED_TEXT 0..1 DV_CODED_TEXT Property representing leaf value object of `ELEMENT`.
Binding: Excluded Symptom ValueSet (required)

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
CLUSTER.items:at0002.​value:DV_CODED_TEXT Base required Excluded Symptom ValueSet 📦1.0.0-ballot This IG

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. CLUSTER C 0..* CLUSTER Exclusion of a symptom or sign
Constraints: Links_valid, Archetyped_valid, Archetype_node_id_valid
... name 1..1 DV_TEXT Runtime name of this fragment, used to build runtime paths.
... archetype_node_id 1..1 string Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths.
... uid 0..1 UID_BASED_ID Optional globally unique object identifier for root points of archetyped structures.
... archetype_details 0..1 ARCHETYPED Details of archetyping used on this node.
... feeder_audit 0..1 FEEDER_AUDIT Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.
... Slices for items 1..* ITEM Ordered list of items - `CLUSTER` or `ELEMENT` objects - under this `CLUSTER`.
Slice: Unordered, Closed by profile:$this
.... items:at0001 0..1 ELEMENT Exclusion Statement
..... name 1..1 DV_TEXT Runtime name of this fragment, used to build runtime paths.
..... archetype_node_id 1..1 string Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths.
..... uid 0..1 UID_BASED_ID Optional globally unique object identifier for root points of archetyped structures.
..... links 0..* LINK Links to other archetyped structures (data whose root object inherits from `ARCHETYPED`, such as `ENTRY`, `SECTION` and so on).
..... archetype_details 0..1 ARCHETYPED Details of archetyping used on this node.
..... feeder_audit 0..1 FEEDER_AUDIT Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.
..... null_flavour 0..1 DV_CODED_TEXT Flavour of null value, e.
..... value 0..1 DV_TEXT Property representing leaf value object of `ELEMENT`.
..... null_reason 0..1 DV_TEXT Optional specific reason for null value; if set, `_null_flavour_` must be set.
.... items:at0002 0..1 ELEMENT Excluded Symptom
..... name 1..1 DV_TEXT Runtime name of this fragment, used to build runtime paths.
..... archetype_node_id 1..1 string Design-time archetype identifier of this node taken from its generating archetype; used to build archetype paths.
..... uid 0..1 UID_BASED_ID Optional globally unique object identifier for root points of archetyped structures.
..... links 0..* LINK Links to other archetyped structures (data whose root object inherits from `ARCHETYPED`, such as `ENTRY`, `SECTION` and so on).
..... archetype_details 0..1 ARCHETYPED Details of archetyping used on this node.
..... feeder_audit 0..1 FEEDER_AUDIT Audit trail from non-openEHR system of original commit of information forming the content of this node, or from a conversion gateway which has synthesised this node.
..... null_flavour 0..1 DV_CODED_TEXT Flavour of null value, e.
..... Slices for value 0..1 DATA_VALUE Property representing leaf value object of `ELEMENT`.
Slice: Unordered, Closed by type:$this
...... value:DV_TEXT 0..1 DV_TEXT Property representing leaf value object of `ELEMENT`.
...... value:DV_CODED_TEXT 0..1 DV_CODED_TEXT Property representing leaf value object of `ELEMENT`.
..... null_reason 0..1 DV_TEXT Optional specific reason for null value; if set, `_null_flavour_` must be set.

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
Archetype_node_id_valid error CLUSTER Archetype node id valid must not be empty archetype_node_id.empty().not()
Archetyped_valid error CLUSTER Archetyped valid must satisfy exclusive conditions is_archetype_root() xor archetype_details .empty()
Links_valid error CLUSTER Links valid must be present links.exists() implies links.empty().not()

openEHR View

.Items
..Exclusion Statement
Optional
DV_TEXT
 A statement about the exclusion of known symptoms in the health record.
..Excluded Symptom
Optional
DV_TEXT
 Identification of the specific symptom to which the Exclusion Statement applies.
..Excluded Symptom
Optional
DV_CODED_TEXT
 Identification of the specific symptom to which the Exclusion Statement applies.

doco Documentation for this format
archetype (adl_version=1.4; rm_release=1.1.0; uid=659df819-b8da-4489-9b7e-0a20074f543c)
	openEHR-EHR-CLUSTER.exclusion_symptom_sign.v0

concept
	[at0000]	-- Exclusion of a symptom or sign
language
	original_language = <[ISO_639-1::en]>
	translations = <
		["nb"] = <
			language = <[ISO_639-1::nb]>
			author = <
				["name"] = <"Lars Bitsch-Larsen">
				["organisation"] = <"Haukeland University Hospital of Bergen, Norway">
			>
			accreditation = <"MD, DEAA, MBA, spec in anesthesia, spec in tropical medicine.">
		>
	>
description
	original_author = <
		["name"] = <"Heather Leslie">
		["organisation"] = <"Ocean Informatics">
		["email"] = <"heather.leslie@oceaninformatics.com">
		["date"] = <"2015-06-26">
	>
	details = <
		["nb"] = <
			language = <[ISO_639-1::nb]>
			purpose = <"Anvendes for registrering av fravær av et spesifikk symptom som definert i \"openEHR-EHR-CLUSTER.symptom.v1 archetype\".">
			use = <"">
			keywords = <"Symptom", "fravær", "eksklusjon">
			misuse = <"">
			copyright = <"© openEHR Foundation">
		>
		["en"] = <
			language = <[ISO_639-1::en]>
			purpose = <"To record a positive statement to explicitly record that a symptom or sign was reported as not present.">
			use = <"Use to record a positive statement to explicitly record that a symptom or sign was reported as not present.
Use to record exlicitly that a symptom or sign was absolutely not present. If this is not absolutely required, consider use of the 'Nil significant' data element within the CLUSTER.symptom_sign archetype.

This archetype has been specifically designed to be used in the 'Structured detail' SLOT within the OBSERVATION.story archetype, but can also be used within other OBSERVATION or CLUSTER archetypes, where clinically appropriate.">
			keywords = <"symptom, absence, exclusion", ...>
			misuse = <"">
			copyright = <"© openEHR Foundation">
		>
	>
	lifecycle_state = <"in_development">
	other_contributors = <>
	other_details = <
		["licence"] = <"This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/.">
		["custodian_organisation"] = <"openEHR Foundation">
		["current_contact"] = <"Heather Leslie, Ocean Informatics<heather.leslie@oceaninformatics.com>">
		["original_namespace"] = <"org.openehr">
		["original_publisher"] = <"openEHR Foundation">
		["custodian_namespace"] = <"org.openehr">
		["MD5-CAM-1.0.1"] = <"4C7933C02F879864FC54A31737ABEBD3">
		["build_uid"] = <"e1d694db-a6eb-48c3-a4d1-f4fef9f65b75">
		["revision"] = <"0.0.1-alpha">
	>

definition
	CLUSTER[at0000] matches {	-- Exclusion of a symptom or sign
		items cardinality matches {1..*; unordered} matches {
			ELEMENT[at0001] occurrences matches {0..1} matches {	-- Exclusion Statement
				value matches {
					DV_TEXT matches {*}
				}
			}
			ELEMENT[at0002] occurrences matches {0..1} matches {	-- Excluded Symptom
				value matches {
					DV_TEXT matches {*}
					DV_CODED_TEXT matches {
						defining_code matches {[local::]}
					}
				}
			}
		}
	}


ontology
	term_definitions = <
		["en"] = <
			items = <
				["at0000"] = <
					text = <"Exclusion of a symptom or sign">
					description = <"Statement to explicitly record that a symptom or signe was reported as not present.">
				>
				["at0001"] = <
					text = <"Exclusion Statement">
					description = <"A statement about the exclusion of known symptoms in the health record.">
					comment = <"For example: \"No significant symptoms\".">
				>
				["at0002"] = <
					text = <"Excluded Symptom">
					description = <"Identification of the specific symptom to which the Exclusion Statement applies.">
					comment = <"Coding of the Symptom with a terminology is desirable, where possible.">
				>
			>
		>
		["nb"] = <
			items = <
				["at0000"] = <
					text = <"*Exclusion of a symptom or sign(en)">
					description = <"*Statement to explicitly record that a symptom or signe was reported as not present.(en)">
				>
				["at0001"] = <
					text = <"*Exclusion Statement(en)">
					description = <"*A statement about the exclusion of known symptoms in the health record.(en)">
					comment = <"*For example: \"No significant symptoms\".(en)">
				>
				["at0002"] = <
					text = <"*Excluded Symptom(en)">
					description = <"*Identification of the specific symptom to which the Exclusion Statement applies.(en)">
					comment = <"*Coding of the Symptom with a terminology is desirable, where possible.(en)">
				>
			>
		>
	>

Summary

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of CLUSTER.items (Closed)
  • The element 1 is sliced based on the value of CLUSTER.items.value (Closed)

Maturity: 1

 

Other representations of profile: CSV, Excel