臺灣榮總腦中風實作指引（TW VGH Stroke IG）, published by 高雄榮民總醫院 (VGHKS). This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/SitatechCo/TWVGHStroke_IG_Build/ and changes regularly. See the Directory of published versions
Resource Profile: 腦中風－檢驗結果
| Official URL: http://vgh-stroke-ig.fhir.tw/StructureDefinition/StrokeLaboratory | Version: 0.1.0 | |||
| Draft as of 2026-10-07 | Computable Name: StrokeLaboratory | |||
此 Profile 說明本 IG 如何進一步定義 FHIR 的 Observation Resource，以呈現腦中風病人的抽血檢驗結果，例如血液常規、凝血功能、血糖、腎功能、肝功能與血脂。
每個檢驗項目、每次採檢各建立一筆 Observation，以 code 區分項目。有實際採檢時間才建立；沒有採檢時間時，原值只保存在登錄表單（StrokeRegistryResponse）。
Usages:
- Use this Profile: 腦中風－個管系統個案資料包 and 腦中風－EVT 登錄個案資料包
- Examples for this Profile: Observation/stroke-lab-hemoglobin-example and Observation/stroke-lab-inr-not-available-example
You can also check for usages in the FHIR IG Statistics
Formal Views of Profile Content
Description of Profiles, Differentials, Snapshots and how the different presentations work.
| Name | Flags | Card. | Type | Description & Constraints Filter:  |
|---|---|---|---|---|
  Observation |
C | 0..* | TWCoreObservationLaboratoryResult | 檢驗檢查，測量及簡單的判定。 Constraints: obs-6, obs-7, tw-core-4 |
  implicitRules |
0..1 | uri | 創建此內容所依據的一組規則 | |
 modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |
| status |
1..1 | code | 結果狀態。[填 final／amended／unknown 等] Binding: ObservationStatus (required): 檢驗檢查的狀態代碼；應填入所綁定值集中的其中一個代碼。 | |
  Slices for category |
1..* | CodeableConceptTW  |
結果類別。[應包含 laboratory] Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): 高層次的檢驗檢查分類；鼓勵使用所綁定值集中的代碼，但不強制一定要使用此值集，你也可使用其他值集的代碼或單純以文字表示。 Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
   category:twcore |
1..1 | CodeableConcept | Classification of type of observation Binding: 臺灣衛福部資訊處Observation Clinical Result類型值集 (required): 此slice綁定的值集之綁定強度雖為最高強度「要求使用(Requird)」，但因slice之特性，其不會限制僅能填此值集中的代碼，故在實作時也可使用其他值集的代碼。 Required Pattern: At least the following | |
  id |
0..1 | string | Unique id for inter-element referencing | |
 extension |
0..* | Extension | Additional content defined by implementations | |
  coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
 id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: laboratory | |
| display |
0..1 | string | Representation defined by the system | |
 userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
 text |
0..1 | string | Plain text representation of the concept | |
| code |
1..1 | CodeableConceptTW |
檢驗項目。[strokeObservation Slice 應填入 StrokeLaboratoryCodeVS 的代碼] Binding: 臺灣核心-實驗室檢驗檢查值集 (extensible) | |
| Slices for coding |
1..* | CodingTW |
由專門術語系統（terminology system）定義的代碼 Slice: Unordered, Open by pattern:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
  coding:All Slices |
Content/Rules for all slices | |||
  system |
1..1 | uri | 專門術語系統（terminology system）的識別 | |
| code |
1..1 | code | 系統定義的語法之符號 | |
 display |
0..1 | string | 由系統定義的表示法 | |
| coding:strokeObservation |
1..1 | CodingTW |
本 IG 檢驗項目代碼。[應填入 StrokeLaboratoryCodeVS 的代碼] Binding: 腦中風－檢驗結果項目值集 (required) Required Pattern: At least the following | |
| 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://vgh-stroke-ig.fhir.tw/CodeSystem/stroke-observation | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
0..1 | code | Symbol in syntax defined by the system | |
| 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 | 概念的文字表示法 | |
 subject |
1..1 | Reference(腦中風－病人基本資料) | 病人。[應參照 StrokePatient] | |
| encounter |
0..1 | Reference(腦中風－就醫事件) | 就醫事件。[應參照 StrokeEncounter] | |
| effective[x] |
C | 1..1 | dateTime | 採檢日期與時間。[YYYY-MM-DD；時區確認後填 YYYY-MM-DDThh:mm:ss＋時區] Constraints: tw-core-3 |
| performer |
0..* | Reference(TW Core Practitioner | TW Core Organization | TW Core Patient | TW Core PractitionerRole | TW Core CareTeam) | 誰負責這項檢驗檢查 | |
| value[x] |
C | 0..1 | Quantity | 檢驗數值。[依來源原值填寫] Constraints: tw-core-5 |
| value |
1..1 | decimal | 數值。[照來源原值填寫] | |
| comparator |
0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented. | |
| unit |
0..1 | string | 單位顯示。[確認單位後填寫] | |
| system |
C | 0..1 | uri | 單位系統。[固定為 http://unitsofmeasure.org] Required Pattern: http://unitsofmeasure.org |
| code |
0..1 | code | UCUM 單位代碼。[確認單位後填寫] | |
| dataAbsentReason |
C | 0..1 | CodeableConceptTW |
缺值原因。[結果為 NA 等無數值時填 unknown] Binding: DataAbsentReason (extensible): 代碼具體說明檢驗檢查結果缺少的原因；應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。 |
 component |
0..* | BackboneElement | 組成之（部分）檢驗檢查的檢驗結果 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| code |
1..1 | CodeableConceptTW |
組成之檢驗檢查的型別（代碼／型別） Binding: 臺灣核心-實驗室檢驗檢查值集 (example) | |
 value[x] |
0..1 | 組成之檢驗檢查的實際結果 | ||
| valueQuantity |
Quantity | |||
| valueCodeableConcept |
CodeableConcept | |||
| valueString |
string | |||
| valueBoolean |
boolean | |||
| valueInteger |
integer | |||
| valueRange |
Range | |||
| valueRatio |
Ratio | |||
| valueSampledData |
SampledData | |||
| valueTime |
time | |||
| valueDateTime |
dateTime | |||
| valuePeriod |
Period | |||
| 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:twcore | Base | required | 臺灣衛福部資訊處Observation Clinical Result類型值集 | 📦0.3.0 | 臺灣核心實作指引 v1.0 |
| Observation.code | Base | extensible | 臺灣核心-實驗室檢驗檢查值集 | 📦1.0.0 | 臺灣核心實作指引 v1.0 |
| Observation.code.coding:strokeObservation | Base | required | 腦中風－檢驗結果項目值集 | 📦0.1.0 | This IG |
| Observation.value[x].comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std. |
| Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component.code | Base | example | 臺灣核心-實驗室檢驗檢查值集 | 📦1.0.0 | 臺灣核心實作指引 v1.0 |
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()
|
| tw-core-3 | error | Observation.effective[x] | Datetime must be at least to day. |
$this is dateTime implies $this.toString().length() >= 10
|
| tw-core-4 | error | Observation | If there is no component or hasMember element then either a value[x] or a data absent reason must be present. |
(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
|
| tw-core-5 | error | Observation.value[x] | SHALL use UCUM for coded quantity units. |
ofType(Quantity).system.empty() or ofType(Quantity).system = 'http://unitsofmeasure.org'
|
This structure is derived from TWCoreObservationLaboratoryResult
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Observation |
TWCoreObservationLaboratoryResult | |||
| status |
1..1 | code | 結果狀態。[填 final／amended／unknown 等] | |
| category |
1..* | CodeableConceptTW | 結果類別。[應包含 laboratory] | |
| code |
1..1 | CodeableConceptTW | 檢驗項目。[strokeObservation Slice 應填入 StrokeLaboratoryCodeVS 的代碼] | |
| Slices for coding |
1..* | CodingTW | 由專門術語系統（terminology system）定義的代碼 Slice: Unordered, Open by pattern:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:All Slices |
Content/Rules for all slices | |||
| system |
1..1 | uri | 專門術語系統（terminology system）的識別 | |
| code |
1..1 | code | 系統定義的語法之符號 | |
| coding:strokeObservation |
1..1 | CodingTW | 本 IG 檢驗項目代碼。[應填入 StrokeLaboratoryCodeVS 的代碼] Binding: 腦中風－檢驗結果項目值集 (required) Required Pattern: At least the following | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://vgh-stroke-ig.fhir.tw/CodeSystem/stroke-observation | |
| subject |
1..1 | Reference(腦中風－病人基本資料) | 病人。[應參照 StrokePatient] | |
| encounter |
0..1 | Reference(腦中風－就醫事件) | 就醫事件。[應參照 StrokeEncounter] | |
| effective[x] |
1..1 | dateTime | 採檢日期與時間。[YYYY-MM-DD；時區確認後填 YYYY-MM-DDThh:mm:ss＋時區] | |
| value[x] |
0..1 | Quantity | 檢驗數值。[依來源原值填寫] | |
| value |
1..1 | decimal | 數值。[照來源原值填寫] | |
| unit |
0..1 | string | 單位顯示。[確認單位後填寫] | |
| system |
0..1 | uri | 單位系統。[固定為 http://unitsofmeasure.org] Required Pattern: http://unitsofmeasure.org | |
| code |
0..1 | code | UCUM 單位代碼。[確認單位後填寫] | |
| dataAbsentReason |
0..1 | CodeableConceptTW | 缺值原因。[結果為 NA 等無數值時填 unknown] | |
| Documentation for this format | ||||
Terminology Bindings (Differential)
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.code.coding:strokeObservation | Base | required | 腦中風－檢驗結果項目值集 | 📦0.1.0 | This IG |
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| Observation |
C | 0..* | TWCoreObservationLaboratoryResult | 檢驗檢查，測量及簡單的判定。 Constraints: obs-6, obs-7, tw-core-4 | ||||
| id |
0..1 | id | 不重複的ID用以識別儲存在特定FHIR Server中的Observation紀錄，通常又稱為邏輯性ID。 | |||||
| meta |
0..1 | Meta | 此Observation Resource的metadata | |||||
| implicitRules |
0..1 | uri | 創建此內容所依據的一組規則 | |||||
| language |
0..1 | code | 用以表述Observation Resource內容的語言。 Binding: CommonLanguages (preferred): 人類語言；鼓勵使用CommonLanguages代碼表中的代碼，但不強制一定要使用此代碼表，你也可使用其他代碼表的代碼或單純以文字表示。
Example Value: zh-TW | |||||
| text |
0..1 | Narrative | Observation Resource之內容摘要以供人閱讀 This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
 extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |||||
| identifier |
0..* | Identifier | 檢驗檢查的識別碼，通常為業務目的所使用的識別碼，例如：檢驗序號或單號。 | |||||
| basedOn |
0..* | Reference(TW Core CarePlan | DeviceRequest | ImmunizationRecommendation | TW Core MedicationRequest | NutritionOrder | TW Core ServiceRequest) | 依據的照護計畫／提議／醫令 | |||||
| partOf |
0..* | Reference(MedicationAdministration | TW Core MedicationDispense | TW Core MedicationStatement | TW Core Procedure | TW Core Immunization | TW Core ImagingStudy) | 此檢驗檢查是哪個參照事件的一部分 | |||||
| status |
1..1 | code | 結果狀態。[填 final／amended／unknown 等] Binding: ObservationStatus (required): 檢驗檢查的狀態代碼；應填入所綁定值集中的其中一個代碼。 | |||||
| Slices for category |
1..* | CodeableConceptTW |
結果類別。[應包含 laboratory] Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): 高層次的檢驗檢查分類；鼓勵使用所綁定值集中的代碼，但不強制一定要使用此值集，你也可使用其他值集的代碼或單純以文字表示。 Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| category:twcore |
1..1 | CodeableConcept | Classification of type of observation Binding: 臺灣衛福部資訊處Observation Clinical Result類型值集 (required): 此slice綁定的值集之綁定強度雖為最高強度「要求使用(Requird)」，但因slice之特性，其不會限制僅能填此值集中的代碼，故在實作時也可使用其他值集的代碼。 Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: laboratory | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
1..1 | CodeableConceptTW |
檢驗項目。[strokeObservation Slice 應填入 StrokeLaboratoryCodeVS 的代碼] Binding: 臺灣核心-實驗室檢驗檢查值集 (extensible) | |||||
| id |
0..1 | string | 唯一可識別ID，以供資料項目間相互參照。 | |||||
| extension |
0..* | Extension | 擴充的資料項目 Slice: Unordered, Open by value:url | |||||
| Slices for coding |
1..* | CodingTW |
由專門術語系統（terminology system）定義的代碼 Slice: Unordered, Open by pattern:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| coding:All Slices |
Content/Rules for all slices | |||||||
| id |
0..1 | string | 唯一可識別ID，以供資料項目間相互參照。 | |||||
| extension |
0..* | Extension | 擴充的資料項目 Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | 專門術語系統（terminology system）的識別 | |||||
| version |
0..1 | string | 系統的版本—如果相關的話 | |||||
| code |
1..1 | code | 系統定義的語法之符號 | |||||
| display |
0..1 | string | 由系統定義的表示法 | |||||
| userSelected |
0..1 | boolean | 此編碼是否由使用者直接選擇？ | |||||
| coding:strokeObservation |
1..1 | CodingTW |
本 IG 檢驗項目代碼。[應填入 StrokeLaboratoryCodeVS 的代碼] Binding: 腦中風－檢驗結果項目值集 (required) Required Pattern: At least the following | |||||
| 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://vgh-stroke-ig.fhir.tw/CodeSystem/stroke-observation | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
0..1 | code | Symbol in syntax defined by the system | |||||
| 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 | 概念的文字表示法 | |||||
| subject |
1..1 | Reference(腦中風－病人基本資料) | 病人。[應參照 StrokePatient] | |||||
| focus |
0..* | Reference(Resource) | 當檢驗檢查並非有關於與病人本身，檢驗檢查是關於什麼。 | |||||
| encounter |
0..1 | Reference(腦中風－就醫事件) | 就醫事件。[應參照 StrokeEncounter] | |||||
| effective[x] |
C | 1..1 | dateTime | 採檢日期與時間。[YYYY-MM-DD；時區確認後填 YYYY-MM-DDThh:mm:ss＋時區] Constraints: tw-core-3 | ||||
| issued |
0..1 | instant | 此版本檢驗檢查完成的日期或時間 | |||||
| performer |
0..* | Reference(TW Core Practitioner | TW Core Organization | TW Core Patient | TW Core PractitionerRole | TW Core CareTeam) | 誰負責這項檢驗檢查 | |||||
| value[x] |
C | 0..1 | Quantity | 檢驗數值。[依來源原值填寫] Constraints: tw-core-5 | ||||
| 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 |
1..1 | decimal | 數值。[照來源原值填寫] | |||||
| comparator |
0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented. | |||||
| unit |
0..1 | string | 單位顯示。[確認單位後填寫] | |||||
| system |
C | 0..1 | uri | 單位系統。[固定為 http://unitsofmeasure.org] Required Pattern: http://unitsofmeasure.org | ||||
| code |
0..1 | code | UCUM 單位代碼。[確認單位後填寫] | |||||
| dataAbsentReason |
C | 0..1 | CodeableConceptTW |
缺值原因。[結果為 NA 等無數值時填 unknown] Binding: DataAbsentReason (extensible): 代碼具體說明檢驗檢查結果缺少的原因；應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。 | ||||
| interpretation |
0..* | CodeableConceptTW |
高、低、正常等 Binding: ObservationInterpretationCodes (extensible): 代碼指明檢驗檢查結果的解釋；應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。 | |||||
| note |
0..* | Annotation | 關於此檢驗檢查之解說 | |||||
| bodySite |
0..1 | CodeableConceptTW |
接受檢驗檢查的身體部位。此為SNOMED CT代碼，若機構已有購買相關授權，亦可使用。 Binding: SNOMEDCTBodyStructures (extensible) | |||||
| method |
0..1 | CodeableConceptTW |
此檢驗檢查使用何種方法完成 Binding: ObservationMethods (extensible) | |||||
| specimen |
0..1 | Reference(TW Core Specimen) | 此檢驗檢查的檢體 | |||||
| device |
0..1 | Reference(Device | DeviceMetric) | （測量）設備 | |||||
| referenceRange |
C | 0..* | BackboneElement | 解釋結果值的指引。
obs-3：必須至少有低、高或文字表述。 Constraints: obs-3 | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| low |
C | 0..1 | SimpleQuantity(4.0.1) | 參考範圍值的下限值，如果相關。 Constraints: sqty-1 | ||||
| high |
C | 0..1 | SimpleQuantity(4.0.1) | 參考範圍值的上限值，如果相關。 Constraints: sqty-1 | ||||
| type |
0..1 | CodeableConceptTW |
參考範圍值的限定詞 Binding: ObservationReferenceRangeMeaningCodes (preferred): 用以表述參考範圍值之含意的代碼；鼓勵使用所綁定值集中的代碼，但不強制一定要使用此值集，你也可使用其他值集的代碼或單純以文字表示。 | |||||
| appliesTo |
0..* | CodeableConceptTW |
參考範圍值是用適用的對象或人口群 Binding: ObservationReferenceRangeAppliesToCodes (example): 用以指明參考範圍值適用的對象或人口群之代碼；可參考所綁定代碼表，但此代碼表只是針對這個欄位的一個可能值的示例，不預期也不鼓勵使用者一定要使用此代碼表的代碼代碼表中的代碼。 | |||||
| age |
0..1 | Range | 適用的年齡範圍值，如果相關。 | |||||
| text |
0..1 | string | 檢驗檢查中以文字表述的參考範圍值 | |||||
| hasMember |
0..* | Reference(TW Core Observation Laboratory Result | TW Core QuestionnaireResponse | MolecularSequence) | 屬於此組檢驗檢查的相關Resource | |||||
| derivedFrom |
0..* | Reference(TW Core DocumentReference | TW Core ImagingStudy | TW Core Media | TW Core QuestionnaireResponse | TW Core Observation Laboratory Result | MolecularSequence) | 檢驗檢查源自哪些相關測量 | |||||
| component |
0..* | BackboneElement | 組成之（部分）檢驗檢查的檢驗結果 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| code |
1..1 | CodeableConceptTW |
組成之檢驗檢查的型別（代碼／型別） Binding: 臺灣核心-實驗室檢驗檢查值集 (example) | |||||
| value[x] |
0..1 | 組成之檢驗檢查的實際結果 | ||||||
| valueQuantity |
Quantity | |||||||
| valueCodeableConcept |
CodeableConcept | |||||||
| valueString |
string | |||||||
| valueBoolean |
boolean | |||||||
| valueInteger |
integer | |||||||
| valueRange |
Range | |||||||
| valueRatio |
Ratio | |||||||
| valueSampledData |
SampledData | |||||||
| valueTime |
time | |||||||
| valueDateTime |
dateTime | |||||||
| valuePeriod |
Period | |||||||
| dataAbsentReason |
C | 0..1 | CodeableConceptTW |
為什麼缺少組成之檢驗檢查結果 Binding: DataAbsentReason (extensible): 代碼指明為什麼結果（Observation.value[x]）缺少；應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。 | ||||
| interpretation |
0..* | CodeableConceptTW |
高、低、正常等。 Binding: ObservationInterpretationCodes (extensible): 用以指明檢驗檢查的解釋之代碼。應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。 | |||||
| referenceRange |
0..* | See referenceRange (Observation) | 解釋此組成之檢驗驗查的結果值之指引 | |||||
| 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:twcore | Base | required | 臺灣衛福部資訊處Observation Clinical Result類型值集 | 📦0.3.0 | 臺灣核心實作指引 v1.0 |
| Observation.code | Base | extensible | 臺灣核心-實驗室檢驗檢查值集 | 📦1.0.0 | 臺灣核心實作指引 v1.0 |
| Observation.code.coding:strokeObservation | Base | required | 腦中風－檢驗結果項目值集 | 📦0.1.0 | This IG |
| Observation.value[x].comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std. |
| Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.interpretation | Base | extensible | Observation Interpretation Codes | 📦4.0.1 | FHIR Std. |
| Observation.bodySite | Base | extensible | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std. |
| Observation.method | Base | extensible | 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 | 臺灣核心-實驗室檢驗檢查值集 | 📦1.0.0 | 臺灣核心實作指引 v1.0 |
| Observation.component.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component.interpretation | Base | extensible | Observation Interpretation Codes | 📦4.0.1 | FHIR Std. |
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-3 | error | Observation.referenceRange | Must have at least a low or a high or text |
low.exists() or high.exists() or text.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()
|
| sqty-1 | error | Observation.referenceRange.low, Observation.referenceRange.high | The comparator is not used on a SimpleQuantity |
comparator.empty()
|
| tw-core-3 | error | Observation.effective[x] | Datetime must be at least to day. |
$this is dateTime implies $this.toString().length() >= 10
|
| tw-core-4 | error | Observation | If there is no component or hasMember element then either a value[x] or a data absent reason must be present. |
(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
|
| tw-core-5 | error | Observation.value[x] | SHALL use UCUM for coded quantity units. |
ofType(Quantity).system.empty() or ofType(Quantity).system = 'http://unitsofmeasure.org'
|
This structure is derived from TWCoreObservationLaboratoryResult
Summary
Mandatory: 4 elements(1 nested mandatory element)
Must-Support: 5 elements
Structures
This structure refers to these other structures:
- 腦中風－病人基本資料 (http://vgh-stroke-ig.fhir.tw/StructureDefinition/StrokePatient)
- 腦中風－就醫事件 (http://vgh-stroke-ig.fhir.tw/StructureDefinition/StrokeEncounter)
Slices
This structure defines the following Slices:
- The element 1 is sliced based on the value of Observation.code.coding
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Observation |
C | 0..* | TWCoreObservationLaboratoryResult | 檢驗檢查，測量及簡單的判定。 Constraints: obs-6, obs-7, tw-core-4 |
| implicitRules |
0..1 | uri | 創建此內容所依據的一組規則 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |
| status |
1..1 | code | 結果狀態。[填 final／amended／unknown 等] Binding: ObservationStatus (required): 檢驗檢查的狀態代碼；應填入所綁定值集中的其中一個代碼。 | |
| Slices for category |
1..* | CodeableConceptTW |
結果類別。[應包含 laboratory] Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): 高層次的檢驗檢查分類；鼓勵使用所綁定值集中的代碼，但不強制一定要使用此值集，你也可使用其他值集的代碼或單純以文字表示。 Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| category:twcore |
1..1 | CodeableConcept | Classification of type of observation Binding: 臺灣衛福部資訊處Observation Clinical Result類型值集 (required): 此slice綁定的值集之綁定強度雖為最高強度「要求使用(Requird)」，但因slice之特性，其不會限制僅能填此值集中的代碼，故在實作時也可使用其他值集的代碼。 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://terminology.hl7.org/CodeSystem/observation-category | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: laboratory | |
| 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 |
1..1 | CodeableConceptTW |
檢驗項目。[strokeObservation Slice 應填入 StrokeLaboratoryCodeVS 的代碼] Binding: 臺灣核心-實驗室檢驗檢查值集 (extensible) | |
| Slices for coding |
1..* | CodingTW |
由專門術語系統（terminology system）定義的代碼 Slice: Unordered, Open by pattern:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:All Slices |
Content/Rules for all slices | |||
| system |
1..1 | uri | 專門術語系統（terminology system）的識別 | |
| code |
1..1 | code | 系統定義的語法之符號 | |
| display |
0..1 | string | 由系統定義的表示法 | |
| coding:strokeObservation |
1..1 | CodingTW |
本 IG 檢驗項目代碼。[應填入 StrokeLaboratoryCodeVS 的代碼] Binding: 腦中風－檢驗結果項目值集 (required) Required Pattern: At least the following | |
| 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://vgh-stroke-ig.fhir.tw/CodeSystem/stroke-observation | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
0..1 | code | Symbol in syntax defined by the system | |
| 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 | 概念的文字表示法 | |
| subject |
1..1 | Reference(腦中風－病人基本資料) | 病人。[應參照 StrokePatient] | |
| encounter |
0..1 | Reference(腦中風－就醫事件) | 就醫事件。[應參照 StrokeEncounter] | |
| effective[x] |
C | 1..1 | dateTime | 採檢日期與時間。[YYYY-MM-DD；時區確認後填 YYYY-MM-DDThh:mm:ss＋時區] Constraints: tw-core-3 |
| performer |
0..* | Reference(TW Core Practitioner | TW Core Organization | TW Core Patient | TW Core PractitionerRole | TW Core CareTeam) | 誰負責這項檢驗檢查 | |
| value[x] |
C | 0..1 | Quantity | 檢驗數值。[依來源原值填寫] Constraints: tw-core-5 |
| value |
1..1 | decimal | 數值。[照來源原值填寫] | |
| comparator |
0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented. | |
| unit |
0..1 | string | 單位顯示。[確認單位後填寫] | |
| system |
C | 0..1 | uri | 單位系統。[固定為 http://unitsofmeasure.org] Required Pattern: http://unitsofmeasure.org |
| code |
0..1 | code | UCUM 單位代碼。[確認單位後填寫] | |
| dataAbsentReason |
C | 0..1 | CodeableConceptTW |
缺值原因。[結果為 NA 等無數值時填 unknown] Binding: DataAbsentReason (extensible): 代碼具體說明檢驗檢查結果缺少的原因；應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。 |
| component |
0..* | BackboneElement | 組成之（部分）檢驗檢查的檢驗結果 | |
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |
| code |
1..1 | CodeableConceptTW |
組成之檢驗檢查的型別（代碼／型別） Binding: 臺灣核心-實驗室檢驗檢查值集 (example) | |
| value[x] |
0..1 | 組成之檢驗檢查的實際結果 | ||
| valueQuantity |
Quantity | |||
| valueCodeableConcept |
CodeableConcept | |||
| valueString |
string | |||
| valueBoolean |
boolean | |||
| valueInteger |
integer | |||
| valueRange |
Range | |||
| valueRatio |
Ratio | |||
| valueSampledData |
SampledData | |||
| valueTime |
time | |||
| valueDateTime |
dateTime | |||
| valuePeriod |
Period | |||
| 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:twcore | Base | required | 臺灣衛福部資訊處Observation Clinical Result類型值集 | 📦0.3.0 | 臺灣核心實作指引 v1.0 |
| Observation.code | Base | extensible | 臺灣核心-實驗室檢驗檢查值集 | 📦1.0.0 | 臺灣核心實作指引 v1.0 |
| Observation.code.coding:strokeObservation | Base | required | 腦中風－檢驗結果項目值集 | 📦0.1.0 | This IG |
| Observation.value[x].comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std. |
| Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component.code | Base | example | 臺灣核心-實驗室檢驗檢查值集 | 📦1.0.0 | 臺灣核心實作指引 v1.0 |
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()
|
| tw-core-3 | error | Observation.effective[x] | Datetime must be at least to day. |
$this is dateTime implies $this.toString().length() >= 10
|
| tw-core-4 | error | Observation | If there is no component or hasMember element then either a value[x] or a data absent reason must be present. |
(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
|
| tw-core-5 | error | Observation.value[x] | SHALL use UCUM for coded quantity units. |
ofType(Quantity).system.empty() or ofType(Quantity).system = 'http://unitsofmeasure.org'
|
Differential View
This structure is derived from TWCoreObservationLaboratoryResult
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Observation |
TWCoreObservationLaboratoryResult | |||
| status |
1..1 | code | 結果狀態。[填 final／amended／unknown 等] | |
| category |
1..* | CodeableConceptTW | 結果類別。[應包含 laboratory] | |
| code |
1..1 | CodeableConceptTW | 檢驗項目。[strokeObservation Slice 應填入 StrokeLaboratoryCodeVS 的代碼] | |
| Slices for coding |
1..* | CodingTW | 由專門術語系統（terminology system）定義的代碼 Slice: Unordered, Open by pattern:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |
| coding:All Slices |
Content/Rules for all slices | |||
| system |
1..1 | uri | 專門術語系統（terminology system）的識別 | |
| code |
1..1 | code | 系統定義的語法之符號 | |
| coding:strokeObservation |
1..1 | CodingTW | 本 IG 檢驗項目代碼。[應填入 StrokeLaboratoryCodeVS 的代碼] Binding: 腦中風－檢驗結果項目值集 (required) Required Pattern: At least the following | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://vgh-stroke-ig.fhir.tw/CodeSystem/stroke-observation | |
| subject |
1..1 | Reference(腦中風－病人基本資料) | 病人。[應參照 StrokePatient] | |
| encounter |
0..1 | Reference(腦中風－就醫事件) | 就醫事件。[應參照 StrokeEncounter] | |
| effective[x] |
1..1 | dateTime | 採檢日期與時間。[YYYY-MM-DD；時區確認後填 YYYY-MM-DDThh:mm:ss＋時區] | |
| value[x] |
0..1 | Quantity | 檢驗數值。[依來源原值填寫] | |
| value |
1..1 | decimal | 數值。[照來源原值填寫] | |
| unit |
0..1 | string | 單位顯示。[確認單位後填寫] | |
| system |
0..1 | uri | 單位系統。[固定為 http://unitsofmeasure.org] Required Pattern: http://unitsofmeasure.org | |
| code |
0..1 | code | UCUM 單位代碼。[確認單位後填寫] | |
| dataAbsentReason |
0..1 | CodeableConceptTW | 缺值原因。[結果為 NA 等無數值時填 unknown] | |
| Documentation for this format | ||||
Terminology Bindings (Differential)
| Path | Status | Usage | ValueSet | Version | Source |
| Observation.code.coding:strokeObservation | Base | required | 腦中風－檢驗結果項目值集 | 📦0.1.0 | This IG |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| Observation |
C | 0..* | TWCoreObservationLaboratoryResult | 檢驗檢查，測量及簡單的判定。 Constraints: obs-6, obs-7, tw-core-4 | ||||
| id |
0..1 | id | 不重複的ID用以識別儲存在特定FHIR Server中的Observation紀錄，通常又稱為邏輯性ID。 | |||||
| meta |
0..1 | Meta | 此Observation Resource的metadata | |||||
| implicitRules |
0..1 | uri | 創建此內容所依據的一組規則 | |||||
| language |
0..1 | code | 用以表述Observation Resource內容的語言。 Binding: CommonLanguages (preferred): 人類語言；鼓勵使用CommonLanguages代碼表中的代碼，但不強制一定要使用此代碼表，你也可使用其他代碼表的代碼或單純以文字表示。
Example Value: zh-TW | |||||
| text |
0..1 | Narrative | Observation Resource之內容摘要以供人閱讀 This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored | |||||
| identifier |
0..* | Identifier | 檢驗檢查的識別碼，通常為業務目的所使用的識別碼，例如：檢驗序號或單號。 | |||||
| basedOn |
0..* | Reference(TW Core CarePlan | DeviceRequest | ImmunizationRecommendation | TW Core MedicationRequest | NutritionOrder | TW Core ServiceRequest) | 依據的照護計畫／提議／醫令 | |||||
| partOf |
0..* | Reference(MedicationAdministration | TW Core MedicationDispense | TW Core MedicationStatement | TW Core Procedure | TW Core Immunization | TW Core ImagingStudy) | 此檢驗檢查是哪個參照事件的一部分 | |||||
| status |
1..1 | code | 結果狀態。[填 final／amended／unknown 等] Binding: ObservationStatus (required): 檢驗檢查的狀態代碼；應填入所綁定值集中的其中一個代碼。 | |||||
| Slices for category |
1..* | CodeableConceptTW |
結果類別。[應包含 laboratory] Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): 高層次的檢驗檢查分類；鼓勵使用所綁定值集中的代碼，但不強制一定要使用此值集，你也可使用其他值集的代碼或單純以文字表示。 Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| category:twcore |
1..1 | CodeableConcept | Classification of type of observation Binding: 臺灣衛福部資訊處Observation Clinical Result類型值集 (required): 此slice綁定的值集之綁定強度雖為最高強度「要求使用(Requird)」，但因slice之特性，其不會限制僅能填此值集中的代碼，故在實作時也可使用其他值集的代碼。 Required Pattern: At least the following | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: laboratory | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| code |
1..1 | CodeableConceptTW |
檢驗項目。[strokeObservation Slice 應填入 StrokeLaboratoryCodeVS 的代碼] Binding: 臺灣核心-實驗室檢驗檢查值集 (extensible) | |||||
| id |
0..1 | string | 唯一可識別ID，以供資料項目間相互參照。 | |||||
| extension |
0..* | Extension | 擴充的資料項目 Slice: Unordered, Open by value:url | |||||
| Slices for coding |
1..* | CodingTW |
由專門術語系統（terminology system）定義的代碼 Slice: Unordered, Open by pattern:$this Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them | |||||
| coding:All Slices |
Content/Rules for all slices | |||||||
| id |
0..1 | string | 唯一可識別ID，以供資料項目間相互參照。 | |||||
| extension |
0..* | Extension | 擴充的資料項目 Slice: Unordered, Open by value:url | |||||
| system |
1..1 | uri | 專門術語系統（terminology system）的識別 | |||||
| version |
0..1 | string | 系統的版本—如果相關的話 | |||||
| code |
1..1 | code | 系統定義的語法之符號 | |||||
| display |
0..1 | string | 由系統定義的表示法 | |||||
| userSelected |
0..1 | boolean | 此編碼是否由使用者直接選擇？ | |||||
| coding:strokeObservation |
1..1 | CodingTW |
本 IG 檢驗項目代碼。[應填入 StrokeLaboratoryCodeVS 的代碼] Binding: 腦中風－檢驗結果項目值集 (required) Required Pattern: At least the following | |||||
| 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://vgh-stroke-ig.fhir.tw/CodeSystem/stroke-observation | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
0..1 | code | Symbol in syntax defined by the system | |||||
| 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 | 概念的文字表示法 | |||||
| subject |
1..1 | Reference(腦中風－病人基本資料) | 病人。[應參照 StrokePatient] | |||||
| focus |
0..* | Reference(Resource) | 當檢驗檢查並非有關於與病人本身，檢驗檢查是關於什麼。 | |||||
| encounter |
0..1 | Reference(腦中風－就醫事件) | 就醫事件。[應參照 StrokeEncounter] | |||||
| effective[x] |
C | 1..1 | dateTime | 採檢日期與時間。[YYYY-MM-DD；時區確認後填 YYYY-MM-DDThh:mm:ss＋時區] Constraints: tw-core-3 | ||||
| issued |
0..1 | instant | 此版本檢驗檢查完成的日期或時間 | |||||
| performer |
0..* | Reference(TW Core Practitioner | TW Core Organization | TW Core Patient | TW Core PractitionerRole | TW Core CareTeam) | 誰負責這項檢驗檢查 | |||||
| value[x] |
C | 0..1 | Quantity | 檢驗數值。[依來源原值填寫] Constraints: tw-core-5 | ||||
| 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 |
1..1 | decimal | 數值。[照來源原值填寫] | |||||
| comparator |
0..1 | code | < | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented. | |||||
| unit |
0..1 | string | 單位顯示。[確認單位後填寫] | |||||
| system |
C | 0..1 | uri | 單位系統。[固定為 http://unitsofmeasure.org] Required Pattern: http://unitsofmeasure.org | ||||
| code |
0..1 | code | UCUM 單位代碼。[確認單位後填寫] | |||||
| dataAbsentReason |
C | 0..1 | CodeableConceptTW |
缺值原因。[結果為 NA 等無數值時填 unknown] Binding: DataAbsentReason (extensible): 代碼具體說明檢驗檢查結果缺少的原因；應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。 | ||||
| interpretation |
0..* | CodeableConceptTW |
高、低、正常等 Binding: ObservationInterpretationCodes (extensible): 代碼指明檢驗檢查結果的解釋；應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。 | |||||
| note |
0..* | Annotation | 關於此檢驗檢查之解說 | |||||
| bodySite |
0..1 | CodeableConceptTW |
接受檢驗檢查的身體部位。此為SNOMED CT代碼，若機構已有購買相關授權，亦可使用。 Binding: SNOMEDCTBodyStructures (extensible) | |||||
| method |
0..1 | CodeableConceptTW |
此檢驗檢查使用何種方法完成 Binding: ObservationMethods (extensible) | |||||
| specimen |
0..1 | Reference(TW Core Specimen) | 此檢驗檢查的檢體 | |||||
| device |
0..1 | Reference(Device | DeviceMetric) | （測量）設備 | |||||
| referenceRange |
C | 0..* | BackboneElement | 解釋結果值的指引。
obs-3：必須至少有低、高或文字表述。 Constraints: obs-3 | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| low |
C | 0..1 | SimpleQuantity(4.0.1) | 參考範圍值的下限值，如果相關。 Constraints: sqty-1 | ||||
| high |
C | 0..1 | SimpleQuantity(4.0.1) | 參考範圍值的上限值，如果相關。 Constraints: sqty-1 | ||||
| type |
0..1 | CodeableConceptTW |
參考範圍值的限定詞 Binding: ObservationReferenceRangeMeaningCodes (preferred): 用以表述參考範圍值之含意的代碼；鼓勵使用所綁定值集中的代碼，但不強制一定要使用此值集，你也可使用其他值集的代碼或單純以文字表示。 | |||||
| appliesTo |
0..* | CodeableConceptTW |
參考範圍值是用適用的對象或人口群 Binding: ObservationReferenceRangeAppliesToCodes (example): 用以指明參考範圍值適用的對象或人口群之代碼；可參考所綁定代碼表，但此代碼表只是針對這個欄位的一個可能值的示例，不預期也不鼓勵使用者一定要使用此代碼表的代碼代碼表中的代碼。 | |||||
| age |
0..1 | Range | 適用的年齡範圍值，如果相關。 | |||||
| text |
0..1 | string | 檢驗檢查中以文字表述的參考範圍值 | |||||
| hasMember |
0..* | Reference(TW Core Observation Laboratory Result | TW Core QuestionnaireResponse | MolecularSequence) | 屬於此組檢驗檢查的相關Resource | |||||
| derivedFrom |
0..* | Reference(TW Core DocumentReference | TW Core ImagingStudy | TW Core Media | TW Core QuestionnaireResponse | TW Core Observation Laboratory Result | MolecularSequence) | 檢驗檢查源自哪些相關測量 | |||||
| component |
0..* | BackboneElement | 組成之（部分）檢驗檢查的檢驗結果 | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| modifierExtension |
0..* | Extension | Extensions that cannot be ignored even if unrecognized | |||||
| code |
1..1 | CodeableConceptTW |
組成之檢驗檢查的型別（代碼／型別） Binding: 臺灣核心-實驗室檢驗檢查值集 (example) | |||||
| value[x] |
0..1 | 組成之檢驗檢查的實際結果 | ||||||
| valueQuantity |
Quantity | |||||||
| valueCodeableConcept |
CodeableConcept | |||||||
| valueString |
string | |||||||
| valueBoolean |
boolean | |||||||
| valueInteger |
integer | |||||||
| valueRange |
Range | |||||||
| valueRatio |
Ratio | |||||||
| valueSampledData |
SampledData | |||||||
| valueTime |
time | |||||||
| valueDateTime |
dateTime | |||||||
| valuePeriod |
Period | |||||||
| dataAbsentReason |
C | 0..1 | CodeableConceptTW |
為什麼缺少組成之檢驗檢查結果 Binding: DataAbsentReason (extensible): 代碼指明為什麼結果（Observation.value[x]）缺少；應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。 | ||||
| interpretation |
0..* | CodeableConceptTW |
高、低、正常等。 Binding: ObservationInterpretationCodes (extensible): 用以指明檢驗檢查的解釋之代碼。應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。 | |||||
| referenceRange |
0..* | See referenceRange (Observation) | 解釋此組成之檢驗驗查的結果值之指引 | |||||
| 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:twcore | Base | required | 臺灣衛福部資訊處Observation Clinical Result類型值集 | 📦0.3.0 | 臺灣核心實作指引 v1.0 |
| Observation.code | Base | extensible | 臺灣核心-實驗室檢驗檢查值集 | 📦1.0.0 | 臺灣核心實作指引 v1.0 |
| Observation.code.coding:strokeObservation | Base | required | 腦中風－檢驗結果項目值集 | 📦0.1.0 | This IG |
| Observation.value[x].comparator | Base | required | QuantityComparator | 📍4.0.1 | FHIR Std. |
| Observation.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.interpretation | Base | extensible | Observation Interpretation Codes | 📦4.0.1 | FHIR Std. |
| Observation.bodySite | Base | extensible | SNOMED CT Body Structures | 📦4.0.1 | FHIR Std. |
| Observation.method | Base | extensible | 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 | 臺灣核心-實驗室檢驗檢查值集 | 📦1.0.0 | 臺灣核心實作指引 v1.0 |
| Observation.component.dataAbsentReason | Base | extensible | DataAbsentReason | 📦4.0.1 | FHIR Std. |
| Observation.component.interpretation | Base | extensible | Observation Interpretation Codes | 📦4.0.1 | FHIR Std. |
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-3 | error | Observation.referenceRange | Must have at least a low or a high or text |
low.exists() or high.exists() or text.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()
|
| sqty-1 | error | Observation.referenceRange.low, Observation.referenceRange.high | The comparator is not used on a SimpleQuantity |
comparator.empty()
|
| tw-core-3 | error | Observation.effective[x] | Datetime must be at least to day. |
$this is dateTime implies $this.toString().length() >= 10
|
| tw-core-4 | error | Observation | If there is no component or hasMember element then either a value[x] or a data absent reason must be present. |
(component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
|
| tw-core-5 | error | Observation.value[x] | SHALL use UCUM for coded quantity units. |
ofType(Quantity).system.empty() or ofType(Quantity).system = 'http://unitsofmeasure.org'
|
This structure is derived from TWCoreObservationLaboratoryResult
Summary
Mandatory: 4 elements(1 nested mandatory element)
Must-Support: 5 elements
Structures
This structure refers to these other structures:
- 腦中風－病人基本資料 (http://vgh-stroke-ig.fhir.tw/StructureDefinition/StrokePatient)
- 腦中風－就醫事件 (http://vgh-stroke-ig.fhir.tw/StructureDefinition/StrokeEncounter)
Slices
This structure defines the following Slices:
- The element 1 is sliced based on the value of Observation.code.coding
Other representations of profile: CSV, Excel, Schematron