IDEA4RC FHIR Implementation Guide
1.0.0 - release 150

IDEA4RC FHIR Implementation Guide, published by IDEA4RC Project. 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-eu/idea4rc/ and changes regularly. See the Directory of published versions

Resource Profile: ConditionPrimaryCancerI4rc - Detailed Descriptions

Active as of 2026-09-17

Definitions for the Condition-primaryCancer-eu-i4rc resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. Condition
Definition

A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.

ShortDetailed information about conditions, problems or diagnoses
Control0..*
Is Modifierfalse
Summaryfalse
Invariantscon-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item (clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty())
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission (abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists())
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error (verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item (clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty())
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission (abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists())
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error (verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty())
2. Condition.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Condition.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Condition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Condition.extension:condition-occurredFollowing
    Slice Namecondition-occurredFollowing
    Definition

    Further conditions, problems, diagnoses, procedures or events or the substance that preceded this Condition.

    ShortPrecedent for this Condition
    Control0..*
    This element is affected by the following invariants: ele-1
    TypeExtension(Condition Occurred Following) (Extension Type: Choice of: CodeableConcept, Reference(Condition, Procedure, MedicationAdministration, Immunization, MedicationStatement))
    Is Modifierfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. Condition.extension:condition-occurredFollowing.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..0*
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Condition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 10. Condition.extension:condition-occurredFollowing.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttp://hl7.org/fhir/StructureDefinition/condition-occurredFollowing
      12. Condition.extension:condition-occurredFollowing.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control10..1
      BindingFor example codes, see For codes, see ConditionPredecessorCodes
      (example to http://hl7.org/fhir/ValueSet/condition-predecessor)

      Codes that describe activities or observations that occurred prior to the condition.

      TypeReference(Condition, Procedure, MedicationAdministration, Immunization, MedicationStatement), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on Condition.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
      • type @ $this
      • 14. Condition.extension:condition-occurredFollowing.value[x]:valueCodeableConcept
        Slice NamevalueCodeableConcept
        Definition

        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

        ShortValue of extension
        Control0..01
        BindingFor example codes, see For codes, see ConditionPredecessorCodes
        (example to http://hl7.org/fhir/ValueSet/condition-predecessor)

        Codes that describe activities or observations that occurred prior to the condition.

        TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. Condition.extension:condition-occurredFollowing.value[x]:valueReference
        Slice NamevalueReference
        Definition

        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

        ShortFor relapses, reference to the first occurance of this tumor.Value of extension
        Control0..1
        TypeReference(Condition: Primary Cancer), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. Condition.extension:condition-dueTo
        Slice Namecondition-dueTo
        Definition

        Further conditions, problems, diagnoses, procedures or events or the substance that caused/triggered this Condition.

        ShortIf Radiation therapy induced
        Comments

        Although a condition may be caused by a substance, this is not intended to be used to record allergies/adverse reactions to substances.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(Condition Due To) (Extension Type: Choice of: CodeableConcept, Reference(Condition, Procedure, MedicationAdministration, Immunization, MedicationStatement))
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        20. Condition.extension:condition-dueTo.extension
        Definition

        An Extension


        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortExtensionAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..0*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Condition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 22. Condition.extension:condition-dueTo.url
          Definition

          Source of the definition for the extension code - a logical name or a URL.

          Shortidentifies the meaning of the extension
          Comments

          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

          Control1..1
          Typeuri
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          Fixed Valuehttp://hl7.org/fhir/StructureDefinition/condition-dueTo
          24. Condition.extension:condition-dueTo.value[x]
          Definition

          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

          ShortValue of extension
          Control10..1
          BindingFor example codes, see For codes, see ConditionCauseCodes
          (example to http://hl7.org/fhir/ValueSet/condition-cause)

          Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.

          TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingThis element introduces a set of slices on Condition.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
          • type @ $this
          • 26. Condition.extension:condition-dueTo.value[x]:valueCodeableConcept
            Slice NamevalueCodeableConcept
            Definition

            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

            ShortValue of extension
            Control10..1
            BindingFor example codes, see For codes, see ConditionCauseCodes
            (example to http://hl7.org/fhir/ValueSet/condition-cause)

            Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.

            TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summaryfalse
            Pattern Value{
              "coding" : [{
                "system" : "http://fhir.ohdsi.org/CodeSystem/concepts",
                "code" : "4029715"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. Condition.extension:sameHospital
            Slice NamesameHospital
            Definition

            This extension is included in the guide for covering the request of tracking if information has been captured at the same hospital that recorded the data.

            ShortSame Hospital
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Same Hospital) (Extension Type: boolean)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            30. Condition.extension:assertedDate
            Slice NameassertedDate
            Definition

            When the asserter identified the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept that may have risen to a level of or remains a concern. For example, when the patient experiences chest pain, the asserted date represents when the clinician began following the chest pain - not when the patient experienced the chest pain. Asserted date supports the recognition that information is not always entered in a system immediately. Assertion and recording are different acts, so asserted date and recorded date are semantically different. However, they may be the same date and close in time. If this difference is significant for your use case, assertion date may be useful.

            ShortDate the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted
            Comments

            The assertedDate is in the context of the recording practitioner and might not be the same as the recordedDate.

            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Condition Asserted Date) (Extension Type: dateTime)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            32. Condition.extension:previousStatus
            Slice NamepreviousStatus
            Definition

            This extension provides a mean to indicate the previous clinicalStatus of a condition. It might be used for example to indicate if a relapse is now in remission.

            ShortPrevious Status
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Previous Status) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            34. Condition.extension:histology-morphology-behavior
            Slice Namehistology-morphology-behavior
            Definition

            This extension provides a mean to indicate the histology behaviours of a condition

            ShortHistology Morphology Behavior
            Control0..2
            This element is affected by the following invariants: ele-1
            TypeExtension(Histology Morphology Behavior) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            36. Condition.extension:relapseType
            Slice NamerelapseType
            Definition

            This extension is used to indicate if a relapse/progression is local, remote or combined.

            ShortRelapse Type
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Relapse Type) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            38. Condition.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Summaryfalse
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            40. Condition.clinicalStatus
            Definition

            The clinical status of the condition.

            Shortactive | recurrence | relapse | inactive | remission | resolved
            Comments

            The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

            Control0..1
            This element is affected by the following invariants: con-3, con-4, con-5
            BindingThe codes SHALL be taken from ConditionClinicalStatusCodeshttp://hl7.org/fhir/ValueSet/condition-clinical|4.0.1
            (required to http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1)

            The clinical status of the condition or diagnosis.

            TypeCodeableConcept
            Is Modifiertrue because This element is labeled as a modifier because the status contains codes that mark the condition as no longer active.
            Summarytrue
            ExampleRelapse: { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical", "code" : "relapse" }] }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            42. Condition.clinicalStatus.coding
            Definition

            A reference to a code defined by a terminology system.

            ShortCode defined by a terminology system
            Comments

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Control10..*
            TypeCoding
            Is Modifierfalse
            Summarytrue
            Requirements

            Allows for alternative encodings within a code system, and translations to other code systems.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on Condition.clinicalStatus.coding. The slices areOrdered and Open, and can be differentiated using the following discriminators:
            • value @ $this
            • 44. Condition.clinicalStatus.coding:condition-clinical
              Slice Namecondition-clinical
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control10..1*
              BindingThe codes SHALL be taken from For codes, see ConditionClinicalStatusCodes
              (required to http://hl7.org/fhir/ValueSet/condition-clinical)
              TypeCoding
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              46. Condition.clinicalStatus.coding:athena
              Slice Nameathena
              Definition

              A reference to a code defined by a terminology system.

              ShortCode defined by a terminology system
              Comments

              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

              Control0..1*
              BindingThe codes SHALL be taken from For codes, see Disease Status: Athena
              (required to http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-event-type-vs)
              TypeCoding
              Is Modifierfalse
              Summarytrue
              Requirements

              Allows for alternative encodings within a code system, and translations to other code systems.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              48. Condition.verificationStatus
              Definition

              The verification status to support the clinical status of the condition.

              Shortunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
              Comments

              verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status. The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

              Control0..1
              This element is affected by the following invariants: con-3, con-5
              BindingThe codes SHALL be taken from ConditionVerificationStatushttp://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1
              (required to http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1)

              The verification status to support or decline the clinical status of the condition or diagnosis.

              TypeCodeableConcept
              Is Modifiertrue because This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              50. Condition.code
              Definition

              Identification of the condition, problem or diagnosis.

              ShortIdentification of the condition, problem or diagnosis
              Control10..1
              BindingUnless not suitable, these codes SHALL be taken from For example codes, see Cancer Diagnosis: Athenahttp://hl7.org/fhir/ValueSet/condition-code|4.0.1
              (extensible to http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-diagnosis-athena-vs)
              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Requirements

              0..1 to account for primarily narrative only resources.

              Alternate Namestype
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              52. Condition.bodySite
              Definition

              The anatomical location where this condition manifests itself.

              ShortAnatomical location, if relevant
              Comments

              Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

              Control0..*
              BindingUnless not suitable, these codes SHALL be taken from For example codes, see Cancer site: Athenahttp://hl7.org/fhir/ValueSet/body-site|4.0.1
              (extensible to http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-sites-vs)
              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              54. Condition.bodySite.extension:qualifier
              Slice Namequalifier
              Definition

              Qualifier to refine an body location. These include qualifiers for relative location, directionality, number, and plane, and exclude qualifiers for laterality.

              ShortBody Location Qualifier
              Control0..*
              TypeExtension(Body Location Qualifier) (Extension Type: CodeableConcept)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              56. Condition.bodySite.extension:qualifier.extension
              Definition

              An Extension


              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortExtensionAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..0*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Condition.bodySite.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 58. Condition.bodySite.extension:qualifier.url
                Definition

                Source of the definition for the extension code - a logical name or a URL.

                Shortidentifies the meaning of the extension
                Comments

                The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                Control1..1
                Typeuri
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                Fixed Valuehttp://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
                60. Condition.bodySite.extension:qualifier.value[x]
                Definition

                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                ShortValue of extension
                Control10..1
                BindingUnless not suitable, these codes SHALL be taken from For codes, see Body site qualifier
                (extensible to http://hl7.eu/fhir/ig/idea4rc/ValueSet/site-qualifier-i4rc)
                TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                62. Condition.bodySite.extension:laterality
                Slice Namelaterality
                Definition

                Qualifier to specify laterality.

                ShortLaterality Qualifier
                Control0..1
                TypeExtension(Laterality Qualifier) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                64. Condition.bodySite.extension:laterality.extension
                Definition

                An Extension


                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortExtensionAdditional content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..0*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Condition.bodySite.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 66. Condition.bodySite.extension:laterality.url
                  Definition

                  Source of the definition for the extension code - a logical name or a URL.

                  Shortidentifies the meaning of the extension
                  Comments

                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                  Control1..1
                  Typeuri
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  Fixed Valuehttp://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier
                  68. Condition.bodySite.extension:laterality.value[x]
                  Definition

                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                  ShortValue of extension
                  Control10..1
                  BindingUnless not suitable, these codes SHALL be taken from For codes, see Laterality Qualifier Value Set
                  (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-laterality-qualifier-vs)
                  TypeCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  70. Condition.subject
                  Definition

                  Indicates the patient or group who the condition record is associated with.

                  ShortWho has the condition?
                  Control1..1
                  TypeReference(Patient: IDEA4RC, Patient, Group)
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Group is typically used for veterinary or public health use cases.

                  Alternate Namespatient
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  72. Condition.encounter
                  Definition

                  Encounter this primary cancer has been identified. To be used for subsequent primary cancers.


                  The Encounter during which this Condition was created or to which the creation of this record is tightly associated.

                  ShortEncounter this primary cancer has been identifiedEncounter created as part of
                  Comments

                  This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. This record indicates the encounter this particular record is associated with. In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known".

                  Control0..1
                  TypeReference(Encounter: IDEA4RC, Encounter)
                  Is Modifierfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  74. Condition.onset[x]
                  Definition

                  Estimated or actual date or date-time the condition began, in the opinion of the clinician.

                  ShortEstimated or actual date, date-time, or age
                  Comments

                  Age is generally used when the patient reports an age at which the Condition began to occur.

                  Control0..1
                  TypeChoice of: dateTime, Age, Period, Range, string
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Must Supporttrue
                  Must Support TypesNo must-support rules about the choice of types/profiles
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  76. Condition.note
                  Definition

                  Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis.

                  ShortAdditional information about the Cancer ConditionAdditional information about the Condition
                  Control0..*
                  TypeAnnotation
                  Is Modifierfalse
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

                  Guidance on how to interpret the contents of this table can be foundhere

                  0. Condition
                  2. Condition.extension
                  SlicingThis element introduces a set of slices on Condition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 4. Condition.extension:condition-occurredFollowing
                    Slice Namecondition-occurredFollowing
                    Control0..*
                    TypeExtension(Condition Occurred Following) (Extension Type: Choice of: CodeableConcept, Reference(Condition, Procedure, MedicationAdministration, Immunization, MedicationStatement))
                    6. Condition.extension:condition-occurredFollowing.value[x]
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    SlicingThis element introduces a set of slices on Condition.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 8. Condition.extension:condition-occurredFollowing.value[x]:valueCodeableConcept
                      Slice NamevalueCodeableConcept
                      Control0..0
                      TypeCodeableConcept
                      10. Condition.extension:condition-occurredFollowing.value[x]:valueReference
                      Slice NamevalueReference
                      ShortFor relapses, reference to the first occurance of this tumor.
                      Control0..1
                      TypeReference(Condition: Primary Cancer)
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      12. Condition.extension:condition-dueTo
                      Slice Namecondition-dueTo
                      ShortIf Radiation therapy induced
                      Control0..*
                      TypeExtension(Condition Due To) (Extension Type: Choice of: CodeableConcept, Reference(Condition, Procedure, MedicationAdministration, Immunization, MedicationStatement))
                      14. Condition.extension:condition-dueTo.value[x]
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      SlicingThis element introduces a set of slices on Condition.extension.value[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                      • type @ $this
                      • 16. Condition.extension:condition-dueTo.value[x]:valueCodeableConcept
                        Slice NamevalueCodeableConcept
                        Control1..1
                        TypeCodeableConcept
                        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                        Pattern Value{
                          "coding" : [{
                            "system" : "http://fhir.ohdsi.org/CodeSystem/concepts",
                            "code" : "4029715"
                          }]
                        }
                        18. Condition.extension:sameHospital
                        Slice NamesameHospital
                        Control0..1
                        TypeExtension(Same Hospital) (Extension Type: boolean)
                        20. Condition.extension:assertedDate
                        Slice NameassertedDate
                        Control0..1
                        TypeExtension(Condition Asserted Date) (Extension Type: dateTime)
                        22. Condition.extension:previousStatus
                        Slice NamepreviousStatus
                        Control0..1
                        TypeExtension(Previous Status) (Extension Type: CodeableConcept)
                        24. Condition.extension:histology-morphology-behavior
                        Slice Namehistology-morphology-behavior
                        Control0..2
                        TypeExtension(Histology Morphology Behavior) (Extension Type: CodeableConcept)
                        26. Condition.extension:relapseType
                        Slice NamerelapseType
                        Control0..1
                        TypeExtension(Relapse Type) (Extension Type: CodeableConcept)
                        28. Condition.clinicalStatus
                        ExampleRelapse: { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical", "code" : "relapse" }] }
                        30. Condition.clinicalStatus.coding
                        Control1..?
                        SlicingThis element introduces a set of slices on Condition.clinicalStatus.coding. The slices areOrdered and Open, and can be differentiated using the following discriminators:
                        • value @ $this
                        • 32. Condition.clinicalStatus.coding:condition-clinical
                          Slice Namecondition-clinical
                          Control1..1
                          BindingThe codes SHALL be taken from ConditionClinicalStatusCodes
                          (required to http://hl7.org/fhir/ValueSet/condition-clinical)
                          34. Condition.clinicalStatus.coding:athena
                          Slice Nameathena
                          Control0..1
                          BindingThe codes SHALL be taken from Disease Status: Athena
                          (required to http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-event-type-vs)
                          36. Condition.code
                          Control1..?
                          BindingUnless not suitable, these codes SHALL be taken from Cancer Diagnosis: Athena
                          (extensible to http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-diagnosis-athena-vs)
                          38. Condition.bodySite
                          BindingUnless not suitable, these codes SHALL be taken from Cancer site: Athena
                          (extensible to http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-sites-vs)
                          40. Condition.bodySite.extension:qualifier
                          Slice Namequalifier
                          Control0..*
                          TypeExtension(Body Location Qualifier) (Extension Type: CodeableConcept)
                          42. Condition.bodySite.extension:qualifier.value[x]
                          BindingUnless not suitable, these codes SHALL be taken from Body site qualifier
                          (extensible to http://hl7.eu/fhir/ig/idea4rc/ValueSet/site-qualifier-i4rc)
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          44. Condition.bodySite.extension:laterality
                          Slice Namelaterality
                          Control0..1
                          TypeExtension(Laterality Qualifier) (Extension Type: CodeableConcept)
                          46. Condition.bodySite.extension:laterality.value[x]
                          BindingUnless not suitable, these codes SHALL be taken from Laterality Qualifier Value Set
                          (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-laterality-qualifier-vs)
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          48. Condition.subject
                          TypeReference(Patient: IDEA4RC)
                          50. Condition.encounter
                          Definition

                          Encounter this primary cancer has been identified. To be used for subsequent primary cancers.

                          ShortEncounter this primary cancer has been identified
                          TypeReference(Encounter: IDEA4RC)
                          52. Condition.onset[x]
                          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                          Must Supporttrue
                          54. Condition.stage
                          56. Condition.stage.summary
                          Definition

                          As for mCODE, in IDEA4RC staging information MUST be captured in an Observation that conforms to the CancerStageGroup profile. For convenience, the stage group MAY appear in this element, copied from the CancerStageGroup, but Data Senders and Receivers MAY ignore it.

                          ShortMost recent Stage Group
                          BindingThe codes SHALL be taken from Cancer Stage Grading: Athena
                          (required to http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-stageGrading-athena-vs)
                          58. Condition.stage.assessment
                          TypeReference(Observation: Head Neck Cancer Stage Group, Observation: Sarcoma Cancer and Disease Extent Stage Group)
                          60. Condition.stage.type
                          Definition

                          As for mCODE, in IDEA4RC staging information MUST be captured in an Observation that conforms to the CancerStageGroup profile. For convenience, the staging system MAY appear in this element, but Data Senders and Receivers MAY ignore it.

                          ShortStaging system used.
                          62. Condition.evidence
                          64. Condition.evidence.detail
                          TypeReference(Observation: Diagnosis details, Observation: test results, Observation: Genetic Test Expression, Observation)
                          66. Condition.note
                          ShortAdditional information about the Cancer Condition

                          Guidance on how to interpret the contents of this table can be foundhere

                          0. Condition
                          Definition

                          A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.

                          ShortDetailed information about conditions, problems or diagnoses
                          Control0..*
                          Is Modifierfalse
                          Summaryfalse
                          Invariantscon-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item (clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty())
                          con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission (abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists())
                          con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error (verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty())
                          dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
                          dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
                          dom-6: A resource should have narrative for robust management (text.`div`.exists())
                          2. Condition.id
                          Definition

                          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

                          ShortLogical id of this artifact
                          Comments

                          The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

                          Control0..1
                          Typeid
                          Is Modifierfalse
                          Summarytrue
                          4. Condition.meta
                          Definition

                          The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

                          ShortMetadata about the resource
                          Control0..1
                          TypeMeta
                          Is Modifierfalse
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          6. Condition.implicitRules
                          Definition

                          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

                          ShortA set of rules under which this content was created
                          Comments

                          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

                          Control0..1
                          Typeuri
                          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summarytrue
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          8. Condition.language
                          Definition

                          The base language in which the resource is written.

                          ShortLanguage of the resource content
                          Comments

                          Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

                          Control0..1
                          BindingThe codes SHOULD be taken from CommonLanguages
                          (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

                          A human language.

                          Additional BindingsPurpose
                          AllLanguagesMax Binding
                          Typecode
                          Is Modifierfalse
                          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          10. Condition.text
                          Definition

                          A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

                          ShortText summary of the resource, for human interpretation
                          Comments

                          Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

                          Control0..1
                          TypeNarrative
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesnarrative, html, xhtml, display
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          12. Condition.contained
                          Definition

                          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

                          ShortContained, inline Resources
                          Comments

                          This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

                          Control0..*
                          TypeResource
                          Is Modifierfalse
                          Summaryfalse
                          Alternate Namesinline resources, anonymous resources, contained resources
                          14. Condition.extension
                          Definition

                          An Extension

                          ShortExtension
                          Control0..*
                          TypeExtension
                          Is Modifierfalse
                          Summaryfalse
                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingThis element introduces a set of slices on Condition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                          • value @ url
                          • 16. Condition.extension:condition-occurredFollowing
                            Slice Namecondition-occurredFollowing
                            Definition

                            Further conditions, problems, diagnoses, procedures or events or the substance that preceded this Condition.

                            ShortPrecedent for this Condition
                            Control0..*
                            This element is affected by the following invariants: ele-1
                            TypeExtension(Condition Occurred Following) (Extension Type: Choice of: CodeableConcept, Reference(Condition, Procedure, MedicationAdministration, Immunization, MedicationStatement))
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            18. Condition.extension:condition-occurredFollowing.id
                            Definition

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            ShortUnique id for inter-element referencing
                            Control0..1
                            Typestring
                            Is Modifierfalse
                            XML FormatIn the XML format, this property is represented as an attribute.
                            Summaryfalse
                            20. Condition.extension:condition-occurredFollowing.extension
                            Definition

                            An Extension

                            ShortExtension
                            Control0..0
                            TypeExtension
                            Is Modifierfalse
                            Summaryfalse
                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingThis element introduces a set of slices on Condition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                            • value @ url
                            • 22. Condition.extension:condition-occurredFollowing.url
                              Definition

                              Source of the definition for the extension code - a logical name or a URL.

                              Shortidentifies the meaning of the extension
                              Comments

                              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                              Control1..1
                              Typeuri
                              Is Modifierfalse
                              XML FormatIn the XML format, this property is represented as an attribute.
                              Summaryfalse
                              Fixed Valuehttp://hl7.org/fhir/StructureDefinition/condition-occurredFollowing
                              24. Condition.extension:condition-occurredFollowing.value[x]
                              Definition

                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                              ShortValue of extension
                              Control1..1
                              BindingFor example codes, see ConditionPredecessorCodes
                              (example to http://hl7.org/fhir/ValueSet/condition-predecessor)

                              Codes that describe activities or observations that occurred prior to the condition.

                              TypeReference(Condition, Procedure, MedicationAdministration, Immunization, MedicationStatement)
                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                              Is Modifierfalse
                              Summaryfalse
                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              SlicingThis element introduces a set of slices on Condition.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                              • type @ $this
                              • 26. Condition.extension:condition-occurredFollowing.value[x]:valueCodeableConcept
                                Slice NamevalueCodeableConcept
                                Definition

                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                ShortValue of extension
                                Control0..0
                                BindingFor example codes, see ConditionPredecessorCodes
                                (example to http://hl7.org/fhir/ValueSet/condition-predecessor)

                                Codes that describe activities or observations that occurred prior to the condition.

                                TypeCodeableConcept
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                28. Condition.extension:condition-occurredFollowing.value[x]:valueReference
                                Slice NamevalueReference
                                Definition

                                Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                ShortFor relapses, reference to the first occurance of this tumor.
                                Control0..1
                                TypeReference(Condition: Primary Cancer)
                                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                30. Condition.extension:condition-dueTo
                                Slice Namecondition-dueTo
                                Definition

                                Further conditions, problems, diagnoses, procedures or events or the substance that caused/triggered this Condition.

                                ShortIf Radiation therapy induced
                                Comments

                                Although a condition may be caused by a substance, this is not intended to be used to record allergies/adverse reactions to substances.

                                Control0..*
                                This element is affected by the following invariants: ele-1
                                TypeExtension(Condition Due To) (Extension Type: Choice of: CodeableConcept, Reference(Condition, Procedure, MedicationAdministration, Immunization, MedicationStatement))
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                32. Condition.extension:condition-dueTo.id
                                Definition

                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                ShortUnique id for inter-element referencing
                                Control0..1
                                Typestring
                                Is Modifierfalse
                                XML FormatIn the XML format, this property is represented as an attribute.
                                Summaryfalse
                                34. Condition.extension:condition-dueTo.extension
                                Definition

                                An Extension

                                ShortExtension
                                Control0..0
                                TypeExtension
                                Is Modifierfalse
                                Summaryfalse
                                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingThis element introduces a set of slices on Condition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                • value @ url
                                • 36. Condition.extension:condition-dueTo.url
                                  Definition

                                  Source of the definition for the extension code - a logical name or a URL.

                                  Shortidentifies the meaning of the extension
                                  Comments

                                  The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                  Control1..1
                                  Typeuri
                                  Is Modifierfalse
                                  XML FormatIn the XML format, this property is represented as an attribute.
                                  Summaryfalse
                                  Fixed Valuehttp://hl7.org/fhir/StructureDefinition/condition-dueTo
                                  38. Condition.extension:condition-dueTo.value[x]
                                  Definition

                                  Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                  ShortValue of extension
                                  Control1..1
                                  BindingFor example codes, see ConditionCauseCodes
                                  (example to http://hl7.org/fhir/ValueSet/condition-cause)

                                  Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.

                                  TypeCodeableConcept
                                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                  Is Modifierfalse
                                  Summaryfalse
                                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  SlicingThis element introduces a set of slices on Condition.extension.value[x]. The slices areUnordered and Closed, and can be differentiated using the following discriminators:
                                  • type @ $this
                                  • 40. Condition.extension:condition-dueTo.value[x]:valueCodeableConcept
                                    Slice NamevalueCodeableConcept
                                    Definition

                                    Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                    ShortValue of extension
                                    Control1..1
                                    BindingFor example codes, see ConditionCauseCodes
                                    (example to http://hl7.org/fhir/ValueSet/condition-cause)

                                    Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.

                                    TypeCodeableConcept
                                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                    Is Modifierfalse
                                    Summaryfalse
                                    Pattern Value{
                                      "coding" : [{
                                        "system" : "http://fhir.ohdsi.org/CodeSystem/concepts",
                                        "code" : "4029715"
                                      }]
                                    }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    42. Condition.extension:sameHospital
                                    Slice NamesameHospital
                                    Definition

                                    This extension is included in the guide for covering the request of tracking if information has been captured at the same hospital that recorded the data.

                                    ShortSame Hospital
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(Same Hospital) (Extension Type: boolean)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    44. Condition.extension:assertedDate
                                    Slice NameassertedDate
                                    Definition

                                    When the asserter identified the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept that may have risen to a level of or remains a concern. For example, when the patient experiences chest pain, the asserted date represents when the clinician began following the chest pain - not when the patient experienced the chest pain. Asserted date supports the recognition that information is not always entered in a system immediately. Assertion and recording are different acts, so asserted date and recorded date are semantically different. However, they may be the same date and close in time. If this difference is significant for your use case, assertion date may be useful.

                                    ShortDate the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted
                                    Comments

                                    The assertedDate is in the context of the recording practitioner and might not be the same as the recordedDate.

                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(Condition Asserted Date) (Extension Type: dateTime)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    46. Condition.extension:previousStatus
                                    Slice NamepreviousStatus
                                    Definition

                                    This extension provides a mean to indicate the previous clinicalStatus of a condition. It might be used for example to indicate if a relapse is now in remission.

                                    ShortPrevious Status
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(Previous Status) (Extension Type: CodeableConcept)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    48. Condition.extension:histology-morphology-behavior
                                    Slice Namehistology-morphology-behavior
                                    Definition

                                    This extension provides a mean to indicate the histology behaviours of a condition

                                    ShortHistology Morphology Behavior
                                    Control0..2
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(Histology Morphology Behavior) (Extension Type: CodeableConcept)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    50. Condition.extension:relapseType
                                    Slice NamerelapseType
                                    Definition

                                    This extension is used to indicate if a relapse/progression is local, remote or combined.

                                    ShortRelapse Type
                                    Control0..1
                                    This element is affected by the following invariants: ele-1
                                    TypeExtension(Relapse Type) (Extension Type: CodeableConcept)
                                    Is Modifierfalse
                                    Summaryfalse
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    52. Condition.modifierExtension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                    ShortExtensions that cannot be ignored
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..*
                                    TypeExtension
                                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
                                    Summaryfalse
                                    Requirements

                                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    54. Condition.identifier
                                    Definition

                                    Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

                                    ShortExternal Ids for this condition
                                    Comments

                                    This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

                                    NoteThis is a business identifier, not a resource identifier (see discussion)
                                    Control0..*
                                    TypeIdentifier
                                    Is Modifierfalse
                                    Summarytrue
                                    Requirements

                                    Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers.

                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    56. Condition.clinicalStatus
                                    Definition

                                    The clinical status of the condition.

                                    Shortactive | recurrence | relapse | inactive | remission | resolved
                                    Comments

                                    The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

                                    Control0..1
                                    This element is affected by the following invariants: con-3, con-4, con-5
                                    BindingThe codes SHALL be taken from ConditionClinicalStatusCodes
                                    (required to http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1)

                                    The clinical status of the condition or diagnosis.

                                    TypeCodeableConcept
                                    Is Modifiertrue because This element is labeled as a modifier because the status contains codes that mark the condition as no longer active.
                                    Summarytrue
                                    ExampleRelapse: { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/condition-clinical", "code" : "relapse" }] }
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    58. Condition.clinicalStatus.id
                                    Definition

                                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                    ShortUnique id for inter-element referencing
                                    Control0..1
                                    Typestring
                                    Is Modifierfalse
                                    XML FormatIn the XML format, this property is represented as an attribute.
                                    Summaryfalse
                                    60. Condition.clinicalStatus.extension
                                    Definition

                                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                    ShortAdditional content defined by implementations
                                    Comments

                                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                    Control0..*
                                    TypeExtension
                                    Is Modifierfalse
                                    Summaryfalse
                                    Alternate Namesextensions, user content
                                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                    SlicingThis element introduces a set of slices on Condition.clinicalStatus.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                    • value @ url
                                    • 62. Condition.clinicalStatus.coding
                                      Definition

                                      A reference to a code defined by a terminology system.

                                      ShortCode defined by a terminology system
                                      Comments

                                      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                      Control1..*
                                      TypeCoding
                                      Is Modifierfalse
                                      Summarytrue
                                      Requirements

                                      Allows for alternative encodings within a code system, and translations to other code systems.

                                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                      SlicingThis element introduces a set of slices on Condition.clinicalStatus.coding. The slices areOrdered and Open, and can be differentiated using the following discriminators:
                                      • value @ $this
                                      • 64. Condition.clinicalStatus.coding:condition-clinical
                                        Slice Namecondition-clinical
                                        Definition

                                        A reference to a code defined by a terminology system.

                                        ShortCode defined by a terminology system
                                        Comments

                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                        Control1..1
                                        BindingThe codes SHALL be taken from ConditionClinicalStatusCodes
                                        (required to http://hl7.org/fhir/ValueSet/condition-clinical)
                                        TypeCoding
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        66. Condition.clinicalStatus.coding:athena
                                        Slice Nameathena
                                        Definition

                                        A reference to a code defined by a terminology system.

                                        ShortCode defined by a terminology system
                                        Comments

                                        Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                        Control0..1
                                        BindingThe codes SHALL be taken from Disease Status: Athena
                                        (required to http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-event-type-vs)
                                        TypeCoding
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        Allows for alternative encodings within a code system, and translations to other code systems.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        68. Condition.clinicalStatus.text
                                        Definition

                                        A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                        ShortPlain text representation of the concept
                                        Comments

                                        Very often the text is the same as a displayName of one of the codings.

                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                        Summarytrue
                                        Requirements

                                        The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        70. Condition.verificationStatus
                                        Definition

                                        The verification status to support the clinical status of the condition.

                                        Shortunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
                                        Comments

                                        verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status. The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

                                        Control0..1
                                        This element is affected by the following invariants: con-3, con-5
                                        BindingThe codes SHALL be taken from ConditionVerificationStatus
                                        (required to http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1)

                                        The verification status to support or decline the clinical status of the condition or diagnosis.

                                        TypeCodeableConcept
                                        Is Modifiertrue because This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        72. Condition.category
                                        Definition

                                        A category assigned to the condition.

                                        Shortproblem-list-item | encounter-diagnosis
                                        Comments

                                        The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

                                        Control0..*
                                        BindingUnless not suitable, these codes SHALL be taken from ConditionCategoryCodes
                                        (extensible to http://hl7.org/fhir/ValueSet/condition-category|4.0.1)

                                        A category assigned to the condition.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        74. Condition.severity
                                        Definition

                                        A subjective assessment of the severity of the condition as evaluated by the clinician.

                                        ShortSubjective severity of condition
                                        Comments

                                        Coding of the severity with a terminology is preferred, where possible.

                                        Control0..1
                                        BindingThe codes SHOULD be taken from Condition/DiagnosisSeverity
                                        (preferred to http://hl7.org/fhir/ValueSet/condition-severity|4.0.1)

                                        A subjective assessment of the severity of the condition as evaluated by the clinician.

                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summaryfalse
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        76. Condition.code
                                        Definition

                                        Identification of the condition, problem or diagnosis.

                                        ShortIdentification of the condition, problem or diagnosis
                                        Control1..1
                                        BindingUnless not suitable, these codes SHALL be taken from Cancer Diagnosis: Athena
                                        (extensible to http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-diagnosis-athena-vs)
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summarytrue
                                        Requirements

                                        0..1 to account for primarily narrative only resources.

                                        Alternate Namestype
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        78. Condition.bodySite
                                        Definition

                                        The anatomical location where this condition manifests itself.

                                        ShortAnatomical location, if relevant
                                        Comments

                                        Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

                                        Control0..*
                                        BindingUnless not suitable, these codes SHALL be taken from Cancer site: Athena
                                        (extensible to http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-sites-vs)
                                        TypeCodeableConcept
                                        Is Modifierfalse
                                        Summarytrue
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        80. Condition.bodySite.id
                                        Definition

                                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                        ShortUnique id for inter-element referencing
                                        Control0..1
                                        Typestring
                                        Is Modifierfalse
                                        XML FormatIn the XML format, this property is represented as an attribute.
                                        Summaryfalse
                                        82. Condition.bodySite.extension
                                        Definition

                                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                        ShortAdditional content defined by implementations
                                        Comments

                                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                        Control0..*
                                        TypeExtension
                                        Is Modifierfalse
                                        Summaryfalse
                                        Alternate Namesextensions, user content
                                        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                        SlicingThis element introduces a set of slices on Condition.bodySite.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                        • value @ url
                                        • 84. Condition.bodySite.extension:qualifier
                                          Slice Namequalifier
                                          Definition

                                          Qualifier to refine an body location. These include qualifiers for relative location, directionality, number, and plane, and exclude qualifiers for laterality.

                                          ShortBody Location Qualifier
                                          Control0..*
                                          TypeExtension(Body Location Qualifier) (Extension Type: CodeableConcept)
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          86. Condition.bodySite.extension:qualifier.id
                                          Definition

                                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                          ShortUnique id for inter-element referencing
                                          Control0..1
                                          Typestring
                                          Is Modifierfalse
                                          XML FormatIn the XML format, this property is represented as an attribute.
                                          Summaryfalse
                                          88. Condition.bodySite.extension:qualifier.extension
                                          Definition

                                          An Extension

                                          ShortExtension
                                          Control0..0
                                          TypeExtension
                                          Is Modifierfalse
                                          Summaryfalse
                                          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                          SlicingThis element introduces a set of slices on Condition.bodySite.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                          • value @ url
                                          • 90. Condition.bodySite.extension:qualifier.url
                                            Definition

                                            Source of the definition for the extension code - a logical name or a URL.

                                            Shortidentifies the meaning of the extension
                                            Comments

                                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                            Control1..1
                                            Typeuri
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            Fixed Valuehttp://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
                                            92. Condition.bodySite.extension:qualifier.value[x]
                                            Definition

                                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                            ShortValue of extension
                                            Control1..1
                                            BindingUnless not suitable, these codes SHALL be taken from Body site qualifier
                                            (extensible to http://hl7.eu/fhir/ig/idea4rc/ValueSet/site-qualifier-i4rc)
                                            TypeCodeableConcept
                                            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            94. Condition.bodySite.extension:laterality
                                            Slice Namelaterality
                                            Definition

                                            Qualifier to specify laterality.

                                            ShortLaterality Qualifier
                                            Control0..1
                                            TypeExtension(Laterality Qualifier) (Extension Type: CodeableConcept)
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            96. Condition.bodySite.extension:laterality.id
                                            Definition

                                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                            ShortUnique id for inter-element referencing
                                            Control0..1
                                            Typestring
                                            Is Modifierfalse
                                            XML FormatIn the XML format, this property is represented as an attribute.
                                            Summaryfalse
                                            98. Condition.bodySite.extension:laterality.extension
                                            Definition

                                            An Extension

                                            ShortExtension
                                            Control0..0
                                            TypeExtension
                                            Is Modifierfalse
                                            Summaryfalse
                                            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                            SlicingThis element introduces a set of slices on Condition.bodySite.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                                            • value @ url
                                            • 100. Condition.bodySite.extension:laterality.url
                                              Definition

                                              Source of the definition for the extension code - a logical name or a URL.

                                              Shortidentifies the meaning of the extension
                                              Comments

                                              The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                                              Control1..1
                                              Typeuri
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              Fixed Valuehttp://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier
                                              102. Condition.bodySite.extension:laterality.value[x]
                                              Definition

                                              Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                                              ShortValue of extension
                                              Control1..1
                                              BindingUnless not suitable, these codes SHALL be taken from Laterality Qualifier Value Set
                                              (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-laterality-qualifier-vs)
                                              TypeCodeableConcept
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              104. Condition.bodySite.coding
                                              Definition

                                              A reference to a code defined by a terminology system.

                                              ShortCode defined by a terminology system
                                              Comments

                                              Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                              Control0..*
                                              TypeCoding
                                              Is Modifierfalse
                                              Summarytrue
                                              Requirements

                                              Allows for alternative encodings within a code system, and translations to other code systems.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              106. Condition.bodySite.text
                                              Definition

                                              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                              ShortPlain text representation of the concept
                                              Comments

                                              Very often the text is the same as a displayName of one of the codings.

                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Requirements

                                              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              108. Condition.subject
                                              Definition

                                              Indicates the patient or group who the condition record is associated with.

                                              ShortWho has the condition?
                                              Control1..1
                                              TypeReference(Patient: IDEA4RC)
                                              Is Modifierfalse
                                              Summarytrue
                                              Requirements

                                              Group is typically used for veterinary or public health use cases.

                                              Alternate Namespatient
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              110. Condition.encounter
                                              Definition

                                              Encounter this primary cancer has been identified. To be used for subsequent primary cancers.

                                              ShortEncounter this primary cancer has been identified
                                              Comments

                                              This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. This record indicates the encounter this particular record is associated with. In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known".

                                              Control0..1
                                              TypeReference(Encounter: IDEA4RC)
                                              Is Modifierfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              112. Condition.onset[x]
                                              Definition

                                              Estimated or actual date or date-time the condition began, in the opinion of the clinician.

                                              ShortEstimated or actual date, date-time, or age
                                              Comments

                                              Age is generally used when the patient reports an age at which the Condition began to occur.

                                              Control0..1
                                              TypeChoice of: dateTime, Age, Period, Range, string
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Must Supporttrue
                                              Must Support TypesNo must-support rules about the choice of types/profiles
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              114. Condition.abatement[x]
                                              Definition

                                              The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate.

                                              ShortWhen in resolution/remission
                                              Comments

                                              There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid. When abatementString exists, it implies the condition is abated.

                                              Control0..1
                                              This element is affected by the following invariants: con-4
                                              TypeChoice of: dateTime, Age, Period, Range, string
                                              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              116. Condition.recordedDate
                                              Definition

                                              The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date.

                                              ShortDate record was first recorded
                                              Control0..1
                                              TypedateTime
                                              Is Modifierfalse
                                              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              118. Condition.recorder
                                              Definition

                                              Individual who recorded the record and takes responsibility for its content.

                                              ShortWho recorded the condition
                                              Control0..1
                                              TypeReference(Practitioner, PractitionerRole, Patient, RelatedPerson)
                                              Is Modifierfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              120. Condition.asserter
                                              Definition

                                              Individual who is making the condition statement.

                                              ShortPerson who asserts this condition
                                              Control0..1
                                              TypeReference(Practitioner, PractitionerRole, Patient, RelatedPerson)
                                              Is Modifierfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              122. Condition.stage
                                              Definition

                                              Clinical stage or grade of a condition. May include formal severity assessments.

                                              ShortStage/grade, usually assessed formally
                                              Control0..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantscon-1: Stage SHALL have summary or assessment (summary.exists() or assessment.exists())
                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              124. Condition.stage.id
                                              Definition

                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              126. Condition.stage.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              128. Condition.stage.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              130. Condition.stage.summary
                                              Definition

                                              As for mCODE, in IDEA4RC staging information MUST be captured in an Observation that conforms to the CancerStageGroup profile. For convenience, the stage group MAY appear in this element, copied from the CancerStageGroup, but Data Senders and Receivers MAY ignore it.

                                              ShortMost recent Stage Group
                                              Control0..1
                                              This element is affected by the following invariants: con-1
                                              BindingThe codes SHALL be taken from Cancer Stage Grading: Athena
                                              (required to http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-stageGrading-athena-vs)
                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              132. Condition.stage.assessment
                                              Definition

                                              Reference to a formal record of the evidence on which the staging assessment is based.

                                              ShortFormal record of assessment
                                              Control0..*
                                              This element is affected by the following invariants: con-1
                                              TypeReference(Observation: Head Neck Cancer Stage Group, Observation: Sarcoma Cancer and Disease Extent Stage Group)
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              134. Condition.stage.type
                                              Definition

                                              As for mCODE, in IDEA4RC staging information MUST be captured in an Observation that conforms to the CancerStageGroup profile. For convenience, the staging system MAY appear in this element, but Data Senders and Receivers MAY ignore it.

                                              ShortStaging system used.
                                              Control0..1
                                              BindingFor example codes, see ConditionStageType
                                              (example to http://hl7.org/fhir/ValueSet/condition-stage-type|4.0.1)

                                              Codes describing the kind of condition staging (e.g. clinical or pathological).

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              136. Condition.evidence
                                              Definition

                                              Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the condition.

                                              ShortSupporting evidence
                                              Comments

                                              The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.

                                              Control0..*
                                              TypeBackboneElement
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantscon-2: evidence SHALL have code or details (code.exists() or detail.exists())
                                              ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              138. Condition.evidence.id
                                              Definition

                                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                              ShortUnique id for inter-element referencing
                                              Control0..1
                                              Typestring
                                              Is Modifierfalse
                                              XML FormatIn the XML format, this property is represented as an attribute.
                                              Summaryfalse
                                              140. Condition.evidence.extension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                              ShortAdditional content defined by implementations
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifierfalse
                                              Summaryfalse
                                              Alternate Namesextensions, user content
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              142. Condition.evidence.modifierExtension
                                              Definition

                                              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                              ShortExtensions that cannot be ignored even if unrecognized
                                              Comments

                                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                              Control0..*
                                              TypeExtension
                                              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                              Summarytrue
                                              Requirements

                                              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                              Alternate Namesextensions, user content, modifiers
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                              144. Condition.evidence.code
                                              Definition

                                              A manifestation or symptom that led to the recording of this condition.

                                              ShortManifestation/symptom
                                              Control0..*
                                              This element is affected by the following invariants: con-2
                                              BindingFor example codes, see ManifestationAndSymptomCodes
                                              (example to http://hl7.org/fhir/ValueSet/manifestation-or-symptom|4.0.1)

                                              Codes that describe the manifestation or symptoms of a condition.

                                              TypeCodeableConcept
                                              Is Modifierfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              146. Condition.evidence.detail
                                              Definition

                                              Links to other relevant information, including pathology reports.

                                              ShortSupporting information found elsewhere
                                              Control0..*
                                              This element is affected by the following invariants: con-2
                                              TypeReference(Observation: Diagnosis details, Observation: test results, Observation: Genetic Test Expression, Observation)
                                              Is Modifierfalse
                                              Summarytrue
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                              148. Condition.note
                                              Definition

                                              Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis.

                                              ShortAdditional information about the Cancer Condition
                                              Control0..*
                                              TypeAnnotation
                                              Is Modifierfalse
                                              Summaryfalse
                                              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))