IDEA4RC FHIR Implementation Guide, published by IDEA4RC Project. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/idea4rc/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON
• TTL

Resource Profile: Condition: Primary Cancer

This profile defines how to represent Primary Cancer Condition in HL7 FHIR for the purpose of the IDEA4RC project. This profile is inspired from the mCode IG. A primary cancer condition, the original or first tumor in the body (Definition from: NCI Dictionary of Cancer Terms). Cancers that are not clearly secondary (i.e., of uncertain origin or behavior) should be documented as primary. This profile should be also used for documenting primary cancer relapses during or after FLT.

Usage:

• Use this Resource Profile: Bundle: IDEA4RC
• Refer to this Resource Profile: Condition: Primary Cancer, Condition: Metastatic Cancer, Encounter: IDEA4RC, MedicationAdministration: Chemotherapy... Show 11 more, Procedure: Other Treatment, Procedure: Radiotherapy, Procedure: Surgery, EpisodeOfCare: IDEA4RC, Observation: Head Neck Cancer Stage Group, Observation: TNM Distant Metastases Category, Observation: TNM Primary Tumor Category, Observation: TNM Regional Nodes Category, Observation: Sarcoma Cancer Stage Group, Observation: Localized Category (Stage, Sarcoma) and Observation: LocoRegional Category (Stage, Sarcoma)
• Examples for this Resource Profile: Condition/condition-id-10, Condition/condition-id-16 and Condition/condition-id-8

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from Condition

Name	Flags	Card.	Type	Description & Constraints
Condition			Condition
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
condition-occurredFollowing		0..*	(Complex)	Precedent for this Condition URL: http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing
Slices for value[x]		1..1	CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)	Value of extension Slice: Unordered, Open by type:$this
value[x]:valueCodeableConcept		0..0
value[x]:valueReference		0..1	Reference(Condition: Primary Cancer)	For relapses, reference to the first occurance of this tumor.
condition-dueTo		0..*	(Complex)	If Radiation therapy induced URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Open by type:$this
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.ohdsi.org/CodeSystem/concepts
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4029715
assertedDate		0..1	dateTime	Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
relapseType		0..1	CodeableConcept	Relapse Type URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
clinicalStatus		0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Example Relapse: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/condition-clinical","code":"relapse"}]}
Slices for coding		1..*	Coding	Code defined by a terminology system Slice: Ordered, Open by value:system
coding:condition-clinical		1..1	Coding	Code defined by a terminology system Binding: ConditionClinicalStatusCodes (required)
coding:athena		0..1	Coding	Code defined by a terminology system Binding: Cancer Event Type: Athena (required)
code		1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Cancer diagnosis: Athena (extensible)
bodySite		0..*	CodeableConcept	Anatomical location, if relevant Binding: Subsites: Athena (extensible)
Slices for extension				Content/Rules for all slices
qualifier		0..*	(Complex)	Body Location Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
value[x]		1..1	CodeableConcept	Value of extension Binding: Body site qualifier (extensible) Additional Bindings Purpose Body Location Qualifier Value Set Preferred
laterality		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier
value[x]		1..1	CodeableConcept	Value of extension Binding: Laterality Qualifier Value Set (extensible)
subject		1..1	Reference(Patient: IDEA4RC)	Who has the condition?
encounter		0..1	Reference(Encounter: IDEA4RC)	Encounter this primary cancer has been identified
onset[x]	S	0..1	dateTime, Age, Period, Range, string	Estimated or actual date, date-time, or age
stage
summary		0..1	CodeableConcept	Most recent Stage Group Binding: Cancer Stage Grading: Athena (required)
assessment		0..*	Reference(Observation: Head Neck Cancer Stage Group | Observation: Sarcoma Cancer Stage Group)	Formal record of assessment
type		0..1	CodeableConcept	Staging system used.
Slices for evidence		0..*	BackboneElement	Supporting evidence Slice: Unordered, Open by profile:$this.detail.resolve()
evidence:diagnosisDetails		0..1	BackboneElement	Diagnosis Details
detail		0..*	Reference(Observation: Diagnosis details)	Supporting information found elsewhere
evidence:simpleResult		0..*	BackboneElement	Tumor size, Mitotic count score, laboratory Test results
detail		0..*	Reference(Observation: test results)	Supporting information found elsewhere
evidence:genetic-test		0..*	BackboneElement	Genetic Tests performed
detail		0..*	Reference(Observation: Yes / No assertions)	Supporting information found elsewhere
note		0..*	Annotation	Additional information about the Cancer Condition
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Condition.clinicalStatus.coding:condition-clinical	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical from the FHIR Standard
Condition.clinicalStatus.coding:athena	required	CancerEventTypeVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-event-type-vs from this IG
Condition.code	extensible	CancerDiagnosisVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-diagnosis-athena-vs from this IG
Condition.bodySite	extensible	VsSubsiteAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/nasal-subsite-athena-i4rc from this IG
Condition.bodySite.extension:qualifier.value[x]	extensible	VsSiteQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/site-qualifier-i4rc from this IG
Condition.bodySite.extension:laterality.value[x]	extensible	LateralityQualifierVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-laterality-qualifier-vs
Condition.stage.summary	required	CancerStageGradingVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-stageGrading-athena-vs from this IG

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	Condition	Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
condition-occurredFollowing		0..*	(Complex)	Precedent for this Condition URL: http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing"
Slices for value[x]		1..1		Value of extension Slice: Unordered, Closed by type:$this Binding: ConditionPredecessorCodes (example): Codes that describe activities or observations that occurred prior to the condition.
valueCodeableConcept			CodeableConcept
valueReference			Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)
value[x]:valueReference		0..1	Reference(Condition: Primary Cancer)	For relapses, reference to the first occurance of this tumor.
condition-dueTo		0..*	(Complex)	If Radiation therapy induced URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-dueTo"
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.ohdsi.org/CodeSystem/concepts
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4029715
assertedDate		0..1	dateTime	Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
relapseType		0..1	CodeableConcept	Relapse Type URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
clinicalStatus	?!ΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis. Example Relapse: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/condition-clinical","code":"relapse"}]}
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Ordered, Open by value:system
coding:condition-clinical	Σ	1..1	Coding	Code defined by a terminology system Binding: ConditionClinicalStatusCodes (required)
coding:athena	Σ	0..1	Coding	Code defined by a terminology system Binding: Cancer Event Type: Athena (required)
verificationStatus	?!ΣC	0..1	CodeableConcept	unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
code	Σ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Cancer diagnosis: Athena (extensible)
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: Subsites: Athena (extensible)
Slices for extension				Content/Rules for all slices
qualifier		0..*	(Complex)	Body Location Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Body site qualifier (extensible) Additional Bindings Purpose Body Location Qualifier Value Set Preferred
laterality		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Laterality Qualifier Value Set (extensible)
subject	Σ	1..1	Reference(Patient: IDEA4RC)	Who has the condition?
encounter	Σ	0..1	Reference(Encounter: IDEA4RC)	Encounter this primary cancer has been identified
onset[x]	SΣ	0..1		Estimated or actual date, date-time, or age
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
Slices for evidence	C	0..*	BackboneElement	Supporting evidence Slice: Unordered, Open by profile:$this.detail.resolve() con-2: evidence SHALL have code or details
evidence:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
evidence:diagnosisDetails	C	0..1	BackboneElement	Diagnosis Details con-2: evidence SHALL have code or details
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
detail	ΣC	0..*	Reference(Observation: Diagnosis details)	Supporting information found elsewhere
evidence:simpleResult	C	0..*	BackboneElement	Tumor size, Mitotic count score, laboratory Test results con-2: evidence SHALL have code or details
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
detail	ΣC	0..*	Reference(Observation: test results)	Supporting information found elsewhere
evidence:genetic-test	C	0..*	BackboneElement	Genetic Tests performed con-2: evidence SHALL have code or details
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
detail	ΣC	0..*	Reference(Observation: Yes / No assertions)	Supporting information found elsewhere
note		0..*	Annotation	Additional information about the Cancer Condition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Condition.extension:condition-occurredFollowing.value[x]	example	ConditionPredecessorCodes (a valid code from SNOMED CT) http://hl7.org/fhir/ValueSet/condition-predecessor
Condition.extension:condition-dueTo.value[x]	example	ConditionCauseCodes (a valid code from SNOMED CT) http://hl7.org/fhir/ValueSet/condition-cause
Condition.extension:condition-dueTo.value[x]:valueCodeableConcept	example	Pattern: 4029715 http://hl7.org/fhir/ValueSet/condition-cause
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1 from the FHIR Standard
Condition.clinicalStatus.coding:condition-clinical	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical from the FHIR Standard
Condition.clinicalStatus.coding:athena	required	CancerEventTypeVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-event-type-vs from this IG
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1 from the FHIR Standard
Condition.code	extensible	CancerDiagnosisVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-diagnosis-athena-vs from this IG
Condition.bodySite	extensible	VsSubsiteAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/nasal-subsite-athena-i4rc from this IG
Condition.bodySite.extension:qualifier.value[x]	extensible	VsSiteQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/site-qualifier-i4rc from this IG
Condition.bodySite.extension:laterality.value[x]	extensible	LateralityQualifierVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-laterality-qualifier-vs

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	Condition	Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
condition-occurredFollowing		0..*	(Complex)	Precedent for this Condition URL: http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing"
Slices for value[x]		1..1		Value of extension Slice: Unordered, Closed by type:$this Binding: ConditionPredecessorCodes (example): Codes that describe activities or observations that occurred prior to the condition.
valueCodeableConcept			CodeableConcept
valueReference			Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)
value[x]:valueReference		0..1	Reference(Condition: Primary Cancer)	For relapses, reference to the first occurance of this tumor.
condition-dueTo		0..*	(Complex)	If Radiation therapy induced URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-dueTo"
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.ohdsi.org/CodeSystem/concepts
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4029715
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
assertedDate		0..1	dateTime	Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
relapseType		0..1	CodeableConcept	Relapse Type URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this condition
clinicalStatus	?!ΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis. Example Relapse: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/condition-clinical","code":"relapse"}]}
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Ordered, Open by value:system
coding:condition-clinical	Σ	1..1	Coding	Code defined by a terminology system Binding: ConditionClinicalStatusCodes (required)
coding:athena	Σ	0..1	Coding	Code defined by a terminology system Binding: Cancer Event Type: Athena (required)
text	Σ	0..1	string	Plain text representation of the concept
verificationStatus	?!ΣC	0..1	CodeableConcept	unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
category		0..*	CodeableConcept	problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
severity		0..1	CodeableConcept	Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	Σ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Cancer diagnosis: Athena (extensible)
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: Subsites: Athena (extensible)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
qualifier		0..*	(Complex)	Body Location Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Body site qualifier (extensible) Additional Bindings Purpose Body Location Qualifier Value Set Preferred
laterality		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Laterality Qualifier Value Set (extensible)
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(Patient: IDEA4RC)	Who has the condition?
encounter	Σ	0..1	Reference(Encounter: IDEA4RC)	Encounter this primary cancer has been identified
onset[x]	SΣ	0..1		Estimated or actual date, date-time, or age
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
abatement[x]	C	0..1		When in resolution/remission
abatementDateTime			dateTime
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	Σ	0..1	dateTime	Date record was first recorded
recorder	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Who recorded the condition
asserter	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Person who asserts this condition
stage	C	0..*	BackboneElement	Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary	C	0..1	CodeableConcept	Most recent Stage Group Binding: Cancer Stage Grading: Athena (required)
assessment	C	0..*	Reference(Observation: Head Neck Cancer Stage Group | Observation: Sarcoma Cancer Stage Group)	Formal record of assessment
type		0..1	CodeableConcept	Staging system used. Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
Slices for evidence	C	0..*	BackboneElement	Supporting evidence Slice: Unordered, Open by profile:$this.detail.resolve() con-2: evidence SHALL have code or details
evidence:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail	ΣC	0..*	Reference(Resource)	Supporting information found elsewhere
evidence:diagnosisDetails	C	0..1	BackboneElement	Diagnosis Details con-2: evidence SHALL have code or details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail	ΣC	0..*	Reference(Observation: Diagnosis details)	Supporting information found elsewhere
evidence:simpleResult	C	0..*	BackboneElement	Tumor size, Mitotic count score, laboratory Test results con-2: evidence SHALL have code or details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail	ΣC	0..*	Reference(Observation: test results)	Supporting information found elsewhere
evidence:genetic-test	C	0..*	BackboneElement	Genetic Tests performed con-2: evidence SHALL have code or details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail	ΣC	0..*	Reference(Observation: Yes / No assertions)	Supporting information found elsewhere
note		0..*	Annotation	Additional information about the Cancer Condition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Condition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Condition.extension:condition-occurredFollowing.value[x]	example	ConditionPredecessorCodes (a valid code from SNOMED CT) http://hl7.org/fhir/ValueSet/condition-predecessor
Condition.extension:condition-dueTo.value[x]	example	ConditionCauseCodes (a valid code from SNOMED CT) http://hl7.org/fhir/ValueSet/condition-cause
Condition.extension:condition-dueTo.value[x]:valueCodeableConcept	example	Pattern: 4029715 http://hl7.org/fhir/ValueSet/condition-cause
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1 from the FHIR Standard
Condition.clinicalStatus.coding:condition-clinical	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical from the FHIR Standard
Condition.clinicalStatus.coding:athena	required	CancerEventTypeVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-event-type-vs from this IG
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1 from the FHIR Standard
Condition.category	extensible	ConditionCategoryCodes http://hl7.org/fhir/ValueSet/condition-category from the FHIR Standard
Condition.severity	preferred	Condition/DiagnosisSeverity http://hl7.org/fhir/ValueSet/condition-severity from the FHIR Standard
Condition.code	extensible	CancerDiagnosisVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-diagnosis-athena-vs from this IG
Condition.bodySite	extensible	VsSubsiteAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/nasal-subsite-athena-i4rc from this IG
Condition.bodySite.extension:qualifier.value[x]	extensible	VsSiteQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/site-qualifier-i4rc from this IG
Condition.bodySite.extension:laterality.value[x]	extensible	LateralityQualifierVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-laterality-qualifier-vs
Condition.stage.summary	required	CancerStageGradingVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-stageGrading-athena-vs from this IG
Condition.stage.type	example	ConditionStageType http://hl7.org/fhir/ValueSet/condition-stage-type from the FHIR Standard
Condition.evidence.code	example	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard
Condition.evidence:diagnosisDetails.code	example	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard
Condition.evidence:simpleResult.code	example	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard
Condition.evidence:genetic-test.code	example	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard

This structure is derived from Condition

Summary

Mandatory: 1 element(3 nested mandatory elements)
Must-Support: 1 element
Prohibited: 1 element

Structures

This structure refers to these other structures:

• Condition: Primary Cancer (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/Condition-primaryCancer-eu-i4rc)
• Patient: IDEA4RC (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/patient-eu-i4rc)
• Encounter: IDEA4RC (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/Encounter-eu-i4rc)
• Observation: Head Neck Cancer Stage Group (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/hn-cancer-stage-group)
• Observation: Sarcoma Cancer Stage Group (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/sarcoma-cancer-stage-group)
• Observation: Diagnosis details (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/Observation-diagnosis-eu-i4rc)
• Observation: test results (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/observation-testResult-eu-i4rc)
• Observation: Yes / No assertions (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/observation-yesNo-eu-i4rc)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing
• http://hl7.org/fhir/StructureDefinition/condition-dueTo
• http://hl7.org/fhir/StructureDefinition/condition-assertedDate
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Condition.extension.value[x]
• The element 1 is sliced based on the value of Condition.clinicalStatus.coding (ordered)
• The element 1 is sliced based on the value of Condition.evidence

Differential View

This structure is derived from Condition

Name	Flags	Card.	Type	Description & Constraints
Condition			Condition
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
condition-occurredFollowing		0..*	(Complex)	Precedent for this Condition URL: http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing
Slices for value[x]		1..1	CodeableConcept, Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)	Value of extension Slice: Unordered, Open by type:$this
value[x]:valueCodeableConcept		0..0
value[x]:valueReference		0..1	Reference(Condition: Primary Cancer)	For relapses, reference to the first occurance of this tumor.
condition-dueTo		0..*	(Complex)	If Radiation therapy induced URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Open by type:$this
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.ohdsi.org/CodeSystem/concepts
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4029715
assertedDate		0..1	dateTime	Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
relapseType		0..1	CodeableConcept	Relapse Type URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
clinicalStatus		0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Example Relapse: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/condition-clinical","code":"relapse"}]}
Slices for coding		1..*	Coding	Code defined by a terminology system Slice: Ordered, Open by value:system
coding:condition-clinical		1..1	Coding	Code defined by a terminology system Binding: ConditionClinicalStatusCodes (required)
coding:athena		0..1	Coding	Code defined by a terminology system Binding: Cancer Event Type: Athena (required)
code		1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Cancer diagnosis: Athena (extensible)
bodySite		0..*	CodeableConcept	Anatomical location, if relevant Binding: Subsites: Athena (extensible)
Slices for extension				Content/Rules for all slices
qualifier		0..*	(Complex)	Body Location Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
value[x]		1..1	CodeableConcept	Value of extension Binding: Body site qualifier (extensible) Additional Bindings Purpose Body Location Qualifier Value Set Preferred
laterality		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier
value[x]		1..1	CodeableConcept	Value of extension Binding: Laterality Qualifier Value Set (extensible)
subject		1..1	Reference(Patient: IDEA4RC)	Who has the condition?
encounter		0..1	Reference(Encounter: IDEA4RC)	Encounter this primary cancer has been identified
onset[x]	S	0..1	dateTime, Age, Period, Range, string	Estimated or actual date, date-time, or age
stage
summary		0..1	CodeableConcept	Most recent Stage Group Binding: Cancer Stage Grading: Athena (required)
assessment		0..*	Reference(Observation: Head Neck Cancer Stage Group | Observation: Sarcoma Cancer Stage Group)	Formal record of assessment
type		0..1	CodeableConcept	Staging system used.
Slices for evidence		0..*	BackboneElement	Supporting evidence Slice: Unordered, Open by profile:$this.detail.resolve()
evidence:diagnosisDetails		0..1	BackboneElement	Diagnosis Details
detail		0..*	Reference(Observation: Diagnosis details)	Supporting information found elsewhere
evidence:simpleResult		0..*	BackboneElement	Tumor size, Mitotic count score, laboratory Test results
detail		0..*	Reference(Observation: test results)	Supporting information found elsewhere
evidence:genetic-test		0..*	BackboneElement	Genetic Tests performed
detail		0..*	Reference(Observation: Yes / No assertions)	Supporting information found elsewhere
note		0..*	Annotation	Additional information about the Cancer Condition
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Condition.clinicalStatus.coding:condition-clinical	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical from the FHIR Standard
Condition.clinicalStatus.coding:athena	required	CancerEventTypeVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-event-type-vs from this IG
Condition.code	extensible	CancerDiagnosisVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-diagnosis-athena-vs from this IG
Condition.bodySite	extensible	VsSubsiteAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/nasal-subsite-athena-i4rc from this IG
Condition.bodySite.extension:qualifier.value[x]	extensible	VsSiteQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/site-qualifier-i4rc from this IG
Condition.bodySite.extension:laterality.value[x]	extensible	LateralityQualifierVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-laterality-qualifier-vs
Condition.stage.summary	required	CancerStageGradingVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-stageGrading-athena-vs from this IG

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	Condition	Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
condition-occurredFollowing		0..*	(Complex)	Precedent for this Condition URL: http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing"
Slices for value[x]		1..1		Value of extension Slice: Unordered, Closed by type:$this Binding: ConditionPredecessorCodes (example): Codes that describe activities or observations that occurred prior to the condition.
valueCodeableConcept			CodeableConcept
valueReference			Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)
value[x]:valueReference		0..1	Reference(Condition: Primary Cancer)	For relapses, reference to the first occurance of this tumor.
condition-dueTo		0..*	(Complex)	If Radiation therapy induced URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-dueTo"
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.ohdsi.org/CodeSystem/concepts
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4029715
assertedDate		0..1	dateTime	Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
relapseType		0..1	CodeableConcept	Relapse Type URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
clinicalStatus	?!ΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis. Example Relapse: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/condition-clinical","code":"relapse"}]}
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Ordered, Open by value:system
coding:condition-clinical	Σ	1..1	Coding	Code defined by a terminology system Binding: ConditionClinicalStatusCodes (required)
coding:athena	Σ	0..1	Coding	Code defined by a terminology system Binding: Cancer Event Type: Athena (required)
verificationStatus	?!ΣC	0..1	CodeableConcept	unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
code	Σ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Cancer diagnosis: Athena (extensible)
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: Subsites: Athena (extensible)
Slices for extension				Content/Rules for all slices
qualifier		0..*	(Complex)	Body Location Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Body site qualifier (extensible) Additional Bindings Purpose Body Location Qualifier Value Set Preferred
laterality		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Laterality Qualifier Value Set (extensible)
subject	Σ	1..1	Reference(Patient: IDEA4RC)	Who has the condition?
encounter	Σ	0..1	Reference(Encounter: IDEA4RC)	Encounter this primary cancer has been identified
onset[x]	SΣ	0..1		Estimated or actual date, date-time, or age
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
Slices for evidence	C	0..*	BackboneElement	Supporting evidence Slice: Unordered, Open by profile:$this.detail.resolve() con-2: evidence SHALL have code or details
evidence:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
evidence:diagnosisDetails	C	0..1	BackboneElement	Diagnosis Details con-2: evidence SHALL have code or details
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
detail	ΣC	0..*	Reference(Observation: Diagnosis details)	Supporting information found elsewhere
evidence:simpleResult	C	0..*	BackboneElement	Tumor size, Mitotic count score, laboratory Test results con-2: evidence SHALL have code or details
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
detail	ΣC	0..*	Reference(Observation: test results)	Supporting information found elsewhere
evidence:genetic-test	C	0..*	BackboneElement	Genetic Tests performed con-2: evidence SHALL have code or details
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
detail	ΣC	0..*	Reference(Observation: Yes / No assertions)	Supporting information found elsewhere
note		0..*	Annotation	Additional information about the Cancer Condition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Condition.extension:condition-occurredFollowing.value[x]	example	ConditionPredecessorCodes (a valid code from SNOMED CT) http://hl7.org/fhir/ValueSet/condition-predecessor
Condition.extension:condition-dueTo.value[x]	example	ConditionCauseCodes (a valid code from SNOMED CT) http://hl7.org/fhir/ValueSet/condition-cause
Condition.extension:condition-dueTo.value[x]:valueCodeableConcept	example	Pattern: 4029715 http://hl7.org/fhir/ValueSet/condition-cause
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1 from the FHIR Standard
Condition.clinicalStatus.coding:condition-clinical	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical from the FHIR Standard
Condition.clinicalStatus.coding:athena	required	CancerEventTypeVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-event-type-vs from this IG
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1 from the FHIR Standard
Condition.code	extensible	CancerDiagnosisVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-diagnosis-athena-vs from this IG
Condition.bodySite	extensible	VsSubsiteAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/nasal-subsite-athena-i4rc from this IG
Condition.bodySite.extension:qualifier.value[x]	extensible	VsSiteQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/site-qualifier-i4rc from this IG
Condition.bodySite.extension:laterality.value[x]	extensible	LateralityQualifierVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-laterality-qualifier-vs

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Condition	C	0..*	Condition	Detailed information about conditions, problems or diagnoses con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
condition-occurredFollowing		0..*	(Complex)	Precedent for this Condition URL: http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing"
Slices for value[x]		1..1		Value of extension Slice: Unordered, Closed by type:$this Binding: ConditionPredecessorCodes (example): Codes that describe activities or observations that occurred prior to the condition.
valueCodeableConcept			CodeableConcept
valueReference			Reference(Condition | Procedure | MedicationAdministration | Immunization | MedicationStatement)
value[x]:valueReference		0..1	Reference(Condition: Primary Cancer)	For relapses, reference to the first occurance of this tumor.
condition-dueTo		0..*	(Complex)	If Radiation therapy induced URL: http://hl7.org/fhir/StructureDefinition/condition-dueTo
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-dueTo"
Slices for value[x]		1..1	CodeableConcept	Value of extension Slice: Unordered, Closed by type:$this Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc.
value[x]:valueCodeableConcept		1..1	CodeableConcept	Value of extension Binding: ConditionCauseCodes (example): Codes that describe causes of patient conditions; e.g. Surgical mishap, escalation of a previous condition, etc. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.ohdsi.org/CodeSystem/concepts
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4029715
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
assertedDate		0..1	dateTime	Date the allergy, intolerance, condition, problem, or diagnosis or other event, situation, issue, or clinical concept was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate
previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
relapseType		0..1	CodeableConcept	Relapse Type URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this condition
clinicalStatus	?!ΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis. Example Relapse: {"coding":[{"system":"http://terminology.hl7.org/CodeSystem/condition-clinical","code":"relapse"}]}
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Ordered, Open by value:system
coding:condition-clinical	Σ	1..1	Coding	Code defined by a terminology system Binding: ConditionClinicalStatusCodes (required)
coding:athena	Σ	0..1	Coding	Code defined by a terminology system Binding: Cancer Event Type: Athena (required)
text	Σ	0..1	string	Plain text representation of the concept
verificationStatus	?!ΣC	0..1	CodeableConcept	unconfirmed | provisional | differential | confirmed | refuted | entered-in-error Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.
category		0..*	CodeableConcept	problem-list-item | encounter-diagnosis Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
severity		0..1	CodeableConcept	Subjective severity of condition Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	Σ	1..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Cancer diagnosis: Athena (extensible)
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: Subsites: Athena (extensible)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
qualifier		0..*	(Complex)	Body Location Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Body site qualifier (extensible) Additional Bindings Purpose Body Location Qualifier Value Set Preferred
laterality		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Laterality Qualifier Value Set (extensible)
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(Patient: IDEA4RC)	Who has the condition?
encounter	Σ	0..1	Reference(Encounter: IDEA4RC)	Encounter this primary cancer has been identified
onset[x]	SΣ	0..1		Estimated or actual date, date-time, or age
onsetDateTime			dateTime
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
abatement[x]	C	0..1		When in resolution/remission
abatementDateTime			dateTime
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	Σ	0..1	dateTime	Date record was first recorded
recorder	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Who recorded the condition
asserter	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Person who asserts this condition
stage	C	0..*	BackboneElement	Stage/grade, usually assessed formally con-1: Stage SHALL have summary or assessment
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
summary	C	0..1	CodeableConcept	Most recent Stage Group Binding: Cancer Stage Grading: Athena (required)
assessment	C	0..*	Reference(Observation: Head Neck Cancer Stage Group | Observation: Sarcoma Cancer Stage Group)	Formal record of assessment
type		0..1	CodeableConcept	Staging system used. Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
Slices for evidence	C	0..*	BackboneElement	Supporting evidence Slice: Unordered, Open by profile:$this.detail.resolve() con-2: evidence SHALL have code or details
evidence:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail	ΣC	0..*	Reference(Resource)	Supporting information found elsewhere
evidence:diagnosisDetails	C	0..1	BackboneElement	Diagnosis Details con-2: evidence SHALL have code or details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail	ΣC	0..*	Reference(Observation: Diagnosis details)	Supporting information found elsewhere
evidence:simpleResult	C	0..*	BackboneElement	Tumor size, Mitotic count score, laboratory Test results con-2: evidence SHALL have code or details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail	ΣC	0..*	Reference(Observation: test results)	Supporting information found elsewhere
evidence:genetic-test	C	0..*	BackboneElement	Genetic Tests performed con-2: evidence SHALL have code or details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.
detail	ΣC	0..*	Reference(Observation: Yes / No assertions)	Supporting information found elsewhere
note		0..*	Annotation	Additional information about the Cancer Condition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Condition.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Condition.extension:condition-occurredFollowing.value[x]	example	ConditionPredecessorCodes (a valid code from SNOMED CT) http://hl7.org/fhir/ValueSet/condition-predecessor
Condition.extension:condition-dueTo.value[x]	example	ConditionCauseCodes (a valid code from SNOMED CT) http://hl7.org/fhir/ValueSet/condition-cause
Condition.extension:condition-dueTo.value[x]:valueCodeableConcept	example	Pattern: 4029715 http://hl7.org/fhir/ValueSet/condition-cause
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1 from the FHIR Standard
Condition.clinicalStatus.coding:condition-clinical	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical from the FHIR Standard
Condition.clinicalStatus.coding:athena	required	CancerEventTypeVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-event-type-vs from this IG
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1 from the FHIR Standard
Condition.category	extensible	ConditionCategoryCodes http://hl7.org/fhir/ValueSet/condition-category from the FHIR Standard
Condition.severity	preferred	Condition/DiagnosisSeverity http://hl7.org/fhir/ValueSet/condition-severity from the FHIR Standard
Condition.code	extensible	CancerDiagnosisVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-diagnosis-athena-vs from this IG
Condition.bodySite	extensible	VsSubsiteAthenaI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/nasal-subsite-athena-i4rc from this IG
Condition.bodySite.extension:qualifier.value[x]	extensible	VsSiteQualifierI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/site-qualifier-i4rc from this IG
Condition.bodySite.extension:laterality.value[x]	extensible	LateralityQualifierVS http://hl7.org/fhir/us/mcode/ValueSet/mcode-laterality-qualifier-vs
Condition.stage.summary	required	CancerStageGradingVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/cancer-stageGrading-athena-vs from this IG
Condition.stage.type	example	ConditionStageType http://hl7.org/fhir/ValueSet/condition-stage-type from the FHIR Standard
Condition.evidence.code	example	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard
Condition.evidence:diagnosisDetails.code	example	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard
Condition.evidence:simpleResult.code	example	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard
Condition.evidence:genetic-test.code	example	ManifestationAndSymptomCodes http://hl7.org/fhir/ValueSet/manifestation-or-symptom from the FHIR Standard

This structure is derived from Condition

Summary

Mandatory: 1 element(3 nested mandatory elements)
Must-Support: 1 element
Prohibited: 1 element

Structures

This structure refers to these other structures:

• Condition: Primary Cancer (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/Condition-primaryCancer-eu-i4rc)
• Patient: IDEA4RC (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/patient-eu-i4rc)
• Encounter: IDEA4RC (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/Encounter-eu-i4rc)
• Observation: Head Neck Cancer Stage Group (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/hn-cancer-stage-group)
• Observation: Sarcoma Cancer Stage Group (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/sarcoma-cancer-stage-group)
• Observation: Diagnosis details (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/Observation-diagnosis-eu-i4rc)
• Observation: test results (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/observation-testResult-eu-i4rc)
• Observation: Yes / No assertions (http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/observation-yesNo-eu-i4rc)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/condition-occurredFollowing
• http://hl7.org/fhir/StructureDefinition/condition-dueTo
• http://hl7.org/fhir/StructureDefinition/condition-assertedDate
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Condition.extension.value[x]
• The element 1 is sliced based on the value of Condition.clinicalStatus.coding (ordered)
• The element 1 is sliced based on the value of Condition.evidence