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: Metastatic Cancer

This profile defines how to represent metastatic cancer in FHIR for the purpose of the IDEA4RC project. This profile is inspired from the mCode IG. Records the history of secondary neoplasms, including location(s) and the date of onset of metastases. A secondary cancer results from the spread (metastasization) of cancer from its original site (Definition from: NCI Dictionary of Cancer Terms).

Usages:

• Use this Profile: Bundle: IDEA4RC
• Examples for this Profile: Condition/GOFSH-GENERATED-id-36 and Condition/condition-id-7

Formal Views of Profile Content

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

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

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition	C	0..*	Condition	Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension: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
extension:previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:histology-morphology-behavior		0..2	CodeableConcept	Histology Morphology Behavior URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-histology-morphology-behavior Binding: Cancer histology behaviour: Athena (required)
extension:relapseType		0..1	CodeableConcept	Relapse Type URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
extension:relatedPrimaryCancerCondition		1..1	(Complex)	Related Primary Cancer Condition URL: http://hl7.org/fhir/StructureDefinition/condition-related
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-related"
value[x]		1..1	Reference(Condition: Primary Cancer)	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
clinicalStatus	?!SΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!SΣC	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	0..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Metastatis: Athena (extensible)
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: Site of metastasis (extensible)
Slices for extension				Content/Rules for all slices
extension: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
extension: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?
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1 From the FHIR Standard
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1 From the FHIR Standard
Condition.code	extensible	MetastasisDisorderVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/metastasis-disorder-athena-vs From this IG
Condition.bodySite	extensible	VsSiteOfMetastasisI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/site-of-metastasis-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

Constraints

Id	Grade	Path(s)	Details	Requirements
con-3	best practice	Condition	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	error	Condition	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	error	Condition	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	error	Condition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Condition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Condition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Condition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Condition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from Condition

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition			Condition
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension: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
extension:previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:histology-morphology-behavior		0..2	CodeableConcept	Histology Morphology Behavior URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-histology-morphology-behavior Binding: Cancer histology behaviour: Athena (required)
extension:relapseType		0..1	CodeableConcept	Relapse Type URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
extension:relatedPrimaryCancerCondition		1..1	(Complex)	Related Primary Cancer Condition URL: http://hl7.org/fhir/StructureDefinition/condition-related
value[x]		1..1	Reference(Condition: Primary Cancer)	Value of extension
clinicalStatus	S	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved
verificationStatus	S	0..1	CodeableConcept	unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
code		0..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Metastatis: Athena (extensible)
bodySite		0..*	CodeableConcept	Anatomical location, if relevant Binding: Site of metastasis (extensible)
Slices for extension				Content/Rules for all slices
extension: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
extension: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?
stage		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Condition.code	extensible	MetastasisDisorderVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/metastasis-disorder-athena-vs From this IG
Condition.bodySite	extensible	VsSiteOfMetastasisI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/site-of-metastasis-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    Filter: Bindings Constraints Obligations
Condition	C	0..*	Condition	Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension: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
extension:previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:histology-morphology-behavior		0..2	CodeableConcept	Histology Morphology Behavior URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-histology-morphology-behavior Binding: Cancer histology behaviour: Athena (required)
extension:relapseType		0..1	CodeableConcept	Relapse Type URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
extension:relatedPrimaryCancerCondition		1..1	(Complex)	Related Primary Cancer Condition URL: http://hl7.org/fhir/StructureDefinition/condition-related
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-related"
value[x]		1..1	Reference(Condition: Primary Cancer)	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this condition
clinicalStatus	?!SΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!SΣC	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	0..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Metastatis: Athena (extensible)
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: Site of metastasis (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
extension: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
extension: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)	Encounter created as part of
onset[x]	Σ	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
evidence	C	0..*	BackboneElement	Supporting evidence Constraints: con-2
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
note		0..*	Annotation	Additional information about the Condition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Condition.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1 From the FHIR Standard
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	MetastasisDisorderVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/metastasis-disorder-athena-vs From this IG
Condition.bodySite	extensible	VsSiteOfMetastasisI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/site-of-metastasis-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	example	ConditionStage http://hl7.org/fhir/ValueSet/condition-stage From the FHIR Standard
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

Constraints

Id	Grade	Path(s)	Details	Requirements
con-2	error	Condition.evidence	evidence SHALL have code or details : code.exists() or detail.exists()
con-3	best practice	Condition	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	error	Condition	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	error	Condition	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	error	Condition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Condition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Condition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Condition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Condition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from Condition

Summary

Mandatory: 2 elements
Must-Support: 2 elements
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)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/condition-assertedDate
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-histology-morphology-behavior
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
• http://hl7.org/fhir/StructureDefinition/condition-related
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition	C	0..*	Condition	Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension: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
extension:previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:histology-morphology-behavior		0..2	CodeableConcept	Histology Morphology Behavior URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-histology-morphology-behavior Binding: Cancer histology behaviour: Athena (required)
extension:relapseType		0..1	CodeableConcept	Relapse Type URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
extension:relatedPrimaryCancerCondition		1..1	(Complex)	Related Primary Cancer Condition URL: http://hl7.org/fhir/StructureDefinition/condition-related
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-related"
value[x]		1..1	Reference(Condition: Primary Cancer)	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
clinicalStatus	?!SΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!SΣC	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	0..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Metastatis: Athena (extensible)
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: Site of metastasis (extensible)
Slices for extension				Content/Rules for all slices
extension: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
extension: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?
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1 From the FHIR Standard
Condition.verificationStatus	required	ConditionVerificationStatus http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1 From the FHIR Standard
Condition.code	extensible	MetastasisDisorderVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/metastasis-disorder-athena-vs From this IG
Condition.bodySite	extensible	VsSiteOfMetastasisI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/site-of-metastasis-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

Constraints

Id	Grade	Path(s)	Details	Requirements
con-3	best practice	Condition	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	error	Condition	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	error	Condition	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	error	Condition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Condition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Condition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Condition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Condition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from Condition

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition			Condition
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension: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
extension:previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:histology-morphology-behavior		0..2	CodeableConcept	Histology Morphology Behavior URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-histology-morphology-behavior Binding: Cancer histology behaviour: Athena (required)
extension:relapseType		0..1	CodeableConcept	Relapse Type URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
extension:relatedPrimaryCancerCondition		1..1	(Complex)	Related Primary Cancer Condition URL: http://hl7.org/fhir/StructureDefinition/condition-related
value[x]		1..1	Reference(Condition: Primary Cancer)	Value of extension
clinicalStatus	S	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved
verificationStatus	S	0..1	CodeableConcept	unconfirmed | provisional | differential | confirmed | refuted | entered-in-error
code		0..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Metastatis: Athena (extensible)
bodySite		0..*	CodeableConcept	Anatomical location, if relevant Binding: Site of metastasis (extensible)
Slices for extension				Content/Rules for all slices
extension: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
extension: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?
stage		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Condition.code	extensible	MetastasisDisorderVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/metastasis-disorder-athena-vs From this IG
Condition.bodySite	extensible	VsSiteOfMetastasisI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/site-of-metastasis-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    Filter: Bindings Constraints Obligations
Condition	C	0..*	Condition	Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5
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 This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension: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
extension:previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:histology-morphology-behavior		0..2	CodeableConcept	Histology Morphology Behavior URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-histology-morphology-behavior Binding: Cancer histology behaviour: Athena (required)
extension:relapseType		0..1	CodeableConcept	Relapse Type URL: http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
extension:relatedPrimaryCancerCondition		1..1	(Complex)	Related Primary Cancer Condition URL: http://hl7.org/fhir/StructureDefinition/condition-related
id		0..1	id	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-related"
value[x]		1..1	Reference(Condition: Primary Cancer)	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this condition
clinicalStatus	?!SΣC	0..1	CodeableConcept	active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.
verificationStatus	?!SΣC	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	0..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Metastatis: Athena (extensible)
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: Site of metastasis (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
extension: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
extension: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)	Encounter created as part of
onset[x]	Σ	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
evidence	C	0..*	BackboneElement	Supporting evidence Constraints: con-2
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
note		0..*	Annotation	Additional information about the Condition
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Condition.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Condition.clinicalStatus	required	ConditionClinicalStatusCodes http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1 From the FHIR Standard
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	MetastasisDisorderVS http://hl7.eu/fhir/ig/idea4rc/ValueSet/metastasis-disorder-athena-vs From this IG
Condition.bodySite	extensible	VsSiteOfMetastasisI4rc http://hl7.eu/fhir/ig/idea4rc/ValueSet/site-of-metastasis-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	example	ConditionStage http://hl7.org/fhir/ValueSet/condition-stage From the FHIR Standard
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

Constraints

Id	Grade	Path(s)	Details	Requirements
con-2	error	Condition.evidence	evidence SHALL have code or details : code.exists() or detail.exists()
con-3	best practice	Condition	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	error	Condition	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	error	Condition	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	error	Condition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Condition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Condition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Condition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Condition	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from Condition

Summary

Mandatory: 2 elements
Must-Support: 2 elements
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)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/condition-assertedDate
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-previousStatus
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-histology-morphology-behavior
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/condition-relapseType
• http://hl7.org/fhir/StructureDefinition/condition-related
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-body-location-qualifier
• http://hl7.eu/fhir/ig/idea4rc/StructureDefinition/mcode-laterality-qualifier

Other representations of profile: CSV, Excel, Schematron