PanCareSurPass Project HL7 FHIR Implementation Guide, published by PanCareSurPass Project. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/pcsp/ and changes regularly. See the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples
• XML
• JSON
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Resource Profile: Condition: Metastatic Cancer

This profile defines how to represent metastatic cancer in FHIR for the purpose of the PanCareSurPass 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: Survivor Passport
• Refer to this Profile: Composition: Survivor Passport
• Examples for this Profile: Condition/ConditionSecCancerMainzZeisig

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

• 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:histologyMorphologyBehavior		0..1	(Complex)	Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior"
value[x]		1..1	CodeableConcept	Value of extension Binding: ICD-O-3 Morphology (required)
extension:previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:relapseType		0..1	(Complex)	Relapse Type URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType"
value[x]		0..1	CodeableConcept	Value of extension Binding: Relapse type (Local/Distant/Combined) (preferred)
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	SΣ	0..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: ICD-O-3 Topography (extensible)
Slices for extension				Content/Rules for all slices
extension:locationQualifier		0..*	CodeableConcept	Body Location Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (preferred)
extension:lateralityQualifier		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Laterality Qualifier Value Set (preferred): Qualifiers to specify laterality. Additional Bindings Purpose Laterality Qualifier Value Set candidate
subject	Σ	1..1	Reference(Patient: PCSP)	Who has the condition?
stage	C	0..*	BackboneElement	Not used in this profile Constraints: con-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Condition.extension:histologyMorphologyBehavior.​value[x]	Base	required	ICD-O-3 Morphology	📦1.0.0	This IG
Condition.extension:relapseType.​value[x]	Base	preferred	Relapse type (Local/Distant/Combined)	📦1.0.0	This IG
Condition.clinicalStatus	Base	required	Condition Clinical Status Codes	📍4.0.1	FHIR Std.
Condition.verificationStatus	Base	required	ConditionVerificationStatus	📍4.0.1	FHIR Std.
Condition.code	Base	example	Condition/Problem/Diagnosis Codes	📍4.0.1	FHIR Std.
Condition.bodySite	Base	extensible	ICD-O-3 Topography	📦1.0.0	This IG
Condition.bodySite.extension:lateralityQualifier.​value[x]	Base	preferred	Laterality Qualifier Value Set	📦1.0.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
con-1	error	Condition.stage	Stage SHALL have summary or assessment	summary.exists() or assessment.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

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:histologyMorphologyBehavior		0..1	(Complex)	Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
value[x]		1..1	CodeableConcept	Value of extension Binding: ICD-O-3 Morphology (required)
extension:previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:relapseType		0..1	(Complex)	Relapse Type URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
value[x]		0..1	CodeableConcept	Value of extension Binding: Relapse type (Local/Distant/Combined) (preferred)
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	S	0..1	CodeableConcept	Identification of the condition, problem or diagnosis
bodySite		0..*	CodeableConcept	Anatomical location, if relevant Binding: ICD-O-3 Topography (extensible)
Slices for extension				Content/Rules for all slices
extension:locationQualifier		0..*	CodeableConcept	Body Location Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (preferred)
extension:lateralityQualifier		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier
value[x]		1..1	CodeableConcept	Value of extension Binding: Laterality Qualifier Value Set (preferred): Qualifiers to specify laterality. Additional Bindings Purpose Laterality Qualifier Value Set candidate
subject		1..1	Reference(Patient: PCSP)	Who has the condition?
stage		0..*	BackboneElement	Not used in this profile
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Condition.extension:histologyMorphologyBehavior.​value[x]	Base	required	ICD-O-3 Morphology	📦1.0.0	This IG
Condition.extension:relapseType.​value[x]	Base	preferred	Relapse type (Local/Distant/Combined)	📦1.0.0	This IG
Condition.bodySite	Base	extensible	ICD-O-3 Topography	📦1.0.0	This IG
Condition.bodySite.extension:lateralityQualifier.​value[x]	Base	preferred	Laterality Qualifier Value Set	📦1.0.0	This IG

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:histologyMorphologyBehavior		0..1	(Complex)	Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior"
value[x]		1..1	CodeableConcept	Value of extension Binding: ICD-O-3 Morphology (required)
extension:previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:relapseType		0..1	(Complex)	Relapse Type URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType"
value[x]		0..1	CodeableConcept	Value of extension Binding: Relapse type (Local/Distant/Combined) (preferred)
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	SΣ	0..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: ICD-O-3 Topography (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:locationQualifier		0..*	CodeableConcept	Body Location Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (preferred)
extension:lateralityQualifier		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/pcsp/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/pcsp/StructureDefinition/mcode-laterality-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Laterality Qualifier Value Set (preferred): Qualifiers to specify laterality. Additional Bindings Purpose Laterality Qualifier Value Set candidate
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: PCSP)	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
stage	C	0..*	BackboneElement	Not used in this profile Constraints: con-1
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	Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).
assessment	C	0..*	Reference(ClinicalImpression | DiagnosticReport | Observation)	Formal record of assessment
type		0..1	CodeableConcept	Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
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	Status	Usage	ValueSet	Version	Source
Condition.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Condition.extension:histologyMorphologyBehavior.​value[x]	Base	required	ICD-O-3 Morphology	📦1.0.0	This IG
Condition.extension:relapseType.​value[x]	Base	preferred	Relapse type (Local/Distant/Combined)	📦1.0.0	This IG
Condition.clinicalStatus	Base	required	Condition Clinical Status Codes	📍4.0.1	FHIR Std.
Condition.verificationStatus	Base	required	ConditionVerificationStatus	📍4.0.1	FHIR Std.
Condition.category	Base	extensible	Condition Category Codes	📍4.0.1	FHIR Std.
Condition.severity	Base	preferred	Condition/Diagnosis Severity	📍4.0.1	FHIR Std.
Condition.code	Base	example	Condition/Problem/Diagnosis Codes	📍4.0.1	FHIR Std.
Condition.bodySite	Base	extensible	ICD-O-3 Topography	📦1.0.0	This IG
Condition.bodySite.extension:lateralityQualifier.​value[x]	Base	preferred	Laterality Qualifier Value Set	📦1.0.0	This IG
Condition.stage.summary	Base	example	Condition Stage	📍4.0.1	FHIR Std.
Condition.stage.type	Base	example	Condition Stage Type	📍4.0.1	FHIR Std.
Condition.evidence.code	Base	example	Manifestation and Symptom Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
con-1	error	Condition.stage	Stage SHALL have summary or assessment	summary.exists() or assessment.exists()
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: 3 elements

Structures

This structure refers to these other structures:

• Condition: Primary Cancer (http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Condition-primaryCancer-eu-pcsp)
• Patient: PCSP (http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Patient-eu-pcsp)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/condition-assertedDate|5.2.0
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
• http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus
• http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
• http://hl7.org/fhir/StructureDefinition/condition-related|5.2.0
• http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier
• http://hl7.eu/fhir/ig/pcsp/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:histologyMorphologyBehavior		0..1	(Complex)	Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior"
value[x]		1..1	CodeableConcept	Value of extension Binding: ICD-O-3 Morphology (required)
extension:previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:relapseType		0..1	(Complex)	Relapse Type URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType"
value[x]		0..1	CodeableConcept	Value of extension Binding: Relapse type (Local/Distant/Combined) (preferred)
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	SΣ	0..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: ICD-O-3 Topography (extensible)
Slices for extension				Content/Rules for all slices
extension:locationQualifier		0..*	CodeableConcept	Body Location Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (preferred)
extension:lateralityQualifier		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Laterality Qualifier Value Set (preferred): Qualifiers to specify laterality. Additional Bindings Purpose Laterality Qualifier Value Set candidate
subject	Σ	1..1	Reference(Patient: PCSP)	Who has the condition?
stage	C	0..*	BackboneElement	Not used in this profile Constraints: con-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Condition.extension:histologyMorphologyBehavior.​value[x]	Base	required	ICD-O-3 Morphology	📦1.0.0	This IG
Condition.extension:relapseType.​value[x]	Base	preferred	Relapse type (Local/Distant/Combined)	📦1.0.0	This IG
Condition.clinicalStatus	Base	required	Condition Clinical Status Codes	📍4.0.1	FHIR Std.
Condition.verificationStatus	Base	required	ConditionVerificationStatus	📍4.0.1	FHIR Std.
Condition.code	Base	example	Condition/Problem/Diagnosis Codes	📍4.0.1	FHIR Std.
Condition.bodySite	Base	extensible	ICD-O-3 Topography	📦1.0.0	This IG
Condition.bodySite.extension:lateralityQualifier.​value[x]	Base	preferred	Laterality Qualifier Value Set	📦1.0.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
con-1	error	Condition.stage	Stage SHALL have summary or assessment	summary.exists() or assessment.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()

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:histologyMorphologyBehavior		0..1	(Complex)	Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
value[x]		1..1	CodeableConcept	Value of extension Binding: ICD-O-3 Morphology (required)
extension:previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:relapseType		0..1	(Complex)	Relapse Type URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
value[x]		0..1	CodeableConcept	Value of extension Binding: Relapse type (Local/Distant/Combined) (preferred)
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	S	0..1	CodeableConcept	Identification of the condition, problem or diagnosis
bodySite		0..*	CodeableConcept	Anatomical location, if relevant Binding: ICD-O-3 Topography (extensible)
Slices for extension				Content/Rules for all slices
extension:locationQualifier		0..*	CodeableConcept	Body Location Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (preferred)
extension:lateralityQualifier		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier
value[x]		1..1	CodeableConcept	Value of extension Binding: Laterality Qualifier Value Set (preferred): Qualifiers to specify laterality. Additional Bindings Purpose Laterality Qualifier Value Set candidate
subject		1..1	Reference(Patient: PCSP)	Who has the condition?
stage		0..*	BackboneElement	Not used in this profile
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Condition.extension:histologyMorphologyBehavior.​value[x]	Base	required	ICD-O-3 Morphology	📦1.0.0	This IG
Condition.extension:relapseType.​value[x]	Base	preferred	Relapse type (Local/Distant/Combined)	📦1.0.0	This IG
Condition.bodySite	Base	extensible	ICD-O-3 Topography	📦1.0.0	This IG
Condition.bodySite.extension:lateralityQualifier.​value[x]	Base	preferred	Laterality Qualifier Value Set	📦1.0.0	This IG

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:histologyMorphologyBehavior		0..1	(Complex)	Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior"
value[x]		1..1	CodeableConcept	Value of extension Binding: ICD-O-3 Morphology (required)
extension:previousStatus		0..1	CodeableConcept	Previous Status URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus Binding: ConditionClinicalStatusCodes (required)
extension:relapseType		0..1	(Complex)	Relapse Type URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
id		0..1	string	Unique id for inter-element referencing
extension		0..0
url		1..1	uri	"http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType"
value[x]		0..1	CodeableConcept	Value of extension Binding: Relapse type (Local/Distant/Combined) (preferred)
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	SΣ	0..1	CodeableConcept	Identification of the condition, problem or diagnosis Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.
bodySite	Σ	0..*	CodeableConcept	Anatomical location, if relevant Binding: ICD-O-3 Topography (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:locationQualifier		0..*	CodeableConcept	Body Location Qualifier URL: http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (preferred)
extension:lateralityQualifier		0..1	(Complex)	Laterality Qualifier URL: http://hl7.eu/fhir/ig/pcsp/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/pcsp/StructureDefinition/mcode-laterality-qualifier"
value[x]		1..1	CodeableConcept	Value of extension Binding: Laterality Qualifier Value Set (preferred): Qualifiers to specify laterality. Additional Bindings Purpose Laterality Qualifier Value Set candidate
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: PCSP)	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
stage	C	0..*	BackboneElement	Not used in this profile Constraints: con-1
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	Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).
assessment	C	0..*	Reference(ClinicalImpression | DiagnosticReport | Observation)	Formal record of assessment
type		0..1	CodeableConcept	Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
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	Status	Usage	ValueSet	Version	Source
Condition.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Condition.extension:histologyMorphologyBehavior.​value[x]	Base	required	ICD-O-3 Morphology	📦1.0.0	This IG
Condition.extension:relapseType.​value[x]	Base	preferred	Relapse type (Local/Distant/Combined)	📦1.0.0	This IG
Condition.clinicalStatus	Base	required	Condition Clinical Status Codes	📍4.0.1	FHIR Std.
Condition.verificationStatus	Base	required	ConditionVerificationStatus	📍4.0.1	FHIR Std.
Condition.category	Base	extensible	Condition Category Codes	📍4.0.1	FHIR Std.
Condition.severity	Base	preferred	Condition/Diagnosis Severity	📍4.0.1	FHIR Std.
Condition.code	Base	example	Condition/Problem/Diagnosis Codes	📍4.0.1	FHIR Std.
Condition.bodySite	Base	extensible	ICD-O-3 Topography	📦1.0.0	This IG
Condition.bodySite.extension:lateralityQualifier.​value[x]	Base	preferred	Laterality Qualifier Value Set	📦1.0.0	This IG
Condition.stage.summary	Base	example	Condition Stage	📍4.0.1	FHIR Std.
Condition.stage.type	Base	example	Condition Stage Type	📍4.0.1	FHIR Std.
Condition.evidence.code	Base	example	Manifestation and Symptom Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
con-1	error	Condition.stage	Stage SHALL have summary or assessment	summary.exists() or assessment.exists()
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: 3 elements

Structures

This structure refers to these other structures:

• Condition: Primary Cancer (http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Condition-primaryCancer-eu-pcsp)
• Patient: PCSP (http://hl7.eu/fhir/ig/pcsp/StructureDefinition/Patient-eu-pcsp)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/condition-assertedDate|5.2.0
• http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior
• http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-previousStatus
• http://hl7.eu/fhir/ig/pcsp/StructureDefinition/condition-relapseType
• http://hl7.org/fhir/StructureDefinition/condition-related|5.2.0
• http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-body-location-qualifier
• http://hl7.eu/fhir/ig/pcsp/StructureDefinition/mcode-laterality-qualifier

Other representations of profile: CSV, Excel, Schematron