PanCareSurPass Project HL7 FHIR Implementation Guide
0.2.0 - CI Build 150

PanCareSurPass Project HL7 FHIR Implementation Guide, published by PanCareSurPass Project. This guide is not an authorized publication; it is the continuous build for version 0.2.0 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

Logical Model: Diagnosis - Detailed Descriptions

Draft as of 2024-09-11

Definitions for the Diagnosis logical model.

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

0. Diagnosis
Definition

Diagnosis Maturity Level: 2 - Ready for Review

ShortDiagnosis
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. Diagnosis.identifier
Definition

diagnosis identifier

ShortID
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..*
TypeIdentifier
4. Diagnosis.dateOfDiagnosis
Definition

Official date of diagnosis. Please report the date as documented in the clinical record. Differences across institutions may occur in defining this date (either the date of the final test (laboratory, imaging, surgery or pathology report) based on which therapeutic decision was taken. In other cases the date of the pathology report is used to define the date of diagnosis. The system will send an 'error' message if the date of diagnosis is more recent hat the date of start of treatment. If the date is unkown or partially missed insert the year at the best of your knowledge.

ShortDate of diagnosis
Control0..*
TypeBackboneElement
6. Diagnosis.centerOfDiagnosis
Definition

Institution in which the diagnosis was made.

ShortCenter of diagnosis
Control0..*
TypeBackboneElement
8. Diagnosis.centerOfDiagnosis.identifier
Definition

Code of the institution in which the diagnosis was made. IN AIEOP thus information is retrievable from the Mod.1.01 database

ShortCenter code
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
10. Diagnosis.centerOfDiagnosis.name
Definition

Center name

ShortCenter name
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
12. Diagnosis.centerOfDiagnosis.city
Definition

Center city

ShortCenter city
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
14. Diagnosis.centerOfDiagnosis.country
Definition

Center country

ShortCenter country
Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
16. Diagnosis.primaryTreatmentCenter
Definition

Report here the institution in which most of the treatment was given

ShortPrimary treatment center
Control0..1
TypeBackboneElement
18. Diagnosis.primaryTreatmentCenter.name
Definition

Primary treatment center name

ShortPrimary treatment center name
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
20. Diagnosis.primaryTreatmentCenter.city
Definition

Primary treatment center city

ShortPrimary treatment center city
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
22. Diagnosis.primaryTreatmentCenter.country
Definition

Primary treatment center country

ShortPrimary treatment center country
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
24. Diagnosis.dateOfArrivalAtCenter
Definition

Date of arrival to our institution

ShortDate of arrival to our institution
Control1..*
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
26. Diagnosis.diagnosticGroup
Definition

Diagnostic Group. ICCC-3 Classification (Main and Extended classification tables)

ShortDiagnostic Group
Control0..*
TypeCodeableConcept
28. Diagnosis.morphologyCode
Definition

Report the diagnosis using the ICD-O-3 Morphology coding system (an help tool is built into the system). If also the site of the tumor will be reported (see 'site') using the ICD-O-3 Topography codes, the system will automatically define the tumor according to ICCC-3 classic pediatric classification (see: Cancer category). This field is automatically generated if both ICD-O-3 Morphology and Topography data have been reported

ShortDiagnosis
Control0..*
TypeCodeableConcept
30. Diagnosis.tumorBehaviour
Definition

Tumour behaviour. Automatically generated by the system for benign tumors

ShortTumour behaviour (ICD-O-3 type)
Control0..*
TypeCodeableConcept
32. Diagnosis.description
Definition

Diagnosis description

ShortDiagnosis description
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
34. Diagnosis.site
Definition

Site of the tumor

ShortSite
Control0..*
TypeBackboneElement
36. Diagnosis.site.code
Definition

Site . Report the site of the tumor using the ICD-O-3 Topography (an help tool is built into the system). If also ICD-O-3 Morphology data have been reported, the system will automatically define the tumor also according to ICCC-3 classic pediatric classification (see: Cancer category)

ShortSite(ICD-O-3 topography)
Control0..*
TypeCodeableConcept
38. Diagnosis.site.description
Definition

Site description . Free text to report the site of the tumor

ShortSite description
Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
40. Diagnosis.laterality
Definition

Laterality

ShortLaterality
Control0..*
TypeCodeableConcept
42. Diagnosis.metastasis
Definition

Some tumors may be either localized (e.g. stage III neuroblastoma) or metastatic. Please specify.

ShortMetastatic
Control0..*
TypeBackboneElement
44. Diagnosis.metastasis.identifier
Definition

Number of metastases

ShortMetastasis id
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
46. Diagnosis.metastasis.site
Definition

Please report here the site(s) of metastases detected at diagnosis.

ShortMetastasis site
Control0..*
TypeBackboneElement
48. Diagnosis.metastasis.site.code
Definition

Metastases detected at diagnosis (using ICD-O-3 Topography). If site(s) is unknown, code C80.9

ShortMetastasis site code
Control0..*
TypeCodeableConcept
50. Diagnosis.metastasis.site.description
Definition

Additional description of sites of metastatis

ShortAdditional description of sites of metastatis
Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
52. Diagnosis.geneticMarkers
Definition

Please report here any genetic marker: chromosomal alterations (e.g. translocation, deletions, duplications); or other types of genetic alterations (amplification, deletion, mutation)

ShortGenetic markers(text)
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
54. Diagnosis.stage
Definition

Stage/Risk. Free trext to specify the stage, if applicable, of the tumor at diagnosis. Staging codes may be different across tumor types and eras of treatment. Please report the one used to define the survivors' tumor at the moment of diagnosis. In case of leukemia the 'risk' (e.g. high, standard) could be reported. If the stage is unknown, specifie 'NK'

ShortStage/Risk
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
56. Diagnosis.immunology
Definition

Immunology . This is a free text field. Report here, if applicable (e.g. leukemias) the immunophenotype of the disease (sometimes already reported in the ICD-O-3 Morphology coding). If immunology is unknown, specify 'NK'

ShortImmunology
Control0..*
TypeCodeableConcept
58. Diagnosis.hereditaryPredisposition
Definition

Hereditary Cancer Predisposition Syndromeor medical condition cancer associated. Report here if the survivor has some Hereditary Cancer Predisposition Syndrome or a medical conditions, cancer associated. The SurPass system provides a list of the most common Hereditary Cancer Predisposition Syndromes or other medical conditions reported to be cancer associated (an help tool is build into the system: when you start writing the computer proposes the syndromes/conditions with similar spelling). If the syndrome is not listed, please mark other and then 'Specify'

ShortHereditary Cancer Predisposition
Control0..*
TypeCodeableConcept
60. Diagnosis.notes
Definition

Notes

ShortNotes
Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension

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

0. Diagnosis
Definition

Diagnosis Maturity Level: 2 - Ready for Review

ShortDiagnosis
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. Diagnosis.identifier
Definition

diagnosis identifier

ShortID
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..*
TypeIdentifier
4. Diagnosis.dateOfDiagnosis
Definition

Official date of diagnosis. Please report the date as documented in the clinical record. Differences across institutions may occur in defining this date (either the date of the final test (laboratory, imaging, surgery or pathology report) based on which therapeutic decision was taken. In other cases the date of the pathology report is used to define the date of diagnosis. The system will send an 'error' message if the date of diagnosis is more recent hat the date of start of treatment. If the date is unkown or partially missed insert the year at the best of your knowledge.

ShortDate of diagnosis
Control0..*
TypeBackboneElement
6. Diagnosis.centerOfDiagnosis
Definition

Institution in which the diagnosis was made.

ShortCenter of diagnosis
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Diagnosis.centerOfDiagnosis.modifierExtension
Definition

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

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Code of the institution in which the diagnosis was made. IN AIEOP thus information is retrievable from the Mod.1.01 database

ShortCenter code
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..1
TypeIdentifier
12. Diagnosis.centerOfDiagnosis.name
Definition

Center name

ShortCenter name
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
14. Diagnosis.centerOfDiagnosis.city
Definition

Center city

ShortCenter city
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
16. Diagnosis.centerOfDiagnosis.country
Definition

Center country

ShortCenter country
Control1..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
18. Diagnosis.primaryTreatmentCenter
Definition

Report here the institution in which most of the treatment was given

ShortPrimary treatment center
Control0..1
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. Diagnosis.primaryTreatmentCenter.modifierExtension
Definition

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

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Primary treatment center name

ShortPrimary treatment center name
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
24. Diagnosis.primaryTreatmentCenter.city
Definition

Primary treatment center city

ShortPrimary treatment center city
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
26. Diagnosis.primaryTreatmentCenter.country
Definition

Primary treatment center country

ShortPrimary treatment center country
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
28. Diagnosis.dateOfArrivalAtCenter
Definition

Date of arrival to our institution

ShortDate of arrival to our institution
Control1..*
TypedateTime
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
30. Diagnosis.diagnosticGroup
Definition

Diagnostic Group. ICCC-3 Classification (Main and Extended classification tables)

ShortDiagnostic Group
Control0..*
TypeCodeableConcept
32. Diagnosis.morphologyCode
Definition

Report the diagnosis using the ICD-O-3 Morphology coding system (an help tool is built into the system). If also the site of the tumor will be reported (see 'site') using the ICD-O-3 Topography codes, the system will automatically define the tumor according to ICCC-3 classic pediatric classification (see: Cancer category). This field is automatically generated if both ICD-O-3 Morphology and Topography data have been reported

ShortDiagnosis
Control0..*
TypeCodeableConcept
34. Diagnosis.tumorBehaviour
Definition

Tumour behaviour. Automatically generated by the system for benign tumors

ShortTumour behaviour (ICD-O-3 type)
Control0..*
TypeCodeableConcept
36. Diagnosis.description
Definition

Diagnosis description

ShortDiagnosis description
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
38. Diagnosis.site
Definition

Site of the tumor

ShortSite
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. Diagnosis.site.modifierExtension
Definition

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

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Site . Report the site of the tumor using the ICD-O-3 Topography (an help tool is built into the system). If also ICD-O-3 Morphology data have been reported, the system will automatically define the tumor also according to ICCC-3 classic pediatric classification (see: Cancer category)

ShortSite(ICD-O-3 topography)
Control0..*
TypeCodeableConcept
44. Diagnosis.site.description
Definition

Site description . Free text to report the site of the tumor

ShortSite description
Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
46. Diagnosis.laterality
Definition

Laterality

ShortLaterality
Control0..*
TypeCodeableConcept
48. Diagnosis.metastasis
Definition

Some tumors may be either localized (e.g. stage III neuroblastoma) or metastatic. Please specify.

ShortMetastatic
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. Diagnosis.metastasis.modifierExtension
Definition

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

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Number of metastases

ShortMetastasis id
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
Typeinteger
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
54. Diagnosis.metastasis.site
Definition

Please report here the site(s) of metastases detected at diagnosis.

ShortMetastasis site
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. Diagnosis.metastasis.site.modifierExtension
Definition

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

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

ShortExtensions that cannot be ignored even if unrecognized
Comments

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

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

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

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

Metastases detected at diagnosis (using ICD-O-3 Topography). If site(s) is unknown, code C80.9

ShortMetastasis site code
Control0..*
TypeCodeableConcept
60. Diagnosis.metastasis.site.description
Definition

Additional description of sites of metastatis

ShortAdditional description of sites of metastatis
Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
62. Diagnosis.geneticMarkers
Definition

Please report here any genetic marker: chromosomal alterations (e.g. translocation, deletions, duplications); or other types of genetic alterations (amplification, deletion, mutation)

ShortGenetic markers(text)
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
64. Diagnosis.stage
Definition

Stage/Risk. Free trext to specify the stage, if applicable, of the tumor at diagnosis. Staging codes may be different across tumor types and eras of treatment. Please report the one used to define the survivors' tumor at the moment of diagnosis. In case of leukemia the 'risk' (e.g. high, standard) could be reported. If the stage is unknown, specifie 'NK'

ShortStage/Risk
Control0..1
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
66. Diagnosis.immunology
Definition

Immunology . This is a free text field. Report here, if applicable (e.g. leukemias) the immunophenotype of the disease (sometimes already reported in the ICD-O-3 Morphology coding). If immunology is unknown, specify 'NK'

ShortImmunology
Control0..*
TypeCodeableConcept
68. Diagnosis.hereditaryPredisposition
Definition

Hereditary Cancer Predisposition Syndromeor medical condition cancer associated. Report here if the survivor has some Hereditary Cancer Predisposition Syndrome or a medical conditions, cancer associated. The SurPass system provides a list of the most common Hereditary Cancer Predisposition Syndromes or other medical conditions reported to be cancer associated (an help tool is build into the system: when you start writing the computer proposes the syndromes/conditions with similar spelling). If the syndrome is not listed, please mark other and then 'Specify'

ShortHereditary Cancer Predisposition
Control0..*
TypeCodeableConcept
70. Diagnosis.notes
Definition

Notes

ShortNotes
Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension

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

0. Diagnosis
Definition

Diagnosis Maturity Level: 2 - Ready for Review

ShortDiagnosis
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. Diagnosis.identifier
Definition

diagnosis identifier

ShortID
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..*
TypeIdentifier
4. Diagnosis.dateOfDiagnosis
Definition

Official date of diagnosis. Please report the date as documented in the clinical record. Differences across institutions may occur in defining this date (either the date of the final test (laboratory, imaging, surgery or pathology report) based on which therapeutic decision was taken. In other cases the date of the pathology report is used to define the date of diagnosis. The system will send an 'error' message if the date of diagnosis is more recent hat the date of start of treatment. If the date is unkown or partially missed insert the year at the best of your knowledge.

ShortDate of diagnosis
Control0..*
TypeBackboneElement
6. Diagnosis.centerOfDiagnosis
Definition

Institution in which the diagnosis was made.

ShortCenter of diagnosis
Control0..*
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Diagnosis.centerOfDiagnosis.id
Definition

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

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

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

ShortAdditional content defined by implementations
Comments

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

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

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

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

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

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

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

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

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

    Code of the institution in which the diagnosis was made. IN AIEOP thus information is retrievable from the Mod.1.01 database

    ShortCenter code
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1
    TypeIdentifier
    16. Diagnosis.centerOfDiagnosis.name
    Definition

    Center name

    ShortCenter name
    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    18. Diagnosis.centerOfDiagnosis.city
    Definition

    Center city

    ShortCenter city
    Control0..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    20. Diagnosis.centerOfDiagnosis.country
    Definition

    Center country

    ShortCenter country
    Control1..1
    Typestring
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    22. Diagnosis.primaryTreatmentCenter
    Definition

    Report here the institution in which most of the treatment was given

    ShortPrimary treatment center
    Control0..1
    TypeBackboneElement
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    24. Diagnosis.primaryTreatmentCenter.id
    Definition

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

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

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

    ShortAdditional content defined by implementations
    Comments

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

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

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

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

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

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

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

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

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

      Primary treatment center name

      ShortPrimary treatment center name
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      32. Diagnosis.primaryTreatmentCenter.city
      Definition

      Primary treatment center city

      ShortPrimary treatment center city
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      34. Diagnosis.primaryTreatmentCenter.country
      Definition

      Primary treatment center country

      ShortPrimary treatment center country
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      36. Diagnosis.dateOfArrivalAtCenter
      Definition

      Date of arrival to our institution

      ShortDate of arrival to our institution
      Control1..*
      TypedateTime
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      38. Diagnosis.diagnosticGroup
      Definition

      Diagnostic Group. ICCC-3 Classification (Main and Extended classification tables)

      ShortDiagnostic Group
      Control0..*
      TypeCodeableConcept
      40. Diagnosis.morphologyCode
      Definition

      Report the diagnosis using the ICD-O-3 Morphology coding system (an help tool is built into the system). If also the site of the tumor will be reported (see 'site') using the ICD-O-3 Topography codes, the system will automatically define the tumor according to ICCC-3 classic pediatric classification (see: Cancer category). This field is automatically generated if both ICD-O-3 Morphology and Topography data have been reported

      ShortDiagnosis
      Control0..*
      TypeCodeableConcept
      42. Diagnosis.tumorBehaviour
      Definition

      Tumour behaviour. Automatically generated by the system for benign tumors

      ShortTumour behaviour (ICD-O-3 type)
      Control0..*
      TypeCodeableConcept
      44. Diagnosis.description
      Definition

      Diagnosis description

      ShortDiagnosis description
      Control0..1
      Typestring
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      46. Diagnosis.site
      Definition

      Site of the tumor

      ShortSite
      Control0..*
      TypeBackboneElement
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. Diagnosis.site.id
      Definition

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

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

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

      ShortAdditional content defined by implementations
      Comments

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

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

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

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

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

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

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

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

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

        Site . Report the site of the tumor using the ICD-O-3 Topography (an help tool is built into the system). If also ICD-O-3 Morphology data have been reported, the system will automatically define the tumor also according to ICCC-3 classic pediatric classification (see: Cancer category)

        ShortSite(ICD-O-3 topography)
        Control0..*
        TypeCodeableConcept
        56. Diagnosis.site.description
        Definition

        Site description . Free text to report the site of the tumor

        ShortSite description
        Control0..*
        Typestring
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        58. Diagnosis.laterality
        Definition

        Laterality

        ShortLaterality
        Control0..*
        TypeCodeableConcept
        60. Diagnosis.metastasis
        Definition

        Some tumors may be either localized (e.g. stage III neuroblastoma) or metastatic. Please specify.

        ShortMetastatic
        Control0..*
        TypeBackboneElement
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        62. Diagnosis.metastasis.id
        Definition

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

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

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

        ShortAdditional content defined by implementations
        Comments

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

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

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

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

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

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

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

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

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

          Number of metastases

          ShortMetastasis id
          NoteThis is a business identifier, not a resource identifier (see discussion)
          Control0..*
          Typeinteger
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          70. Diagnosis.metastasis.site
          Definition

          Please report here the site(s) of metastases detected at diagnosis.

          ShortMetastasis site
          Control0..*
          TypeBackboneElement
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. Diagnosis.metastasis.site.id
          Definition

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

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

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

          ShortAdditional content defined by implementations
          Comments

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

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

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

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

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

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

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

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

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

            Metastases detected at diagnosis (using ICD-O-3 Topography). If site(s) is unknown, code C80.9

            ShortMetastasis site code
            Control0..*
            TypeCodeableConcept
            80. Diagnosis.metastasis.site.description
            Definition

            Additional description of sites of metastatis

            ShortAdditional description of sites of metastatis
            Control0..*
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            82. Diagnosis.geneticMarkers
            Definition

            Please report here any genetic marker: chromosomal alterations (e.g. translocation, deletions, duplications); or other types of genetic alterations (amplification, deletion, mutation)

            ShortGenetic markers(text)
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            84. Diagnosis.stage
            Definition

            Stage/Risk. Free trext to specify the stage, if applicable, of the tumor at diagnosis. Staging codes may be different across tumor types and eras of treatment. Please report the one used to define the survivors' tumor at the moment of diagnosis. In case of leukemia the 'risk' (e.g. high, standard) could be reported. If the stage is unknown, specifie 'NK'

            ShortStage/Risk
            Control0..1
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            86. Diagnosis.immunology
            Definition

            Immunology . This is a free text field. Report here, if applicable (e.g. leukemias) the immunophenotype of the disease (sometimes already reported in the ICD-O-3 Morphology coding). If immunology is unknown, specify 'NK'

            ShortImmunology
            Control0..*
            TypeCodeableConcept
            88. Diagnosis.hereditaryPredisposition
            Definition

            Hereditary Cancer Predisposition Syndromeor medical condition cancer associated. Report here if the survivor has some Hereditary Cancer Predisposition Syndrome or a medical conditions, cancer associated. The SurPass system provides a list of the most common Hereditary Cancer Predisposition Syndromes or other medical conditions reported to be cancer associated (an help tool is build into the system: when you start writing the computer proposes the syndromes/conditions with similar spelling). If the syndrome is not listed, please mark other and then 'Specify'

            ShortHereditary Cancer Predisposition
            Control0..*
            TypeCodeableConcept
            90. Diagnosis.notes
            Definition

            Notes

            ShortNotes
            Control0..*
            Typestring
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension