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PROTECT-CHILD Pediatric Transplant Data Implementation Guide
0.1.0-ci-build -

PROTECT-CHILD Pediatric Transplant Data Implementation Guide
0.1.0-ci-build - ci-build

PROTECT-CHILD Pediatric Transplant Data Implementation Guide, published by Protect Child. This guide is not an authorized publication; it is the continuous build for version 0.1.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/protect-child/ and changes regularly. See the Directory of published versions

Resource Profile: Clinical Event Flag Observation

Official URL: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/clinical-event-flag-observation Version: 0.1.0-ci-build
Draft as of 2026-06-05 Computable Name: ClinicalEventFlagObservation

Boolean flag associated with a clinical event (DMv1.2 clinical_event table). Each instance represents one true flag. Absence of an instance for a given code means the flag is false. Linked to the parent ClinicalEvent via Observation.focus. The transplant type extension enables organ-specific invariants pc-flag-1 through pc-flag-3.

Usages:

  • This Profile is not used by any profiles in this Specification

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.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, pc-flag-1, pc-flag-2, pc-flag-3
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:tx_type S 0..1 CodeableConcept Transplant type context — required when code is an organ-specific flag (dgf, episodes-aki-after-ltx, hypoxic-ischemic-pltx)
URL: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext
Binding: Transplant Type ValueSet (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... category S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Fixed Value: As shown (Exam)
.... id 0..0 string Unique id for inter-element referencing
.... extension 0..0 Extension Additional content defined by implementations
.... coding 1..1 Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..0 string Unique id for inter-element referencing
..... extension 0..0 Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
..... version 0..0 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: exam
..... display 0..0 string Representation defined by the system
..... userSelected 0..0 boolean If this coding was chosen directly by the user
.... text 0..0 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept Flag type — one of: dgf (kidney/combined), episodes-aki-after-ltx (liver/combined), histologic-evidence-cni-tox, hypoxic-ischemic-pltx (liver/combined), concomitant-medications, treatment-adherence
Binding: Clinical Event Flag ValueSet (required)
... subject SΣ 1..1 Reference(Transplant Recipient) Transplant recipient
... focus SΣ 1..1 Reference(Clinical Event) The ClinicalEvent (Condition) this flag belongs to
... encounter SΣ 0..1 Reference(Visit) Visit at which this flag was recorded
... value[x] SΣC 1..1 boolean Always true — the presence of this Observation means the flag is set
Fixed Value: true

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base required Clinical Event Flag ValueSet 📦0.1.0-ci-build This IG

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation 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 Observation 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 Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation 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()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
pc-flag-1 error Observation Delayed graft function (DGF) is a kidney-specific flag; only applicable for kidney or combined transplants. code.coding.where(code = 'dgf').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'kidney' or code = 'combined').exists()
pc-flag-2 error Observation Episodes of AKI after LTx is a liver-specific flag; only applicable for liver or combined transplants. code.coding.where(code = 'episodes-aki-after-ltx').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'liver' or code = 'combined').exists()
pc-flag-3 error Observation Hypoxic-ischaemic event post liver transplant is a liver-specific flag; only applicable for liver or combined transplants. code.coding.where(code = 'hypoxic-ischemic-pltx').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'liver' or code = 'combined').exists()

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: pc-flag-1, pc-flag-2, pc-flag-3
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:tx_type S 0..1 CodeableConcept Transplant type context — required when code is an organ-specific flag (dgf, episodes-aki-after-ltx, hypoxic-ischemic-pltx)
URL: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext
Binding: Transplant Type ValueSet (required)
... status S 1..1 code registered | preliminary | final | amended +
Fixed Value: final
... category S 1..1 CodeableConcept Classification of type of observation
Fixed Value: As shown (Exam)
.... coding 1..1 Coding Code defined by a terminology system
Fixed Value: (Complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: exam
... subject S 1..1 Reference(Transplant Recipient) Transplant recipient
... focus S 1..1 Reference(Clinical Event) The ClinicalEvent (Condition) this flag belongs to
... encounter S 0..1 Reference(Visit) Visit at which this flag was recorded
... value[x] S 1..1 boolean Always true — the presence of this Observation means the flag is set
Fixed Value: true

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.code Base required Clinical Event Flag ValueSet 📦0.1.0-ci-build This IG

Constraints

Id Grade Path(s) Description Expression
pc-flag-1 error Observation Delayed graft function (DGF) is a kidney-specific flag; only applicable for kidney or combined transplants. code.coding.where(code = 'dgf').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'kidney' or code = 'combined').exists()
pc-flag-2 error Observation Episodes of AKI after LTx is a liver-specific flag; only applicable for liver or combined transplants. code.coding.where(code = 'episodes-aki-after-ltx').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'liver' or code = 'combined').exists()
pc-flag-3 error Observation Hypoxic-ischaemic event post liver transplant is a liver-specific flag; only applicable for liver or combined transplants. code.coding.where(code = 'hypoxic-ischemic-pltx').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'liver' or code = 'combined').exists()
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, pc-flag-1, pc-flag-2, pc-flag-3
... 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 BindingsPurpose
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 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:tx_type S 0..1 CodeableConcept Transplant type context — required when code is an organ-specific flag (dgf, episodes-aki-after-ltx, hypoxic-ischemic-pltx)
URL: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext
Binding: Transplant Type ValueSet (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!SΣ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Fixed Value: final
... category S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Fixed Value: As shown (Exam)
.... id 0..0 string Unique id for inter-element referencing
.... extension 0..0 Extension Additional content defined by implementations
.... coding 1..1 Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..0 string Unique id for inter-element referencing
..... extension 0..0 Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
..... version 0..0 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: exam
..... display 0..0 string Representation defined by the system
..... userSelected 0..0 boolean If this coding was chosen directly by the user
.... text 0..0 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept Flag type — one of: dgf (kidney/combined), episodes-aki-after-ltx (liver/combined), histologic-evidence-cni-tox, hypoxic-ischemic-pltx (liver/combined), concomitant-medications, treatment-adherence
Binding: Clinical Event Flag ValueSet (required)
... subject SΣ 1..1 Reference(Transplant Recipient) Transplant recipient
... focus SΣ 1..1 Reference(Clinical Event) The ClinicalEvent (Condition) this flag belongs to
... encounter SΣ 0..1 Reference(Visit) Visit at which this flag was recorded
... effective[x] Σ 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... value[x] SΣC 1..1 boolean Always true — the presence of this Observation means the flag is set
Fixed Value: true
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
... specimen 0..1 Reference(Specimen) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... 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
.... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
... component Σ 0..* BackboneElement Component results
.... 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 Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base required Clinical Event Flag ValueSet 📦0.1.0-ci-build This IG
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation 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 Observation 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 Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation 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()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
pc-flag-1 error Observation Delayed graft function (DGF) is a kidney-specific flag; only applicable for kidney or combined transplants. code.coding.where(code = 'dgf').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'kidney' or code = 'combined').exists()
pc-flag-2 error Observation Episodes of AKI after LTx is a liver-specific flag; only applicable for liver or combined transplants. code.coding.where(code = 'episodes-aki-after-ltx').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'liver' or code = 'combined').exists()
pc-flag-3 error Observation Hypoxic-ischaemic event post liver transplant is a liver-specific flag; only applicable for liver or combined transplants. code.coding.where(code = 'hypoxic-ischemic-pltx').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'liver' or code = 'combined').exists()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, pc-flag-1, pc-flag-2, pc-flag-3
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:tx_type S 0..1 CodeableConcept Transplant type context — required when code is an organ-specific flag (dgf, episodes-aki-after-ltx, hypoxic-ischemic-pltx)
URL: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext
Binding: Transplant Type ValueSet (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... category S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Fixed Value: As shown (Exam)
.... id 0..0 string Unique id for inter-element referencing
.... extension 0..0 Extension Additional content defined by implementations
.... coding 1..1 Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..0 string Unique id for inter-element referencing
..... extension 0..0 Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
..... version 0..0 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: exam
..... display 0..0 string Representation defined by the system
..... userSelected 0..0 boolean If this coding was chosen directly by the user
.... text 0..0 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept Flag type — one of: dgf (kidney/combined), episodes-aki-after-ltx (liver/combined), histologic-evidence-cni-tox, hypoxic-ischemic-pltx (liver/combined), concomitant-medications, treatment-adherence
Binding: Clinical Event Flag ValueSet (required)
... subject SΣ 1..1 Reference(Transplant Recipient) Transplant recipient
... focus SΣ 1..1 Reference(Clinical Event) The ClinicalEvent (Condition) this flag belongs to
... encounter SΣ 0..1 Reference(Visit) Visit at which this flag was recorded
... value[x] SΣC 1..1 boolean Always true — the presence of this Observation means the flag is set
Fixed Value: true

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base required Clinical Event Flag ValueSet 📦0.1.0-ci-build This IG

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation 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 Observation 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 Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation 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()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
pc-flag-1 error Observation Delayed graft function (DGF) is a kidney-specific flag; only applicable for kidney or combined transplants. code.coding.where(code = 'dgf').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'kidney' or code = 'combined').exists()
pc-flag-2 error Observation Episodes of AKI after LTx is a liver-specific flag; only applicable for liver or combined transplants. code.coding.where(code = 'episodes-aki-after-ltx').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'liver' or code = 'combined').exists()
pc-flag-3 error Observation Hypoxic-ischaemic event post liver transplant is a liver-specific flag; only applicable for liver or combined transplants. code.coding.where(code = 'hypoxic-ischemic-pltx').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'liver' or code = 'combined').exists()

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: pc-flag-1, pc-flag-2, pc-flag-3
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:tx_type S 0..1 CodeableConcept Transplant type context — required when code is an organ-specific flag (dgf, episodes-aki-after-ltx, hypoxic-ischemic-pltx)
URL: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext
Binding: Transplant Type ValueSet (required)
... status S 1..1 code registered | preliminary | final | amended +
Fixed Value: final
... category S 1..1 CodeableConcept Classification of type of observation
Fixed Value: As shown (Exam)
.... coding 1..1 Coding Code defined by a terminology system
Fixed Value: (Complex)
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: exam
... subject S 1..1 Reference(Transplant Recipient) Transplant recipient
... focus S 1..1 Reference(Clinical Event) The ClinicalEvent (Condition) this flag belongs to
... encounter S 0..1 Reference(Visit) Visit at which this flag was recorded
... value[x] S 1..1 boolean Always true — the presence of this Observation means the flag is set
Fixed Value: true

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.code Base required Clinical Event Flag ValueSet 📦0.1.0-ci-build This IG

Constraints

Id Grade Path(s) Description Expression
pc-flag-1 error Observation Delayed graft function (DGF) is a kidney-specific flag; only applicable for kidney or combined transplants. code.coding.where(code = 'dgf').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'kidney' or code = 'combined').exists()
pc-flag-2 error Observation Episodes of AKI after LTx is a liver-specific flag; only applicable for liver or combined transplants. code.coding.where(code = 'episodes-aki-after-ltx').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'liver' or code = 'combined').exists()
pc-flag-3 error Observation Hypoxic-ischaemic event post liver transplant is a liver-specific flag; only applicable for liver or combined transplants. code.coding.where(code = 'hypoxic-ischemic-pltx').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'liver' or code = 'combined').exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, pc-flag-1, pc-flag-2, pc-flag-3
... 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 BindingsPurpose
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 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:tx_type S 0..1 CodeableConcept Transplant type context — required when code is an organ-specific flag (dgf, episodes-aki-after-ltx, hypoxic-ischemic-pltx)
URL: https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext
Binding: Transplant Type ValueSet (required)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!SΣ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Fixed Value: final
... category S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Fixed Value: As shown (Exam)
.... id 0..0 string Unique id for inter-element referencing
.... extension 0..0 Extension Additional content defined by implementations
.... coding 1..1 Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..0 string Unique id for inter-element referencing
..... extension 0..0 Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
..... version 0..0 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: exam
..... display 0..0 string Representation defined by the system
..... userSelected 0..0 boolean If this coding was chosen directly by the user
.... text 0..0 string Plain text representation of the concept
... code SΣ 1..1 CodeableConcept Flag type — one of: dgf (kidney/combined), episodes-aki-after-ltx (liver/combined), histologic-evidence-cni-tox, hypoxic-ischemic-pltx (liver/combined), concomitant-medications, treatment-adherence
Binding: Clinical Event Flag ValueSet (required)
... subject SΣ 1..1 Reference(Transplant Recipient) Transplant recipient
... focus SΣ 1..1 Reference(Clinical Event) The ClinicalEvent (Condition) this flag belongs to
... encounter SΣ 0..1 Reference(Visit) Visit at which this flag was recorded
... effective[x] Σ 0..1 Clinically relevant time/time-period for observation
.... effectiveDateTime dateTime
.... effectivePeriod Period
.... effectiveTiming Timing
.... effectiveInstant instant
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... value[x] SΣC 1..1 boolean Always true — the presence of this Observation means the flag is set
Fixed Value: true
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept How it was done
Binding: ObservationMethods (example): Methods for simple observations.
... specimen 0..1 Reference(Specimen) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... 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
.... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
... component Σ 0..* BackboneElement Component results
.... 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 Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base required Clinical Event Flag ValueSet 📦0.1.0-ci-build This IG
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation 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 Observation 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 Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation 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()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
pc-flag-1 error Observation Delayed graft function (DGF) is a kidney-specific flag; only applicable for kidney or combined transplants. code.coding.where(code = 'dgf').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'kidney' or code = 'combined').exists()
pc-flag-2 error Observation Episodes of AKI after LTx is a liver-specific flag; only applicable for liver or combined transplants. code.coding.where(code = 'episodes-aki-after-ltx').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'liver' or code = 'combined').exists()
pc-flag-3 error Observation Hypoxic-ischaemic event post liver transplant is a liver-specific flag; only applicable for liver or combined transplants. code.coding.where(code = 'hypoxic-ischemic-pltx').exists() implies extension.where(url = 'https://hl7.eu/fhir/ig/hl7.eu.fhir.protect-child/StructureDefinition/transplant-type-ext').value.ofType(CodeableConcept).coding.where(code = 'liver' or code = 'combined').exists()

 

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