HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE), v0.9.1

HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE), v0.9.1 - Local Development build (v0.9.1). See the Directory of published versions

Primary extensions defined as part of this Implementation Guide

Name Definition
BloodPressureCuffSize

The size of cuff used, if applicable.

BodyPosition

The position or physical attitude of the body.

DateOfDiagnosis

The date the disease was first clinically recognized with sufficient certainty, regardless of whether it was fully characterized at that time.

EvidenceType

The type of evidence considered in making the determination.

GeneStudied

A gene targeted for mutation analysis, identified in HUGO Gene Nomenclature Committee (HGNC) notation. The required code is HGNC gene ID. Gene IDs are of the format HGNC:n, where n is a unique number. Only the number, n, should be given as the code. For example, the HGNC identifier for the EGFR gene is 3236. The display text associated with the code should be the HGNC official gene symbol. For example, the official gene symbol for epidermal growth factor receptor is EGFR.

HistologyMorphologyBehavior

A description of the morphologic and behavioral characteristics of the cancer.

Laterality

Body side of the body location, if needed to distinguish from a similar location on the other side of the body.

The laterality element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases.

  • Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location.
  • Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation.
  • Relation to landmark: The location relative to a landmark is specified by:
  • Establishing the location and type of landmark using a body site code and optional laterality/orientation, and
  • Specifying the direction and distance from the landmark to the body location.

Note that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR’s stand-alone BodySite (aka BodyStructure in r4) which ‘is not … intended for describing the type of anatomical location but rather a specific body site on a specific patient’ (FHIR 3.5).

Orientation

Orientation of the body location, if needed to distinguish from a similar location in another orientation. The orientation element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases.

  • Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location.
  • Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation.
  • Relation to landmark: The location relative to a landmark is specified by:
  • Establishing the location and type of landmark using a body site code and optional laterality/orientation, and
  • Specifying the direction and distance from the landmark to the body location.

Note that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR’s stand-alone BodySite (aka BodyStructure in r4) which ‘is not … intended for describing the type of anatomical location but rather a specific body site on a specific patient’ (FHIR 3.5).

Precondition

A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.

PrimaryCancerCondition

Records the history of the primary cancer condition, the original or first tumor in the body (ref https://www.cancer.gov/publications/dictionaries/cancer-terms/def/primary-tumor).

RadiationDosePerFraction

The total number of treatment sessions (fractions) administered during a course of radiation therapy therapy. A fraction is a portion of the total radiation dose, delivered as a series of treatments that make up the full course of radiotherapy. (source: LOINC)

RadiationFractionsDelivered

The total number of treatment sessions (fractions) administered during a course of radiation therapy therapy. A fraction is a portion of the total radiation dose, delivered as a series of treatments that make up the full course of radiotherapy. (source: LOINC)

RegionStudied

A description of the coverage of the genome that was tested for variants.

RelatedCancerCondition

Cancer condition this information relates to. Includes the primary cancer, secondary cancer, or a particular tumor.

RelationToLandmark

The relationship between a landmark that helps determine a body location and the body location itself. The location relative to a landmark is specified by:

  • Specifying the location and type of landmark using a body site code and optional laterality/orientation,
  • Specifying the direction from the landmark to the body location, and
  • Specifying the distance from the landmark to the body location.

The RelationToLandmark element is part of BodyLocation, a flexible structure that allows the location to be determined by a single code, or a code plus laterality and/or orientation. The body location can also be specified in relation to one or more body landmarks. SNOMED CT is used in all cases.

  • Code only: The code should include (precoordinate) laterality and/orientation to the degree necessary to completely specify the body location.
  • Code plus laterality and/or orientation: The basic code augmented by codes specifying the body side and/or anatomical orientation.
  • Relation to landmark: The location relative to a landmark is specified by:
  • Establishing the location and type of landmark using a body site code and optional laterality/orientation, and
  • Specifying the direction and distance from the landmark to the body location.

Note that BodyLocation is a data type (a reusable structure), not a stand-alone entity. The concept is similar to how a postal address can apply to a person, location, or organization. This contrasts with FHIR’s stand-alone BodySite (aka BodyStructure in r4) which ‘is not … intended for describing the type of anatomical location but rather a specific body site on a specific patient’ (FHIR 3.5).

SpecimenType

The type of material the specimen contains or consists of.

StatementDateTime

The point in time when the statement was created.

TerminationReason

A code explaining unplanned or premature termination of a plan of treatment, course of medication, or research study.

TotalRadiationDoseDelivered

The total amount of radiation dose delivered for the course of therapy. (source: SNOMED, ASTRO)

TreatmentIntent

The purpose of a treatment.

VariantTested

The specific genetic variant that is targeted by this test.