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 FHIR Profiles - Local Development build (v0.9.1). See the Directory of published versions

PrimaryCancerCondition

Definitions for onco-core-PrimaryCancerCondition.

1. Condition-argoprofile
Definition

Records the history of the primary cancer condition, the original or first tumor in the body (reference https://www.cancer.gov/publications/dictionaries/cancer-terms/def/primary-tumor). Cancers that are not clearly secondary (i.e., of uncertain origin or behavior) should be documented as primary.

Cancer staging information summarized in this profile should reflect the most recent staging assessment on the patient, and should be updated if and when there is a new staging assessment. Past staging assessments will be preserved in instances of the TNMClinicalStageGroup and/or TNMPathologicalStageGroup, which refer back to PrimaryCancerCondition.

Conformance note: For the code attribute, to be compliant with US Core Profiles, SNOMED CT must be used unless there is no suitable code, in which case ICD-10-CM can be used.

Control0..*
Max Length0
InvariantsDefined on this element
arg-1: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error (: clinicalStatus.exists() = (verificationStatus != 'entered-in-error'))
2. Condition-argoprofile.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Control0..1
Typeid
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Bundles always have an id, though it is usually a generated UUID.

Max Length0
3. Condition-argoprofile.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.

Control0..1
TypeMeta
Max Length0
4. Condition-argoprofile.meta.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
5. Condition-argoprofile.meta.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

SlicingThis element introduces a set of slices on Condition.meta.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
6. sourcesystem
SliceNamesourcesystem
Definition

FHIR: This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. FHIM: Identifies the computer system that created the medical record. This optional field may also be used to indicate that the medical record was originally created by a different organization from the one that is currently storing or utilizing the record in that the assigning authority of the Id could be set to that originating organization. This property is optional, as some systems will assume that all records that it contains originated in that system, however it is anticipated that it will become increasingly commonplace for records from multiple systems and organizations will be comingled in order to provide a complete picture of the patient's health record.

Control0..1
TypeExtension(SourceSystem) (Extension Type: uri)
7. Condition-argoprofile.meta.versionId
Definition

The version specific identifier, as it appears in the version portion of the URL. This values changes when the resource is created, updated, or deleted.

Control0..1
Typeid
Comments

The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

8. Condition-argoprofile.meta.lastUpdated
Definition

When the resource last changed - e.g. when the version changed.

Control0..1
Typeinstant
Comments

This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant.

9. Condition-argoprofile.meta.profile
Definition

A list of profiles StructureDefinitions that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

Control0..*
Typeuri
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

10. Condition-argoprofile.meta.security
Definition

Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

Control0..*
BindingSecurity Labels from the Healthcare Privacy and Security Classification System.
The codes SHALL be taken from All Security Labels; other codes may be used where these codes are not suitable
TypeCoding
Comments

The security labels can be updated without changing the stated version of the resource The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

11. Condition-argoprofile.meta.tag
Definition

Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

Control0..*
BindingCodes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones"
TypeCoding
Comments

The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

12. Condition-argoprofile.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.

Control0..1
Typeuri
Is Modifiertrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element as much as possible.

Max Length0
13. Condition-argoprofile.language
Definition

The base language in which the resource is written.

Control0..1
BindingA human language.
The codes SHALL be taken from http://tools.ietf.org/html/bcp47
Typecode
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Max Length0
14. Condition-argoprofile.text
Definition

A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Control0..1 This element is affected by the following invariants: dom-1
TypeNarrative
Alternate Namesnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative.

Max Length0
15. Condition-argoprofile.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Control0..*
TypeResource
Alternate Namesinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

Max Length0
16. Condition-argoprofile.extension
Definition

May be used to represent additional information that is not part of the basic definition of the resource. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

Max Length0
SlicingThis element introduces a set of slices on Condition.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
17. author
SliceNameauthor
Definition

The actor who created the item and it responsible for the content (regardless of the information source or who recorded it). If only the author is given, it is assumed the author is the information source and the recorder.

Control0..1
TypeExtension(Author) (Extension Type: Reference(Practitioner | Basic | http://fhir.org/guides/argonaut/StructureDefinition/argo-device | Patient | RelatedPerson | Organization))
Max Length0
18. annotation
SliceNameannotation
Definition

An added or follow-up note, often after the fact, that contains metadata about who made the statement and when.

Control0..*
TypeExtension(Annotation) (Extension Type: Annotation(Annotation))
Max Length0
19. dateofdiagnosis
SliceNamedateofdiagnosis
Definition

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

Control0..1
TypeExtension(DateOfDiagnosis) (Extension Type: dateTime)
Must Supporttrue
Max Length0
20. histologymorphologybehavior
SliceNamehistologymorphologybehavior
Definition

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

Control0..1
TypeExtension(HistologyMorphologyBehavior) (Extension Type: CodeableConcept)
Must Supporttrue
Max Length0
21. Condition-argoprofile.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order 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 is allowed to 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content
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.

Max Length0
22. Condition-argoprofile.identifier
Definition

This records identifiers associated with this condition that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Requirements

Need to allow connection to a wider workflow.

Max Length0
23. Condition-argoprofile.patient
Definition

Indicates the patient who the condition record is associated with.

Control1..1
TypeReference(Patient)
Must Supporttrue
Max Length0
24. Condition-argoprofile.encounter
Definition

Encounter during which the condition was first asserted.

Control0..1
TypeReference(Encounter)
Comments

This record indicates the encounter this particular record is associated with. In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known".

Max Length0
25. Condition-argoprofile.asserter
Definition

The information comes from a practitioner who asserts the condition.

Control0..1
TypeReference(Practitioner)
Max Length0
26. Condition-argoprofile.dateRecorded
Definition

A date, when the Condition statement was documented.

Control0..1
Typedate
Comments

The Date Recorded represents the date when this particular Condition record was created in the EHR, not the date of the most recent update in terms of when severity, abatement, etc. were specified.  The date of the last record modification can be retrieved from the resource metadata.

Max Length0
27. Condition-argoprofile.code
Definition

Identification of the condition, problem or diagnosis.

Control1..1
BindingThe codes SHALL be taken from PrimaryOrUncertainBehaviorCancerDisorderVS; other codes may be used where these codes are not suitable
TypeCodeableConcept
Must Supporttrue
Max Length0
28. Condition-argoprofile.category
Definition

A category assigned to the condition.

Control1..1
BindingExtended category code valueset to support the intent of the separate concepts of problems and health concerns
The codes SHOULD be taken from http://fhir.org/guides/argonaut/ValueSet/condition-category
TypeCodeableConcept
Comments

The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

Max Length0
29. Condition-argoprofile.category.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
30. Condition-argoprofile.category.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

31. Condition-argoprofile.category.coding
Definition

A reference to a code defined by a terminology system.

Control1..*
TypeCoding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

SlicingThis element introduces a set of slices on Condition.category.coding. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ code
32. Fixed_64572001
SliceNameFixed_64572001
Definition

Disease

Control1..1
TypeCoding
33. Condition-argoprofile.category.coding-Fixed-64572001.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
34. Condition-argoprofile.category.coding-Fixed-64572001.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

35. Condition-argoprofile.category.coding-Fixed-64572001.system
Definition

The identification of the code system that defines the meaning of the symbol in the code.

Control0..1
Typeuri
Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.

Fixed Valuehttp://snomed.info/sct
36. Condition-argoprofile.category.coding-Fixed-64572001.version
Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

NoteThis is a business versionId, not a resource version id (see discussion)
Control0..1
Typestring
Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

37. Condition-argoprofile.category.coding-Fixed-64572001.code
Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Control0..1
Typecode
Requirements

Need to refer to a particular code in the system.

Fixed Value64572001
38. Condition-argoprofile.category.coding-Fixed-64572001.display
Definition

A representation of the meaning of the code in the system, following the rules of the system.

Control0..1
Typestring
Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

39. Condition-argoprofile.category.coding-Fixed-64572001.use
Definition

Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).

Control0..1
Typeboolean
Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

40. Condition-argoprofile.category.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control0..1
Typestring
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

41. Condition-argoprofile.clinicalStatus
Definition

The clinical status of the condition.

Control0..1
BindingThe codes SHALL be taken from Condition Clinical Status Codes
Typecode
Is Modifiertrue
Must Supporttrue
Max Length0
42. Condition-argoprofile.verificationStatus
Definition

The verification status to support the clinical status of the condition.

Control1..1
BindingThe codes SHALL be taken from ConditionVerificationStatus
Typecode
Is Modifiertrue
Must Supporttrue
Max Length0
43. Condition-argoprofile.severity
Definition

A subjective assessment of the severity of the condition as evaluated by the clinician.

Control0..0
BindingA subjective assessment of the severity of the condition as evaluated by the clinician.
The codes SHOULD be taken from Condition/Diagnosis Severity
TypeCodeableConcept
Comments

Coding of the severity with a terminology is preferred, where possible.

Max Length0
44. Condition-argoprofile.onsetx
Definition

Estimated or actual date or date-time the condition began, in the opinion of the clinician.

Control0..1
TypeChoice of: dateTime, Quantity(Age), Period, Range, string
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

Age is generally used when the patient reports an age at which the Condition began to occur.

Max Length0
45. Condition-argoprofile.abatementx
Definition

The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate.

Control0..1
TypeChoice of: dateTime, Quantity(Age), boolean, Period, Range, string
[x] NoteSee Choice of Data Types for further information about how to use [x]
Comments

There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid.

Max Length0
46. Condition-argoprofile.stage
Definition

Clinical stage or grade of a condition. May include formal severity assessments.

Control0..1
TypeBackboneElement
Max Length0
InvariantsDefined on this element
con-1: Stage SHALL have summary or assessment (: )
47. Condition-argoprofile.stage.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Max Length0
48. Condition-argoprofile.stage.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

Max Length0
SlicingThis element introduces a set of slices on Condition.stage.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • exists @ url
49. type
SliceNametype
Definition

A code describing the item at a greater level of detail.

Control0..1
TypeExtension(Type) (Extension Type: CodeableConcept)
Max Length0
50. Condition-argoprofile.stage.extension-type.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
51. Condition-argoprofile.stage.extension-type.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..0
TypeExtension
Alternate Namesextensions, user content
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.

52. Condition-argoprofile.stage.extension-type.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition should be version specific. This will ideally be the URI for the Resource Profile defining the extension, with the code for the extension after a #.

Fixed Valuehttp://mcodeinitiative.org/us/mcode/StructureDefinition/obf-datatype-Type-extension
53. Condition-argoprofile.stage.extension-type.valueCodeableConcept
Definition

Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).

Control1..1
BindingFor example codes, see condition-stage-type
TypeCodeableConcept
54. Condition-argoprofile.stage.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 that contains it. Usually modifier elements provide negation or qualification. In order 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 is allowed to 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

Max Length0
55. Condition-argoprofile.stage.summary
Definition

A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific.

Control0..1 This element is affected by the following invariants: con-1
BindingCodes describing condition stages (e.g. Cancer stages).
For example codes, see Condition Stage
TypeCodeableConcept
Max Length0
56. Condition-argoprofile.stage.assessment
Definition

Reference to a formal record of the evidence on which the staging assessment is based.

Control0..1 This element is affected by the following invariants: con-1
TypeReference(CancerStageGroup)
Max Length0
57. Condition-argoprofile.evidence
Definition

Supporting Evidence / manifestations that are the basis on which this condition is suspected or confirmed.

Control0..*
TypeBackboneElement
Comments

The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.

Max Length0
InvariantsDefined on this element
con-2: evidence SHALL have code or details (: )
58. Condition-argoprofile.evidence.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
Max Length0
59. Condition-argoprofile.evidence.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

Max Length0
60. Condition-argoprofile.evidence.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 that contains it. Usually modifier elements provide negation or qualification. In order 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 is allowed to 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.

Control0..*
TypeExtension
Is Modifiertrue
Alternate Namesextensions, user content, modifiers
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.

Max Length0
61. Condition-argoprofile.evidence.code
Definition

A manifestation or symptom that led to the recording of this condition.

Control0..1 This element is affected by the following invariants: con-2
BindingFor example codes, see SNOMED CT Clinical Findings
TypeCodeableConcept
Max Length0
62. Condition-argoprofile.evidence.detail
Definition

Links to other relevant information, including pathology reports.

Control0..* This element is affected by the following invariants: con-2
TypeReference(Resource)
Max Length0
63. Condition-argoprofile.bodySite
Definition

The anatomical location where this condition manifests itself.

Control0..*
BindingThe codes SHOULD be taken from CancerBodyLocationVS
TypeCodeableConcept
Must Supporttrue
Comments

May be a summary code, or a reference to a very precise definition of the location, or both.

Max Length0
64. Condition-argoprofile.bodySite.id
Definition

unique id for the element within a resource (for internal references).

Control0..1
Typeid
65. Condition-argoprofile.bodySite.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control0..*
TypeExtension
Alternate Namesextensions, user content
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.

SlicingThis element introduces a set of slices on Condition.bodySite.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
66. laterality
SliceNamelaterality
Definition

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).

Control0..*
TypeExtension(Laterality) (Extension Type: CodeableConcept)
67. anatomicalorientation
SliceNameanatomicalorientation
Definition

AnatomicalOrientation 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).

Control0..*
TypeExtension(AnatomicalOrientation) (Extension Type: CodeableConcept)
68. relationtolandmark
SliceNamerelationtolandmark
Definition

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).

Control0..*
TypeExtension(RelationToLandmark) (Extension Type: Choice of: boolean, integer, decimal, base64Binary, instant, string, uri, date, dateTime, time, code, oid, id, unsignedInt, positiveInt, markdown, Annotation, Attachment, Identifier, CodeableConcept, Coding, Quantity, Range, Period, Ratio, SampledData, Signature, HumanName, Address, ContactPoint, Timing, Reference, Meta)
69. Condition-argoprofile.bodySite.coding
Definition

A reference to a code defined by a terminology system.

Control0..*
TypeCoding
Requirements

Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labelled as UserSelected = true.

70. Condition-argoprofile.bodySite.text
Definition

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

Control0..1
Typestring
Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Very often the text is the same as a displayName of one of the codings.

71. Condition-argoprofile.notes
Definition

Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis.

Control0..1
Typestring
Max Length0