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

TNMClinicalRegionalNodesCategory

 

The official URL for this profile is: 

http://mcodeinitiative.org/us/mcode/StructureDefinition/onco-core-TNMClinicalRegionalNodesCategory

Category of the presence or absence of metastases in regional lymph nodes, assessed using tests that are done before surgery. These include physical exams, imaging tests, laboratory tests (such as blood tests), and biopsies (definition adapted from NCI Dictionary of Cancer Terms).

This profile builds on Observation.

This profile was published on Wed Oct 23 00:00:00 EDT 2019 as a draft by The MITRE Corporation.

Summary

Mandatory: 0 element (4 nested mandatory elements)
Must-Support: 4 elements
Fixed Value: 3 elements
Prohibited: 7 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Observation.code.coding is sliced based on the value of value:code

Mapping Source

This structure represents the following mapping definition:

onco.core.TNMClinicalRegionalNodesCategory maps to Observation:
  Language maps to language
  ImplicitRules maps to implicitRules
  Metadata.VersionId maps to meta.versionId
  Metadata.SourceSystem maps to meta.extension
  Metadata.Profile maps to meta.profile
  Metadata.LastUpdated maps to meta.lastUpdated
  Metadata.SecurityLabel maps to meta.security
  Metadata.Tag maps to meta.tag
  Narrative maps to text
  Identifier maps to identifier
  ProceduralObservationBasedOn maps to extension
  ProceduralObservationPartOf maps to extension
  Status maps to status
  Category maps to category
  Code maps to code
  ObservationSubjectOfRecord maps to subject
  FocalSubject maps to modifierExtension
  CareContext maps to encounter
  RelevantTime maps to effective[x]
  StatementDateTime maps to issued
  Performer maps to performer
  DataValue maps to value[x]
  DataAbsentReason maps to dataAbsentReason
  Interpretation maps to interpretation
  Annotation maps to extension
  BodyLocation.Code maps to bodySite
  BodyLocation.Laterality maps to bodySite.extension
  BodyLocation.AnatomicalOrientation maps to bodySite.extension
  BodyLocation.RelationToLandmark maps to bodySite.extension
  CancerStagingSystem maps to method
  Specimen maps to specimen
  Device maps to device
  ReferenceRange maps to referenceRange
  ReferenceRange.LowerBound maps to referenceRange.low
  ReferenceRange.UpperBound maps to referenceRange.high
  ReferenceRange.Type maps to referenceRange.meaning
  ReferenceRange.ApplicableSubpopulation maps to referenceRange.extension
  ReferenceRange.ApplicableAgeRange maps to referenceRange.age
  ReferenceRange.Text maps to referenceRange.text
  fix related.type to #has-member
  PanelMembers maps to related
  PanelMembers.Observation maps to related.target (slice at = related; slice on = target.reference.resolve(); slice on type = profile; slice strategy = includes)
  ObservationDerivedFrom maps to extension
  Components.ObservationComponent maps to component (slice on = code.coding.code; slice strategy = includes)
  Components.ObservationComponent.Code maps to component.code
  Components.ObservationComponent.DataValue maps to component.value[x]
  Components.ObservationComponent.DataAbsentReason maps to component.dataAbsentReason
  Components.ObservationComponent.ReferenceRange maps to component.referenceRange
  Components.ObservationComponent.ReferenceRange.LowerBound maps to component.referenceRange.low
  Components.ObservationComponent.ReferenceRange.UpperBound maps to component.referenceRange.high
  Components.ObservationComponent.ReferenceRange.Type maps to component.referenceRange.meaning
  Components.ObservationComponent.ReferenceRange.ApplicableAgeRange maps to component.referenceRange.age
  Components.ObservationComponent.ReferenceRange.Text maps to component.referenceRange.text
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation onco-core-TNMClinicalRegionalNodesCategory
... meta
.... extension Slice: Unordered, Open by value:url
.... obf-SourceSystem-extension 0..1uriSourceSystem
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-SourceSystem-extension
... extension Slice: Unordered, Open by value:url
... obf-ProceduralObservationBasedOn-extension 0..*Reference(obf-ProcedureRequest)ProceduralObservationBasedOn
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-ProceduralObservationBasedOn-extension
... obf-ProceduralObservationPartOf-extension 0..*Reference(obf-Procedure)ProceduralObservationPartOf
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-ProceduralObservationPartOf-extension
... obf-Annotation-extension 0..*AnnotationAnnotation
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-Annotation-extension
... obf-ObservationDerivedFrom-extension 0..*Reference(DocumentReference | Media | obf-QuestionnaireResponse | obf-Observation)ObservationDerivedFrom
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-ObservationDerivedFrom-extension
... modifierExtension (Slice Definition)Slice: Unordered, Open by value:url
... modifierExtension:focalsubject ?!S0..*FocalSubject
.... valueReference Reference(onco-core-PrimaryCancerCondition)PrimaryCancerCondition: 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)
... category Binding: Observation Category Codes (extensible)
... code
.... coding 1..*(Slice Definition)Slice: Unordered, Open by value:code
​..... coding:Fixed_21906-3 Σ1..1CodingRegional lymph nodes.clinical [Class] Cancer
...... system Fixed Value: http://loinc.org
...... code Fixed Value: 21906-3
... subject 1..1Reference(obf-Patient)The subject of an observation
... effective[x] S
... performer Reference(Practitioner)
... valueCodeableConcept S1..1CodeableConceptBinding: TNMRegionalNodesCategoryVS (preferred)
... dataAbsentReason 0..0
... bodySite 0..0
... method SMethod or staging system used to stage the cancer
Binding: CancerStagingSystemVS (extensible)
... specimen 0..0
... device 0..0
... referenceRange 0..0
... related 0..0
... component 0..0

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*onco-core-TNMClinicalRegionalNodesCategory
obs-6: SHALL only be present if Observation.value[x] is not present
obs-7: Component code SHALL not be same as observation code
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... obf-SourceSystem-extension 0..1uriSourceSystem
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-SourceSystem-extension
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated Σ0..1instantWhen the resource version last changed
.... profile Σ0..*uriProfiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible)
.... tag Σ0..*CodingTags applied to this resource
Binding: (unbound) (example)
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: http://tools.ietf.org/html/bcp47 (required)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
... obf-ProceduralObservationBasedOn-extension 0..*Reference(obf-ProcedureRequest)ProceduralObservationBasedOn
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-ProceduralObservationBasedOn-extension
... obf-ProceduralObservationPartOf-extension 0..*Reference(obf-Procedure)ProceduralObservationPartOf
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-ProceduralObservationPartOf-extension
... obf-Annotation-extension 0..*AnnotationAnnotation
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-Annotation-extension
... obf-ObservationDerivedFrom-extension 0..*Reference(DocumentReference | Media | obf-QuestionnaireResponse | obf-Observation)ObservationDerivedFrom
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-ObservationDerivedFrom-extension
... modifierExtension ?!0..*(Slice Definition)Extensions that cannot be ignored
Slice: Unordered, Open by exists:url
​.... modifierExtension:focalsubject ?!S0..*FocalSubject
..... id 0..1idxml:id (or equivalent in JSON)
..... url 1..1uri"http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-FocalSubject-extension"
..... valueReference 1..1Reference(onco-core-PrimaryCancerCondition)PrimaryCancerCondition: 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)
... identifier 0..*IdentifierUnique Id for this particular observation
... status ?!Σ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category 0..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (extensible)
... code Σ1..1CodeableConceptType of observation (code / type)
Binding: LOINC Codes (example)
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... coding Σ1..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Open by value:code
​..... coding:Fixed_21906-3 Σ1..1CodingRegional lymph nodes.clinical [Class] Cancer
...... id 0..1idxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
...... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: 21906-3
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject Σ1..1Reference(obf-Patient)The subject of an observation
... encounter 0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣ0..1Clinically relevant time/time-period for observation
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued Σ0..1instantDate/Time this was made available
... performer Σ0..*Reference(Practitioner)Who is responsible for the observation
... valueCodeableConcept SΣ1..1CodeableConceptActual result
Binding: TNMRegionalNodesCategoryVS (preferred)
... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
... comments 0..1stringComments about result
... method S0..1CodeableConceptMethod or staging system used to stage the cancer
Binding: CancerStagingSystemVS (extensible)

doco Documentation for this format

Summary

Mandatory: 0 element (4 nested mandatory elements)
Must-Support: 4 elements
Fixed Value: 3 elements
Prohibited: 7 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Observation.code.coding is sliced based on the value of value:code

Mapping Source

This structure represents the following mapping definition:

onco.core.TNMClinicalRegionalNodesCategory maps to Observation:
  Language maps to language
  ImplicitRules maps to implicitRules
  Metadata.VersionId maps to meta.versionId
  Metadata.SourceSystem maps to meta.extension
  Metadata.Profile maps to meta.profile
  Metadata.LastUpdated maps to meta.lastUpdated
  Metadata.SecurityLabel maps to meta.security
  Metadata.Tag maps to meta.tag
  Narrative maps to text
  Identifier maps to identifier
  ProceduralObservationBasedOn maps to extension
  ProceduralObservationPartOf maps to extension
  Status maps to status
  Category maps to category
  Code maps to code
  ObservationSubjectOfRecord maps to subject
  FocalSubject maps to modifierExtension
  CareContext maps to encounter
  RelevantTime maps to effective[x]
  StatementDateTime maps to issued
  Performer maps to performer
  DataValue maps to value[x]
  DataAbsentReason maps to dataAbsentReason
  Interpretation maps to interpretation
  Annotation maps to extension
  BodyLocation.Code maps to bodySite
  BodyLocation.Laterality maps to bodySite.extension
  BodyLocation.AnatomicalOrientation maps to bodySite.extension
  BodyLocation.RelationToLandmark maps to bodySite.extension
  CancerStagingSystem maps to method
  Specimen maps to specimen
  Device maps to device
  ReferenceRange maps to referenceRange
  ReferenceRange.LowerBound maps to referenceRange.low
  ReferenceRange.UpperBound maps to referenceRange.high
  ReferenceRange.Type maps to referenceRange.meaning
  ReferenceRange.ApplicableSubpopulation maps to referenceRange.extension
  ReferenceRange.ApplicableAgeRange maps to referenceRange.age
  ReferenceRange.Text maps to referenceRange.text
  fix related.type to #has-member
  PanelMembers maps to related
  PanelMembers.Observation maps to related.target (slice at = related; slice on = target.reference.resolve(); slice on type = profile; slice strategy = includes)
  ObservationDerivedFrom maps to extension
  Components.ObservationComponent maps to component (slice on = code.coding.code; slice strategy = includes)
  Components.ObservationComponent.Code maps to component.code
  Components.ObservationComponent.DataValue maps to component.value[x]
  Components.ObservationComponent.DataAbsentReason maps to component.dataAbsentReason
  Components.ObservationComponent.ReferenceRange maps to component.referenceRange
  Components.ObservationComponent.ReferenceRange.LowerBound maps to component.referenceRange.low
  Components.ObservationComponent.ReferenceRange.UpperBound maps to component.referenceRange.high
  Components.ObservationComponent.ReferenceRange.Type maps to component.referenceRange.meaning
  Components.ObservationComponent.ReferenceRange.ApplicableAgeRange maps to component.referenceRange.age
  Components.ObservationComponent.ReferenceRange.Text maps to component.referenceRange.text

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation onco-core-TNMClinicalRegionalNodesCategory
... meta
.... extension Slice: Unordered, Open by value:url
.... obf-SourceSystem-extension 0..1uriSourceSystem
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-SourceSystem-extension
... extension Slice: Unordered, Open by value:url
... obf-ProceduralObservationBasedOn-extension 0..*Reference(obf-ProcedureRequest)ProceduralObservationBasedOn
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-ProceduralObservationBasedOn-extension
... obf-ProceduralObservationPartOf-extension 0..*Reference(obf-Procedure)ProceduralObservationPartOf
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-ProceduralObservationPartOf-extension
... obf-Annotation-extension 0..*AnnotationAnnotation
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-Annotation-extension
... obf-ObservationDerivedFrom-extension 0..*Reference(DocumentReference | Media | obf-QuestionnaireResponse | obf-Observation)ObservationDerivedFrom
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-ObservationDerivedFrom-extension
... modifierExtension (Slice Definition)Slice: Unordered, Open by value:url
... modifierExtension:focalsubject ?!S0..*FocalSubject
.... valueReference Reference(onco-core-PrimaryCancerCondition)PrimaryCancerCondition: 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)
... category Binding: Observation Category Codes (extensible)
... code
.... coding 1..*(Slice Definition)Slice: Unordered, Open by value:code
​..... coding:Fixed_21906-3 Σ1..1CodingRegional lymph nodes.clinical [Class] Cancer
...... system Fixed Value: http://loinc.org
...... code Fixed Value: 21906-3
... subject 1..1Reference(obf-Patient)The subject of an observation
... effective[x] S
... performer Reference(Practitioner)
... valueCodeableConcept S1..1CodeableConceptBinding: TNMRegionalNodesCategoryVS (preferred)
... dataAbsentReason 0..0
... bodySite 0..0
... method SMethod or staging system used to stage the cancer
Binding: CancerStagingSystemVS (extensible)
... specimen 0..0
... device 0..0
... referenceRange 0..0
... related 0..0
... component 0..0

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*onco-core-TNMClinicalRegionalNodesCategory
obs-6: SHALL only be present if Observation.value[x] is not present
obs-7: Component code SHALL not be same as observation code
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... obf-SourceSystem-extension 0..1uriSourceSystem
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-SourceSystem-extension
.... versionId Σ0..1idVersion specific identifier
.... lastUpdated Σ0..1instantWhen the resource version last changed
.... profile Σ0..*uriProfiles this resource claims to conform to
.... security Σ0..*CodingSecurity Labels applied to this resource
Binding: All Security Labels (extensible)
.... tag Σ0..*CodingTags applied to this resource
Binding: (unbound) (example)
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: http://tools.ietf.org/html/bcp47 (required)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
... obf-ProceduralObservationBasedOn-extension 0..*Reference(obf-ProcedureRequest)ProceduralObservationBasedOn
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-ProceduralObservationBasedOn-extension
... obf-ProceduralObservationPartOf-extension 0..*Reference(obf-Procedure)ProceduralObservationPartOf
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-ProceduralObservationPartOf-extension
... obf-Annotation-extension 0..*AnnotationAnnotation
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-Annotation-extension
... obf-ObservationDerivedFrom-extension 0..*Reference(DocumentReference | Media | obf-QuestionnaireResponse | obf-Observation)ObservationDerivedFrom
URL: http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-ObservationDerivedFrom-extension
... modifierExtension ?!0..*(Slice Definition)Extensions that cannot be ignored
Slice: Unordered, Open by exists:url
​.... modifierExtension:focalsubject ?!S0..*FocalSubject
..... id 0..1idxml:id (or equivalent in JSON)
..... url 1..1uri"http://mcodeinitiative.org/us/mcode/StructureDefinition/obf-FocalSubject-extension"
..... valueReference 1..1Reference(onco-core-PrimaryCancerCondition)PrimaryCancerCondition: 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)
... identifier 0..*IdentifierUnique Id for this particular observation
... status ?!Σ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category 0..1CodeableConceptClassification of type of observation
Binding: Observation Category Codes (extensible)
... code Σ1..1CodeableConceptType of observation (code / type)
Binding: LOINC Codes (example)
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... coding Σ1..*(Slice Definition)Code defined by a terminology system
Slice: Unordered, Open by value:code
​..... coding:Fixed_21906-3 Σ1..1CodingRegional lymph nodes.clinical [Class] Cancer
...... id 0..1idxml:id (or equivalent in JSON)
...... extension 0..*ExtensionAdditional Content defined by implementations
...... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: 21906-3
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject Σ1..1Reference(obf-Patient)The subject of an observation
... encounter 0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣ0..1Clinically relevant time/time-period for observation
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued Σ0..1instantDate/Time this was made available
... performer Σ0..*Reference(Practitioner)Who is responsible for the observation
... valueCodeableConcept SΣ1..1CodeableConceptActual result
Binding: TNMRegionalNodesCategoryVS (preferred)
... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: Observation Interpretation Codes (extensible)
... comments 0..1stringComments about result
... method S0..1CodeableConceptMethod or staging system used to stage the cancer
Binding: CancerStagingSystemVS (extensible)

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON, TTL), Schema: XML Schematron

 

Terminology Bindings

PathConformanceValueSet / Code
Observation.meta.securityextensibleAll Security Labels
Observation.meta.tagexample
Observation.languagerequiredhttp://tools.ietf.org/html/bcp47
Observation.statusrequiredObservationStatus
Observation.categoryextensibleObservation Category Codes
Observation.codeexampleLOINC Codes
Observation.valueCodeableConceptpreferredTNMRegionalNodesCategoryVS
Observation.interpretationextensibleObservation Interpretation Codes
Observation.methodextensibleCancerStagingSystemVS
Observation.referenceRange.meaningextensibleObservation Reference Range Meaning Codes
Observation.related.typerequiredFixed Value: has-member
Observation.component.codeexampleLOINC Codes
Observation.component.dataAbsentReasonextensibleObservation Value Absent Reason
Observation.component.referenceRange.meaningextensibleObservation Reference Range Meaning Codes

 

Constraints

IdPathDetailsRequirements
obs-6ObservationSHALL only be present if Observation.value[x] is not present
:
obs-7ObservationComponent code SHALL not be same as observation code
: