HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE), v0.9.0

- Local Development build (v0.9.0). See the Directory of published versions

ComorbidCondition

 

The official URL for this profile is:

http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-ComorbidCondition

A comorbidity refers to one or more diseases or conditions that occur along with another condition in the same person at the same time. Conditions considered comorbidities are often long-term or chronic conditions. Comorbidities are defined relative to an index disease and may be categorical, rather than described in full detail. The comorbid condition class provides comorbidity codes corresponding the Elixhauser Comorbidity Index.

This profile builds on http://fhir.org/guides/argonaut/StructureDefinition/argo-condition.

This profile was published on Wed Apr 17 00:00:00 EDT 2019 as a draft by The MITRE Corporation.

Summary

Mandatory: 0 element (3 nested mandatory elements)
Fixed Value: 2 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 Condition.category.coding is sliced based on the value of value:code

Mapping Source

This structure represents the following mapping definition:

shr.core.ComorbidCondition maps to http://fhir.org/guides/argonaut/StructureDefinition/argo-condition:
  _Entry.EntryId maps to id
  Language maps to language
  Narrative maps to text
  ImplicitRules maps to implicitRules
  Metadata.VersionId maps to meta.versionId
  Metadata.Profile maps to meta.profile
  Metadata.LastUpdated maps to meta.lastUpdated
  Metadata.SecurityLabel maps to meta.security
  Metadata.Tag maps to meta.tag
  Identifier maps to identifier
  StatementDateTime maps to dateRecorded
  PersonInformationSource maps to asserter
  PatientSubjectOfRecord maps to patient
  Category maps to category
  Code maps to code
  BodyLocation.LocationCode maps to bodySite
  BodyLocation.Laterality maps to bodySite.extension
  BodyLocation.Orientation maps to bodySite.extension
  BodyLocation.RelationToLandmark maps to bodySite.extension
  CareContext maps to encounter
  ClinicalStatus maps to clinicalStatus
  Status maps to verificationStatus
  Onset maps to onset[x]
  Abatement maps to abatement[x]
  Severity maps to severity
  StageInformation maps to stage
  StageInformation.StageSummary maps to stage.summary
  StageInformation.StageDetail maps to stage.assessment
  Evidence.Manifestation maps to evidence.code
  Evidence.DomainResource maps to evidence.detail

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition shr-core-ComorbidCondition
... patient Reference(shr-core-Patient)
... encounter Reference(shr-core-Encounter)
... asserter Reference(shr-core-Practitioner | shr-core-Patient)
... code Binding: ComorbidConditionVS (extensible)
... category
.... coding Slice: Unordered, Open by value:code
.... coding Σ1..1CodingCo-morbid conditions (finding)
..... system Fixed Value: http://snomed.info/sct
..... code Fixed Value: 398192003
... clinicalStatus 1..1
... severity Binding: Condition/Diagnosis Severity (required)
... stage
.... assessment 0..1Reference(shr-core-Observation)
... evidence
.... code Binding: SNOMED CT Clinical Findings (example)
.... detail Reference(shr-core-DomainResource)
... bodySite Binding: BodyLocationVS (preferred)
.... extension Slice: Unordered, Open by value:url
.... shr-core-Laterality-extension 0..*CodeableConceptLaterality
URL: http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Laterality-extension
Binding: LateralityVS (extensible)
.... shr-core-Orientation-extension 0..*CodeableConceptOrientation
URL: http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Orientation-extension
Binding: OrientationVS (extensible)
.... shr-core-RelationToLandmark-extension 0..*(Complex)RelationToLandmark
URL: http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-RelationToLandmark-extension

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition I0..*shr-core-ComorbidCondition
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
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... 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
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this condition
... patient S1..1Reference(shr-core-Patient)Who has the condition?
... encounter Σ0..1Reference(shr-core-Encounter)Encounter when condition first asserted
... asserter Σ0..1Reference(shr-core-Practitioner | shr-core-Patient)Person who asserts this condition
... dateRecorded Σ0..1dateWhen first entered
... code S1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: ComorbidConditionVS (extensible)
... category 1..1CodeableConceptcomplaint | symptom | finding | diagnosis
Binding: http://fhir.org/guides/argonaut/ValueSet/condition-category (preferred)
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
.... coding Σ1..1CodingCo-morbid conditions (finding)
..... 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://snomed.info/sct
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: 398192003
..... 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
... clinicalStatus ?!S1..1codeactive | relapse | remission | resolved
Binding: Condition Clinical Status Codes (required)
... verificationStatus ?!S1..1codeprovisional | differential | confirmed | refuted | entered-in-error | unknown
Binding: ConditionVerificationStatus (required)
... severity Σ0..1CodeableConceptSubjective severity of condition
Binding: Condition/Diagnosis Severity (required)
... onset[x] Σ0..1dateTime, Age, Period, Range, stringEstimated or actual date, date-time, or age
... abatement[x] Σ0..1dateTime, Age, boolean, Period, Range, stringIf/when in resolution/remission
... stage ΣI0..1BackboneElementStage/grade, usually assessed formally
con-1: Stage SHALL have summary or assessment
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
.... summary ΣI0..1CodeableConceptSimple summary (disease specific)
Binding: Condition Stage (example)
.... assessment ΣI0..1Reference(shr-core-Observation)Formal record of assessment
... evidence ΣI0..*BackboneElementSupporting evidence
con-2: evidence SHALL have code or details
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
.... code ΣI0..1CodeableConceptManifestation/symptom
Binding: SNOMED CT Clinical Findings (example)
.... detail ΣI0..*Reference(shr-core-DomainResource)Supporting information found elsewhere
... bodySite Σ0..*CodeableConceptAnatomical location, if relevant
Binding: BodyLocationVS (preferred)
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... shr-core-Laterality-extension 0..*CodeableConceptLaterality
URL: http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Laterality-extension
Binding: LateralityVS (extensible)
.... shr-core-Orientation-extension 0..*CodeableConceptOrientation
URL: http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Orientation-extension
Binding: OrientationVS (extensible)
.... shr-core-RelationToLandmark-extension 0..*(Complex)RelationToLandmark
URL: http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-RelationToLandmark-extension
.... coding Σ0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... notes Σ0..1stringAdditional information about the Condition

doco Documentation for this format

Summary

Mandatory: 0 element (3 nested mandatory elements)
Fixed Value: 2 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 Condition.category.coding is sliced based on the value of value:code

Mapping Source

This structure represents the following mapping definition:

shr.core.ComorbidCondition maps to http://fhir.org/guides/argonaut/StructureDefinition/argo-condition:
  _Entry.EntryId maps to id
  Language maps to language
  Narrative maps to text
  ImplicitRules maps to implicitRules
  Metadata.VersionId maps to meta.versionId
  Metadata.Profile maps to meta.profile
  Metadata.LastUpdated maps to meta.lastUpdated
  Metadata.SecurityLabel maps to meta.security
  Metadata.Tag maps to meta.tag
  Identifier maps to identifier
  StatementDateTime maps to dateRecorded
  PersonInformationSource maps to asserter
  PatientSubjectOfRecord maps to patient
  Category maps to category
  Code maps to code
  BodyLocation.LocationCode maps to bodySite
  BodyLocation.Laterality maps to bodySite.extension
  BodyLocation.Orientation maps to bodySite.extension
  BodyLocation.RelationToLandmark maps to bodySite.extension
  CareContext maps to encounter
  ClinicalStatus maps to clinicalStatus
  Status maps to verificationStatus
  Onset maps to onset[x]
  Abatement maps to abatement[x]
  Severity maps to severity
  StageInformation maps to stage
  StageInformation.StageSummary maps to stage.summary
  StageInformation.StageDetail maps to stage.assessment
  Evidence.Manifestation maps to evidence.code
  Evidence.DomainResource maps to evidence.detail

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition shr-core-ComorbidCondition
... patient Reference(shr-core-Patient)
... encounter Reference(shr-core-Encounter)
... asserter Reference(shr-core-Practitioner | shr-core-Patient)
... code Binding: ComorbidConditionVS (extensible)
... category
.... coding Slice: Unordered, Open by value:code
.... coding Σ1..1CodingCo-morbid conditions (finding)
..... system Fixed Value: http://snomed.info/sct
..... code Fixed Value: 398192003
... clinicalStatus 1..1
... severity Binding: Condition/Diagnosis Severity (required)
... stage
.... assessment 0..1Reference(shr-core-Observation)
... evidence
.... code Binding: SNOMED CT Clinical Findings (example)
.... detail Reference(shr-core-DomainResource)
... bodySite Binding: BodyLocationVS (preferred)
.... extension Slice: Unordered, Open by value:url
.... shr-core-Laterality-extension 0..*CodeableConceptLaterality
URL: http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Laterality-extension
Binding: LateralityVS (extensible)
.... shr-core-Orientation-extension 0..*CodeableConceptOrientation
URL: http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Orientation-extension
Binding: OrientationVS (extensible)
.... shr-core-RelationToLandmark-extension 0..*(Complex)RelationToLandmark
URL: http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-RelationToLandmark-extension

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition I0..*shr-core-ComorbidCondition
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
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... 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
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this condition
... patient S1..1Reference(shr-core-Patient)Who has the condition?
... encounter Σ0..1Reference(shr-core-Encounter)Encounter when condition first asserted
... asserter Σ0..1Reference(shr-core-Practitioner | shr-core-Patient)Person who asserts this condition
... dateRecorded Σ0..1dateWhen first entered
... code S1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: ComorbidConditionVS (extensible)
... category 1..1CodeableConceptcomplaint | symptom | finding | diagnosis
Binding: http://fhir.org/guides/argonaut/ValueSet/condition-category (preferred)
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
.... coding Σ1..1CodingCo-morbid conditions (finding)
..... 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://snomed.info/sct
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: 398192003
..... 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
... clinicalStatus ?!S1..1codeactive | relapse | remission | resolved
Binding: Condition Clinical Status Codes (required)
... verificationStatus ?!S1..1codeprovisional | differential | confirmed | refuted | entered-in-error | unknown
Binding: ConditionVerificationStatus (required)
... severity Σ0..1CodeableConceptSubjective severity of condition
Binding: Condition/Diagnosis Severity (required)
... onset[x] Σ0..1dateTime, Age, Period, Range, stringEstimated or actual date, date-time, or age
... abatement[x] Σ0..1dateTime, Age, boolean, Period, Range, stringIf/when in resolution/remission
... stage ΣI0..1BackboneElementStage/grade, usually assessed formally
con-1: Stage SHALL have summary or assessment
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
.... summary ΣI0..1CodeableConceptSimple summary (disease specific)
Binding: Condition Stage (example)
.... assessment ΣI0..1Reference(shr-core-Observation)Formal record of assessment
... evidence ΣI0..*BackboneElementSupporting evidence
con-2: evidence SHALL have code or details
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
.... code ΣI0..1CodeableConceptManifestation/symptom
Binding: SNOMED CT Clinical Findings (example)
.... detail ΣI0..*Reference(shr-core-DomainResource)Supporting information found elsewhere
... bodySite Σ0..*CodeableConceptAnatomical location, if relevant
Binding: BodyLocationVS (preferred)
.... id 0..1idxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
Slice: Unordered, Open by value:url
.... shr-core-Laterality-extension 0..*CodeableConceptLaterality
URL: http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Laterality-extension
Binding: LateralityVS (extensible)
.... shr-core-Orientation-extension 0..*CodeableConceptOrientation
URL: http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-Orientation-extension
Binding: OrientationVS (extensible)
.... shr-core-RelationToLandmark-extension 0..*(Complex)RelationToLandmark
URL: http://hl7.org/fhir/us/shr/StructureDefinition/shr-core-RelationToLandmark-extension
.... coding Σ0..*CodingCode defined by a terminology system
.... text Σ0..1stringPlain text representation of the concept
... notes Σ0..1stringAdditional information about the Condition

doco Documentation for this format

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

 

Terminology Bindings

PathConformanceValueSet
Condition.codeextensibleComorbidConditionVS
Condition.clinicalStatusrequiredCondition Clinical Status Codes
Condition.verificationStatusrequiredConditionVerificationStatus

 

Constraints

IdPathDetailsRequirements
arg-1ConditionCondition.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')
con-1Condition.stageStage SHALL have summary or assessment
:
con-2Condition.evidenceevidence SHALL have code or details
: