R4 Ballot #1 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.3.0: R4 Ballot 2). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

4.8 Resource ValueSet - Content

Vocabulary Work GroupMaturity Level: 5 Normative Compartments: Not linked to any defined compartments

Normative Candidate Note: This page is candidate normative content for R4 in the Conformance Package. Once normative, it will lose it's Maturity Level, and breaking changes will no longer be made.

A ValueSet resource specifies a set of codes drawn from one or more code systems, intended for use in a particular context. Value sets link between [[[CodeSystem]]] definitions and their use in [coded elements](terminologies.html).

4.8.1 Scope and Usage

The FHIR terminology specification is based on two key concepts, originally defined in HL7 v3 Core Principles :

  • CodeSystem - defines a set of codes with meanings (also known as enumeration, terminology, classification, and/or ontology) - e.g. define which codes (symbols and/or expressions) exist, and how they are understood
  • ValueSet - selects a set of codes from those defined by one or more code systems to specify which codes can be used in a particular context

Value sets have 2 aspects:

  • .compose: A definition of which codes are intended to be in the value set ("intension")
  • .expansion: The list of codes that are actually in the value set under a given set of conditions ("extension") - see Value Set Expansion

The ValueSet resource can carry either the .compose or the .expansion, or both. There is an "$expand" operation which can be used to ask a server to generate an expansion given the composition rules.

4.8.2 Boundaries and Relationships

  • Value sets use CodeSystem resources by referring to them via their canonical URI (sometimes called "canonical URL").
  • Value sets are used in ElementDefinition and Questionnaire resources to specify the allowable contents for coded elements
  • ConceptMap resources describe mappings between value sets
  • The ValueSet resource design is based on the functionality described in the OMG CTS 2 specification, along with metadata in the HL7 Value Set Definition specification. Value set resources can be converted to CTS2 value set and code system instances.
  • The value set resource is aligned with the Value Set Definition (VSD) project. Not all of the elements defined by the VSD are part of the base resource - some are defined as part of the ValueSet Extensions. In the ValueSet resource, the compose element is the VSD "Content Logical definition".

4.8.3 Background and Context

When using value sets, proper differentiation between a code system and a value set is important. This is one very common area where significant clinical safety risks occur in practice. Implementers should be familiar with the content in Using Codes in Resources.

4.8.3.1 ValueSet Identification

A value set has 3 identifiers:

  • ValueSet.id: the logical id on the system that holds the value set - this changes as it moves from server to server (this id, with the server address prepended, is called the 'literal identity' of the resource)
  • ValueSet.url: the canonical URI that never changes for this value set - it is the same in every copy. The element is named url rather than uri for legacy reasons and also to strongly encourage providing a resolvable URL as the identifier whenever possible. Ideally, it should be a literal URL that is the location of the master version of the value set, though this is not always possible
  • ValueSet.identifier: A system/value pair that is used to identify the value set in other contexts (such as an OID in an HL7 v3 specification)

For further information regarding resource identification, see Resource Identity.

This means that each value set has 2 different URLs that can be used to reference it - its canonical URI (the url element), and its local location from which it may be retrieved (which includes the id element). Because it is common practice to copy (cache) value sets locally, most references to value sets use the canonical URI.

For example, the value sets published as part of FHIR all have a location ("literal") URI which is the URL where they may be accessed in the FHIR specification itself. Note, though, that while a new version of the FHIR Specification is being prepared, value sets that are published in the drafts will not be found in the current published FHIR specification at their canonical URI.

Alternatively, the identifier and version elements may be used to reference this value set in a design, a profile, a CDA template or HL7 v3 message (in the CD data type valueSet and valueSetVersion properties). These different contexts may make additional restrictions on the possible values of these elements. The identifier is generally not needed when using value sets in a FHIR context, where the canonical URI (or "canonical URL") is always the focus.

This resource is referenced by CodeSystem, ConceptMap, OperationDefinition and Questionnaire

4.8.4 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ValueSet INDomainResourceA set of codes drawn from one or more code systems
+ Status must = 'active' if expansion is present and compose is absent
+ Value set SHALL contain at least one of a compose or an expansion element
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... url Σ0..1uriCanonical identifier for this value set, represented as a URI (globally unique)
... identifier Σ0..*IdentifierAdditional identifier for the value set (business identifier)
... version Σ0..1stringBusiness version of the value set
... name Σ0..1stringName for this value set (computer friendly)
... title Σ0..1stringName for this value set (human friendly)
... status ?!ΣI1..1codedraft | active | retired | unknown
PublicationStatus (Required)
... experimental ?!Σ0..1booleanFor testing purposes, not real usage
... date Σ0..1dateTimeDate last changed
... publisher Σ0..1stringName of the publisher (organization or individual)
... contact Σ0..*ContactDetailContact details for the publisher
... description 0..1markdownNatural language description of the value set
... useContext ΣTU0..*UsageContextThe context that the content is intended to support
... jurisdiction Σ0..*CodeableConceptIntended jurisdiction for value set (if applicable)
Jurisdiction ValueSet (Extensible)
... immutable Σ0..1booleanIndicates whether or not any change to the content logical definition may occur
... purpose 0..1markdownWhy this value set is defined
... copyright 0..1markdownUse and/or publishing restrictions
... extensible Σ0..1booleanWhether this is intended to be used with an extensible binding
... compose I0..1BackboneElementDefinition of the content of the value set
.... lockedDate Σ0..1dateFixed date for version-less references (transitive)
.... inactive Σ0..1booleanWhether inactive codes are in the value set
.... include ΣI1..*BackboneElementInclude one or more codes from a code system or other value set(s)
+ A value set with concepts or filters SHALL include a system
+ Cannot have both concept and filter
+ A value set include/exclude SHALL have a value set or a system
..... system ΣI0..1uriThe system the codes come from
..... version Σ0..1stringSpecific version of the code system referred to
..... concept I0..*BackboneElementA concept defined in the system
...... code 1..1codeCode or expression from system
...... display 0..1stringText to display for this code for this value set in this valueset
...... designation 0..*BackboneElementAdditional representations for this concept
....... language 0..1codeHuman language of the designation
Common Languages (Extensible but limited to All Languages)
....... use 0..1CodingDetails how this designation would be used
Designation Use (Extensible)
....... value 1..1stringThe text value for this designation
..... filter ΣI0..*BackboneElementSelect codes/concepts by their properties (including relationships)
...... property Σ1..1codeA property defined by the code system
...... op Σ1..1code= | is-a | descendent-of | is-not-a | regex | in | not-in | generalizes | exists
FilterOperator (Required)
...... value Σ1..1stringCode from the system, or regex criteria, or boolean value for exists
..... valueSet ΣI0..*canonicalSelect the contents included in this value set
.... exclude I0..*see includeExplicitly exclude codes from a code system or other value sets
... expansion I0..1BackboneElementUsed when the value set is "expanded"
.... identifier 0..1uriUniquely identifies this expansion
.... timestamp 1..1dateTimeTime ValueSet expansion happened
.... total 0..1integerTotal number of codes in the expansion
.... offset 0..1integerOffset at which this resource starts
.... parameter 0..*BackboneElementParameter that controlled the expansion process
..... name 1..1stringName as assigned by the server
..... value[x] 0..1Value of the named parameter
...... valueStringstring
...... valueBooleanboolean
...... valueIntegerinteger
...... valueDecimaldecimal
...... valueUriuri
...... valueCodecode
.... contains I0..*BackboneElementCodes in the value set
+ SHALL have a code or a display
+ Must have a code if not abstract
+ Must have a system if a code is present
..... system 0..1uriSystem value for the code
..... abstract 0..1booleanIf user cannot select this entry
..... inactive 0..1booleanIf concept is inactive in the code system
..... version 0..1stringVersion in which this code/display is defined
..... code I0..1codeCode - if blank, this is not a selectable code
..... display I0..1stringUser display for the concept
..... designation 0..*see designationAdditional representations for this item
..... contains 0..*see containsCodes contained under this entry

doco Documentation for this format

UML Diagram (Legend)

ValueSet (DomainResource)An absolute URI that is used to identify this value set when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which this value set is (or will be) publishedurl : uri [0..1]A formal identifier that is used to identify this value set when it is represented in other formats, or referenced in a specification, model, design or an instanceidentifier : Identifier [0..*]The identifier that is used to identify this version of the value set when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the value set author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequenceversion : string [0..1]A natural language name identifying the value set. This name should be usable as an identifier for the module by machine processing applications such as code generationname : string [0..1]A short, descriptive, user-friendly title for the value settitle : string [0..1]The status of this value set. Enables tracking the life-cycle of the content (this element modifies the meaning of other elements)status : code [1..1] « The lifecycle status of an artifact. (Strength=Required)PublicationStatus! »A Boolean value to indicate that this value set is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage (this element modifies the meaning of other elements)experimental : boolean [0..1]The date (and optionally time) when the value set was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the value set changes. (e.g. the 'content logical definition')date : dateTime [0..1]The name of the organization or individual that published the value setpublisher : string [0..1]Contact details to assist a user in finding and communicating with the publishercontact : ContactDetail [0..*]A free text natural language description of the value set from a consumer's perspectivedescription : markdown [0..1]The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching for appropriate value set instancesuseContext : UsageContext [0..*]A legal or geographic region in which the value set is intended to be usedjurisdiction : CodeableConcept [0..*] « Countries and regions within which this artifact is targeted for use (Strength=Extensible)Jurisdiction ValueSet+ »If this is set to 'true', then no new versions of the content logical definition can be created. Note: Other metadata might still changeimmutable : boolean [0..1]Explanation of why this value set is needed and why it has been designed as it haspurpose : markdown [0..1]A copyright statement relating to the value set and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the value setcopyright : markdown [0..1]Whether this is intended to be used with an extensible binding or notextensible : boolean [0..1]ComposeIf a locked date is defined, then the Content Logical Definition must be evaluated using the current version as of the locked date for referenced code system(s) and value set instances where ValueSet.compose.include.version is not definedlockedDate : date [0..1]Whether inactive codes - codes that are not approved for current use - are in the value set. If inactive = true, inactive codes are to be included in the expansion, if inactive = false, the inactive codes will not be included in the expansion. If absent, the behavior is determined by the implementation, or by the applicable ExpansionProfile (but generally, inactive codes would be expected to be included)inactive : boolean [0..1]ConceptSetAn absolute URI which is the code system from which the selected codes come fromsystem : uri [0..1]The version of the code system that the codes are selected fromversion : string [0..1]Selects the concepts found in this value set (based on its value set definition). This is an absolute URI that is a reference to ValueSet.url. If multiple value sets are specified this includes the union of the contents of all of the referenced value setsvalueSet : canonical [0..*]ConceptReferenceSpecifies a code for the concept to be included or excludedcode : code [1..1]The text to display to the user for this concept in the context of this valueset. If no display is provided, then applications using the value set use the display specified for the code by the systemdisplay : string [0..1]DesignationThe language this designation is defined forlanguage : code [0..1] « A human language. (Strength=Extensible)Common Languages+ »A code that details how this designation would be useduse : Coding [0..1] « Details of how a designation would be used. (Strength=Extensible)Designation Use+ »The text value for this designationvalue : string [1..1]FilterA code that identifies a property defined in the code systemproperty : code [1..1]The kind of operation to perform as a part of the filter criteriaop : code [1..1] « The kind of operation to perform as a part of a property based filter. (Strength=Required)FilterOperator! »The match value may be either a code defined by the system, or a string value, which is a regex match on the literal string of the property value when the operation is 'regex', or one of the values (true and false), when the operation is 'exists'value : string [1..1]ExpansionAn identifier that uniquely identifies this expansion of the valueset. Systems may re-use the same identifier as long as the expansion and the definition remain the same, but are not required to do soidentifier : uri [0..1]The time at which the expansion was produced by the expanding systemtimestamp : dateTime [1..1]The total number of concepts in the expansion. If the number of concept nodes in this resource is less than the stated number, then the server can return more using the offset parametertotal : integer [0..1]If paging is being used, the offset at which this resource starts. I.e. this resource is a partial view into the expansion. If paging is not being used, this element SHALL not be presentoffset : integer [0..1]ParameterThe name of the parametername : string [1..1]The value of the parametervalue[x] : Type [0..1] « string|boolean|integer|decimal|uri|code »ContainsAn absolute URI which is the code system in which the code for this item in the expansion is definedsystem : uri [0..1]If true, this entry is included in the expansion for navigational purposes, and the user cannot select the code directly as a proper valueabstract : boolean [0..1]If the concept is inactive in the code system that defines it. Inactive codes are those that are no longer to be used, but are maintained by the code system for understanding legacy data. It might not be known or specified whether an concept is inactive (and it may depend on the context of use)inactive : boolean [0..1]The version of this code system that defined this code and/or display. This should only be used with code systems that do not enforce concept permanenceversion : string [0..1]The code for this item in the expansion hierarchy. If this code is missing the entry in the hierarchy is a place holder (abstract) and does not represent a valid code in the value setcode : code [0..1]The recommended display for this item in the expansiondisplay : string [0..1]Additional representations for this concept when used in this value set - other languages, aliases, specialized purposes, used for particular purposes, etcdesignation[0..*]Specifies a concept to be included or excludedconcept[0..*]Select concepts by specify a matching criteria based on the properties (including relationships) defined by the system. If multiple filters are specified, they SHALL all be truefilter[0..*]Include one or more codes from a code system or other value set(s)include[1..*]Exclude one or more codes from the value set based on code system filters and/or other value setsexclude[0..*]A set of criteria that define the contents of the value set by including or excluding codes selected from the specified code system(s) that the value set draws from. This is also known as the Content Logical Definition (CLD)compose[0..1]A parameter that controlled the expansion process. These parameters may be used by users of expanded value sets to check whether the expansion is suitable for a particular purpose, or to pick the correct expansionparameter[0..*]Additional representations for this item - other languages, aliases, specialized purposes, used for particular purposes, etc. These are relevant when the conditions of the expansion do not fix to a single correct representationdesignation[0..*]Other codes and entries contained under this entry in the hierarchycontains[0..*]The codes that are contained in the value set expansioncontains[0..*]A value set can also be "expanded", where the value set is turned into a simple collection of enumerated codes. This element holds the expansion, if it has been performedexpansion[0..1]

XML Template

<ValueSet xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Canonical identifier for this value set, represented as a URI (globally unique) -->
 <identifier><!-- 0..* Identifier Additional identifier for the value set (business identifier) --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of the value set -->
 <name value="[string]"/><!-- 0..1 Name for this value set (computer friendly) -->
 <title value="[string]"/><!-- 0..1 Name for this value set (human friendly) -->
 <status value="[code]"/><!-- ?? 1..1 draft | active | retired | unknown -->
 <experimental value="[boolean]"/><!-- 0..1 For testing purposes, not real usage -->
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <description value="[markdown]"/><!-- 0..1 Natural language description of the value set -->
 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <jurisdiction><!-- 0..* CodeableConcept Intended jurisdiction for value set (if applicable) --></jurisdiction>
 <immutable value="[boolean]"/><!-- 0..1 Indicates whether or not any change to the content logical definition may occur -->
 <purpose value="[markdown]"/><!-- 0..1 Why this value set is defined -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <extensible value="[boolean]"/><!-- 0..1 Whether this is intended to be used with an extensible binding -->
 <compose>  <!-- ?? 0..1 Definition of the content of the value set -->
  <lockedDate value="[date]"/><!-- 0..1 Fixed date for version-less references (transitive) -->
  <inactive value="[boolean]"/><!-- 0..1 Whether inactive codes are in the value set -->
  <include>  <!-- 1..* Include one or more codes from a code system or other value set(s) -->
   <system value="[uri]"/><!-- ?? 0..1 The system the codes come from -->
   <version value="[string]"/><!-- 0..1 Specific version of the code system referred to -->
   <concept>  <!-- ?? 0..* A concept defined in the system -->
    <code value="[code]"/><!-- 1..1 Code or expression from system -->
    <display value="[string]"/><!-- 0..1 Text to display for this code for this value set in this valueset -->
    <designation>  <!-- 0..* Additional representations for this concept -->
     <language value="[code]"/><!-- 0..1 Human language of the designation -->
     <use><!-- 0..1 Coding Details how this designation would be used --></use>
     <value value="[string]"/><!-- 1..1 The text value for this designation -->
    </designation>
   </concept>
   <filter>  <!-- ?? 0..* Select codes/concepts by their properties (including relationships) -->
    <property value="[code]"/><!-- 1..1 A property defined by the code system -->
    <op value="[code]"/><!-- 1..1 = | is-a | descendent-of | is-not-a | regex | in | not-in | generalizes | exists -->
    <value value="[string]"/><!-- 1..1 Code from the system, or regex criteria, or boolean value for exists -->
   </filter>
   <valueSet><!-- ?? 0..* canonical(ValueSet) Select the contents included in this value set --></valueSet>
  </include>
  <exclude><!-- ?? 0..* Content as for ValueSet.compose.include Explicitly exclude codes from a code system or other value sets --></exclude>
 </compose>
 <expansion>  <!-- ?? 0..1 Used when the value set is "expanded" -->
  <identifier value="[uri]"/><!-- 0..1 Uniquely identifies this expansion -->
  <timestamp value="[dateTime]"/><!-- 1..1 Time ValueSet expansion happened -->
  <total value="[integer]"/><!-- 0..1 Total number of codes in the expansion -->
  <offset value="[integer]"/><!-- 0..1 Offset at which this resource starts -->
  <parameter>  <!-- 0..* Parameter that controlled the expansion process -->
   <name value="[string]"/><!-- 1..1 Name as assigned by the server -->
   <value[x]><!-- 0..1 string|boolean|integer|decimal|uri|code Value of the named parameter --></value[x]>
  </parameter>
  <contains>  <!-- 0..* Codes in the value set -->
   <system value="[uri]"/><!-- 0..1 System value for the code -->
   <abstract value="[boolean]"/><!-- 0..1 If user cannot select this entry -->
   <inactive value="[boolean]"/><!-- 0..1 If concept is inactive in the code system -->
   <version value="[string]"/><!-- 0..1 Version in which this code/display is defined -->
   <code value="[code]"/><!-- ?? 0..1 Code - if blank, this is not a selectable code -->
   <display value="[string]"/><!-- ?? 0..1 User display for the concept -->
   <designation><!-- 0..* Content as for ValueSet.compose.include.concept.designation Additional representations for this item --></designation>
   <contains><!-- 0..* Content as for ValueSet.expansion.contains Codes contained under this entry --></contains>
  </contains>
 </expansion>
</ValueSet>

JSON Template

{doco
  "resourceType" : "ValueSet",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Canonical identifier for this value set, represented as a URI (globally unique)
  "identifier" : [{ Identifier }], // Additional identifier for the value set (business identifier)
  "version" : "<string>", // Business version of the value set
  "name" : "<string>", // Name for this value set (computer friendly)
  "title" : "<string>", // Name for this value set (human friendly)
  "status" : "<code>", // C? R!  draft | active | retired | unknown
  "experimental" : <boolean>, // For testing purposes, not real usage
  "date" : "<dateTime>", // Date last changed
  "publisher" : "<string>", // Name of the publisher (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "description" : "<markdown>", // Natural language description of the value set
  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "jurisdiction" : [{ CodeableConcept }], // Intended jurisdiction for value set (if applicable)
  "immutable" : <boolean>, // Indicates whether or not any change to the content logical definition may occur
  "purpose" : "<markdown>", // Why this value set is defined
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "extensible" : <boolean>, // Whether this is intended to be used with an extensible binding
  "compose" : { // C? Definition of the content of the value set
    "lockedDate" : "<date>", // Fixed date for version-less references (transitive)
    "inactive" : <boolean>, // Whether inactive codes are in the value set
    "include" : [{ // R!  Include one or more codes from a code system or other value set(s)
      "system" : "<uri>", // C? The system the codes come from
      "version" : "<string>", // Specific version of the code system referred to
      "concept" : [{ // C? A concept defined in the system
        "code" : "<code>", // R!  Code or expression from system
        "display" : "<string>", // Text to display for this code for this value set in this valueset
        "designation" : [{ // Additional representations for this concept
          "language" : "<code>", // Human language of the designation
          "use" : { Coding }, // Details how this designation would be used
          "value" : "<string>" // R!  The text value for this designation
        }]
      }],
      "filter" : [{ // C? Select codes/concepts by their properties (including relationships)
        "property" : "<code>", // R!  A property defined by the code system
        "op" : "<code>", // R!  = | is-a | descendent-of | is-not-a | regex | in | not-in | generalizes | exists
        "value" : "<string>" // R!  Code from the system, or regex criteria, or boolean value for exists
      }],
      "valueSet" : ["<canonical>"] // C? Select the contents included in this value set
    }],
    "exclude" : [{ Content as for ValueSet.compose.include }] // C? Explicitly exclude codes from a code system or other value sets
  },
  "expansion" : { // C? Used when the value set is "expanded"
    "identifier" : "<uri>", // Uniquely identifies this expansion
    "timestamp" : "<dateTime>", // R!  Time ValueSet expansion happened
    "total" : <integer>, // Total number of codes in the expansion
    "offset" : <integer>, // Offset at which this resource starts
    "parameter" : [{ // Parameter that controlled the expansion process
      "name" : "<string>", // R!  Name as assigned by the server
      // value[x]: Value of the named parameter. One of these 6:
      "valueString" : "<string>"
      "valueBoolean" : <boolean>
      "valueInteger" : <integer>
      "valueDecimal" : <decimal>
      "valueUri" : "<uri>"
      "valueCode" : "<code>"
    }],
    "contains" : [{ // Codes in the value set
      "system" : "<uri>", // System value for the code
      "abstract" : <boolean>, // If user cannot select this entry
      "inactive" : <boolean>, // If concept is inactive in the code system
      "version" : "<string>", // Version in which this code/display is defined
      "code" : "<code>", // C? Code - if blank, this is not a selectable code
      "display" : "<string>", // C? User display for the concept
      "designation" : [{ Content as for ValueSet.compose.include.concept.designation }], // Additional representations for this item
      "contains" : [{ Content as for ValueSet.expansion.contains }] // Codes contained under this entry
    }]
  }
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:ValueSet;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:ValueSet.url [ uri ]; # 0..1 Canonical identifier for this value set, represented as a URI (globally unique)
  fhir:ValueSet.identifier [ Identifier ], ... ; # 0..* Additional identifier for the value set (business identifier)
  fhir:ValueSet.version [ string ]; # 0..1 Business version of the value set
  fhir:ValueSet.name [ string ]; # 0..1 Name for this value set (computer friendly)
  fhir:ValueSet.title [ string ]; # 0..1 Name for this value set (human friendly)
  fhir:ValueSet.status [ code ]; # 1..1 draft | active | retired | unknown
  fhir:ValueSet.experimental [ boolean ]; # 0..1 For testing purposes, not real usage
  fhir:ValueSet.date [ dateTime ]; # 0..1 Date last changed
  fhir:ValueSet.publisher [ string ]; # 0..1 Name of the publisher (organization or individual)
  fhir:ValueSet.contact [ ContactDetail ], ... ; # 0..* Contact details for the publisher
  fhir:ValueSet.description [ markdown ]; # 0..1 Natural language description of the value set
  fhir:ValueSet.useContext [ UsageContext ], ... ; # 0..* The context that the content is intended to support
  fhir:ValueSet.jurisdiction [ CodeableConcept ], ... ; # 0..* Intended jurisdiction for value set (if applicable)
  fhir:ValueSet.immutable [ boolean ]; # 0..1 Indicates whether or not any change to the content logical definition may occur
  fhir:ValueSet.purpose [ markdown ]; # 0..1 Why this value set is defined
  fhir:ValueSet.copyright [ markdown ]; # 0..1 Use and/or publishing restrictions
  fhir:ValueSet.extensible [ boolean ]; # 0..1 Whether this is intended to be used with an extensible binding
  fhir:ValueSet.compose [ # 0..1 Definition of the content of the value set
    fhir:ValueSet.compose.lockedDate [ date ]; # 0..1 Fixed date for version-less references (transitive)
    fhir:ValueSet.compose.inactive [ boolean ]; # 0..1 Whether inactive codes are in the value set
    fhir:ValueSet.compose.include [ # 1..* Include one or more codes from a code system or other value set(s)
      fhir:ValueSet.compose.include.system [ uri ]; # 0..1 The system the codes come from
      fhir:ValueSet.compose.include.version [ string ]; # 0..1 Specific version of the code system referred to
      fhir:ValueSet.compose.include.concept [ # 0..* A concept defined in the system
        fhir:ValueSet.compose.include.concept.code [ code ]; # 1..1 Code or expression from system
        fhir:ValueSet.compose.include.concept.display [ string ]; # 0..1 Text to display for this code for this value set in this valueset
        fhir:ValueSet.compose.include.concept.designation [ # 0..* Additional representations for this concept
          fhir:ValueSet.compose.include.concept.designation.language [ code ]; # 0..1 Human language of the designation
          fhir:ValueSet.compose.include.concept.designation.use [ Coding ]; # 0..1 Details how this designation would be used
          fhir:ValueSet.compose.include.concept.designation.value [ string ]; # 1..1 The text value for this designation
        ], ...;
      ], ...;
      fhir:ValueSet.compose.include.filter [ # 0..* Select codes/concepts by their properties (including relationships)
        fhir:ValueSet.compose.include.filter.property [ code ]; # 1..1 A property defined by the code system
        fhir:ValueSet.compose.include.filter.op [ code ]; # 1..1 = | is-a | descendent-of | is-not-a | regex | in | not-in | generalizes | exists
        fhir:ValueSet.compose.include.filter.value [ string ]; # 1..1 Code from the system, or regex criteria, or boolean value for exists
      ], ...;
      fhir:ValueSet.compose.include.valueSet [ canonical(ValueSet) ], ... ; # 0..* Select the contents included in this value set
    ], ...;
    fhir:ValueSet.compose.exclude [ See ValueSet.compose.include ], ... ; # 0..* Explicitly exclude codes from a code system or other value sets
  ];
  fhir:ValueSet.expansion [ # 0..1 Used when the value set is "expanded"
    fhir:ValueSet.expansion.identifier [ uri ]; # 0..1 Uniquely identifies this expansion
    fhir:ValueSet.expansion.timestamp [ dateTime ]; # 1..1 Time ValueSet expansion happened
    fhir:ValueSet.expansion.total [ integer ]; # 0..1 Total number of codes in the expansion
    fhir:ValueSet.expansion.offset [ integer ]; # 0..1 Offset at which this resource starts
    fhir:ValueSet.expansion.parameter [ # 0..* Parameter that controlled the expansion process
      fhir:ValueSet.expansion.parameter.name [ string ]; # 1..1 Name as assigned by the server
      # ValueSet.expansion.parameter.value[x] : 0..1 Value of the named parameter. One of these 6
        fhir:ValueSet.expansion.parameter.valueString [ string ]
        fhir:ValueSet.expansion.parameter.valueBoolean [ boolean ]
        fhir:ValueSet.expansion.parameter.valueInteger [ integer ]
        fhir:ValueSet.expansion.parameter.valueDecimal [ decimal ]
        fhir:ValueSet.expansion.parameter.valueUri [ uri ]
        fhir:ValueSet.expansion.parameter.valueCode [ code ]
    ], ...;
    fhir:ValueSet.expansion.contains [ # 0..* Codes in the value set
      fhir:ValueSet.expansion.contains.system [ uri ]; # 0..1 System value for the code
      fhir:ValueSet.expansion.contains.abstract [ boolean ]; # 0..1 If user cannot select this entry
      fhir:ValueSet.expansion.contains.inactive [ boolean ]; # 0..1 If concept is inactive in the code system
      fhir:ValueSet.expansion.contains.version [ string ]; # 0..1 Version in which this code/display is defined
      fhir:ValueSet.expansion.contains.code [ code ]; # 0..1 Code - if blank, this is not a selectable code
      fhir:ValueSet.expansion.contains.display [ string ]; # 0..1 User display for the concept
      fhir:ValueSet.expansion.contains.designation [ See ValueSet.compose.include.concept.designation ], ... ; # 0..* Additional representations for this item
      fhir:ValueSet.expansion.contains.contains [ See ValueSet.expansion.contains ], ... ; # 0..* Codes contained under this entry
    ], ...;
  ];
]

Changes since R3

ValueSet
ValueSet.compose.include.filter
  • No longer marked as Modifier
ValueSet.compose.include.filter.value
  • Type changed from code to string
ValueSet.compose.include.valueSet
  • Type changed from uri to canonical
ValueSet.expansion.identifier
  • Min Cardinality changed from 1 to 0
ValueSet.expansion.contains.abstract
  • Default Value "false" removed
ValueSet.expansion.contains.inactive
  • Default Value "false" removed

See the Full Difference for further information

This analysis is available as XML or JSON.

See R2 <--> R3 Conversion Maps (status = 11 tests that all execute ok. 5 fail round-trip testing and 4 r3 resources are invalid (4 errors).). Note: these have note yet been updated to be R3 to R4

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. ValueSet INDomainResourceA set of codes drawn from one or more code systems
+ Status must = 'active' if expansion is present and compose is absent
+ Value set SHALL contain at least one of a compose or an expansion element
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... url Σ0..1uriCanonical identifier for this value set, represented as a URI (globally unique)
... identifier Σ0..*IdentifierAdditional identifier for the value set (business identifier)
... version Σ0..1stringBusiness version of the value set
... name Σ0..1stringName for this value set (computer friendly)
... title Σ0..1stringName for this value set (human friendly)
... status ?!ΣI1..1codedraft | active | retired | unknown
PublicationStatus (Required)
... experimental ?!Σ0..1booleanFor testing purposes, not real usage
... date Σ0..1dateTimeDate last changed
... publisher Σ0..1stringName of the publisher (organization or individual)
... contact Σ0..*ContactDetailContact details for the publisher
... description 0..1markdownNatural language description of the value set
... useContext ΣTU0..*UsageContextThe context that the content is intended to support
... jurisdiction Σ0..*CodeableConceptIntended jurisdiction for value set (if applicable)
Jurisdiction ValueSet (Extensible)
... immutable Σ0..1booleanIndicates whether or not any change to the content logical definition may occur
... purpose 0..1markdownWhy this value set is defined
... copyright 0..1markdownUse and/or publishing restrictions
... extensible Σ0..1booleanWhether this is intended to be used with an extensible binding
... compose I0..1BackboneElementDefinition of the content of the value set
.... lockedDate Σ0..1dateFixed date for version-less references (transitive)
.... inactive Σ0..1booleanWhether inactive codes are in the value set
.... include ΣI1..*BackboneElementInclude one or more codes from a code system or other value set(s)
+ A value set with concepts or filters SHALL include a system
+ Cannot have both concept and filter
+ A value set include/exclude SHALL have a value set or a system
..... system ΣI0..1uriThe system the codes come from
..... version Σ0..1stringSpecific version of the code system referred to
..... concept I0..*BackboneElementA concept defined in the system
...... code 1..1codeCode or expression from system
...... display 0..1stringText to display for this code for this value set in this valueset
...... designation 0..*BackboneElementAdditional representations for this concept
....... language 0..1codeHuman language of the designation
Common Languages (Extensible but limited to All Languages)
....... use 0..1CodingDetails how this designation would be used
Designation Use (Extensible)
....... value 1..1stringThe text value for this designation
..... filter ΣI0..*BackboneElementSelect codes/concepts by their properties (including relationships)
...... property Σ1..1codeA property defined by the code system
...... op Σ1..1code= | is-a | descendent-of | is-not-a | regex | in | not-in | generalizes | exists
FilterOperator (Required)
...... value Σ1..1stringCode from the system, or regex criteria, or boolean value for exists
..... valueSet ΣI0..*canonicalSelect the contents included in this value set
.... exclude I0..*see includeExplicitly exclude codes from a code system or other value sets
... expansion I0..1BackboneElementUsed when the value set is "expanded"
.... identifier 0..1uriUniquely identifies this expansion
.... timestamp 1..1dateTimeTime ValueSet expansion happened
.... total 0..1integerTotal number of codes in the expansion
.... offset 0..1integerOffset at which this resource starts
.... parameter 0..*BackboneElementParameter that controlled the expansion process
..... name 1..1stringName as assigned by the server
..... value[x] 0..1Value of the named parameter
...... valueStringstring
...... valueBooleanboolean
...... valueIntegerinteger
...... valueDecimaldecimal
...... valueUriuri
...... valueCodecode
.... contains I0..*BackboneElementCodes in the value set
+ SHALL have a code or a display
+ Must have a code if not abstract
+ Must have a system if a code is present
..... system 0..1uriSystem value for the code
..... abstract 0..1booleanIf user cannot select this entry
..... inactive 0..1booleanIf concept is inactive in the code system
..... version 0..1stringVersion in which this code/display is defined
..... code I0..1codeCode - if blank, this is not a selectable code
..... display I0..1stringUser display for the concept
..... designation 0..*see designationAdditional representations for this item
..... contains 0..*see containsCodes contained under this entry

doco Documentation for this format

UML Diagram (Legend)

ValueSet (DomainResource)An absolute URI that is used to identify this value set when it is referenced in a specification, model, design or an instance; also called its canonical identifier. This SHOULD be globally unique and SHOULD be a literal address at which this value set is (or will be) publishedurl : uri [0..1]A formal identifier that is used to identify this value set when it is represented in other formats, or referenced in a specification, model, design or an instanceidentifier : Identifier [0..*]The identifier that is used to identify this version of the value set when it is referenced in a specification, model, design or instance. This is an arbitrary value managed by the value set author and is not expected to be globally unique. For example, it might be a timestamp (e.g. yyyymmdd) if a managed version is not available. There is also no expectation that versions can be placed in a lexicographical sequenceversion : string [0..1]A natural language name identifying the value set. This name should be usable as an identifier for the module by machine processing applications such as code generationname : string [0..1]A short, descriptive, user-friendly title for the value settitle : string [0..1]The status of this value set. Enables tracking the life-cycle of the content (this element modifies the meaning of other elements)status : code [1..1] « The lifecycle status of an artifact. (Strength=Required)PublicationStatus! »A Boolean value to indicate that this value set is authored for testing purposes (or education/evaluation/marketing) and is not intended to be used for genuine usage (this element modifies the meaning of other elements)experimental : boolean [0..1]The date (and optionally time) when the value set was published. The date must change when the business version changes and it must change if the status code changes. In addition, it should change when the substantive content of the value set changes. (e.g. the 'content logical definition')date : dateTime [0..1]The name of the organization or individual that published the value setpublisher : string [0..1]Contact details to assist a user in finding and communicating with the publishercontact : ContactDetail [0..*]A free text natural language description of the value set from a consumer's perspectivedescription : markdown [0..1]The content was developed with a focus and intent of supporting the contexts that are listed. These terms may be used to assist with indexing and searching for appropriate value set instancesuseContext : UsageContext [0..*]A legal or geographic region in which the value set is intended to be usedjurisdiction : CodeableConcept [0..*] « Countries and regions within which this artifact is targeted for use (Strength=Extensible)Jurisdiction ValueSet+ »If this is set to 'true', then no new versions of the content logical definition can be created. Note: Other metadata might still changeimmutable : boolean [0..1]Explanation of why this value set is needed and why it has been designed as it haspurpose : markdown [0..1]A copyright statement relating to the value set and/or its contents. Copyright statements are generally legal restrictions on the use and publishing of the value setcopyright : markdown [0..1]Whether this is intended to be used with an extensible binding or notextensible : boolean [0..1]ComposeIf a locked date is defined, then the Content Logical Definition must be evaluated using the current version as of the locked date for referenced code system(s) and value set instances where ValueSet.compose.include.version is not definedlockedDate : date [0..1]Whether inactive codes - codes that are not approved for current use - are in the value set. If inactive = true, inactive codes are to be included in the expansion, if inactive = false, the inactive codes will not be included in the expansion. If absent, the behavior is determined by the implementation, or by the applicable ExpansionProfile (but generally, inactive codes would be expected to be included)inactive : boolean [0..1]ConceptSetAn absolute URI which is the code system from which the selected codes come fromsystem : uri [0..1]The version of the code system that the codes are selected fromversion : string [0..1]Selects the concepts found in this value set (based on its value set definition). This is an absolute URI that is a reference to ValueSet.url. If multiple value sets are specified this includes the union of the contents of all of the referenced value setsvalueSet : canonical [0..*]ConceptReferenceSpecifies a code for the concept to be included or excludedcode : code [1..1]The text to display to the user for this concept in the context of this valueset. If no display is provided, then applications using the value set use the display specified for the code by the systemdisplay : string [0..1]DesignationThe language this designation is defined forlanguage : code [0..1] « A human language. (Strength=Extensible)Common Languages+ »A code that details how this designation would be useduse : Coding [0..1] « Details of how a designation would be used. (Strength=Extensible)Designation Use+ »The text value for this designationvalue : string [1..1]FilterA code that identifies a property defined in the code systemproperty : code [1..1]The kind of operation to perform as a part of the filter criteriaop : code [1..1] « The kind of operation to perform as a part of a property based filter. (Strength=Required)FilterOperator! »The match value may be either a code defined by the system, or a string value, which is a regex match on the literal string of the property value when the operation is 'regex', or one of the values (true and false), when the operation is 'exists'value : string [1..1]ExpansionAn identifier that uniquely identifies this expansion of the valueset. Systems may re-use the same identifier as long as the expansion and the definition remain the same, but are not required to do soidentifier : uri [0..1]The time at which the expansion was produced by the expanding systemtimestamp : dateTime [1..1]The total number of concepts in the expansion. If the number of concept nodes in this resource is less than the stated number, then the server can return more using the offset parametertotal : integer [0..1]If paging is being used, the offset at which this resource starts. I.e. this resource is a partial view into the expansion. If paging is not being used, this element SHALL not be presentoffset : integer [0..1]ParameterThe name of the parametername : string [1..1]The value of the parametervalue[x] : Type [0..1] « string|boolean|integer|decimal|uri|code »ContainsAn absolute URI which is the code system in which the code for this item in the expansion is definedsystem : uri [0..1]If true, this entry is included in the expansion for navigational purposes, and the user cannot select the code directly as a proper valueabstract : boolean [0..1]If the concept is inactive in the code system that defines it. Inactive codes are those that are no longer to be used, but are maintained by the code system for understanding legacy data. It might not be known or specified whether an concept is inactive (and it may depend on the context of use)inactive : boolean [0..1]The version of this code system that defined this code and/or display. This should only be used with code systems that do not enforce concept permanenceversion : string [0..1]The code for this item in the expansion hierarchy. If this code is missing the entry in the hierarchy is a place holder (abstract) and does not represent a valid code in the value setcode : code [0..1]The recommended display for this item in the expansiondisplay : string [0..1]Additional representations for this concept when used in this value set - other languages, aliases, specialized purposes, used for particular purposes, etcdesignation[0..*]Specifies a concept to be included or excludedconcept[0..*]Select concepts by specify a matching criteria based on the properties (including relationships) defined by the system. If multiple filters are specified, they SHALL all be truefilter[0..*]Include one or more codes from a code system or other value set(s)include[1..*]Exclude one or more codes from the value set based on code system filters and/or other value setsexclude[0..*]A set of criteria that define the contents of the value set by including or excluding codes selected from the specified code system(s) that the value set draws from. This is also known as the Content Logical Definition (CLD)compose[0..1]A parameter that controlled the expansion process. These parameters may be used by users of expanded value sets to check whether the expansion is suitable for a particular purpose, or to pick the correct expansionparameter[0..*]Additional representations for this item - other languages, aliases, specialized purposes, used for particular purposes, etc. These are relevant when the conditions of the expansion do not fix to a single correct representationdesignation[0..*]Other codes and entries contained under this entry in the hierarchycontains[0..*]The codes that are contained in the value set expansioncontains[0..*]A value set can also be "expanded", where the value set is turned into a simple collection of enumerated codes. This element holds the expansion, if it has been performedexpansion[0..1]

XML Template

<ValueSet xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <url value="[uri]"/><!-- 0..1 Canonical identifier for this value set, represented as a URI (globally unique) -->
 <identifier><!-- 0..* Identifier Additional identifier for the value set (business identifier) --></identifier>
 <version value="[string]"/><!-- 0..1 Business version of the value set -->
 <name value="[string]"/><!-- 0..1 Name for this value set (computer friendly) -->
 <title value="[string]"/><!-- 0..1 Name for this value set (human friendly) -->
 <status value="[code]"/><!-- ?? 1..1 draft | active | retired | unknown -->
 <experimental value="[boolean]"/><!-- 0..1 For testing purposes, not real usage -->
 <date value="[dateTime]"/><!-- 0..1 Date last changed -->
 <publisher value="[string]"/><!-- 0..1 Name of the publisher (organization or individual) -->
 <contact><!-- 0..* ContactDetail Contact details for the publisher --></contact>
 <description value="[markdown]"/><!-- 0..1 Natural language description of the value set -->
 <useContext><!-- 0..* UsageContext The context that the content is intended to support --></useContext>
 <jurisdiction><!-- 0..* CodeableConcept Intended jurisdiction for value set (if applicable) --></jurisdiction>
 <immutable value="[boolean]"/><!-- 0..1 Indicates whether or not any change to the content logical definition may occur -->
 <purpose value="[markdown]"/><!-- 0..1 Why this value set is defined -->
 <copyright value="[markdown]"/><!-- 0..1 Use and/or publishing restrictions -->
 <extensible value="[boolean]"/><!-- 0..1 Whether this is intended to be used with an extensible binding -->
 <compose>  <!-- ?? 0..1 Definition of the content of the value set -->
  <lockedDate value="[date]"/><!-- 0..1 Fixed date for version-less references (transitive) -->
  <inactive value="[boolean]"/><!-- 0..1 Whether inactive codes are in the value set -->
  <include>  <!-- 1..* Include one or more codes from a code system or other value set(s) -->
   <system value="[uri]"/><!-- ?? 0..1 The system the codes come from -->
   <version value="[string]"/><!-- 0..1 Specific version of the code system referred to -->
   <concept>  <!-- ?? 0..* A concept defined in the system -->
    <code value="[code]"/><!-- 1..1 Code or expression from system -->
    <display value="[string]"/><!-- 0..1 Text to display for this code for this value set in this valueset -->
    <designation>  <!-- 0..* Additional representations for this concept -->
     <language value="[code]"/><!-- 0..1 Human language of the designation -->
     <use><!-- 0..1 Coding Details how this designation would be used --></use>
     <value value="[string]"/><!-- 1..1 The text value for this designation -->
    </designation>
   </concept>
   <filter>  <!-- ?? 0..* Select codes/concepts by their properties (including relationships) -->
    <property value="[code]"/><!-- 1..1 A property defined by the code system -->
    <op value="[code]"/><!-- 1..1 = | is-a | descendent-of | is-not-a | regex | in | not-in | generalizes | exists -->
    <value value="[string]"/><!-- 1..1 Code from the system, or regex criteria, or boolean value for exists -->
   </filter>
   <valueSet><!-- ?? 0..* canonical(ValueSet) Select the contents included in this value set --></valueSet>
  </include>
  <exclude><!-- ?? 0..* Content as for ValueSet.compose.include Explicitly exclude codes from a code system or other value sets --></exclude>
 </compose>
 <expansion>  <!-- ?? 0..1 Used when the value set is "expanded" -->
  <identifier value="[uri]"/><!-- 0..1 Uniquely identifies this expansion -->
  <timestamp value="[dateTime]"/><!-- 1..1 Time ValueSet expansion happened -->
  <total value="[integer]"/><!-- 0..1 Total number of codes in the expansion -->
  <offset value="[integer]"/><!-- 0..1 Offset at which this resource starts -->
  <parameter>  <!-- 0..* Parameter that controlled the expansion process -->
   <name value="[string]"/><!-- 1..1 Name as assigned by the server -->
   <value[x]><!-- 0..1 string|boolean|integer|decimal|uri|code Value of the named parameter --></value[x]>
  </parameter>
  <contains>  <!-- 0..* Codes in the value set -->
   <system value="[uri]"/><!-- 0..1 System value for the code -->
   <abstract value="[boolean]"/><!-- 0..1 If user cannot select this entry -->
   <inactive value="[boolean]"/><!-- 0..1 If concept is inactive in the code system -->
   <version value="[string]"/><!-- 0..1 Version in which this code/display is defined -->
   <code value="[code]"/><!-- ?? 0..1 Code - if blank, this is not a selectable code -->
   <display value="[string]"/><!-- ?? 0..1 User display for the concept -->
   <designation><!-- 0..* Content as for ValueSet.compose.include.concept.designation Additional representations for this item --></designation>
   <contains><!-- 0..* Content as for ValueSet.expansion.contains Codes contained under this entry --></contains>
  </contains>
 </expansion>
</ValueSet>

JSON Template

{doco
  "resourceType" : "ValueSet",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "url" : "<uri>", // Canonical identifier for this value set, represented as a URI (globally unique)
  "identifier" : [{ Identifier }], // Additional identifier for the value set (business identifier)
  "version" : "<string>", // Business version of the value set
  "name" : "<string>", // Name for this value set (computer friendly)
  "title" : "<string>", // Name for this value set (human friendly)
  "status" : "<code>", // C? R!  draft | active | retired | unknown
  "experimental" : <boolean>, // For testing purposes, not real usage
  "date" : "<dateTime>", // Date last changed
  "publisher" : "<string>", // Name of the publisher (organization or individual)
  "contact" : [{ ContactDetail }], // Contact details for the publisher
  "description" : "<markdown>", // Natural language description of the value set
  "useContext" : [{ UsageContext }], // The context that the content is intended to support
  "jurisdiction" : [{ CodeableConcept }], // Intended jurisdiction for value set (if applicable)
  "immutable" : <boolean>, // Indicates whether or not any change to the content logical definition may occur
  "purpose" : "<markdown>", // Why this value set is defined
  "copyright" : "<markdown>", // Use and/or publishing restrictions
  "extensible" : <boolean>, // Whether this is intended to be used with an extensible binding
  "compose" : { // C? Definition of the content of the value set
    "lockedDate" : "<date>", // Fixed date for version-less references (transitive)
    "inactive" : <boolean>, // Whether inactive codes are in the value set
    "include" : [{ // R!  Include one or more codes from a code system or other value set(s)
      "system" : "<uri>", // C? The system the codes come from
      "version" : "<string>", // Specific version of the code system referred to
      "concept" : [{ // C? A concept defined in the system
        "code" : "<code>", // R!  Code or expression from system
        "display" : "<string>", // Text to display for this code for this value set in this valueset
        "designation" : [{ // Additional representations for this concept
          "language" : "<code>", // Human language of the designation
          "use" : { Coding }, // Details how this designation would be used
          "value" : "<string>" // R!  The text value for this designation
        }]
      }],
      "filter" : [{ // C? Select codes/concepts by their properties (including relationships)
        "property" : "<code>", // R!  A property defined by the code system
        "op" : "<code>", // R!  = | is-a | descendent-of | is-not-a | regex | in | not-in | generalizes | exists
        "value" : "<string>" // R!  Code from the system, or regex criteria, or boolean value for exists
      }],
      "valueSet" : ["<canonical>"] // C? Select the contents included in this value set
    }],
    "exclude" : [{ Content as for ValueSet.compose.include }] // C? Explicitly exclude codes from a code system or other value sets
  },
  "expansion" : { // C? Used when the value set is "expanded"
    "identifier" : "<uri>", // Uniquely identifies this expansion
    "timestamp" : "<dateTime>", // R!  Time ValueSet expansion happened
    "total" : <integer>, // Total number of codes in the expansion
    "offset" : <integer>, // Offset at which this resource starts
    "parameter" : [{ // Parameter that controlled the expansion process
      "name" : "<string>", // R!  Name as assigned by the server
      // value[x]: Value of the named parameter. One of these 6:
      "valueString" : "<string>"
      "valueBoolean" : <boolean>
      "valueInteger" : <integer>
      "valueDecimal" : <decimal>
      "valueUri" : "<uri>"
      "valueCode" : "<code>"
    }],
    "contains" : [{ // Codes in the value set
      "system" : "<uri>", // System value for the code
      "abstract" : <boolean>, // If user cannot select this entry
      "inactive" : <boolean>, // If concept is inactive in the code system
      "version" : "<string>", // Version in which this code/display is defined
      "code" : "<code>", // C? Code - if blank, this is not a selectable code
      "display" : "<string>", // C? User display for the concept
      "designation" : [{ Content as for ValueSet.compose.include.concept.designation }], // Additional representations for this item
      "contains" : [{ Content as for ValueSet.expansion.contains }] // Codes contained under this entry
    }]
  }
}

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:ValueSet;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:ValueSet.url [ uri ]; # 0..1 Canonical identifier for this value set, represented as a URI (globally unique)
  fhir:ValueSet.identifier [ Identifier ], ... ; # 0..* Additional identifier for the value set (business identifier)
  fhir:ValueSet.version [ string ]; # 0..1 Business version of the value set
  fhir:ValueSet.name [ string ]; # 0..1 Name for this value set (computer friendly)
  fhir:ValueSet.title [ string ]; # 0..1 Name for this value set (human friendly)
  fhir:ValueSet.status [ code ]; # 1..1 draft | active | retired | unknown
  fhir:ValueSet.experimental [ boolean ]; # 0..1 For testing purposes, not real usage
  fhir:ValueSet.date [ dateTime ]; # 0..1 Date last changed
  fhir:ValueSet.publisher [ string ]; # 0..1 Name of the publisher (organization or individual)
  fhir:ValueSet.contact [ ContactDetail ], ... ; # 0..* Contact details for the publisher
  fhir:ValueSet.description [ markdown ]; # 0..1 Natural language description of the value set
  fhir:ValueSet.useContext [ UsageContext ], ... ; # 0..* The context that the content is intended to support
  fhir:ValueSet.jurisdiction [ CodeableConcept ], ... ; # 0..* Intended jurisdiction for value set (if applicable)
  fhir:ValueSet.immutable [ boolean ]; # 0..1 Indicates whether or not any change to the content logical definition may occur
  fhir:ValueSet.purpose [ markdown ]; # 0..1 Why this value set is defined
  fhir:ValueSet.copyright [ markdown ]; # 0..1 Use and/or publishing restrictions
  fhir:ValueSet.extensible [ boolean ]; # 0..1 Whether this is intended to be used with an extensible binding
  fhir:ValueSet.compose [ # 0..1 Definition of the content of the value set
    fhir:ValueSet.compose.lockedDate [ date ]; # 0..1 Fixed date for version-less references (transitive)
    fhir:ValueSet.compose.inactive [ boolean ]; # 0..1 Whether inactive codes are in the value set
    fhir:ValueSet.compose.include [ # 1..* Include one or more codes from a code system or other value set(s)
      fhir:ValueSet.compose.include.system [ uri ]; # 0..1 The system the codes come from
      fhir:ValueSet.compose.include.version [ string ]; # 0..1 Specific version of the code system referred to
      fhir:ValueSet.compose.include.concept [ # 0..* A concept defined in the system
        fhir:ValueSet.compose.include.concept.code [ code ]; # 1..1 Code or expression from system
        fhir:ValueSet.compose.include.concept.display [ string ]; # 0..1 Text to display for this code for this value set in this valueset
        fhir:ValueSet.compose.include.concept.designation [ # 0..* Additional representations for this concept
          fhir:ValueSet.compose.include.concept.designation.language [ code ]; # 0..1 Human language of the designation
          fhir:ValueSet.compose.include.concept.designation.use [ Coding ]; # 0..1 Details how this designation would be used
          fhir:ValueSet.compose.include.concept.designation.value [ string ]; # 1..1 The text value for this designation
        ], ...;
      ], ...;
      fhir:ValueSet.compose.include.filter [ # 0..* Select codes/concepts by their properties (including relationships)
        fhir:ValueSet.compose.include.filter.property [ code ]; # 1..1 A property defined by the code system
        fhir:ValueSet.compose.include.filter.op [ code ]; # 1..1 = | is-a | descendent-of | is-not-a | regex | in | not-in | generalizes | exists
        fhir:ValueSet.compose.include.filter.value [ string ]; # 1..1 Code from the system, or regex criteria, or boolean value for exists
      ], ...;
      fhir:ValueSet.compose.include.valueSet [ canonical(ValueSet) ], ... ; # 0..* Select the contents included in this value set
    ], ...;
    fhir:ValueSet.compose.exclude [ See ValueSet.compose.include ], ... ; # 0..* Explicitly exclude codes from a code system or other value sets
  ];
  fhir:ValueSet.expansion [ # 0..1 Used when the value set is "expanded"
    fhir:ValueSet.expansion.identifier [ uri ]; # 0..1 Uniquely identifies this expansion
    fhir:ValueSet.expansion.timestamp [ dateTime ]; # 1..1 Time ValueSet expansion happened
    fhir:ValueSet.expansion.total [ integer ]; # 0..1 Total number of codes in the expansion
    fhir:ValueSet.expansion.offset [ integer ]; # 0..1 Offset at which this resource starts
    fhir:ValueSet.expansion.parameter [ # 0..* Parameter that controlled the expansion process
      fhir:ValueSet.expansion.parameter.name [ string ]; # 1..1 Name as assigned by the server
      # ValueSet.expansion.parameter.value[x] : 0..1 Value of the named parameter. One of these 6
        fhir:ValueSet.expansion.parameter.valueString [ string ]
        fhir:ValueSet.expansion.parameter.valueBoolean [ boolean ]
        fhir:ValueSet.expansion.parameter.valueInteger [ integer ]
        fhir:ValueSet.expansion.parameter.valueDecimal [ decimal ]
        fhir:ValueSet.expansion.parameter.valueUri [ uri ]
        fhir:ValueSet.expansion.parameter.valueCode [ code ]
    ], ...;
    fhir:ValueSet.expansion.contains [ # 0..* Codes in the value set
      fhir:ValueSet.expansion.contains.system [ uri ]; # 0..1 System value for the code
      fhir:ValueSet.expansion.contains.abstract [ boolean ]; # 0..1 If user cannot select this entry
      fhir:ValueSet.expansion.contains.inactive [ boolean ]; # 0..1 If concept is inactive in the code system
      fhir:ValueSet.expansion.contains.version [ string ]; # 0..1 Version in which this code/display is defined
      fhir:ValueSet.expansion.contains.code [ code ]; # 0..1 Code - if blank, this is not a selectable code
      fhir:ValueSet.expansion.contains.display [ string ]; # 0..1 User display for the concept
      fhir:ValueSet.expansion.contains.designation [ See ValueSet.compose.include.concept.designation ], ... ; # 0..* Additional representations for this item
      fhir:ValueSet.expansion.contains.contains [ See ValueSet.expansion.contains ], ... ; # 0..* Codes contained under this entry
    ], ...;
  ];
]

Changes since DSTU2

ValueSet
ValueSet.compose.include.filter
  • No longer marked as Modifier
ValueSet.compose.include.filter.value
  • Type changed from code to string
ValueSet.compose.include.valueSet
  • Type changed from uri to canonical
ValueSet.expansion.identifier
  • Min Cardinality changed from 1 to 0
ValueSet.expansion.contains.abstract
  • Default Value "false" removed
ValueSet.expansion.contains.inactive
  • Default Value "false" removed

See the Full Difference for further information

This analysis is available as XML or JSON.

See R2 <--> R3 Conversion Maps (status = 11 tests that all execute ok. 5 fail round-trip testing and 4 r3 resources are invalid (4 errors).). Note: these have note yet been updated to be R3 to R4

 

Alternate definitions: Master Definition XML + JSON, XML Schema/Schematron + JSON Schema, ShEx (for Turtle) + see the extensions & the dependency analysis

4.8.4.1 Terminology Bindings

PathDefinitionTypeReference
ValueSet.status The lifecycle status of an artifact.RequiredPublicationStatus
ValueSet.jurisdiction Countries and regions within which this artifact is targeted for useExtensibleJurisdiction ValueSet
ValueSet.compose.include.concept.designation.language A human language.Extensible, but limited to All LanguagesCommon Languages
ValueSet.compose.include.concept.designation.use Details of how a designation would be used.ExtensibleDesignation Use
ValueSet.compose.include.filter.op The kind of operation to perform as a part of a property based filter.RequiredFilterOperator

4.8.4.2 Constraints

  • vsd-1: On ValueSet.compose.include: A value set include/exclude SHALL have a value set or a system (expression on ValueSet.compose.include: valueSet.exists() or system.exists())
  • vsd-10: On ValueSet.expansion.contains: Must have a system if a code is present (expression on ValueSet.expansion.contains: code.empty() or system.exists())
  • vsd-11: Status must = 'active' if expansion is present and compose is absent (expression : status='active' or compose.exists() or expansion.empty())
  • vsd-2: On ValueSet.compose.include: A value set with concepts or filters SHALL include a system (expression on ValueSet.compose.include: (concept.exists() or filter.exists()) implies system.exists())
  • vsd-3: On ValueSet.compose.include: Cannot have both concept and filter (expression on ValueSet.compose.include: concept.empty() or filter.empty())
  • vsd-5: Value set SHALL contain at least one of a compose or an expansion element (expression : compose.exists() or expansion.exists())
  • vsd-6: On ValueSet.expansion.contains: SHALL have a code or a display (expression on ValueSet.expansion.contains: code.exists() or display.exists())
  • vsd-9: On ValueSet.expansion.contains: Must have a code if not abstract (expression on ValueSet.expansion.contains: code.exists() or abstract = true)

4.8.5 Composition Rules

A value set can be a simple list of included codes, or it can be some kind of general selection criteria using the facilities provided by the code system. For these value sets:

  • Multiple include statements are cumulative - e.g. the value set contains the union of all the includes
  • Within an include, all the criterion apply -e.g. the value set contains the intersection of the criterion
  • Within an include, a single system with selection criteria may be listed, and/or one or more value sets may be listed. Rules for interpretation:
    • System only: Codes are 'selected' for inclusion if they are selected by the code system selection (see next point)
    • valueSet only: Codes are 'selected' for inclusion if they are in all the referenced value sets
    • System and valueSet: Codes are 'selected' for inclusion if they are selected by the code system selection and if they are in all the referenced value sets
  • If a system is specified, the following rules apply:
    • no concept or filter: All codes in the system are included
    • concept: Only the enumerated codes are selected
    • filter: Any codes meeting the filter criteria are selected
  • If the system reference is not version specific and filters are present, then the contents of the value set are open and change over time as the underlying code systems are updated
  • Using the property filters is only possible where the code system in use defines the relevant properties. Note that in some cases the underlying code system defines the logical concepts but not the syntax for exercising them. In such cases, the literal definitions may be provided by a third party
  • In addition to include rules, codes may be excluded. Rules for interpretation of exclude statements match those for includes, but codes in the exlude statements are never in the value set
  • Value sets may include abstract codes - that is, codes designated by the underlying code system as not for use as a selectable concept in a particular context. These abstract codes are typically used as a grouping/searching mechanism, and can be included either by enumerating them, or by using a filter.

When a value set enumerates codes, it is sometimes useful to define an alternative display for the code that is to be used wherever the value set is expanded and used in a UI. This facility is provided to cover the following circumstances:

  • The system that defines the code or expression doesn't provide a display for this code (or any codes).
  • The system that defines the code or expression defines multiple choices for display.
  • The system provides a very long display name that is unnecessary or inappropriate in the context of this value set (e.g. a display name of "Glucose [Mass/volume] in Serum or Plasma --10 PM specimen" for LOINC code 48991-4, when the value set only includes Glucose mass/vol in serum/plasma codes). As the display names get longer, this becomes more important.

Note that care must be taken in order to avoid "changing the meaning" of the concept by implying that it means something other than the explicit definition of the concept in the underlying code system (e.g., in the case above, using a display of "Glucose Concentration at 10pm"). For this reason, some contexts of use do not allow a display to be associated with a specific code in a value set.

Any display name for a concept provided in the value set is only used in the UI. The display in a Coding must be taken from the underlying code system definition, even if a value set is referenced explicitly in the Coding (e.g. by an extension). The alternative display specified in the value set would go in CodeableConcept.text, perhaps appended to the UI label for the matching data element.

4.8.6 Value Sets with multiple code systems

Value sets may select codes from multiple code systems - either by including codes from different systems, or importing other value sets that include them. A typical use for crossing code systems is when including a set of codes, and adding a few additional codes to cover cases not catered to by the included codes (e.g. Data missing or workflow error codes).

Best Practice Note: Mixing definitional systems offers the potential for confusing, overlapping, and inconsistent definitions. Creating value sets that cross code systems should be done with care to avoid creating definitional confusion.

4.8.6.1 Code systems Note

Each Code System defines which filters can be used in ValueSet.compose.include.filter. All code systems have base filters and any additional filters defined in (CodeSystem.filter).

This specification also defines filters for various published code systems:

4.8.7 Value Set Expansion

A value set can be "expanded", where the definition of the value set is used to create a simple collection of codes suitable for use for data entry or validation. There is a defined operation $expand to ask a server to perform this expansion. Expansions are most useful when a value set includes all the codes in a code system, or a set of codes by filter.

A resource that represents a value set expansion includes the same identification details as the definition of the value set, and MAY include the definition of the value set (.compose). In addition, it has an .expansion element which contains the list of codes that constitute the value set expansion. If the expansion has nested contains elements, there is no implication about the logical relationship between them, and the structure cannot be used for logical inferencing. The structure exists to provide navigational assistance for helping human users to locate codes in the expansion.

When a request for an expansion is received (e.g., for the $expand operation), the following process should be followed:

  • If the value set already has an expansion (e.g., a stored expansion), simply take the existing expansion as it is. If not, then:
  • For each compose.include:
    1. If there is a system, identify the correct version of the code system, and then:
      • If there are no codes or filters, add every code in the code system to the result set.
      • If codes are listed, check that they are valid, and check their active status, and if ok, add them to the result set (the profile parameter to the $expand operation may be used to control whether active codes are included).
      • If any filters are present, process them in order (as explained above), and add the intersection of their results to the result set.
    2. For each valueSet, find the referenced value set by ValueSet.url, expand that (e.g., using the $expand operation: GET [base]/ValueSet/$expand$url=[compose.include.valueSet]), and add it to the result set. This means that expansion across imports is a recursive process.
    3. Add the intersection of the result set from the system and the result sets from the value sets to the expansion
  • For each compose.exclude, follow the same process as for compose.include, but remove any codes from the result set, instead of adding them.

The final "result set" is then represented in expansion. Note that the expansion structure is inherently ordered, and also provides support for a hierarchical tree of items. This specification does not fix the meaning of use of either the order or the hierarchy, and the conceptual approach described should not be understood to prohibit any implementation approach in these regards. In addition, note that the method described above is a conceptual approach; individual servers may choose to follow alternative approaches that are more efficient, as long as the outcome is the same.

An expansion may include entries in the expansion that only serve an arbitrary grouping purpose, to make it easier for a human to use the list. These entries have no system or code, and must be marked as abstract. Note that the CodeSystem resource and ValueSet.compose offer no support for defining hierarchies and groups, but this does not exclude servers from using extensions or other knowledge to introduce such groups as an implementation feature.

The codes in the expansion should be treated as case sensitive - implementers should use the correct case. Implementers can consult the definition of the underlying code systems to determine whether the code system that defines the code is case sensitive or not.

It is important that expansions be identified properly. Any value set definition may produce an infinite number of expansions, depending on the expansion profile and $expand operation parameters. Any expansions produced must be clearly identified so that there is no confusion. The following rules apply:

  • The canonical URL for the expansion is the same as the value set it was expanded from
  • Each expansion SHALL have a unique identifier in ValueSet.expansion.identifier
  • The result of an $expand operation may use the same identifier in ValueSet.expansion.identifier as a previous expansion, but if it does, the canonical representation of the value set expansion SHALL be identical (e.g. a cached response)

The expansion contains a set of parameters that record what controlled the expansion process. These parameters may be used by users of expanded value sets to check whether the expansion is suitable for a particular purpose, or to pick the correct expansion. The server decides which parameters to include here, but at a minimum, the list SHOULD include the date, filter, and profile parameters passed to the $expand operation (if any). If the codeSystem on the server has a specified version then this version SHALL be provided as a parameter in the expansion (note that not all code systems have a version).

Whether to store expanded value sets, or simply to store their definitions and expand on the fly is a matter for system deployment. Some servers, including public value sets servers, only store expansions. However any system that stores an expansion must be concerned with how to determine whether the expansion is still current, and this requires deep knowledge of how the expansion was created. A system with a dedicated terminology server that returns expansions on demand avoids this problem, but leaves open the question of how to audit the specific expansion that was used for a particular case. One solution to this is to use a dedicated terminology server, and have the clients ask for expansions on demand based on the value set definitions, and for the server to store (and reuse as appropriate) the returned expansion (when it reuses the expansion, ValueSet.expansion.identifier will be the same). If expansions are shared, users need to be aware of how expansion identifiers (which may be server specific) work.

4.8.7.1 Searching for codes in value sets

The search parameters defined on ValueSet include the code parameter. This is intended to allow a consumer to find all the value sets that include a particular code. However, fully evaluating this search parameter is extremely onerous for a server. Further, whether a code is in a value set depends on the context in which expansions are performed (see ExpansionProfile). For this reason, the degree to which the search parameter is supported can be declared in the Terminology Capability statement.

4.8.8 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionExpressionIn Common
codetokenThis special parameter searches for codes in the value set. See additional notes on the ValueSet resourceValueSet.expansion.contains.code | ValueSet.compose.include.concept.code
datedateThe value set publication dateValueSet.date
descriptionstringThe description of the value setValueSet.description
expansionuriUniquely identifies this expansionValueSet.expansion.identifier
identifiertokenExternal identifier for the value setValueSet.identifier
jurisdictiontokenIntended jurisdiction for the value setValueSet.jurisdiction
namestringComputationally friendly name of the value setValueSet.name
publisherstringName of the publisher of the value setValueSet.publisher
referenceuriA code system included or excluded in the value set or an imported value setValueSet.compose.include.system
statustokenThe current status of the value setValueSet.status
titlestringThe human-friendly name of the value setValueSet.title
urluriThe uri that identifies the value setValueSet.url
versiontokenThe business version of the value setValueSet.version