HL7 FHIR Implementation Guide: Breast Cancer Data, Release 1 - US Realm (Draft for Comment 2)
This page is part of the Breast Cancer Data Logical Models and FHIR Profiles (v0.2.0: STU 1 Draft) based on FHIR R3. . For a full list of available versions, see the Directory of published versions 
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="oncology-BreastCancerHistologicGrade-model"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p><b>BC BreastCancerHistologicGrade Logical Model</b></p> <p>The Elston Grade/Nottingham Score, representative of the aggressive potential of the tumor. Well differentiated cells (Grade 1) look similar to normal cells and are usually slow growing, while poorly differentiated cells (Grade 3) look very different than normal and are fast-growing.</p> </div> </text> <url value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastCancerHistologicGrade-model"/> <identifier> <system value="http://hl7.org/fhir/us/breastcancer"/> <value value="oncology.BreastCancerHistologicGrade"/> </identifier> <version value="0.2.0"/> <name value="BreastCancerHistologicGradeModel"/> <title value="BC BreastCancerHistologicGrade Logical Model"/> <status value="draft"/> <date value="2018-08-17T00:00:00+10:00"/> <publisher value="The HL7 Cancer Interoperability Group sponsored by Clinical Interoperability Council Work Group (CIC)"/> <contact> <telecom> <system value="url"/> <value value="http://www.hl7.org/Special/committees/cic/index.cfm"/> </telecom> </contact> <description value="The Elston Grade/Nottingham Score, representative of the aggressive potential of the tumor. Well differentiated cells (Grade 1) look similar to normal cells and are usually slow growing, while poorly differentiated cells (Grade 3) look very different than normal and are fast-growing."/> <keyword> <system value="http://loinc.org"/> <code value="44648-4"/> <display value="Histologic grade [Score] in Breast cancer specimen Qualitative by Nottingham"/> </keyword> <kind value="logical"/> <abstract value="false"/> <type value="oncology-BreastCancerHistologicGrade-model"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Element"/> <derivation value="specialization"/> <snapshot> <element id="oncology-BreastCancerHistologicGrade-model"> <path value="oncology-BreastCancerHistologicGrade-model"/> <definition value="The Elston Grade/Nottingham Score, representative of the aggressive potential of the tumor. Well differentiated cells (Grade 1) look similar to normal cells and are usually slow growing, while poorly differentiated cells (Grade 3) look very different than normal and are fast-growing."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model"/> <min value="0"/> <max value="*"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.personOfRecord"> <path value="oncology-BreastCancerHistologicGrade-model.personOfRecord"/> <short value="The person this entry belongs to."/> <definition value="The person this entry belongs to."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.personOfRecord"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-core-PersonOfRecord-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic"/> <short value="The topic composition for laboratory observations. A specimen is required, anatomical location is excluded (since the specimen indicates the collection body site). Also includes a diagnostic service (indicating the type of laboratory), not present in general observations."/> <definition value="The topic composition for laboratory observations. A specimen is required, anatomical location is excluded (since the specimen indicates the collection body site). Also includes a diagnostic service (indicating the type of laboratory), not present in general observations."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic"/> <min value="1"/> <max value="1"/> </base> <type> <code value="BackboneElement"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode"/> <short value="The concept representing the finding or action that is the topic of the statement."/> <definition value="The concept representing the finding or action that is the topic of the statement. For action topics, the TopicCode represents the action being described. For findings, the TopicCode represents the 'question' or property being investigated. For evaluation result findings, the TopicCode contains a concept for an observable entity, such as systolic blood pressure. For assertion findings, the TopicCode contains a code representing the condition, allergy, or other item being asserted. In all cases, the TopicCode describes the topic independent of the context of the action or the finding."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.id"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.extension"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.system"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in the code."/> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/> <requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://loinc.org"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.version"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.code"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/> <requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="44648-4"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules of the system."/> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.userSelected"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.findingMethod"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.findingMethod"/> <short value="The technique used to create the finding, for example, the specific imaging technical, lab test code, or assessment vehicle."/> <definition value="The technique used to create the finding, for example, the specific imaging technical, lab test code, or assessment vehicle."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.findingMethod"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="preferred"/> <valueSetReference> <reference value="http://loinc.org/vs"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.details"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.details"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C0947611"/> </code> <short value="A text note containing additional details, explanation, description, comment, or summarization. Details can discuss, support, explain changes to, or dispute information."/> <definition value="A text note containing additional details, explanation, description, comment, or summarization. Details can discuss, support, explain changes to, or dispute information."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.details"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.media"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.media"/> <short value="A file that contains audio, video, image, or similar content."/> <definition value="A file that contains audio, video, image, or similar content."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.media"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Media-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category"/> <short value="A class or division of people or things having particular shared characteristics"/> <definition value="A class or division of people or things having particular shared characteristics"/> <min value="1"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category"/> <min value="1"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.id"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.extension"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.system"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in the code."/> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/> <requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.system"/> <min value="1"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://hl7.org/fhir/observation-category"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.version"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.code"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/> <requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.code"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="laboratory"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules of the system."/> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.userSelected"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.anatomicalLocation"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.anatomicalLocation"/> <code> <system value="http://loinc.org"/> <code value="72369-2"/> </code> <short value="A location or structure in the body, including tissues, regions, cavities, and spaces; for example, right elbow, or left ventricle of the heart."/> <definition value="A location or structure in the body, including tissues, regions, cavities, and spaces; for example, right elbow, or left ventricle of the heart."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.anatomicalLocation"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-element-AnatomicalLocation-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.device"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.device"/> <short value="A specific durable physical device used in diagnosis or treatment. The value is the coding for a type of device, for example, a CPAP machine. The same device might be used on multiple patients."/> <definition value="A specific durable physical device used in diagnosis or treatment. The value is the coding for a type of device, for example, a CPAP machine. The same device might be used on multiple patients."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.device"/> <min value="0"/> <max value="0"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Device-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.breastSpecimen"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.breastSpecimen"/> <short value="Specimen resulting from biopsy or excision of breast and surrounding tissue."/> <definition value="Specimen resulting from biopsy or excision of breast and surrounding tissue."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.breastSpecimen"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastSpecimen-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.precondition"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.precondition"/> <short value="A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar."/> <definition value="A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.precondition"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-Observation-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.referenceRange"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.referenceRange"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C0883335"/> </code> <short value="The usual or acceptable range for a test result."/> <definition value="The usual or acceptable range for a test result."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.referenceRange"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-topic-ReferenceRange-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent"/> <short value="A simplified, non-separable evaluation consisting of a finding code (represented by the Concept), value (or exception value), reference range, and interpretation. The subject of the evaluation component is the same as in the parent evaluation."/> <definition value="A simplified, non-separable evaluation consisting of a finding code (represented by the Concept), value (or exception value), reference range, and interpretation. The subject of the evaluation component is the same as in the parent evaluation."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent"/> <min value="0"/> <max value="1"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.tubuleFormationScore"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.tubuleFormationScore"/> <code> <system value="http://loinc.org"/> <code value="85321-8"/> <display value="Granular differentiation [Score] in Breast cancer specimen Qualitative by Nottingham"/> </code> <short value="The degree of glandular differentiation or tubule formation in breast carcinoma is one component of the Nottingham histologic grade, which is a prognostic indicator for patients with breast carcinoma. Less aggressive cancers have more tubule formation."/> <definition value="The degree of glandular differentiation or tubule formation in breast carcinoma is one component of the Nottingham histologic grade, which is a prognostic indicator for patients with breast carcinoma. Less aggressive cancers have more tubule formation."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.tubuleFormationScore"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-TubuleFormationScore-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.nuclearPleomorphismScore"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.nuclearPleomorphismScore"/> <code> <system value="http://loinc.org"/> <code value="44645-0"/> <display value="Nuclear pleomorphism in Breast tumor Qualitative by Nottingham"/> </code> <short value="The degree of nuclear pleomorphism (variability of nuclei) in breast carcinoma is one component of the Nottingham histologic grade, which is a prognostic indicator for patients with breast carcinoma. Increasing degrees of pleomorphism are associated with increasingly aggressive cancers."/> <definition value="The degree of nuclear pleomorphism (variability of nuclei) in breast carcinoma is one component of the Nottingham histologic grade, which is a prognostic indicator for patients with breast carcinoma. Increasing degrees of pleomorphism are associated with increasingly aggressive cancers."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.nuclearPleomorphismScore"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-NuclearPleomorphismScore-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.mitoticCountScore"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.mitoticCountScore"/> <code> <system value="http://loinc.org"/> <code value="85300-2"/> <display value="Mitotic rate [Score] in Breast cancer specimen Qualitative by Nottingham"/> </code> <short value="The degree of mitotic activity in breast carcinoma is one component of the Nottingham histologic grade, which is a prognostic indicator for patients with breast carcinoma. Mitotic activity is assessed as the number of mitoses per 10 high power fields (HPF), with increasing mitotic activity being an indicator of more aggressive cancer. The specific scores assigned to the number of mitoses depends on the size of the HPF. For example, for a HPF size of 0.274 mm^2, less than 10 mitoses per 10 HPF gets a score of 1, 10-19 gets a score of 2, and greater than or equal to 20 gets a score of 3. When larger or smaller HPFs are used, the cutoffs for the number of mitoses corresponding to a specific score are adjusted according to published guidelines."/> <definition value="The degree of mitotic activity in breast carcinoma is one component of the Nottingham histologic grade, which is a prognostic indicator for patients with breast carcinoma. Mitotic activity is assessed as the number of mitoses per 10 high power fields (HPF), with increasing mitotic activity being an indicator of more aggressive cancer. The specific scores assigned to the number of mitoses depends on the size of the HPF. For example, for a HPF size of 0.274 mm^2, less than 10 mitoses per 10 HPF gets a score of 1, 10-19 gets a score of 2, and greater than or equal to 20 gets a score of 3. When larger or smaller HPFs are used, the cutoffs for the number of mitoses corresponding to a specific score are adjusted according to published guidelines."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.mitoticCountScore"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MitoticCountScore-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.panelMembers"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.panelMembers"/> <short value="PanelMembers represent the elements of a group of a related but independent evaluations."/> <definition value="PanelMembers represent the elements of a group of a related but independent evaluations. Examples are the measurements that compose a complete blood count (CBC), or the elements of a pathology report. Each member is an independent evaluation, but the grouping reflects a composite lab order, shared specimen, or a single report author. Typically the Category and Reason are not given for individual findings that are part of the panel, but rather given at the level of the panel itself."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.panelMembers"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-topic-PanelMembers-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService"/> <short value="The service completing the observations, e.g. biochemistry, microbiology, blood bank."/> <definition value="The service completing the observations, e.g. biochemistry, microbiology, blood bank."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.id"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.extension"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.system"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in the code."/> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/> <requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://hl7.org/fhir/v2/0074"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.version"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.code"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/> <requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="PAT"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules of the system."/> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.userSelected"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext"/> <short value="Context for recording an evaluation result, used to indicate an evaluation has been made."/> <definition value="Context for recording an evaluation result, used to indicate an evaluation has been made."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext"/> <min value="1"/> <max value="1"/> </base> <type> <code value="BackboneElement"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode"/> <short value="A code representing the ontological status of the statement, e.g., whether it exists, does not exist, is planned, etc."/> <definition value="A code representing the ontological status of the statement, e.g., whether it exists, does not exist, is planned, etc. Attribute aligns with the SNOMED CT Situation with Explicit Context (SWEC) Concept Model context attributes: 'Finding context (attribute)' (SCTID: 408729009) and 'Procedure context (attribute)' (SCTID: 408730004). The range allowed for this attribute shall be consistent with the SNOMED CT concept model specification for SWEC."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.id"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.extension"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.system"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in the code."/> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/> <requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.system"/> <min value="1"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://snomed.info/sct"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.version"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.code"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/> <requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.code"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="424975005"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules of the system."/> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.userSelected"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.encounter"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.encounter"/> <short value="A description of an interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient."/> <definition value="A description of an interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.encounter"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-encounter-Encounter-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.interpretation"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.interpretation"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C0420833"/> </code> <short value="A clinical interpretation of a finding (applies to both assertions and observation)."/> <definition value="A clinical interpretation of a finding (applies to both assertions and observation)."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.interpretation"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="extensible"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-interpretation"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.findingStatus"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.findingStatus"/> <short value="Indicates whether the finding is preliminary, amended, final, etc."/> <definition value="Indicates whether the finding is preliminary, amended, final, etc."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.findingStatus"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="required"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.relevantTime"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.relevantTime"/> <short value="The time or time period that the finding addresses."/> <definition value="The time or time period that the finding addresses. The clinically relevant time is not necessarily when the information is gathered or when a test is carried out, but for example, when a specimen was collected, or the time period referred to by the question. Use a TimePeriod for a measurement or specimen collection continued over a significant period of time (e.g. 24 hour Urine Sodium)."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.relevantTime"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-TimePeriod-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.resultValue"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.resultValue"/> <short value="The finding itself, such as the blood pressure value recorded."/> <definition value="The finding itself, such as the blood pressure value recorded."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.resultValue"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="required"/> <valueSetReference> <reference value="http://loinc.org/vs/LL4561-8"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.exceptionValue"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.exceptionValue"/> <short value="Reason that a value associated with a test or other finding is missing."/> <definition value="Reason that a value associated with a test or other finding is missing."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.exceptionValue"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="extensible"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/data-absent-reason"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.deltaFlag"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.deltaFlag"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C1705241"/> </code> <short value="Indicator of significant change (delta) from the last or previous measurement."/> <definition value="Indicator of significant change (delta) from the last or previous measurement."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.deltaFlag"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="required"/> <valueSetReference> <reference value="http://hl7.org/fhir/us/breastcancer/ValueSet/cimi-context-DeltaFlagVS"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.issued"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.issued"/> <short value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified."/> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.issued"/> <min value="0"/> <max value="1"/> </base> <type> <code value="instant"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.observer"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.observer"/> <short value="The person or organization who observed or informed the reporter about the characteristic, potentially the clinician, the patient, or a related person."/> <definition value="The person or organization who observed or informed the reporter about the characteristic, potentially the clinician, the patient, or a related person."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.observer"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Practitioner-model"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Organization-model"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Patient-model"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-RelatedPerson-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> </snapshot> <differential> <element id="oncology-BreastCancerHistologicGrade-model"> <path value="oncology-BreastCancerHistologicGrade-model"/> <definition value="The Elston Grade/Nottingham Score, representative of the aggressive potential of the tumor. Well differentiated cells (Grade 1) look similar to normal cells and are usually slow growing, while poorly differentiated cells (Grade 3) look very different than normal and are fast-growing."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model"/> <min value="0"/> <max value="*"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.personOfRecord"> <path value="oncology-BreastCancerHistologicGrade-model.personOfRecord"/> <short value="The person this entry belongs to."/> <definition value="The person this entry belongs to."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.personOfRecord"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-core-PersonOfRecord-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic"/> <short value="The topic composition for laboratory observations. A specimen is required, anatomical location is excluded (since the specimen indicates the collection body site). Also includes a diagnostic service (indicating the type of laboratory), not present in general observations."/> <definition value="The topic composition for laboratory observations. A specimen is required, anatomical location is excluded (since the specimen indicates the collection body site). Also includes a diagnostic service (indicating the type of laboratory), not present in general observations."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic"/> <min value="1"/> <max value="1"/> </base> <type> <code value="BackboneElement"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode"/> <short value="The concept representing the finding or action that is the topic of the statement."/> <definition value="The concept representing the finding or action that is the topic of the statement. For action topics, the TopicCode represents the action being described. For findings, the TopicCode represents the 'question' or property being investigated. For evaluation result findings, the TopicCode contains a concept for an observable entity, such as systolic blood pressure. For assertion findings, the TopicCode contains a code representing the condition, allergy, or other item being asserted. In all cases, the TopicCode describes the topic independent of the context of the action or the finding."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.id"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.extension"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.system"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in the code."/> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/> <requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://loinc.org"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.version"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.code"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/> <requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="44648-4"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules of the system."/> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.userSelected"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.topicCode.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.findingMethod"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.findingMethod"/> <short value="The technique used to create the finding, for example, the specific imaging technical, lab test code, or assessment vehicle."/> <definition value="The technique used to create the finding, for example, the specific imaging technical, lab test code, or assessment vehicle."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.findingMethod"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="preferred"/> <valueSetReference> <reference value="http://loinc.org/vs"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.details"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.details"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C0947611"/> </code> <short value="A text note containing additional details, explanation, description, comment, or summarization. Details can discuss, support, explain changes to, or dispute information."/> <definition value="A text note containing additional details, explanation, description, comment, or summarization. Details can discuss, support, explain changes to, or dispute information."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.details"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.media"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.media"/> <short value="A file that contains audio, video, image, or similar content."/> <definition value="A file that contains audio, video, image, or similar content."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.media"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Media-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category"/> <short value="A class or division of people or things having particular shared characteristics"/> <definition value="A class or division of people or things having particular shared characteristics"/> <min value="1"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category"/> <min value="1"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.id"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.extension"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.system"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in the code."/> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/> <requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.system"/> <min value="1"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://hl7.org/fhir/observation-category"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.version"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.code"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/> <requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.code"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="laboratory"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules of the system."/> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.userSelected"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.category.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.anatomicalLocation"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.anatomicalLocation"/> <code> <system value="http://loinc.org"/> <code value="72369-2"/> </code> <short value="A location or structure in the body, including tissues, regions, cavities, and spaces; for example, right elbow, or left ventricle of the heart."/> <definition value="A location or structure in the body, including tissues, regions, cavities, and spaces; for example, right elbow, or left ventricle of the heart."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.anatomicalLocation"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-element-AnatomicalLocation-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.device"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.device"/> <short value="A specific durable physical device used in diagnosis or treatment. The value is the coding for a type of device, for example, a CPAP machine. The same device might be used on multiple patients."/> <definition value="A specific durable physical device used in diagnosis or treatment. The value is the coding for a type of device, for example, a CPAP machine. The same device might be used on multiple patients."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.device"/> <min value="0"/> <max value="0"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Device-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.breastSpecimen"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.breastSpecimen"/> <short value="Specimen resulting from biopsy or excision of breast and surrounding tissue."/> <definition value="Specimen resulting from biopsy or excision of breast and surrounding tissue."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.breastSpecimen"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastSpecimen-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.precondition"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.precondition"/> <short value="A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar."/> <definition value="A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.precondition"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-Observation-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.referenceRange"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.referenceRange"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C0883335"/> </code> <short value="The usual or acceptable range for a test result."/> <definition value="The usual or acceptable range for a test result."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.referenceRange"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-topic-ReferenceRange-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent"/> <short value="A simplified, non-separable evaluation consisting of a finding code (represented by the Concept), value (or exception value), reference range, and interpretation. The subject of the evaluation component is the same as in the parent evaluation."/> <definition value="A simplified, non-separable evaluation consisting of a finding code (represented by the Concept), value (or exception value), reference range, and interpretation. The subject of the evaluation component is the same as in the parent evaluation."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent"/> <min value="0"/> <max value="1"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.tubuleFormationScore"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.tubuleFormationScore"/> <code> <system value="http://loinc.org"/> <code value="85321-8"/> <display value="Granular differentiation [Score] in Breast cancer specimen Qualitative by Nottingham"/> </code> <short value="The degree of glandular differentiation or tubule formation in breast carcinoma is one component of the Nottingham histologic grade, which is a prognostic indicator for patients with breast carcinoma. Less aggressive cancers have more tubule formation."/> <definition value="The degree of glandular differentiation or tubule formation in breast carcinoma is one component of the Nottingham histologic grade, which is a prognostic indicator for patients with breast carcinoma. Less aggressive cancers have more tubule formation."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.tubuleFormationScore"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-TubuleFormationScore-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.nuclearPleomorphismScore"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.nuclearPleomorphismScore"/> <code> <system value="http://loinc.org"/> <code value="44645-0"/> <display value="Nuclear pleomorphism in Breast tumor Qualitative by Nottingham"/> </code> <short value="The degree of nuclear pleomorphism (variability of nuclei) in breast carcinoma is one component of the Nottingham histologic grade, which is a prognostic indicator for patients with breast carcinoma. Increasing degrees of pleomorphism are associated with increasingly aggressive cancers."/> <definition value="The degree of nuclear pleomorphism (variability of nuclei) in breast carcinoma is one component of the Nottingham histologic grade, which is a prognostic indicator for patients with breast carcinoma. Increasing degrees of pleomorphism are associated with increasingly aggressive cancers."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.nuclearPleomorphismScore"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-NuclearPleomorphismScore-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.mitoticCountScore"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.mitoticCountScore"/> <code> <system value="http://loinc.org"/> <code value="85300-2"/> <display value="Mitotic rate [Score] in Breast cancer specimen Qualitative by Nottingham"/> </code> <short value="The degree of mitotic activity in breast carcinoma is one component of the Nottingham histologic grade, which is a prognostic indicator for patients with breast carcinoma. Mitotic activity is assessed as the number of mitoses per 10 high power fields (HPF), with increasing mitotic activity being an indicator of more aggressive cancer. The specific scores assigned to the number of mitoses depends on the size of the HPF. For example, for a HPF size of 0.274 mm^2, less than 10 mitoses per 10 HPF gets a score of 1, 10-19 gets a score of 2, and greater than or equal to 20 gets a score of 3. When larger or smaller HPFs are used, the cutoffs for the number of mitoses corresponding to a specific score are adjusted according to published guidelines."/> <definition value="The degree of mitotic activity in breast carcinoma is one component of the Nottingham histologic grade, which is a prognostic indicator for patients with breast carcinoma. Mitotic activity is assessed as the number of mitoses per 10 high power fields (HPF), with increasing mitotic activity being an indicator of more aggressive cancer. The specific scores assigned to the number of mitoses depends on the size of the HPF. For example, for a HPF size of 0.274 mm^2, less than 10 mitoses per 10 HPF gets a score of 1, 10-19 gets a score of 2, and greater than or equal to 20 gets a score of 3. When larger or smaller HPFs are used, the cutoffs for the number of mitoses corresponding to a specific score are adjusted according to published guidelines."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.evaluationComponent.mitoticCountScore"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MitoticCountScore-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.panelMembers"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.panelMembers"/> <short value="PanelMembers represent the elements of a group of a related but independent evaluations."/> <definition value="PanelMembers represent the elements of a group of a related but independent evaluations. Examples are the measurements that compose a complete blood count (CBC), or the elements of a pathology report. Each member is an independent evaluation, but the grouping reflects a composite lab order, shared specimen, or a single report author. Typically the Category and Reason are not given for individual findings that are part of the panel, but rather given at the level of the panel itself."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.panelMembers"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-topic-PanelMembers-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService"/> <short value="The service completing the observations, e.g. biochemistry, microbiology, blood bank."/> <definition value="The service completing the observations, e.g. biochemistry, microbiology, blood bank."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.id"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.extension"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.system"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in the code."/> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/> <requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://hl7.org/fhir/v2/0074"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.version"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.code"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/> <requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="PAT"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules of the system."/> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.userSelected"> <path value="oncology-BreastCancerHistologicGrade-model.laboratoryObservationTopic.diagnosticService.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext"/> <short value="Context for recording an evaluation result, used to indicate an evaluation has been made."/> <definition value="Context for recording an evaluation result, used to indicate an evaluation has been made."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext"/> <min value="1"/> <max value="1"/> </base> <type> <code value="BackboneElement"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode"/> <short value="A code representing the ontological status of the statement, e.g., whether it exists, does not exist, is planned, etc."/> <definition value="A code representing the ontological status of the statement, e.g., whether it exists, does not exist, is planned, etc. Attribute aligns with the SNOMED CT Situation with Explicit Context (SWEC) Concept Model context attributes: 'Finding context (attribute)' (SCTID: 408729009) and 'Procedure context (attribute)' (SCTID: 408730004). The range allowed for this attribute shall be consistent with the SNOMED CT concept model specification for SWEC."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.id"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.extension"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.system"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in the code."/> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/> <requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.system"/> <min value="1"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://snomed.info/sct"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.version"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.code"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/> <requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.code"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="424975005"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules of the system."/> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.userSelected"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.contextCode.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.encounter"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.encounter"/> <short value="A description of an interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient."/> <definition value="A description of an interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.encounter"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-encounter-Encounter-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.interpretation"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.interpretation"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C0420833"/> </code> <short value="A clinical interpretation of a finding (applies to both assertions and observation)."/> <definition value="A clinical interpretation of a finding (applies to both assertions and observation)."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.interpretation"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="extensible"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-interpretation"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.findingStatus"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.findingStatus"/> <short value="Indicates whether the finding is preliminary, amended, final, etc."/> <definition value="Indicates whether the finding is preliminary, amended, final, etc."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.findingStatus"/> <min value="1"/> <max value="1"/> </base> <type> <code value="code"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="required"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/observation-status"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.relevantTime"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.relevantTime"/> <short value="The time or time period that the finding addresses."/> <definition value="The time or time period that the finding addresses. The clinically relevant time is not necessarily when the information is gathered or when a test is carried out, but for example, when a specimen was collected, or the time period referred to by the question. Use a TimePeriod for a measurement or specimen collection continued over a significant period of time (e.g. 24 hour Urine Sodium)."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.relevantTime"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-TimePeriod-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.resultValue"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.resultValue"/> <short value="The finding itself, such as the blood pressure value recorded."/> <definition value="The finding itself, such as the blood pressure value recorded."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.resultValue"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="required"/> <valueSetReference> <reference value="http://loinc.org/vs/LL4561-8"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.exceptionValue"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.exceptionValue"/> <short value="Reason that a value associated with a test or other finding is missing."/> <definition value="Reason that a value associated with a test or other finding is missing."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.exceptionValue"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="extensible"/> <valueSetReference> <reference value="http://hl7.org/fhir/ValueSet/data-absent-reason"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.deltaFlag"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.deltaFlag"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C1705241"/> </code> <short value="Indicator of significant change (delta) from the last or previous measurement."/> <definition value="Indicator of significant change (delta) from the last or previous measurement."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.deltaFlag"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="required"/> <valueSetReference> <reference value="http://hl7.org/fhir/us/breastcancer/ValueSet/cimi-context-DeltaFlagVS"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.issued"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.issued"/> <short value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified."/> <definition value="The date and time this observation was made available to providers, typically after the results have been reviewed and verified."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.issued"/> <min value="0"/> <max value="1"/> </base> <type> <code value="instant"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.observationContext.observer"> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.observer"/> <short value="The person or organization who observed or informed the reporter about the characteristic, potentially the clinician, the patient, or a related person."/> <definition value="The person or organization who observed or informed the reporter about the characteristic, potentially the clinician, the patient, or a related person."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.observationContext.observer"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Practitioner-model"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Organization-model"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-Patient-model"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-entity-RelatedPerson-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> </differential> </StructureDefinition>