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-BreastCancerStage-model"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p><b>BC BreastCancerStage Logical Model</b></p> <p>The stage of a breast cancer. Different staging systems use different staging groups, so there are currently no terminology bindings associated with this class.</p> </div> </text> <url value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastCancerStage-model"/> <identifier> <system value="http://hl7.org/fhir/us/breastcancer"/> <value value="oncology.BreastCancerStage"/> </identifier> <version value="0.2.0"/> <name value="BreastCancerStageModel"/> <title value="BC BreastCancerStage 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 stage of a breast cancer. Different staging systems use different staging groups, so there are currently no terminology bindings associated with this class."/> <keyword> <system value="http://ncimeta.nci.nih.gov"/> <code value="C2216702"/> <display value="Malignant Neoplasm of Breast Staging"/> </keyword> <kind value="logical"/> <abstract value="false"/> <type value="oncology-BreastCancerStage-model"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Element"/> <derivation value="specialization"/> <snapshot> <element id="oncology-BreastCancerStage-model"> <path value="oncology-BreastCancerStage-model"/> <definition value="The stage of a breast cancer. Different staging systems use different staging groups, so there are currently no terminology bindings associated with this class."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerStage-model"/> <min value="0"/> <max value="*"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerStage-model.personOfRecord"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.breastCancerStageTopic"> <path value="oncology-BreastCancerStage-model.breastCancerStageTopic"/> <short value="The topic class for describing a breast cancer staging observation."/> <definition value="The topic class for describing a breast cancer staging observation."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerStage-model.breastCancerStageTopic"/> <min value="1"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastCancerStageTopic-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerStage-model.observationContext"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode.id"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode.extension"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode.system"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode.version"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode.code"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode.userSelected"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.encounter"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.interpretation"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.findingStatus"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.relevantTime"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.resultValue"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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="preferred"/> <valueSetReference> <reference value="http://loinc.org/vs/LL240-3"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerStage-model.observationContext.exceptionValue"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.deltaFlag"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.issued"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.observer"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model"> <path value="oncology-BreastCancerStage-model"/> <definition value="The stage of a breast cancer. Different staging systems use different staging groups, so there are currently no terminology bindings associated with this class."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerStage-model"/> <min value="0"/> <max value="*"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerStage-model.personOfRecord"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.breastCancerStageTopic"> <path value="oncology-BreastCancerStage-model.breastCancerStageTopic"/> <short value="The topic class for describing a breast cancer staging observation."/> <definition value="The topic class for describing a breast cancer staging observation."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerStage-model.breastCancerStageTopic"/> <min value="1"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastCancerStageTopic-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerStage-model.observationContext"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode.id"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode.extension"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode.system"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode.version"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode.code"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.contextCode.userSelected"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.encounter"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.interpretation"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.findingStatus"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.relevantTime"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.resultValue"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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="preferred"/> <valueSetReference> <reference value="http://loinc.org/vs/LL240-3"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerStage-model.observationContext.exceptionValue"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.deltaFlag"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.issued"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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-BreastCancerStage-model.observationContext.observer"> <path value="oncology-BreastCancerStage-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-BreastCancerStage-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>