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-BreastTumor-model"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p><b>BC BreastTumor Logical Model</b></p> <p>An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm. (source: NCI)</p> </div> </text> <url value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastTumor-model"/> <identifier> <system value="http://hl7.org/fhir/us/breastcancer"/> <value value="oncology.BreastTumor"/> </identifier> <version value="0.2.0"/> <name value="BreastTumorModel"/> <title value="BC BreastTumor 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="An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm. (source: NCI)"/> <keyword> <system value="http://snomed.info/sct"/> <code value="395557000"/> <display value="Tumor finding (finding)"/> </keyword> <kind value="logical"/> <abstract value="false"/> <type value="oncology-BreastTumor-model"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Element"/> <derivation value="specialization"/> <snapshot> <element id="oncology-BreastTumor-model"> <path value="oncology-BreastTumor-model"/> <definition value="An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm. (source: NCI)"/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastTumor-model"/> <min value="0"/> <max value="*"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.personOfRecord"> <path value="oncology-BreastTumor-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-BreastTumor-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-BreastTumor-model.findingSiteConditionTopic"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C1268086"/> </code> <short value="Presence (or absence) of a distinct anatomical or pathological morphological feature or organizational pattern, acquired or innate. Examples include tissue types, tumors, and wounds."/> <definition value="Presence (or absence) of a distinct anatomical or pathological morphological feature or organizational pattern, acquired or innate. Examples include tissue types, tumors, and wounds. The FindingSiteCondition topic provides not only the AnatomicalLocation (as in CIMI FindingSiteAssertionTopic), tbut also the type of structure found at that location, such as a wound or tumor."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.findingSiteConditionTopic"/> <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-BreastTumor-model.findingSiteConditionTopic.topicCode"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.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-BreastTumor-model.findingSiteConditionTopic.topicCode"/> <min value="1"/> <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/us/core/ValueSet/us-core-problem"/> </valueSetReference> </binding> </element> <element id="oncology-BreastTumor-model.findingSiteConditionTopic.findingMethod"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.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-BreastTumor-model.findingSiteConditionTopic.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://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastCancerDetectionVS"/> </valueSetReference> </binding> </element> <element id="oncology-BreastTumor-model.findingSiteConditionTopic.details"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.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-BreastTumor-model.findingSiteConditionTopic.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-BreastTumor-model.findingSiteConditionTopic.media"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.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="*"/> <base> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.media"/> <min value="0"/> <max value="*"/> </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-BreastTumor-model.findingSiteConditionTopic.category"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.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-BreastTumor-model.findingSiteConditionTopic.category"/> <min value="1"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="preferred"/> <valueSetReference> <reference value="http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category"/> </valueSetReference> </binding> </element> <element id="oncology-BreastTumor-model.findingSiteConditionTopic.breastSite"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.breastSite"/> <short value="A body site specific to the breast structure."/> <definition value="A body site specific to the breast structure."/> <min value="1"/> <max value="*"/> <base> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.breastSite"/> <min value="1"/> <max value="*"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastSite-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.findingSiteConditionTopic.conditionCause"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.conditionCause"/> <short value="The cause of the condition. This includes such causes as disease vectors and endogenous states (e.g., macular degeneration due to diabetes), substances, medications, micro-organisms, and forces associated with the occurrence of a Condition from temporal or causative perspectives"/> <definition value="The cause of the condition. This includes such causes as disease vectors and endogenous states (e.g., macular degeneration due to diabetes), substances, medications, micro-organisms, and forces associated with the occurrence of a Condition from temporal or causative perspectives"/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.conditionCause"/> <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-entity-Entity-model"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-ClinicalStatement-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.findingSiteConditionTopic.alleviatingFactor"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.alleviatingFactor"/> <code> <system value="http://loinc.org"/> <code value="55258-8"/> </code> <short value="Activities that reduce the severity of the pathology"/> <definition value="Activities that reduce the severity of the pathology"/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.alleviatingFactor"/> <min value="0"/> <max value="0"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.findingSiteConditionTopic.exacerbatingFactor"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.exacerbatingFactor"/> <code> <system value="http://loinc.org"/> <code value="55258-8"/> </code> <short value="Activities that increase the severity of the pathology"/> <definition value="Activities that increase the severity of the pathology"/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.exacerbatingFactor"/> <min value="0"/> <max value="0"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.findingSiteConditionTopic.tumorIdentifier"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.tumorIdentifier"/> <short value="A human-readable identifier for the lesion; e.g., a letter or integer."/> <definition value="A human-readable identifier for the lesion; e.g., a letter or integer."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.tumorIdentifier"/> <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-BreastTumor-model.conditionPresenceContext"> <path value="oncology-BreastTumor-model.conditionPresenceContext"/> <short value="The context for a condition that is known, suspected, or possibly present."/> <definition value="The context for a condition that is known, suspected, or possibly present."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext"/> <min value="1"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-context-ConditionPresenceContext-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.contextCode"> <path value="oncology-BreastTumor-model.conditionPresenceContext.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-BreastTumor-model.conditionPresenceContext.contextCode"/> <min value="1"/> <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-PresenceContextVS"/> </valueSetReference> </binding> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.encounter"> <path value="oncology-BreastTumor-model.conditionPresenceContext.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-BreastTumor-model.conditionPresenceContext.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-BreastTumor-model.conditionPresenceContext.verificationStatus"> <path value="oncology-BreastTumor-model.conditionPresenceContext.verificationStatus"/> <short value="Whether an assessment has been confirmed by testing or observation."/> <definition value="Whether an assessment has been confirmed by testing or observation. CIMI Alignment: This attribute corresponds to FindingContext.status, but has been defined to align with FHIR. In AllergyIntolerance, the type is code."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.verificationStatus"/> <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-BreastTumor-model.conditionPresenceContext.onset"> <path value="oncology-BreastTumor-model.conditionPresenceContext.onset"/> <code> <system value="http://loinc.org"/> <code value="85585-8"/> </code> <short value="The beginning or first appearance of a mental or physical disorder."/> <definition value="The beginning or first appearance of a mental or physical disorder."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.onset"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Age-model"/> </type> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-TimePeriod-model"/> </type> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Range-model"/> </type> <type> <code value="string"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.abatement"> <path value="oncology-BreastTumor-model.conditionPresenceContext.abatement"/> <code> <system value="http://loinc.org"/> <code value="88878-4"/> </code> <short value="The end, remission or resolution."/> <definition value="The end, remission or resolution."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.abatement"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Age-model"/> </type> <type> <code value="boolean"/> </type> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-TimePeriod-model"/> </type> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Range-model"/> </type> <type> <code value="string"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.certainty"> <path value="oncology-BreastTumor-model.conditionPresenceContext.certainty"/> <short value="The degree of confidence in a conclusion or assertion."/> <definition value="The degree of confidence in a conclusion or assertion."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.certainty"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.clinicalStatus"> <path value="oncology-BreastTumor-model.conditionPresenceContext.clinicalStatus"/> <short value="A flag indicating whether the condition is active or inactive, recurring, in remission, or resolved (as of the last update of the Condition)."/> <definition value="A flag indicating whether the condition is active or inactive, recurring, in remission, or resolved (as of the last update of the Condition)."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.clinicalStatus"/> <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/condition-clinical"/> </valueSetReference> </binding> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.whenClinicallyRecognized"> <path value="oncology-BreastTumor-model.conditionPresenceContext.whenClinicallyRecognized"/> <short value="The time at which a condition or condition was first identified in a healthcare context."/> <definition value="The time at which a condition or condition was first identified in a healthcare context."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.whenClinicallyRecognized"/> <min value="0"/> <max value="1"/> </base> <type> <code value="date"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.presentOnAdmission"> <path value="oncology-BreastTumor-model.conditionPresenceContext.presentOnAdmission"/> <code> <system value="http://loinc.org"/> <code value="89251-3"/> <display value="Condition present on admission"/> </code> <short value="If the problem or condition existed before the current episode of care."/> <definition value="If the problem or condition existed before the current episode of care."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.presentOnAdmission"/> <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/shr-core-YesNoUnknownVS"/> </valueSetReference> </binding> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.severity"> <path value="oncology-BreastTumor-model.conditionPresenceContext.severity"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C0392364"/> </code> <short value="Degree of harshness or extent of a symptom, disorder, or condition."/> <definition value="Degree of harshness or extent of a symptom, disorder, or condition."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.severity"/> <min value="0"/> <max value="0"/> </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/ValueSet/condition-severity"/> </valueSetReference> </binding> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.stage"> <path value="oncology-BreastTumor-model.conditionPresenceContext.stage"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C0699749"/> </code> <short value="The relative advancement in the course of a disease. The value is the summary stage or stage group. StageDetail optionally contains the full staging information."/> <definition value="The relative advancement in the course of a disease. The value is the summary stage or stage group. StageDetail optionally contains the full staging information."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.stage"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-context-Stage-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.topicCode"> <path value="oncology-BreastTumor-model.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-BreastTumor-model.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-BreastTumor-model.topicCode.id"> <path value="oncology-BreastTumor-model.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-BreastTumor-model.topicCode.extension"> <path value="oncology-BreastTumor-model.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-BreastTumor-model.topicCode.system"> <path value="oncology-BreastTumor-model.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://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-BreastTumor-model.topicCode.version"> <path value="oncology-BreastTumor-model.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-BreastTumor-model.topicCode.code"> <path value="oncology-BreastTumor-model.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="395557000"/> <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-BreastTumor-model.topicCode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastTumor-model.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-BreastTumor-model.topicCode.userSelected"> <path value="oncology-BreastTumor-model.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-BreastTumor-model.category"> <path value="oncology-BreastTumor-model.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="1"/> <base> <path value="oncology-BreastTumor-model.category"/> <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-BreastTumor-model.category.id"> <path value="oncology-BreastTumor-model.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="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-BreastTumor-model.category.extension"> <path value="oncology-BreastTumor-model.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="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-BreastTumor-model.category.system"> <path value="oncology-BreastTumor-model.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="Coding.system"/> <min value="0"/> <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-BreastTumor-model.category.version"> <path value="oncology-BreastTumor-model.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="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-BreastTumor-model.category.code"> <path value="oncology-BreastTumor-model.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="Coding.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="exam"/> <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-BreastTumor-model.category.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastTumor-model.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="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-BreastTumor-model.category.userSelected"> <path value="oncology-BreastTumor-model.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="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> </snapshot> <differential> <element id="oncology-BreastTumor-model"> <path value="oncology-BreastTumor-model"/> <definition value="An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm. (source: NCI)"/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastTumor-model"/> <min value="0"/> <max value="*"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.personOfRecord"> <path value="oncology-BreastTumor-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-BreastTumor-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-BreastTumor-model.findingSiteConditionTopic"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C1268086"/> </code> <short value="Presence (or absence) of a distinct anatomical or pathological morphological feature or organizational pattern, acquired or innate. Examples include tissue types, tumors, and wounds."/> <definition value="Presence (or absence) of a distinct anatomical or pathological morphological feature or organizational pattern, acquired or innate. Examples include tissue types, tumors, and wounds. The FindingSiteCondition topic provides not only the AnatomicalLocation (as in CIMI FindingSiteAssertionTopic), tbut also the type of structure found at that location, such as a wound or tumor."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.findingSiteConditionTopic"/> <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-BreastTumor-model.findingSiteConditionTopic.topicCode"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.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-BreastTumor-model.findingSiteConditionTopic.topicCode"/> <min value="1"/> <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/us/core/ValueSet/us-core-problem"/> </valueSetReference> </binding> </element> <element id="oncology-BreastTumor-model.findingSiteConditionTopic.findingMethod"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.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-BreastTumor-model.findingSiteConditionTopic.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://hl7.org/fhir/us/breastcancer/ValueSet/oncology-BreastCancerDetectionVS"/> </valueSetReference> </binding> </element> <element id="oncology-BreastTumor-model.findingSiteConditionTopic.details"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.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-BreastTumor-model.findingSiteConditionTopic.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-BreastTumor-model.findingSiteConditionTopic.media"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.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="*"/> <base> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.media"/> <min value="0"/> <max value="*"/> </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-BreastTumor-model.findingSiteConditionTopic.category"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.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-BreastTumor-model.findingSiteConditionTopic.category"/> <min value="1"/> <max value="*"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="preferred"/> <valueSetReference> <reference value="http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category"/> </valueSetReference> </binding> </element> <element id="oncology-BreastTumor-model.findingSiteConditionTopic.breastSite"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.breastSite"/> <short value="A body site specific to the breast structure."/> <definition value="A body site specific to the breast structure."/> <min value="1"/> <max value="*"/> <base> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.breastSite"/> <min value="1"/> <max value="*"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastSite-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.findingSiteConditionTopic.conditionCause"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.conditionCause"/> <short value="The cause of the condition. This includes such causes as disease vectors and endogenous states (e.g., macular degeneration due to diabetes), substances, medications, micro-organisms, and forces associated with the occurrence of a Condition from temporal or causative perspectives"/> <definition value="The cause of the condition. This includes such causes as disease vectors and endogenous states (e.g., macular degeneration due to diabetes), substances, medications, micro-organisms, and forces associated with the occurrence of a Condition from temporal or causative perspectives"/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.conditionCause"/> <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-entity-Entity-model"/> </type> <type> <code value="Reference"/> <targetProfile value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-ClinicalStatement-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.findingSiteConditionTopic.alleviatingFactor"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.alleviatingFactor"/> <code> <system value="http://loinc.org"/> <code value="55258-8"/> </code> <short value="Activities that reduce the severity of the pathology"/> <definition value="Activities that reduce the severity of the pathology"/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.alleviatingFactor"/> <min value="0"/> <max value="0"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.findingSiteConditionTopic.exacerbatingFactor"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.exacerbatingFactor"/> <code> <system value="http://loinc.org"/> <code value="55258-8"/> </code> <short value="Activities that increase the severity of the pathology"/> <definition value="Activities that increase the severity of the pathology"/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.exacerbatingFactor"/> <min value="0"/> <max value="0"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.findingSiteConditionTopic.tumorIdentifier"> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.tumorIdentifier"/> <short value="A human-readable identifier for the lesion; e.g., a letter or integer."/> <definition value="A human-readable identifier for the lesion; e.g., a letter or integer."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.findingSiteConditionTopic.tumorIdentifier"/> <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-BreastTumor-model.conditionPresenceContext"> <path value="oncology-BreastTumor-model.conditionPresenceContext"/> <short value="The context for a condition that is known, suspected, or possibly present."/> <definition value="The context for a condition that is known, suspected, or possibly present."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext"/> <min value="1"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-context-ConditionPresenceContext-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.contextCode"> <path value="oncology-BreastTumor-model.conditionPresenceContext.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-BreastTumor-model.conditionPresenceContext.contextCode"/> <min value="1"/> <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-PresenceContextVS"/> </valueSetReference> </binding> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.encounter"> <path value="oncology-BreastTumor-model.conditionPresenceContext.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-BreastTumor-model.conditionPresenceContext.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-BreastTumor-model.conditionPresenceContext.verificationStatus"> <path value="oncology-BreastTumor-model.conditionPresenceContext.verificationStatus"/> <short value="Whether an assessment has been confirmed by testing or observation."/> <definition value="Whether an assessment has been confirmed by testing or observation. CIMI Alignment: This attribute corresponds to FindingContext.status, but has been defined to align with FHIR. In AllergyIntolerance, the type is code."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.verificationStatus"/> <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-BreastTumor-model.conditionPresenceContext.onset"> <path value="oncology-BreastTumor-model.conditionPresenceContext.onset"/> <code> <system value="http://loinc.org"/> <code value="85585-8"/> </code> <short value="The beginning or first appearance of a mental or physical disorder."/> <definition value="The beginning or first appearance of a mental or physical disorder."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.onset"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Age-model"/> </type> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-TimePeriod-model"/> </type> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Range-model"/> </type> <type> <code value="string"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.abatement"> <path value="oncology-BreastTumor-model.conditionPresenceContext.abatement"/> <code> <system value="http://loinc.org"/> <code value="88878-4"/> </code> <short value="The end, remission or resolution."/> <definition value="The end, remission or resolution."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.abatement"/> <min value="0"/> <max value="1"/> </base> <type> <code value="dateTime"/> </type> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Age-model"/> </type> <type> <code value="boolean"/> </type> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-TimePeriod-model"/> </type> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Range-model"/> </type> <type> <code value="string"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.certainty"> <path value="oncology-BreastTumor-model.conditionPresenceContext.certainty"/> <short value="The degree of confidence in a conclusion or assertion."/> <definition value="The degree of confidence in a conclusion or assertion."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.certainty"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.clinicalStatus"> <path value="oncology-BreastTumor-model.conditionPresenceContext.clinicalStatus"/> <short value="A flag indicating whether the condition is active or inactive, recurring, in remission, or resolved (as of the last update of the Condition)."/> <definition value="A flag indicating whether the condition is active or inactive, recurring, in remission, or resolved (as of the last update of the Condition)."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.clinicalStatus"/> <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/condition-clinical"/> </valueSetReference> </binding> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.whenClinicallyRecognized"> <path value="oncology-BreastTumor-model.conditionPresenceContext.whenClinicallyRecognized"/> <short value="The time at which a condition or condition was first identified in a healthcare context."/> <definition value="The time at which a condition or condition was first identified in a healthcare context."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.whenClinicallyRecognized"/> <min value="0"/> <max value="1"/> </base> <type> <code value="date"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.presentOnAdmission"> <path value="oncology-BreastTumor-model.conditionPresenceContext.presentOnAdmission"/> <code> <system value="http://loinc.org"/> <code value="89251-3"/> <display value="Condition present on admission"/> </code> <short value="If the problem or condition existed before the current episode of care."/> <definition value="If the problem or condition existed before the current episode of care."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.presentOnAdmission"/> <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/shr-core-YesNoUnknownVS"/> </valueSetReference> </binding> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.severity"> <path value="oncology-BreastTumor-model.conditionPresenceContext.severity"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C0392364"/> </code> <short value="Degree of harshness or extent of a symptom, disorder, or condition."/> <definition value="Degree of harshness or extent of a symptom, disorder, or condition."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.severity"/> <min value="0"/> <max value="0"/> </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/ValueSet/condition-severity"/> </valueSetReference> </binding> </element> <element id="oncology-BreastTumor-model.conditionPresenceContext.stage"> <path value="oncology-BreastTumor-model.conditionPresenceContext.stage"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C0699749"/> </code> <short value="The relative advancement in the course of a disease. The value is the summary stage or stage group. StageDetail optionally contains the full staging information."/> <definition value="The relative advancement in the course of a disease. The value is the summary stage or stage group. StageDetail optionally contains the full staging information."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastTumor-model.conditionPresenceContext.stage"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-context-Stage-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastTumor-model.topicCode"> <path value="oncology-BreastTumor-model.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-BreastTumor-model.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-BreastTumor-model.topicCode.id"> <path value="oncology-BreastTumor-model.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-BreastTumor-model.topicCode.extension"> <path value="oncology-BreastTumor-model.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-BreastTumor-model.topicCode.system"> <path value="oncology-BreastTumor-model.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://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-BreastTumor-model.topicCode.version"> <path value="oncology-BreastTumor-model.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-BreastTumor-model.topicCode.code"> <path value="oncology-BreastTumor-model.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="395557000"/> <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-BreastTumor-model.topicCode.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastTumor-model.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-BreastTumor-model.topicCode.userSelected"> <path value="oncology-BreastTumor-model.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-BreastTumor-model.category"> <path value="oncology-BreastTumor-model.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="1"/> <base> <path value="oncology-BreastTumor-model.category"/> <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-BreastTumor-model.category.id"> <path value="oncology-BreastTumor-model.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="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-BreastTumor-model.category.extension"> <path value="oncology-BreastTumor-model.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="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-BreastTumor-model.category.system"> <path value="oncology-BreastTumor-model.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="Coding.system"/> <min value="0"/> <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-BreastTumor-model.category.version"> <path value="oncology-BreastTumor-model.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="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-BreastTumor-model.category.code"> <path value="oncology-BreastTumor-model.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="Coding.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="exam"/> <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-BreastTumor-model.category.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastTumor-model.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="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-BreastTumor-model.category.userSelected"> <path value="oncology-BreastTumor-model.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="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> </differential> </StructureDefinition>