HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU1
1.0.0 - STU1

This page is part of the HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU1 (v1.0.0: STU 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

StructureDefinition: CancerDiseaseStatus

A clinician’s qualitative judgment on the current trend of the cancer, e.g., whether it is stable, worsening (progressing), or improving (responding). The judgment may be based a single type or multiple kinds of evidence, such as imaging data, assessment of symptoms, tumor markers, laboratory data, etc.

Note: The LOINC code chosen to represent this observation (LOINC 88040-1, Response to cancer treatment) does not precisely match the meaning of this profile, but it is the closest available LOINC code at the present time. It is acknowledged that the disease status is different than the status of the disease due to treatment, although in the context of an oncologist visit, disease status can mean response to treatment for patients under their care. However, the LOINC code 88041-2 is more granular than the definition of the profile because cancer disease status is observable regardless of whether the patient is under treatment. The plan is to request a new LOINC code that represents cancer disease status, as it is defined here, and replace the current LOINC code with the new code before normative publication of mCODE.

The official URL for this profile is: 

http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Observation

Summary

Mandatory: 1 element
Must-Support: 5 elements
Prohibited: 6 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Observation.value[x] is sliced based on the value of type:$this

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*Observation
... extension 0..*ExtensionSlice: Unordered, Open by value:url
... mcode-evidence-type 0..*CodeableConceptExtension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-evidence-type
.... valueCodeableConcept 0..1CodeableConceptBinding: Cancer Disease Status Evidence Type Value Set (required)
... basedOn 0..*Reference(ServiceRequest | MedicationRequest)
... status S1..1code
... code S1..1CodeableConceptRequired Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 88040-1
... subject S1..1Reference(Cancer Patient)
... focus 0..*Reference(Cancer Condition Parent)
... effective[x] S0..1
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... performer 0..*Reference(US Core Practitioner Profile)
... value[x] 0..1(Slice Definition)Slice: Unordered, Open by type:$this
... valueCodeableConcept S0..1CodeableConceptBinding: Condition Status Trend Value Set (required)
... interpretation 0..1CodeableConcept
... bodySite 0..0
... specimen 0..0
... device 0..0
... referenceRange 0..0
... hasMember 0..0
... component 0..0

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*ObservationMeasurements and simple assertions
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionExtension
Slice: Unordered, Open by value:url
... mcode-evidence-type I0..*CodeableConceptOptional Extensions Element
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-evidence-type
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..0
.... url 1..1uri"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-evidence-type"
.... value[x] I0..1(Slice Definition)Value of extension
Slice: Unordered, Closed by type:$this
..... value[x]:valueCodeableConcept I0..1CodeableConceptValue of extension
Binding: Cancer Disease Status Evidence Type Value Set (required)
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierBusiness Identifier for observation
... basedOn ΣI0..*Reference(ServiceRequest | MedicationRequest)Fulfills plan, proposal or order
... partOf ΣI0..*Reference(MedicationAdministration | MedicationStatement | Procedure)Part of referenced event
... status ?!SΣI1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category I0..*CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred)
... code SΣI1..1CodeableConceptType of observation (code / type)
Binding: LOINCCodes (example)
Required Pattern: At least the following
.... id0..1stringUnique id for inter-element referencing
.... extension0..*ExtensionAdditional content defined by implementations
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 88040-1
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
... subject SΣI1..1Reference(Cancer Patient)Who and/or what the observation is about
... focus ΣI0..*Reference(Cancer Condition Parent)What the observation is about, when it is not about the subject of record
... encounter ΣI0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI0..1Clinically relevant time/time-period for observation
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued ΣI0..1instantDate/Time this version was made available
... performer ΣI0..*Reference(US Core Practitioner Profile)Who is responsible for the observation
... value[x] ΣI0..1(Slice Definition)Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueCodeableConcept SΣI0..1CodeableConceptActual result
Binding: Condition Status Trend Value Set (required)
... dataAbsentReason I0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
... interpretation I0..1CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
... note I0..*AnnotationComments about the observation
... method I0..1CodeableConceptHow it was done
Binding: ObservationMethods (example)
... derivedFrom ΣI0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from

doco Documentation for this format

This structure is derived from Observation

Summary

Mandatory: 1 element
Must-Support: 5 elements
Prohibited: 6 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Observation.value[x] is sliced based on the value of type:$this

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*Observation
... extension 0..*ExtensionSlice: Unordered, Open by value:url
... mcode-evidence-type 0..*CodeableConceptExtension
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-evidence-type
.... valueCodeableConcept 0..1CodeableConceptBinding: Cancer Disease Status Evidence Type Value Set (required)
... basedOn 0..*Reference(ServiceRequest | MedicationRequest)
... status S1..1code
... code S1..1CodeableConceptRequired Pattern: At least the following
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 88040-1
... subject S1..1Reference(Cancer Patient)
... focus 0..*Reference(Cancer Condition Parent)
... effective[x] S0..1
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... performer 0..*Reference(US Core Practitioner Profile)
... value[x] 0..1(Slice Definition)Slice: Unordered, Open by type:$this
... valueCodeableConcept S0..1CodeableConceptBinding: Condition Status Trend Value Set (required)
... interpretation 0..1CodeableConcept
... bodySite 0..0
... specimen 0..0
... device 0..0
... referenceRange 0..0
... hasMember 0..0
... component 0..0

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*ObservationMeasurements and simple assertions
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionExtension
Slice: Unordered, Open by value:url
... mcode-evidence-type I0..*CodeableConceptOptional Extensions Element
URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-evidence-type
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..0
.... url 1..1uri"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-evidence-type"
.... value[x] I0..1(Slice Definition)Value of extension
Slice: Unordered, Closed by type:$this
..... value[x]:valueCodeableConcept I0..1CodeableConceptValue of extension
Binding: Cancer Disease Status Evidence Type Value Set (required)
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI0..*IdentifierBusiness Identifier for observation
... basedOn ΣI0..*Reference(ServiceRequest | MedicationRequest)Fulfills plan, proposal or order
... partOf ΣI0..*Reference(MedicationAdministration | MedicationStatement | Procedure)Part of referenced event
... status ?!SΣI1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category I0..*CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred)
... code SΣI1..1CodeableConceptType of observation (code / type)
Binding: LOINCCodes (example)
Required Pattern: At least the following
.... id0..1stringUnique id for inter-element referencing
.... extension0..*ExtensionAdditional content defined by implementations
.... coding1..*CodingCode defined by a terminology system
Fixed Value: (complex)
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... system1..1uriIdentity of the terminology system
Fixed Value: http://loinc.org
..... version0..1stringVersion of the system - if relevant
..... code1..1codeSymbol in syntax defined by the system
Fixed Value: 88040-1
..... display0..1stringRepresentation defined by the system
..... userSelected0..1booleanIf this coding was chosen directly by the user
.... text0..1stringPlain text representation of the concept
... subject SΣI1..1Reference(Cancer Patient)Who and/or what the observation is about
... focus ΣI0..*Reference(Cancer Condition Parent)What the observation is about, when it is not about the subject of record
... encounter ΣI0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣI0..1Clinically relevant time/time-period for observation
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
... issued ΣI0..1instantDate/Time this version was made available
... performer ΣI0..*Reference(US Core Practitioner Profile)Who is responsible for the observation
... value[x] ΣI0..1(Slice Definition)Actual result
Slice: Unordered, Closed by type:$this
.... value[x]:valueCodeableConcept SΣI0..1CodeableConceptActual result
Binding: Condition Status Trend Value Set (required)
... dataAbsentReason I0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible)
... interpretation I0..1CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible)
... note I0..*AnnotationComments about the observation
... method I0..1CodeableConceptHow it was done
Binding: ObservationMethods (example)
... derivedFrom ΣI0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from

doco Documentation for this format

 

Other representations of profile: Schematron

Terminology Bindings

Terminology Bindings

PathConformanceValueSet / Code
Observation.languagepreferredCommonLanguages
Max Binding: AllLanguages
Observation.extension:evidenceType.value[x]:valueCodeableConceptrequiredCancerDiseaseStatusEvidenceTypeVS
Observation.statusrequiredObservationStatus
Observation.categorypreferredObservationCategoryCodes
Observation.codeexamplePattern: LOINC code 88040-1
Observation.value[x]:valueCodeableConceptrequiredConditionStatusTrendVS
Observation.dataAbsentReasonextensibleDataAbsentReason
Observation.interpretationextensibleObservationInterpretationCodes
Observation.methodexampleObservationMethods
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
Observation.component.codeexampleLOINCCodes
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationextensibleObservationInterpretationCodes

Constraints

Constraints

IdPathDetailsRequirements