minimal Common Oncology Data Elements (mCODE) Implementation Guide
2.1.0 - STU 2.1 United States of America flag

This page is part of the HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU1 (v2.1.0: STU 2) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: TNM Distant Metastases Category Profile

Official URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tnm-distant-metastases-category Version: 2.1.0
Active as of 2023-03-21 Computable Name: TNMDistantMetastasesCategory

Category describing the extent of a tumor metastasis in remote anatomical locations, based on evidence such as physical examination, imaging, and/or biopsy.

Conformance

Observation resources associated with an [in-scope patient] with Observation.code of LOINC 21907-1, 21901-4, or 21913-9 MUST conform to this profile. Beyond this requirement, a producer of resources SHOULD ensure that any resource instance associated with an [in-scope patient] that would reasonably be expected to conform to this profile SHOULD be published in this form.

Usage:

Formal Views of Profile Content

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

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*ObservationMeasurements and simple assertions
... status S1..1coderegistered | preliminary | final | amended +
... code S1..1CodeableConceptType of observation (code / type)
Binding: Staging Type Value Set (for Distant Metastases Category) (required)
... subject S0..1Reference(Cancer Patient Profile)Who and/or what the observation is about
... effective[x] S0..1dateTime, Period, Timing, instantClinically relevant time/time-period for observation
... value[x] S0..1CodeableConceptActual result
Binding: TNM Distant Metastases Category Value Set (preferred)
... method S0..1CodeableConceptHow it was done
Binding: Cancer Staging System Value Set (extensible)
... device 0..1Reference(Device | DeviceMetric)Not used in this profile
... referenceRange 0..*BackboneElementNot used in this profile
... hasMember 0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Not used in this profile
... component 0..*BackboneElementNot used in this profile

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Observation.coderequiredObservationCodesDistantMetastasesVS
Observation.value[x]preferredTNMDistantMetastasesCategoryVS (a valid code from http://cancerstaging.org)
Observation.methodextensibleCancerStagingSystemVS
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationMeasurements and simple assertions
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... subject SΣ0..1Reference(Cancer Patient Profile)Who and/or what the observation is about
... focus SΣ0..*Reference(Primary Cancer Condition Profile)What the observation is about, when it is not about the subject of record
... effective[x] SΣ0..1Clinically relevant time/time-period for observation
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
.... effectiveTimingTiming
.... effectiveInstantinstant
... value[x] SΣC0..1CodeableConceptActual result
Binding: TNM Distant Metastases Category Value Set (preferred)
... method S0..1CodeableConceptHow it was done
Binding: Cancer Staging System Value Set (extensible)
... device 0..1Reference(Device | DeviceMetric)Not used in this profile
... referenceRange C0..*BackboneElementNot used in this profile
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
... hasMember Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Not used in this profile
... component Σ0..*BackboneElementNot used in this profile
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Observation.statusrequiredObservationStatus
Observation.coderequiredObservationCodesDistantMetastasesVS
Observation.value[x]preferredTNMDistantMetastasesCategoryVS (a valid code from http://cancerstaging.org)
Observation.methodextensibleCancerStagingSystemVS
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationMeasurements and simple assertions
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
​AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... category 0..*CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


... code SΣ1..1CodeableConceptType of observation (code / type)
Binding: Staging Type Value Set (for Distant Metastases Category) (required)
... subject SΣ0..1Reference(Cancer Patient Profile)Who and/or what the observation is about
... focus SΣ0..*Reference(Primary Cancer Condition Profile)What the observation is about, when it is not about the subject of record
... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣ0..1Clinically relevant time/time-period for observation
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
.... effectiveTimingTiming
.... effectiveInstantinstant
... issued Σ0..1instantDate/Time this version was made available
... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣC0..1CodeableConceptActual result
Binding: TNM Distant Metastases Category Value Set (preferred)
... dataAbsentReason C0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..*AnnotationComments about the observation
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

... method S0..1CodeableConceptHow it was done
Binding: Cancer Staging System Value Set (extensible)
... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)Not used in this profile
... referenceRange C0..*BackboneElementNot used in this profile
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low C0..1SimpleQuantityLow Range, if relevant
.... high C0..1SimpleQuantityHigh Range, if relevant
.... type 0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... hasMember Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Not used in this profile
... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from
... component Σ0..*BackboneElementNot used in this profile
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... value[x] Σ0..1Actual component result
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason C0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


.... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
​ AllLanguages Max Binding
Observation.statusrequiredObservationStatus
Observation.categorypreferredObservationCategoryCodes
Observation.coderequiredObservationCodesDistantMetastasesVS
Observation.value[x]preferredTNMDistantMetastasesCategoryVS (a valid code from http://cancerstaging.org)
Observation.dataAbsentReasonextensibleDataAbsentReason
Observation.interpretationextensibleObservationInterpretationCodes
Observation.bodySiteexampleSNOMEDCTBodyStructures
Observation.methodextensibleCancerStagingSystemVS
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationextensibleObservationInterpretationCodes

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation 0..*ObservationMeasurements and simple assertions
... status S1..1coderegistered | preliminary | final | amended +
... code S1..1CodeableConceptType of observation (code / type)
Binding: Staging Type Value Set (for Distant Metastases Category) (required)
... subject S0..1Reference(Cancer Patient Profile)Who and/or what the observation is about
... effective[x] S0..1dateTime, Period, Timing, instantClinically relevant time/time-period for observation
... value[x] S0..1CodeableConceptActual result
Binding: TNM Distant Metastases Category Value Set (preferred)
... method S0..1CodeableConceptHow it was done
Binding: Cancer Staging System Value Set (extensible)
... device 0..1Reference(Device | DeviceMetric)Not used in this profile
... referenceRange 0..*BackboneElementNot used in this profile
... hasMember 0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Not used in this profile
... component 0..*BackboneElementNot used in this profile

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
Observation.coderequiredObservationCodesDistantMetastasesVS
Observation.value[x]preferredTNMDistantMetastasesCategoryVS (a valid code from http://cancerstaging.org)
Observation.methodextensibleCancerStagingSystemVS

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationMeasurements and simple assertions
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... subject SΣ0..1Reference(Cancer Patient Profile)Who and/or what the observation is about
... focus SΣ0..*Reference(Primary Cancer Condition Profile)What the observation is about, when it is not about the subject of record
... effective[x] SΣ0..1Clinically relevant time/time-period for observation
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
.... effectiveTimingTiming
.... effectiveInstantinstant
... value[x] SΣC0..1CodeableConceptActual result
Binding: TNM Distant Metastases Category Value Set (preferred)
... method S0..1CodeableConceptHow it was done
Binding: Cancer Staging System Value Set (extensible)
... device 0..1Reference(Device | DeviceMetric)Not used in this profile
... referenceRange C0..*BackboneElementNot used in this profile
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
... hasMember Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Not used in this profile
... component Σ0..*BackboneElementNot used in this profile
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.


doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Observation.statusrequiredObservationStatus
Observation.coderequiredObservationCodesDistantMetastasesVS
Observation.value[x]preferredTNMDistantMetastasesCategoryVS (a valid code from http://cancerstaging.org)
Observation.methodextensibleCancerStagingSystemVS
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation C0..*ObservationMeasurements and simple assertions
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
​AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
... partOf Σ0..*Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)Part of referenced event
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.

... category 0..*CodeableConceptClassification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


... code SΣ1..1CodeableConceptType of observation (code / type)
Binding: Staging Type Value Set (for Distant Metastases Category) (required)
... subject SΣ0..1Reference(Cancer Patient Profile)Who and/or what the observation is about
... focus SΣ0..*Reference(Primary Cancer Condition Profile)What the observation is about, when it is not about the subject of record
... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is made
... effective[x] SΣ0..1Clinically relevant time/time-period for observation
.... effectiveDateTimedateTime
.... effectivePeriodPeriod
.... effectiveTimingTiming
.... effectiveInstantinstant
... issued Σ0..1instantDate/Time this version was made available
... performer Σ0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
... value[x] SΣC0..1CodeableConceptActual result
Binding: TNM Distant Metastases Category Value Set (preferred)
... dataAbsentReason C0..1CodeableConceptWhy the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


... note 0..*AnnotationComments about the observation
... bodySite 0..1CodeableConceptObserved body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

... method S0..1CodeableConceptHow it was done
Binding: Cancer Staging System Value Set (extensible)
... specimen 0..1Reference(Specimen)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)Not used in this profile
... referenceRange C0..*BackboneElementNot used in this profile
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... low C0..1SimpleQuantityLow Range, if relevant
.... high C0..1SimpleQuantityHigh Range, if relevant
.... type 0..1CodeableConceptReference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

.... appliesTo 0..*CodeableConceptReference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.


.... age 0..1RangeApplicable age range, if relevant
.... text 0..1stringText based reference range in an observation
... hasMember Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Not used in this profile
... derivedFrom Σ0..*Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)Related measurements the observation is made from
... component Σ0..*BackboneElementNot used in this profile
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... code Σ1..1CodeableConceptType of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.

.... value[x] Σ0..1Actual component result
..... valueQuantityQuantity
..... valueCodeableConceptCodeableConcept
..... valueStringstring
..... valueBooleanboolean
..... valueIntegerinteger
..... valueRangeRange
..... valueRatioRatio
..... valueSampledDataSampledData
..... valueTimetime
..... valueDateTimedateTime
..... valuePeriodPeriod
.... dataAbsentReason C0..1CodeableConceptWhy the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

.... interpretation 0..*CodeableConceptHigh, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


.... referenceRange 0..*See referenceRange (Observation)Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
Observation.languagepreferredCommonLanguages
Additional Bindings Purpose
​ AllLanguages Max Binding
Observation.statusrequiredObservationStatus
Observation.categorypreferredObservationCategoryCodes
Observation.coderequiredObservationCodesDistantMetastasesVS
Observation.value[x]preferredTNMDistantMetastasesCategoryVS (a valid code from http://cancerstaging.org)
Observation.dataAbsentReasonextensibleDataAbsentReason
Observation.interpretationextensibleObservationInterpretationCodes
Observation.bodySiteexampleSNOMEDCTBodyStructures
Observation.methodextensibleCancerStagingSystemVS
Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
Observation.component.dataAbsentReasonextensibleDataAbsentReason
Observation.component.interpretationextensibleObservationInterpretationCodes

 

Other representations of profile: CSV, Excel, Schematron