minimal Common Oncology Data Elements (mCODE) Implementation Guide
4.0.0 - STU4 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 (v4.0.0: STU4) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: Karnofsky Performance Status Profile

Official URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-karnofsky-performance-status Version: 4.0.0
Active as of 2025-02-16 Maturity Level: 4 Computable Name: KarnofskyPerformanceStatus
Other Identifiers: OID:2.16.840.1.113883.4.642.40.15.42.27

The Karnofsky Performance Status (KPS) is a tool used to measure a patient's functional status. It can be used to compare the effectiveness of different therapies and to help assess the prognosis of certain patients, such as those with certain cancers. The KPS score ranges from 0 to 100 in intervals of 10. Higher scores are associated with better functional status, with 100 representing no symptoms or evidence of disease, and 0 representing death.

Conformance

Observation resources associated with an in-scope patient with Observation.code LOINC 89243-0 SHALL 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:

Changes since version true:

  • New Content

    • Formal Views of Profile Content

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

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* USCoreObservationClinicalResultProfile Measurements and simple assertions
    dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    dom-6: A resource should have narrative for robust management
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ele-1: All FHIR elements must have a @value or children
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... basedOn Σ 0..* Reference(ServiceRequest | CarePlan) Fulfills plan, proposal or order
    ele-1: All FHIR elements must have a @value or children
    ... status ?!SΣ 1..1 code (USCDI) registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.


    ele-1: All FHIR elements must have a @value or children
    ... Slices for category S 1..* CodeableConcept (USCDI) Classification of type of observation
    Slice: Unordered, Open by pattern:$this
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    ele-1: All FHIR elements must have a @value or children
    .... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
    Binding: US Core Clinical Result Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


    ele-1: All FHIR elements must have a @value or children
    ... code SΣ 1..1 CodeableConcept (USCDI) Clinical Test or Procedure Name
    Binding: LOINCCodes (extensible)
    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://loinc.org
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 89243-0
    ... subject SΣ 1..1 Reference(Cancer Patient Profile) (USCDI) Who and/or what the observation is about
    ele-1: All FHIR elements must have a @value or children
    ... effective[x] SΣC 0..1 (USCDI) Clinically relevant time/time-period for observation
    ele-1: All FHIR elements must have a @value or children
    us-core-1: Datetime must be at least to day.
    .... effectiveDateTime dateTime
    ... value[x] SΣC 0..1 integer (USCDI) Result Value
    ele-1: All FHIR elements must have a @value or children
    us-core-3: SHALL use UCUM for coded quantity units.
    ... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.


    ele-1: All FHIR elements must have a @value or children
    ... interpretation S 0..* CodeableConcept High, low, normal, etc.
    Binding: LOINC Answer List LL4986-7 (required)
    ele-1: All FHIR elements must have a @value or children
    ... bodySite 0..1 CodeableConcept Not used in this profile
    Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.


    ele-1: All FHIR elements must have a @value or children
    ... specimen 0..1 Reference(Specimen) Not used in this profile
    ele-1: All FHIR elements must have a @value or children
    ... device 0..1 Reference(Device | DeviceMetric) Not used in this profile
    ele-1: All FHIR elements must have a @value or children
    ... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Not used in this profile
    ele-1: All FHIR elements must have a @value or children
    ... component Σ 0..* BackboneElement Not used in this profile
    ele-1: All FHIR elements must have a @value or children
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    ele-1: All FHIR elements must have a @value or children

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:us-corerequiredUSCoreClinicalResultObservationCategory
    http://hl7.org/fhir/us/core/ValueSet/us-core-clinical-result-observation-category
    Observation.codeextensiblePattern: LOINC Code 89243-0
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.interpretationrequiredLOINC LL4986-7
    http://loinc.org/vs/LL4986-7
    Observation.bodySiteexampleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard

    This structure is derived from USCoreObservationClinicalResultProfile

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation 0..* USCoreObservationClinicalResultProfile Measurements and simple assertions
    ... basedOn 0..* Reference(ServiceRequest | CarePlan) Fulfills plan, proposal or order
    ... partOf 0..* Reference(Procedure) Part of referenced event
    ... code 1..1 CodeableConcept (USCDI) Clinical Test or Procedure Name
    Required Pattern: At least the following
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://loinc.org
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 89243-0
    ... effective[x] 0..1 (USCDI) Clinically relevant time/time-period for observation
    .... effectiveDateTime dateTime
    .... effectivePeriod Period
    ... value[x] 0..1 integer (USCDI) Result Value
    ... interpretation S 0..* CodeableConcept High, low, normal, etc.
    Binding: LOINC Answer List LL4986-7 (required)
    ... bodySite 0..1 CodeableConcept Not used in this profile
    ... specimen 0..1 Reference(Specimen) Not used in this profile
    ... device 0..1 Reference(Device | DeviceMetric) Not used in this profile
    ... hasMember 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Not used in this profile
    ... component 0..* BackboneElement Not used in this profile

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Observation.interpretationrequiredLOINC LL4986-7
    http://loinc.org/vs/LL4986-7
    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* USCoreObservationClinicalResultProfile Measurements and simple assertions
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present
    ... id Σ 0..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier Σ 0..* Identifier Business Identifier for observation
    ... basedOn Σ 0..* Reference(ServiceRequest | CarePlan) Fulfills plan, proposal or order
    ... partOf Σ 0..* Reference(Procedure) Part of referenced event
    ... status ?!SΣ 1..1 code (USCDI) registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    ... Slices for category S 1..* CodeableConcept (USCDI) Classification of type of observation
    Slice: Unordered, Open by pattern:$this
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    .... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
    Binding: US Core Clinical Result Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


    ... code SΣ 1..1 CodeableConcept (USCDI) Clinical Test or Procedure Name
    Binding: LOINCCodes (extensible)
    Required Pattern: At least the following
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://loinc.org
    ..... version 0..1 string Version of the system - if relevant
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 89243-0
    ..... display 0..1 string Representation defined by the system
    ..... userSelected 0..1 boolean If this coding was chosen directly by the user
    .... text 0..1 string Plain text representation of the concept
    ... subject SΣ 1..1 Reference(Cancer Patient Profile) (USCDI) Who and/or what the observation is about
    ... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
    ... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
    ... effective[x] SΣC 0..1 (USCDI) Clinically relevant time/time-period for observation
    us-core-1: Datetime must be at least to day.
    .... effectiveDateTime dateTime S
    .... effectivePeriod Period
    ... issued Σ 0..1 instant Date/Time this version was made available
    ... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
    ... value[x] SΣC 0..1 integer (USCDI) Result Value
    us-core-3: SHALL use UCUM for coded quantity units.
    ... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    ... interpretation S 0..* CodeableConcept High, low, normal, etc.
    Binding: LOINC Answer List LL4986-7 (required)
    ... note 0..* Annotation Comments about the observation
    ... bodySite 0..1 CodeableConcept Not used in this profile
    Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

    ... method 0..1 CodeableConcept How it was done
    Binding: ObservationMethods (example): Methods for simple observations.

    ... specimen 0..1 Reference(Specimen) Not used in this profile
    ... device 0..1 Reference(Device | DeviceMetric) Not used in this profile
    ... referenceRange C 0..* BackboneElement Provides guide for interpretation
    obs-3: Must have at least a low or a high or text
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... low C 0..1 SimpleQuantity Low Range, if relevant
    .... high C 0..1 SimpleQuantity High Range, if relevant
    .... type 0..1 CodeableConcept Reference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

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


    .... age 0..1 Range Applicable age range, if relevant
    .... text 0..1 string Text based reference range in an observation
    ... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Not used in this profile
    ... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
    ... component Σ 0..* BackboneElement Not used in this profile
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.

    .... value[x] Σ 0..1 Actual component result
    ..... valueQuantity Quantity
    ..... valueCodeableConcept CodeableConcept
    ..... valueString string
    ..... valueBoolean boolean
    ..... valueInteger integer
    ..... valueRange Range
    ..... valueRatio Ratio
    ..... valueSampledData SampledData
    ..... valueTime time
    ..... valueDateTime dateTime
    ..... valuePeriod Period
    .... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    .... interpretation 0..* CodeableConcept High, 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 / CodeURI
    Observation.languagepreferredCommonLanguages
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Additional Bindings Purpose
    AllLanguages Max Binding
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:us-corerequiredUSCoreClinicalResultObservationCategory
    http://hl7.org/fhir/us/core/ValueSet/us-core-clinical-result-observation-category
    Observation.codeextensiblePattern: LOINC Code 89243-0
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.interpretationrequiredLOINC LL4986-7
    http://loinc.org/vs/LL4986-7
    Observation.bodySiteexampleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Observation.methodexampleObservationMethods
    http://hl7.org/fhir/ValueSet/observation-methods
    from the FHIR Standard
    Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
    http://hl7.org/fhir/ValueSet/referencerange-meaning
    from the FHIR Standard
    Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
    http://hl7.org/fhir/ValueSet/referencerange-appliesto
    from the FHIR Standard
    Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard

    This structure is derived from USCoreObservationClinicalResultProfile

    Summary

    Must-Support: 1 element

    Structures

    This structure refers to these other structures:

    Maturity: 4

    Key Elements View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* USCoreObservationClinicalResultProfile Measurements and simple assertions
    dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
    dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
    dom-6: A resource should have narrative for robust management
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ele-1: All FHIR elements must have a @value or children
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    ... basedOn Σ 0..* Reference(ServiceRequest | CarePlan) Fulfills plan, proposal or order
    ele-1: All FHIR elements must have a @value or children
    ... status ?!SΣ 1..1 code (USCDI) registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.


    ele-1: All FHIR elements must have a @value or children
    ... Slices for category S 1..* CodeableConcept (USCDI) Classification of type of observation
    Slice: Unordered, Open by pattern:$this
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    ele-1: All FHIR elements must have a @value or children
    .... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
    Binding: US Core Clinical Result Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


    ele-1: All FHIR elements must have a @value or children
    ... code SΣ 1..1 CodeableConcept (USCDI) Clinical Test or Procedure Name
    Binding: LOINCCodes (extensible)
    ele-1: All FHIR elements must have a @value or children
    Required Pattern: At least the following
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://loinc.org
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 89243-0
    ... subject SΣ 1..1 Reference(Cancer Patient Profile) (USCDI) Who and/or what the observation is about
    ele-1: All FHIR elements must have a @value or children
    ... effective[x] SΣC 0..1 (USCDI) Clinically relevant time/time-period for observation
    ele-1: All FHIR elements must have a @value or children
    us-core-1: Datetime must be at least to day.
    .... effectiveDateTime dateTime
    ... value[x] SΣC 0..1 integer (USCDI) Result Value
    ele-1: All FHIR elements must have a @value or children
    us-core-3: SHALL use UCUM for coded quantity units.
    ... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.


    ele-1: All FHIR elements must have a @value or children
    ... interpretation S 0..* CodeableConcept High, low, normal, etc.
    Binding: LOINC Answer List LL4986-7 (required)
    ele-1: All FHIR elements must have a @value or children
    ... bodySite 0..1 CodeableConcept Not used in this profile
    Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.


    ele-1: All FHIR elements must have a @value or children
    ... specimen 0..1 Reference(Specimen) Not used in this profile
    ele-1: All FHIR elements must have a @value or children
    ... device 0..1 Reference(Device | DeviceMetric) Not used in this profile
    ele-1: All FHIR elements must have a @value or children
    ... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Not used in this profile
    ele-1: All FHIR elements must have a @value or children
    ... component Σ 0..* BackboneElement Not used in this profile
    ele-1: All FHIR elements must have a @value or children
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    ele-1: All FHIR elements must have a @value or children
    ext-1: Must have either extensions or value[x], not both
    .... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.


    ele-1: All FHIR elements must have a @value or children

    doco Documentation for this format

    Terminology Bindings

    PathConformanceValueSet / CodeURI
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:us-corerequiredUSCoreClinicalResultObservationCategory
    http://hl7.org/fhir/us/core/ValueSet/us-core-clinical-result-observation-category
    Observation.codeextensiblePattern: LOINC Code 89243-0
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.interpretationrequiredLOINC LL4986-7
    http://loinc.org/vs/LL4986-7
    Observation.bodySiteexampleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard

    Differential View

    This structure is derived from USCoreObservationClinicalResultProfile

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation 0..* USCoreObservationClinicalResultProfile Measurements and simple assertions
    ... basedOn 0..* Reference(ServiceRequest | CarePlan) Fulfills plan, proposal or order
    ... partOf 0..* Reference(Procedure) Part of referenced event
    ... code 1..1 CodeableConcept (USCDI) Clinical Test or Procedure Name
    Required Pattern: At least the following
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://loinc.org
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 89243-0
    ... effective[x] 0..1 (USCDI) Clinically relevant time/time-period for observation
    .... effectiveDateTime dateTime
    .... effectivePeriod Period
    ... value[x] 0..1 integer (USCDI) Result Value
    ... interpretation S 0..* CodeableConcept High, low, normal, etc.
    Binding: LOINC Answer List LL4986-7 (required)
    ... bodySite 0..1 CodeableConcept Not used in this profile
    ... specimen 0..1 Reference(Specimen) Not used in this profile
    ... device 0..1 Reference(Device | DeviceMetric) Not used in this profile
    ... hasMember 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Not used in this profile
    ... component 0..* BackboneElement Not used in this profile

    doco Documentation for this format

    Terminology Bindings (Differential)

    PathConformanceValueSetURI
    Observation.interpretationrequiredLOINC LL4986-7
    http://loinc.org/vs/LL4986-7

    Snapshot View

    NameFlagsCard.TypeDescription & Constraintsdoco
    .. Observation C 0..* USCoreObservationClinicalResultProfile Measurements and simple assertions
    obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present
    obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present
    us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present
    ... id Σ 0..1 id Logical id of this artifact
    ... meta Σ 0..1 Meta Metadata about the resource
    ... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
    ... language 0..1 code Language of the resource content
    Binding: CommonLanguages (preferred): A human language.

    Additional BindingsPurpose
    AllLanguages Max Binding
    ... text 0..1 Narrative Text summary of the resource, for human interpretation
    ... contained 0..* Resource Contained, inline Resources
    ... extension 0..* Extension Additional content defined by implementations
    ... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
    ... identifier Σ 0..* Identifier Business Identifier for observation
    ... basedOn Σ 0..* Reference(ServiceRequest | CarePlan) Fulfills plan, proposal or order
    ... partOf Σ 0..* Reference(Procedure) Part of referenced event
    ... status ?!SΣ 1..1 code (USCDI) registered | preliminary | final | amended +
    Binding: ObservationStatus (required): Codes providing the status of an observation.

    ... Slices for category S 1..* CodeableConcept (USCDI) Classification of type of observation
    Slice: Unordered, Open by pattern:$this
    Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


    .... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
    Binding: US Core Clinical Result Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets


    ... code SΣ 1..1 CodeableConcept (USCDI) Clinical Test or Procedure Name
    Binding: LOINCCodes (extensible)
    Required Pattern: At least the following
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... coding 1..* Coding Code defined by a terminology system
    Fixed Value: (complex)
    ..... id 0..1 string Unique id for inter-element referencing
    ..... extension 0..* Extension Additional content defined by implementations
    ..... system 1..1 uri Identity of the terminology system
    Fixed Value: http://loinc.org
    ..... version 0..1 string Version of the system - if relevant
    ..... code 1..1 code Symbol in syntax defined by the system
    Fixed Value: 89243-0
    ..... display 0..1 string Representation defined by the system
    ..... userSelected 0..1 boolean If this coding was chosen directly by the user
    .... text 0..1 string Plain text representation of the concept
    ... subject SΣ 1..1 Reference(Cancer Patient Profile) (USCDI) Who and/or what the observation is about
    ... focus Σ 0..* Reference(Resource) What the observation is about, when it is not about the subject of record
    ... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
    ... effective[x] SΣC 0..1 (USCDI) Clinically relevant time/time-period for observation
    us-core-1: Datetime must be at least to day.
    .... effectiveDateTime dateTime S
    .... effectivePeriod Period
    ... issued Σ 0..1 instant Date/Time this version was made available
    ... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
    ... value[x] SΣC 0..1 integer (USCDI) Result Value
    us-core-3: SHALL use UCUM for coded quantity units.
    ... dataAbsentReason SC 0..1 CodeableConcept (USCDI) Why the result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    ... interpretation S 0..* CodeableConcept High, low, normal, etc.
    Binding: LOINC Answer List LL4986-7 (required)
    ... note 0..* Annotation Comments about the observation
    ... bodySite 0..1 CodeableConcept Not used in this profile
    Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

    ... method 0..1 CodeableConcept How it was done
    Binding: ObservationMethods (example): Methods for simple observations.

    ... specimen 0..1 Reference(Specimen) Not used in this profile
    ... device 0..1 Reference(Device | DeviceMetric) Not used in this profile
    ... referenceRange C 0..* BackboneElement Provides guide for interpretation
    obs-3: Must have at least a low or a high or text
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... low C 0..1 SimpleQuantity Low Range, if relevant
    .... high C 0..1 SimpleQuantity High Range, if relevant
    .... type 0..1 CodeableConcept Reference range qualifier
    Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

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


    .... age 0..1 Range Applicable age range, if relevant
    .... text 0..1 string Text based reference range in an observation
    ... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Not used in this profile
    ... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
    ... component Σ 0..* BackboneElement Not used in this profile
    .... id 0..1 string Unique id for inter-element referencing
    .... extension 0..* Extension Additional content defined by implementations
    .... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
    .... code Σ 1..1 CodeableConcept Type of component observation (code / type)
    Binding: LOINCCodes (example): Codes identifying names of simple observations.

    .... value[x] Σ 0..1 Actual component result
    ..... valueQuantity Quantity
    ..... valueCodeableConcept CodeableConcept
    ..... valueString string
    ..... valueBoolean boolean
    ..... valueInteger integer
    ..... valueRange Range
    ..... valueRatio Ratio
    ..... valueSampledData SampledData
    ..... valueTime time
    ..... valueDateTime dateTime
    ..... valuePeriod Period
    .... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
    Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

    .... interpretation 0..* CodeableConcept High, 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 / CodeURI
    Observation.languagepreferredCommonLanguages
    http://hl7.org/fhir/ValueSet/languages
    from the FHIR Standard
    Additional Bindings Purpose
    AllLanguages Max Binding
    Observation.statusrequiredObservationStatus
    http://hl7.org/fhir/ValueSet/observation-status|4.0.1
    from the FHIR Standard
    Observation.categorypreferredObservationCategoryCodes
    http://hl7.org/fhir/ValueSet/observation-category
    from the FHIR Standard
    Observation.category:us-corerequiredUSCoreClinicalResultObservationCategory
    http://hl7.org/fhir/us/core/ValueSet/us-core-clinical-result-observation-category
    Observation.codeextensiblePattern: LOINC Code 89243-0
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.interpretationrequiredLOINC LL4986-7
    http://loinc.org/vs/LL4986-7
    Observation.bodySiteexampleSNOMEDCTBodyStructures
    http://hl7.org/fhir/ValueSet/body-site
    from the FHIR Standard
    Observation.methodexampleObservationMethods
    http://hl7.org/fhir/ValueSet/observation-methods
    from the FHIR Standard
    Observation.referenceRange.typepreferredObservationReferenceRangeMeaningCodes
    http://hl7.org/fhir/ValueSet/referencerange-meaning
    from the FHIR Standard
    Observation.referenceRange.appliesToexampleObservationReferenceRangeAppliesToCodes
    http://hl7.org/fhir/ValueSet/referencerange-appliesto
    from the FHIR Standard
    Observation.component.codeexampleLOINCCodes (a valid code from LOINC)
    http://hl7.org/fhir/ValueSet/observation-codes
    from the FHIR Standard
    Observation.component.dataAbsentReasonextensibleDataAbsentReason
    http://hl7.org/fhir/ValueSet/data-absent-reason
    from the FHIR Standard
    Observation.component.interpretationextensibleObservationInterpretationCodes
    http://hl7.org/fhir/ValueSet/observation-interpretation
    from the FHIR Standard

    This structure is derived from USCoreObservationClinicalResultProfile

    Summary

    Must-Support: 1 element

    Structures

    This structure refers to these other structures:

    Maturity: 4

     

    Other representations of profile: CSV, Excel, Schematron