Profile Comparison between http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-assessments vs http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationSexualOrientation

Left:US Core Observation Screening Assessments Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-assessments)
Right:SDOHCC Observation Sexual Orientation (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationSexualOrientation)

Messages

ErrorStructureDefinition.urlValues for url differ: 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-assessments' vs 'http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationSexualOrientation'
ErrorStructureDefinition.versionValues for version differ: '6.0.0-ballot' vs '2.0.0'
InformationStructureDefinition.nameValues for name differ: 'USCoreObservationScreeningAssessmentsProfile' vs 'SDOHCCObservationSexualOrientation'
InformationStructureDefinition.titleValues for title differ: 'US Core Observation Screening Assessments Profile' vs 'SDOHCC Observation Sexual Orientation'
InformationStructureDefinition.statusValues for status differ: 'active' vs 'draft'
InformationStructureDefinition.dateValues for date differ: '2022-04-20' vs '2022-11-21T18:34:14+00:00'
InformationStructureDefinition.publisherValues for publisher differ: 'HL7 International - Cross-Group Projects' vs 'HL7 International - Patient Care WG'
ErrorStructureDefinition.baseDefinitionValues for baseDefinition differ: 'http://hl7.org/fhir/StructureDefinition/Observation' vs 'http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationPersonalCharacteristic'
WarningObservationElements differ in short: 'Survey Observation' vs 'Observation about an individual's sexual orientation'
WarningObservationElements differ in definition: '\-' vs 'Defines constraints that represent the minimum requirement for personal characteristic observations which are observations that are usually self-attested but may be attested to on behalf of the subject (e.g., for a minor or incapable subject) and are generally only verifiable by the source of attestation (e.g., race, ethnicity, sexual orientation, gender identity and personal pronouns), but may sometimes be verifiable by someone other than the source of attestation (e.g., recorded sex).'
WarningObservationElements differ in comments: '\-' vs 'For observations about the sexual orientation of an individual.'
WarningObservation.extensionElements differ in short: 'Additional content defined by implementations' vs 'Extension'
WarningObservation.extensionElements differ in definition: 'May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'An Extension'
WarningObservation.statusElements differ in short: 'registered | preliminary | final | amended +' vs 'final | corrected | entered-in-error | unknown'
WarningObservation.statusElements differ in definition: 'The status of the result value.' vs 'The status of the observation value.'
WarningObservation.statusElements differ in requirements: 'Need to track the status of individual results. Some results are finalized before the whole report is finalized.' vs 'Further constrained to values that are relevant for personal characteristic observations.'
WarningObservation.categoryElements differ in requirements: 'To identify that observation is derived from a questionnaire.' vs 'Used for filtering what observations are retrieved and displayed.'
WarningObservation.categoryElements differ in definition for mustSupport: 'true' vs 'false'
WarningObservation.codeElements differ in comments: '*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.' vs '*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation. NOTE: In LOINC, System Patient is used in the modeling of codes referenced by the Personal Characteristics profiles (e.g., 72826-1 Race OMB.1997, 69490-1 Ethnicity OMB.1997, 76691-5 Gender identity, 76690-7 Sexual orientation, 90778-2 Personal pronouns – Reported, and 99502-7 Recorded sex or gender). If the draft profiles are adopted, new LOINC codes without System Patient would be needed since these profiles can also be used to capture characteristics of a provider (using an extension) or a related person (using focus).'
InformationObservation.codeExample/preferred bindings differ at Observation.code using binding from USCoreObservationScreeningAssessmentsProfile
InformationObservation.subjectElement minimum cardinalities differ: '1' vs '0'
InformationObservation.focusElement maximum cardinalities differ: '2147483647' vs '1'
WarningObservation.effective[x]Elements differ in definition: 'The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the 'physiologically relevant time'.' vs 'The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the 'physiologically relevant time'. This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.'
WarningObservation.effective[x]Elements differ in comments: 'At least a date should be present unless this observation is a historical report.' vs 'At least a date should be present unless this observation is a historical report. For recording imprecise or 'fuzzy' times (For example, a blood glucose measurement taken 'after breakfast') use the [Timing] datatype which allow the measurement to be tied to regular life events. NOTE: dateTime is Must Support, but currently tooling does not support this.'
WarningObservation.effective[x]Elements differ in definition for mustSupport: 'true' vs 'false'
WarningObservation.value[x]Elements differ in comments: 'An observation may have a value if it represents an individual survey, screening, or assessment question and answer pair. An observation should not have a value if it represents a multi-question or multi-select “check all that apply” responses. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.' vs 'An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section] below.'
WarningObservation.value[x]Elements differ in requirements: 'An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.' vs 'An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations. NOTE: This is a value set is for testing purposes only and will ultimately need to be aligned with vetted value sets where terms like “asexual” and “pansexual” may be included.'
InformationObservation.value[x]Element minimum cardinalities differ: '0' vs '1'
WarningObservation.value[x].extensionElements differ in short: 'Additional content defined by implementations' vs 'Extension'
WarningObservation.value[x].extensionElements differ in definition: 'May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'An Extension'
WarningObservation.value[x].codingElements differ in definition for mustSupport: 'false' vs 'true'
WarningObservation.dataAbsentReasonElements differ in comments: ''Null' or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For a given LOINC question, if the LOINC answer list includes concepts such as 'unknown' or 'not available', they should be used for Observation.value. Where these concepts are not part of the value set for Observation.value, the Observation.dataAbsentReason can be used if necessary and appropriate.' vs 'Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be 'detected', 'not detected', 'inconclusive', or 'specimen unsatisfactory'. The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code 'error' could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.'
WarningObservation.dataAbsentReasonElements differ in definition for mustSupport: 'true' vs 'false'
InformationObservation.dataAbsentReasonElement maximum cardinalities differ: '1' vs '0'
InformationObservation.interpretationElement maximum cardinalities differ: '2147483647' vs '0'
InformationObservation.bodySiteElement maximum cardinalities differ: '1' vs '0'
WarningObservation.methodElements differ in definition for mustSupport: 'false' vs 'true'
InformationObservation.methodElement minimum cardinalities differ: '0' vs '1'
WarningObservation.methodElements differ in binding.description: 'Methods for simple observations.' vs 'Methods for personal characteristic observations.'
InformationObservation.specimenElement maximum cardinalities differ: '1' vs '0'
InformationObservation.referenceRangeElement maximum cardinalities differ: '2147483647' vs '0'
WarningObservation.hasMemberElements differ in short: 'Reference to panel or multi-select responses' vs 'Related resource that belongs to the Observation group'
WarningObservation.hasMemberElements differ in definition: 'Aggregate set of Observations that represent question answer pairs for both multi-question surveys, screenings, and assessments and multi-select questions.' vs 'This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.'
WarningObservation.hasMemberElements differ in comments: 'This grouping element is used to represent surveys, screenings, and assessments that group several questions together or individual questions with “check all that apply” responses. For example in the simplest case a flat multi-question survey where the 'panel' observation is the survey instrument itself and instead of an `Observation.value` the `hasMember` element references other Observation that represent the individual questions answer pairs. When there is a heirarchical grouping of questions, the observation 'panels' can be nested. Because surveys, screenings, and assessments can be arbitrarily complex structurally, not all structures can be represented using this Observation grouping pattern.' vs 'When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see [Notes] below. Note that a system may calculate results from [QuestionnaireResponse] into a final score and represent the score as an Observation.'
WarningObservation.hasMemberElements differ in definition for mustSupport: 'true' vs 'false'
WarningObservation.derivedFromElements differ in short: 'Related Observations or QuestionnaireResponses that the observation is made from' vs 'Related measurements the observation is made from'
WarningObservation.derivedFromElements differ in definition: 'Observations or QuestionnaireResponses from which this observation value is derived.' vs 'The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.'
ErrorObservation.derivedFromType Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-assessments], CanonicalType[http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference], CanonicalType[http://hl7.org/fhir/StructureDefinition/ImagingStudy], CanonicalType[http://hl7.org/fhir/StructureDefinition/Media], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence]]) vs Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/DocumentReference], CanonicalType[http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse], CanonicalType[http://hl7.org/fhir/StructureDefinition/Observation]])

Metadata

NameValueComments
.abstractfalse
    .baseDefinitionhttp://hl7.org/fhir/StructureDefinition/Observationhttp://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationPersonalCharacteristic
    • Values Differ
    .copyrightUsed by permission of HL7 International, all rights reserved Creative Commons License
    • Removed the item 'Used by permission of HL7 International, all rights reserved Creative Commons License'
    .date2022-04-202022-11-21T18:34:14+00:00
    • Values Differ
    .descriptionTo promote interoperability and adoption through common implementation, the US Core Observation Survey Profile sets minimum expectations for the Observation Resource to record, search, and fetch retrieve observations that represent the questions and responses to surveys, and screening and assessment tools. It can be used to represent a single response, multiple responses, and multi-select “check all that apply” type questions. It identifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource when using this profile. It provides the floor for standards development for specific use cases.Profile for observations about the sexual orientation of an individual. This profile is intended for draft use only. The Cross-Group Projects work group granted a variance to US Core on 06/23/2022 - Jira ticket FHIR-37583. For further details on this profile see [Draft Specifications for Personal Characteristics](draft_specifications_for_personal_characteristics.html).
    • Values Differ
    .experimental
      .fhirVersion4.0.1
        .jurisdiction
          ..jurisdiction[0]urn:iso:std:iso:3166#US
            .kindresource
              .nameUSCoreObservationScreeningAssessmentsProfileSDOHCCObservationSexualOrientation
              • Values Differ
              .publisherHL7 International - Cross-Group ProjectsHL7 International - Patient Care WG
              • Values Differ
              .purpose
                .statusactivedraft
                • Values Differ
                .titleUS Core Observation Screening Assessments ProfileSDOHCC Observation Sexual Orientation
                • Values Differ
                .typeObservation
                  .urlhttp://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-assessmentshttp://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationSexualOrientation
                  • Values Differ
                  .version6.0.0-ballot2.0.0
                  • Values Differ

                  Structure

                  NameL FlagsL Card.L TypeL Description & ConstraintsR FlagsR Card.L TypeL Description & ConstraintsCommentsdoco
                  .. Observation C0..*ObservationSurvey Observation
                  us-core-2: If there is no component or hasMember element then either a value[x] or a data absent reason must be present
                  us-core-3: SHALL use UCUM for coded quantity units.
                  C0..*SDOHCCObservationPersonalCharacteristicObservation about an individual's sexual orientation
                  • Elements differ in short: 'Survey Observation' vs 'Observation about an individual's sexual orientation'
                  • Elements differ in definition: '\-' vs 'Defines constraints that represent the minimum requirement for personal characteristic observations which are observations that are usually self-attested but may be attested to on behalf of the subject (e.g., for a minor or incapable subject) and are generally only verifiable by the source of attestation (e.g., race, ethnicity, sexual orientation, gender identity and personal pronouns), but may sometimes be verifiable by someone other than the source of attestation (e.g., recorded sex).'
                  • Elements differ in comments: '\-' vs 'For observations about the sexual orientation of an individual.'
                  ... id Σ0..1idLogical id of this artifactΣ0..1idLogical id of this artifact
                    ... meta Σ0..1MetaMetadata about the resourceΣ0..1MetaMetadata about the resource
                      ... implicitRules ?!Σ0..1uriA set of rules under which this content was created?!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
                        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 interpretation0..1NarrativeText summary of the resource, for human interpretation
                            ... contained 0..*ResourceContained, inline Resources
                            0..*ResourceContained, inline Resources
                              ... extension 0..*ExtensionAdditional content defined by implementations
                              0..*ExtensionExtension
                              Slice: Unordered, Open by value:url
                              • Elements differ in short: 'Additional content defined by implementations' vs 'Extension'
                              • Elements differ in definition: 'May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'An Extension'
                              ... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
                              ?!0..*ExtensionExtensions that cannot be ignored
                                ... identifier Σ0..*IdentifierBusiness Identifier for observation
                                Σ0..*IdentifierBusiness Identifier for observation
                                  ... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)Fulfills plan, proposal or order
                                  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
                                    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.

                                      ?!SΣ1..1codefinal | corrected | entered-in-error | unknown
                                      Binding: SDOHCC ValueSet Observation Status (required)
                                      • Elements differ in short: 'registered | preliminary | final | amended +' vs 'final | corrected | entered-in-error | unknown'
                                      • Elements differ in definition: 'The status of the result value.' vs 'The status of the observation value.'
                                      • Elements differ in requirements: 'Need to track the status of individual results. Some results are finalized before the whole report is finalized.' vs 'Further constrained to values that are relevant for personal characteristic observations.'
                                      ... Slices for category S1..*CodeableConceptClassification of type of observation
                                      Slice: Unordered, Open by pattern:$this
                                      Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


                                      1..*CodeableConceptClassification of type of observation
                                      Slice: Unordered, Open by value:$this
                                      Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.


                                      • Elements differ in requirements: 'To identify that observation is derived from a questionnaire.' vs 'Used for filtering what observations are retrieved and displayed.'
                                      • Elements differ in definition for mustSupport: 'true' vs 'false'
                                      ... code SΣ1..1CodeableConceptType of observation (code / type)
                                      Binding: US Core Survey Codes (preferred)
                                      SΣ1..1CodeableConceptType of observation (code / type)
                                      Binding: LOINCCodes (preferred)
                                      Required Pattern: {"coding":[{"system":"http://loinc.org","code":"76690-7"}]}
                                      • Elements differ in comments: '*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.' vs '*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation. NOTE: In LOINC, System Patient is used in the modeling of codes referenced by the Personal Characteristics profiles (e.g., 72826-1 Race OMB.1997, 69490-1 Ethnicity OMB.1997, 76691-5 Gender identity, 76690-7 Sexual orientation, 90778-2 Personal pronouns – Reported, and 99502-7 Recorded sex or gender). If the draft profiles are adopted, new LOINC codes without System Patient would be needed since these profiles can also be used to capture characteristics of a provider (using an extension) or a related person (using focus).'
                                      • Example/preferred bindings differ at Observation.code using binding from USCoreObservationScreeningAssessmentsProfile
                                      ... subject SΣ1..1Reference(US Core Patient Profile)Who and/or what the observation is aboutSΣC0..1Reference(US Core Patient Profile)Who and/or what the observation is about
                                      • Element minimum cardinalities differ: '1' vs '0'
                                      ... focus Σ0..*Reference(Resource)What the observation is about, when it is not about the subject of record
                                      ΣC0..1Reference(RelatedPerson)What the observation is about, when it is not about the subject of record
                                      • Element maximum cardinalities differ: '2147483647' vs '1'
                                      ... encounter Σ0..1Reference(Encounter)Healthcare event during which this observation is madeΣ0..1Reference(Encounter)Healthcare event during which this observation is made
                                        ... effective[x] SΣC0..1dateTime S, Period, Timing, instantClinically relevant time/time-period for observation
                                        us-core-1: Datetime must be at least to day.
                                        Σ0..1dateTime, PeriodClinically relevant time/time-period for observation
                                        • Elements differ in definition: 'The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time".' vs 'The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.'
                                        • Elements differ in comments: 'At least a date should be present unless this observation is a historical report.' vs 'At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the [Timing] datatype which allow the measurement to be tied to regular life events. NOTE: dateTime is Must Support, but currently tooling does not support this.'
                                        • Elements differ in definition for mustSupport: 'true' vs 'false'
                                        ... issued Σ0..1instantDate/Time this version was made availableΣ0..1instantDate/Time this version was made available
                                          ... performer SΣ0..*Reference(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile)Who is responsible for the observation
                                          SΣC0..*Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)Who is responsible for the observation
                                            ... value[x] SΣC0..1Quantity S, CodeableConcept S, string S, boolean, integer, Range, Ratio, SampledData, time, dateTime, PeriodActual resultSΣC1..1CodeableConceptActual result
                                            Binding: LOINC Answer List LL3323-4 (preferred): Codes for sexual orientation

                                            • Elements differ in comments: 'An observation may have a value if it represents an individual survey, screening, or assessment question and answer pair. An observation should not have a value if it represents a multi-question or multi-select “check all that apply” responses. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.' vs 'An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the [Notes section] below.'
                                            • Elements differ in requirements: 'An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.' vs 'An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations. NOTE: This is a value set is for testing purposes only and will ultimately need to be aligned with vetted value sets where terms like “asexual” and “pansexual” may be included.'
                                            • Element minimum cardinalities differ: '0' vs '1'
                                            .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                              .... Slices for extension 0..*ExtensionAdditional content defined by implementations
                                              Slice: Unordered, Open by value:url
                                              0..*ExtensionExtension
                                              Slice: Unordered, Open by value:url
                                              • Elements differ in short: 'Additional content defined by implementations' vs 'Extension'
                                              • Elements differ in definition: 'May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.' vs 'An Extension'
                                              .... coding Σ0..*CodingCode defined by a terminology system
                                              SΣ0..*CodingCode defined by a terminology system
                                              • Elements differ in definition for mustSupport: 'false' vs 'true'
                                              .... text Σ0..1stringPlain text representation of the conceptΣ0..1stringPlain text representation of the concept
                                                ... dataAbsentReason SC0..1CodeableConceptWhy the result is missing
                                                Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

                                                C0..0
                                                • Elements differ in comments: '"Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For a given LOINC question, if the LOINC answer list includes concepts such as 'unknown' or 'not available', they should be used for Observation.value. Where these concepts are not part of the value set for Observation.value, the Observation.dataAbsentReason can be used if necessary and appropriate.' vs 'Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory". The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.'
                                                • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                • Element maximum cardinalities differ: '1' vs '0'
                                                ... interpretation 0..*CodeableConceptHigh, low, normal, etc.
                                                Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.


                                                0..0
                                                • Element maximum cardinalities differ: '2147483647' vs '0'
                                                ... note 0..*AnnotationComments about the observation
                                                0..*AnnotationComments about the observation
                                                  ... bodySite 0..1CodeableConceptObserved body part
                                                  Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.

                                                  0..0
                                                  • Element maximum cardinalities differ: '1' vs '0'
                                                  ... method 0..1CodeableConceptHow it was done
                                                  Binding: ObservationMethods (example): Methods for simple observations.

                                                  S1..1CodeableConceptHow it was done
                                                  Binding: SDOHCC ValueSet Observation Method (extensible): Methods for personal characteristic observations.

                                                  • Elements differ in definition for mustSupport: 'false' vs 'true'
                                                  • Element minimum cardinalities differ: '0' vs '1'
                                                  • Elements differ in binding.description: 'Methods for simple observations.' vs 'Methods for personal characteristic observations.'
                                                  ... specimen 0..1Reference(Specimen)Specimen used for this observation0..0
                                                  • Element maximum cardinalities differ: '1' vs '0'
                                                  ... device 0..1Reference(Device | DeviceMetric)(Measurement) Device0..1Reference(Device | DeviceMetric)(Measurement) Device
                                                    ... referenceRange C0..*BackboneElementProvides guide for interpretation
                                                    C0..0
                                                    • Element maximum cardinalities differ: '2147483647' vs '0'
                                                    .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                      .... extension 0..*ExtensionAdditional content defined by implementations
                                                      0..*ExtensionAdditional content defined by implementations
                                                        .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                        ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                          .... low C0..1SimpleQuantityLow Range, if relevantC0..1SimpleQuantityLow Range, if relevant
                                                            .... high C0..1SimpleQuantityHigh Range, if relevantC0..1SimpleQuantityHigh Range, if relevant
                                                              .... type 0..1CodeableConceptReference range qualifier
                                                              Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.

                                                              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.


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


                                                                  .... age 0..1RangeApplicable age range, if relevant0..1RangeApplicable age range, if relevant
                                                                    .... text 0..1stringText based reference range in an observation0..1stringText based reference range in an observation
                                                                      ... hasMember SΣ0..*Reference(US Core Observation Screening Assessments Profile S | QuestionnaireResponse | MolecularSequence)Reference to panel or multi-select responses
                                                                      Σ0..*Reference(Observation | QuestionnaireResponse | MolecularSequence)Related resource that belongs to the Observation group
                                                                      • Elements differ in short: 'Reference to panel or multi-select responses' vs 'Related resource that belongs to the Observation group'
                                                                      • Elements differ in definition: 'Aggregate set of Observations that represent question answer pairs for both multi-question surveys, screenings, and assessments and multi-select questions.' vs 'This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.'
                                                                      • Elements differ in comments: 'This grouping element is used to represent surveys, screenings, and assessments that group several questions together or individual questions with “check all that apply” responses. For example in the simplest case a flat multi-question survey where the "panel" observation is the survey instrument itself and instead of an `Observation.value` the `hasMember` element references other Observation that represent the individual questions answer pairs. When there is a heirarchical grouping of questions, the observation "panels" can be nested. Because surveys, screenings, and assessments can be arbitrarily complex structurally, not all structures can be represented using this Observation grouping pattern.' vs 'When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see [Notes] below. Note that a system may calculate results from [QuestionnaireResponse] into a final score and represent the score as an Observation.'
                                                                      • Elements differ in definition for mustSupport: 'true' vs 'false'
                                                                      ... derivedFrom SΣ0..*Reference(US Core Observation Screening Assessments Profile S | QuestionnaireResponse | US Core DocumentReference Profile | ImagingStudy | Media | MolecularSequence)Related Observations or QuestionnaireResponses that the observation is made from
                                                                      SΣC0..*Reference(DocumentReference | QuestionnaireResponse | Observation)Related measurements the observation is made from
                                                                      • Elements differ in short: 'Related Observations or QuestionnaireResponses that the observation is made from' vs 'Related measurements the observation is made from'
                                                                      • Elements differ in definition: 'Observations or QuestionnaireResponses from which this observation value is derived.' vs 'The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.'
                                                                      • Type Mismatch: Reference([CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-screening-assessments], CanonicalType[http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse], CanonicalType[http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference], CanonicalType[http://hl7.org/fhir/StructureDefinition/ImagingStudy], CanonicalType[http://hl7.org/fhir/StructureDefinition/Media], CanonicalType[http://hl7.org/fhir/StructureDefinition/MolecularSequence]]) vs Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/DocumentReference], CanonicalType[http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse], CanonicalType[http://hl7.org/fhir/StructureDefinition/Observation]])
                                                                      ... component Σ0..*BackboneElementComponent results
                                                                      Σ0..*BackboneElementComponent results
                                                                        .... id 0..1stringUnique id for inter-element referencing0..1stringUnique id for inter-element referencing
                                                                          .... extension 0..*ExtensionAdditional content defined by implementations
                                                                          0..*ExtensionAdditional content defined by implementations
                                                                            .... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
                                                                            ?!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.

                                                                              Σ1..1CodeableConceptType of component observation (code / type)
                                                                              Binding: LOINCCodes (example): Codes identifying names of simple observations.

                                                                                .... value[x] Σ0..1Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, PeriodActual component resultΣ0..1Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, PeriodActual component result
                                                                                  .... dataAbsentReason C0..1CodeableConceptWhy the component result is missing
                                                                                  Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.

                                                                                  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.


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

                                                                                        doco Documentation for this format