HL7 FHIR® Implementation Guide: Breast Cancer Data, Release 1 - US Realm (Draft for Comment)
This page is part of the Breast Cancer Data Logical Models and FHIR Profiles (v0.1.0: STU 1 Draft) based on FHIR R3. . For a full list of available versions, see the Directory of published versions 
The official URL for this logical model is:
http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-EvaluationResultTopic-model
The base class, independent of context, for evaluations (measurements, tests, or questions) and a value containing the result (answer).
The subject of a finding can be the entire patient, or an entity such as a location body structure, intervention, or condition. Things observed about the subject can include social and behavioral factors, subjective and objective observations, and assessments.
CIMI Alignment: 1) In CIMI V0.0.4, LaboratoryTestResult.specimen is 0..* but that cardinality makes it impossible to map to FHIR Observation, where specimen is 0..1. The cardinality of Specimen has been changed to 0..1 to enable FHIR mapping. 2) In CIMI V0.0.4, Findings (including EvaluationResult and LaboratoryTestResult) do not have related (‘has-member’) observations, nor components (sub-observations). These features of FHIR Observations were found to be very useful in modeling breast cancer pathology, and are included here. This represents a significant departure from the CIMI model. CompoundClinicalStatement has not been used to represent panel-like findings, because of the complexity of mapping this class to FHIR. 3) In CIMI V0.0.4, allowable datatypes for result (aka Value) include EmbeddedContent, GpsLocation, Multimedia, ParsableContent, and other types not allowed in a FHIR Observation. To make mapping feasible, the types of Value were restricted to only the allowable FHIR datatypes. 4) ExceptionValue has been moved to the RecordedContext, because it is only relevant when a value is supposed to be recorded, but is not. 5) The cardinality of FindingMethod has been changed from 0..* to 0..1 to make it possible to map to FHIR, where Observation.method is 0..1. 6) The class PhysicalEvaluationResult has been united with this class, and the body location (AnatomicalLocation) has been added to this class. This is because bodySite is part of Observation, and it cannot be profiled out of EvaluationResult and then re-included in PhysicalEvaluationResult. 7) The cardinality of AnatomicalLocation has been changed from 0..* to 0..1 to make it possible to map to FHIR, where Observation.bodySite is 0..1. 8) The attribute evaluationDate has been moved to RecordedContext, because it only applies to evaluations that have been done. 9) The attributes device and evaluationProcedure have been removed for brevity, since they are not used in the current IG.
This logical model was published on Sun Apr 01 00:00:00 AEDT 2018 as a draft by The HL7 Cancer Interoperability Group sponsored by Clinical Interoperability Council Work Group (CIC).
This IG does not define a corresponding profile for this logical model.
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  cimi-EvaluationResultTopic-model | 0..* | |||
  value[x] | 0..1 | QuantityModel, Coding, string, boolean, RangeModel, RatioModel, time, dateTime, TimePeriodModel | Choice of types representing the base class, independent of context, for evaluations (measurements, tests, or questions) and a value containing the result (answer). | |
 topicCode | 1..1 | TopicCodeModel | The concept representing the finding or action that is the topic of the statement. | |
| findingMethod | 0..1 | FindingMethodModel | The technique used to create the finding; for example, the specific imaging technique, lab test code, or assessment vehicle. | |
| interpretation | 0..1 | InterpretationModel | A clinical interpretation of a finding. | |
| category | 1..* | CategoryModel | A class or division of people or things having particular shared characteristics | |
   value | 1..1 | Coding | Code representing a class or division of people or things having particular shared characteristics Binding: Observation Category Codes (extensible) | |
| anatomicalLocation | 0..1 | AnatomicalLocationModel | A location or structure in the body, including tissues, regions, cavities, and spaces; for example, right elbow, or left ventricle of the heart. | |
| specimen | 0..1 | SpecimenModel | A specimen is a substance, physical object, or collection of objects, that the laboratory considers a single discrete, uniquely identified unit that is the subject of one or more steps in the laboratory workflow. A specimen may include multiple physical pieces as long as they are considered a single unit within the laboratory workflow. A specimen results from one to many specimen collection procedures, and may be contained in multiple specimen containers. Specimen may have one or more processing activities. | |
| deltaFlag | 0..1 | DeltaFlagModel | Indicator of significant change (delta) from the last or previous measurement. | |
| precondition | 0..* | PreconditionModel | A description of the conditions or context of an observation; for example, under sedation, fasting or post-exercise. | |
| referenceRange | 0..* | ReferenceRangeModel | The usual or acceptable range for a test result. | |
| evaluationComponent | 0..* | EvaluationComponentModel | A simplified, non-separable evaluation consisting of a finding code (represented by the Concept), value (or exception value), reference range, and interpretation. | |
| Documentation for this format | ||||
Downloads: StructureDefinition: (XML, JSON, TTL)
| Path | Name | Conformance | ValueSet |
| cimi-EvaluationResultTopic-model.category.value | Observation Category Codes | extensible | Observation Category Codes |