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 
<StructureDefinition xmlns="http://hl7.org/fhir"> <id value="oncology-BreastCancerHistologicGrade-model"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p><b>BC BreastCancerHistologicGrade Logical Model</b></p> <p>The Elston Grade/Nottingham Score, representative of the aggressive potential of the tumor. Well differentiated cells (Grade 1) look similar to normal cells and are usually slow growing, while poorly differentiated cells (Grade 3) look very different than normal and are fast-growing.</p> </div> </text> <url value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastCancerHistologicGrade-model"/> <identifier> <system value="http://hl7.org/fhir/us/breastcancer"/> <value value="oncology.BreastCancerHistologicGrade"/> </identifier> <version value="0.1.0"/> <name value="BreastCancerHistologicGradeModel"/> <title value="BC BreastCancerHistologicGrade Logical Model"/> <status value="draft"/> <date value="2018-04-01T00:00:00+11:00"/> <publisher value="The HL7 Cancer Interoperability Group sponsored by Clinical Interoperability Council Work Group (CIC)"/> <contact> <telecom> <system value="url"/> <value value="http://standardhealthrecord.org"/> </telecom> </contact> <description value="The Elston Grade/Nottingham Score, representative of the aggressive potential of the tumor. Well differentiated cells (Grade 1) look similar to normal cells and are usually slow growing, while poorly differentiated cells (Grade 3) look very different than normal and are fast-growing."/> <keyword> <system value="http://loinc.org"/> <code value="44648-4"/> </keyword> <kind value="logical"/> <abstract value="false"/> <type value="oncology-BreastCancerHistologicGrade-model"/> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Element"/> <derivation value="specialization"/> <snapshot> <element id="oncology-BreastCancerHistologicGrade-model"> <path value="oncology-BreastCancerHistologicGrade-model"/> <definition value="The Elston Grade/Nottingham Score, representative of the aggressive potential of the tumor. Well differentiated cells (Grade 1) look similar to normal cells and are usually slow growing, while poorly differentiated cells (Grade 3) look very different than normal and are fast-growing."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model"/> <min value="0"/> <max value="*"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C1554188"/> </code> <short value="The base class, independent of context, for evaluations (measurements, tests, or questions) and a value containing the result (answer)."/> <definition value="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."/> <alias value="statementTopic"/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic"/> <min value="1"/> <max value="1"/> </base> <type> <code value="BackboneElement"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.valueCodeableConcept"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.valueCodeableConcept"/> <short value="A set of codes drawn from different coding systems, representing the same concept."/> <definition value="A set of codes drawn from different coding systems, representing the same concept."/> <alias value="codeableConcept"/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.valueCodeableConcept"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="required"/> <valueSetReference> <reference value="http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-NottinghamCombinedGradeVS"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode"/> <short value="The concept representing the finding or action that is the topic of the statement."/> <definition value="The concept representing the finding or action that is the topic of the statement. For action topics, the TopicCode represents the action being described. For findings, the TopicCode represents the 'question' or property being investigated. For evaluation result findings, the TopicCode contains a concept for an observable entity, such as systolic blood pressure. For assertion findings, the TopicCode contains a code representing the condition, allergy, or other item being asserted. In all cases, the TopicCode describes the topic independent of the context of the action or the finding. CIMI Alignment: TopicCode is the new CIMI name for the attribute formerly called 'key' in CIMI V0.0.4."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode"/> <min value="1"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-TopicCode-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value"/> <short value="Code representing the concept representing the finding or action that is the topic of the statement."/> <definition value="Code representing the concept representing the finding or action that is the topic of the statement. For action topics, the TopicCode represents the action being described. For findings, the TopicCode represents the 'question' or property being investigated. For evaluation result findings, the TopicCode contains a concept for an observable entity, such as systolic blood pressure. For assertion findings, the TopicCode contains a code representing the condition, allergy, or other item being asserted. In all cases, the TopicCode describes the topic independent of the context of the action or the finding. CIMI Alignment: TopicCode is the new CIMI name for the attribute formerly called 'key' in CIMI V0.0.4."/> <alias value="codeableConcept"/> <min value="1"/> <max value="1"/> <base> <path value="cimi-TopicCode-model.value"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.id"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.extension"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.system"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in the code."/> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/> <requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://loinc.org"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.version"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.code"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/> <requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="44648-4"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules of the system."/> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.userSelected"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.findingMethod"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.findingMethod"/> <short value="The technique used to create the finding; for example, the specific imaging technique, lab test code, or assessment vehicle."/> <definition value="The technique used to create the finding; for example, the specific imaging technique, lab test code, or assessment vehicle. CIMI Alignment: In CIMI V0.0.4, this attribute was called 'method'. The value set binding reflects CIMI's preference for LOINC codes."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.findingMethod"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-FindingMethod-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.interpretation"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.interpretation"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C0420833"/> </code> <short value="A clinical interpretation of a finding."/> <definition value="A clinical interpretation of a finding. CIMI Alignment: The value set binding has been chosen to align with FHIR. (Note: it is not clear if Interpretation belongs in FindingTopic, rather than a context class, but that is how CIMI has modeled it.)"/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.interpretation"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Interpretation-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category"/> <short value="A class or division of people or things having particular shared characteristics"/> <definition value="A class or division of people or things having particular shared characteristics"/> <min value="1"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category"/> <min value="1"/> <max value="*"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Category-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value"/> <short value="Code representing a class or division of people or things having particular shared characteristics"/> <definition value="Code representing a class or division of people or things having particular shared characteristics"/> <alias value="codeableConcept"/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.id"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.extension"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.system"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in the code."/> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/> <requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://hl7.org/fhir/observation-category"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.version"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.code"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/> <requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="laboratory"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules of the system."/> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.userSelected"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.anatomicalLocation"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.anatomicalLocation"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C1545955"/> </code> <short value="A location or structure in the body, including tissues, regions, cavities, and spaces; for example, right elbow, or left ventricle of the heart."/> <definition value="A location or structure in the body, including tissues, regions, cavities, and spaces; for example, right elbow, or left ventricle of the heart. CIMI Alignment: In CIMI V0.0.4, AnatomicalLocation has no parent class. This appears to have been an oversight, and the parent should have been Entity, as modeled here."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.anatomicalLocation"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-AnatomicalLocation-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.breastSpecimen"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.breastSpecimen"/> <short value="Specimen resulting from biopsy or excision of breast and surrounding tissue."/> <definition value="Specimen resulting from biopsy or excision of breast and surrounding tissue."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.breastSpecimen"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastSpecimen-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.deltaFlag"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.deltaFlag"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C1705241"/> </code> <short value="Indicator of significant change (delta) from the last or previous measurement."/> <definition value="Indicator of significant change (delta) from the last or previous measurement."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.deltaFlag"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-DeltaFlag-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.precondition"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.precondition"/> <short value="A description of the conditions or context of an observation; for example, under sedation, fasting or post-exercise."/> <definition value="A description of the conditions or context of an observation; for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.precondition"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Precondition-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.referenceRange"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.referenceRange"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C0883335"/> </code> <short value="The usual or acceptable range for a test result."/> <definition value="The usual or acceptable range for a test result."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.referenceRange"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-ReferenceRange-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent"/> <short value="A simplified, non-separable evaluation consisting of a finding code (represented by the Concept), value (or exception value), reference range, and interpretation."/> <definition value="A simplified, non-separable evaluation consisting of a finding code (represented by the Concept), value (or exception value), reference range, and interpretation. The subject of the evaluation component is the same as in the parent evaluation."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent"/> <min value="0"/> <max value="1"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.tubuleFormationScore"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.tubuleFormationScore"/> <code> <system value="http://snomed.info/sct"/> <code value="371470008"/> </code> <short value="A comparison between structures formed by the tumor cells and those formed by normal cells. Scored 1 to 3 with 3 being the most abnormal."/> <definition value="A comparison between structures formed by the tumor cells and those formed by normal cells. Scored 1 to 3 with 3 being the most abnormal."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.tubuleFormationScore"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-TubuleFormationScore-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.nuclearPleomorphismScore"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.nuclearPleomorphismScore"/> <code> <system value="http://snomed.info/sct"/> <code value="371471007"/> </code> <short value="How large and varied the nuclei of the tumor cells are. Scored 1 to 3, with 3 being the most pleomorphism."/> <definition value="How large and varied the nuclei of the tumor cells are. Scored 1 to 3, with 3 being the most pleomorphism."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.nuclearPleomorphismScore"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-NuclearPleomorphismScore-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.mitoticCountScore"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.mitoticCountScore"/> <code> <system value="http://snomed.info/sct"/> <code value="371472000"/> </code> <short value="How fast the tumor cells are growing and dividing, determined from the number of mitotic cells present. Scored 1 to 3, with 3 being the most mitotic cells."/> <definition value="How fast the tumor cells are growing and dividing, determined from the number of mitotic cells present. Scored 1 to 3, with 3 being the most mitotic cells. We are seeking feedback on the value of representing the mitotic rate as a value rather than coded ranges."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.mitoticCountScore"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MitoticCountScore-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.recordedContext"> <path value="oncology-BreastCancerHistologicGrade-model.recordedContext"/> <short value="Context for an evaluation result, used to indicate an evaluation has been made."/> <definition value="Context for an evaluation result, used to indicate an evaluation has been made. For example, measurement of blood pressure that has been made simply exists (although the value can be present or absent, accurate or inaccurate). The RecordedContext indicates the information presented stands on its own as presented. It can also apply to clinical notes. CIMI Alignment: The RecordedContext class did not exist in CIMI V0.0.4, but CIMI has recently added it."/> <alias value="statementContext"/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.recordedContext"/> <min value="1"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-RecordedContext-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.encounter"> <path value="oncology-BreastCancerHistologicGrade-model.encounter"/> <short value="An abstract class that represents an encounter class. This class has been stubbed out to limit the scope of this implementation guide to classes relevant to this ballot concerning breast cancer."/> <definition value="An abstract class that represents an encounter class. This class has been stubbed out to limit the scope of this implementation guide to classes relevant to this ballot concerning breast cancer."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.encounter"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Encounter-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.members"> <path value="oncology-BreastCancerHistologicGrade-model.members"/> <short value="Members represent the elements of a group of a related but independent evaluations."/> <definition value="Members represent the elements of a group of a related but independent evaluations. Examples are the measurements that compose a complete blood count (CBC), or the elements of a pathology report. Each member is an independent evaluation, but the grouping reflects a composite lab order, shared specimen, or a single report author. Typically the Category and Reason are not given for individual findings that are part of the panel, but rather given at the level of the panel itself. Although the proper place to define Members this might be in EvaluationResultTopic, it cannot be defined there because the value references EvaluationResultRecorded, which is a clinical statement class. CIMI Alignment: CIMI V0.0.4 does not have this attribute and uses CompoundClinicalStatement to create panels. Compared to having a separate class, the current representation closer alignment with FHIR and greater flexibility (related observations can be added to any observation)."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.members"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-Members-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService"/> <short value="A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes."/> <definition value="A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService"/> <min value="0"/> <max value="*"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-DiagnosticService-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value"/> <short value="Code representing a code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes."/> <definition value="Code representing a code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes."/> <alias value="codeableConcept"/> <min value="1"/> <max value="1"/> <base> <path value="cimi-statement-DiagnosticService-model.value"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.id"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.extension"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.system"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in the code."/> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/> <requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://hl7.org/fhir/us/breastcancer/CodeSystem/cimi-statement-DiagnosticServiceCS"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.version"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.code"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/> <requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="pathology"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules of the system."/> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.userSelected"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/> </mapping> </element> </snapshot> <differential> <element id="oncology-BreastCancerHistologicGrade-model"> <path value="oncology-BreastCancerHistologicGrade-model"/> <definition value="The Elston Grade/Nottingham Score, representative of the aggressive potential of the tumor. Well differentiated cells (Grade 1) look similar to normal cells and are usually slow growing, while poorly differentiated cells (Grade 3) look very different than normal and are fast-growing."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model"/> <min value="0"/> <max value="*"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C1554188"/> </code> <short value="The base class, independent of context, for evaluations (measurements, tests, or questions) and a value containing the result (answer)."/> <definition value="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."/> <alias value="statementTopic"/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic"/> <min value="1"/> <max value="1"/> </base> <type> <code value="BackboneElement"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.valueCodeableConcept"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.valueCodeableConcept"/> <short value="A set of codes drawn from different coding systems, representing the same concept."/> <definition value="A set of codes drawn from different coding systems, representing the same concept."/> <alias value="codeableConcept"/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.valueCodeableConcept"/> <min value="0"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> <binding> <strength value="required"/> <valueSetReference> <reference value="http://hl7.org/fhir/us/breastcancer/ValueSet/oncology-NottinghamCombinedGradeVS"/> </valueSetReference> </binding> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode"/> <short value="The concept representing the finding or action that is the topic of the statement."/> <definition value="The concept representing the finding or action that is the topic of the statement. For action topics, the TopicCode represents the action being described. For findings, the TopicCode represents the 'question' or property being investigated. For evaluation result findings, the TopicCode contains a concept for an observable entity, such as systolic blood pressure. For assertion findings, the TopicCode contains a code representing the condition, allergy, or other item being asserted. In all cases, the TopicCode describes the topic independent of the context of the action or the finding. CIMI Alignment: TopicCode is the new CIMI name for the attribute formerly called 'key' in CIMI V0.0.4."/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode"/> <min value="1"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-TopicCode-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value"/> <short value="Code representing the concept representing the finding or action that is the topic of the statement."/> <definition value="Code representing the concept representing the finding or action that is the topic of the statement. For action topics, the TopicCode represents the action being described. For findings, the TopicCode represents the 'question' or property being investigated. For evaluation result findings, the TopicCode contains a concept for an observable entity, such as systolic blood pressure. For assertion findings, the TopicCode contains a code representing the condition, allergy, or other item being asserted. In all cases, the TopicCode describes the topic independent of the context of the action or the finding. CIMI Alignment: TopicCode is the new CIMI name for the attribute formerly called 'key' in CIMI V0.0.4."/> <alias value="codeableConcept"/> <min value="1"/> <max value="1"/> <base> <path value="cimi-TopicCode-model.value"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.id"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.extension"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.system"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in the code."/> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/> <requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://loinc.org"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.version"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.code"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/> <requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="44648-4"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules of the system."/> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.userSelected"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.topicCode.value.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.findingMethod"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.findingMethod"/> <short value="The technique used to create the finding; for example, the specific imaging technique, lab test code, or assessment vehicle."/> <definition value="The technique used to create the finding; for example, the specific imaging technique, lab test code, or assessment vehicle. CIMI Alignment: In CIMI V0.0.4, this attribute was called 'method'. The value set binding reflects CIMI's preference for LOINC codes."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.findingMethod"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-FindingMethod-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.interpretation"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.interpretation"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C0420833"/> </code> <short value="A clinical interpretation of a finding."/> <definition value="A clinical interpretation of a finding. CIMI Alignment: The value set binding has been chosen to align with FHIR. (Note: it is not clear if Interpretation belongs in FindingTopic, rather than a context class, but that is how CIMI has modeled it.)"/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.interpretation"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Interpretation-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category"/> <short value="A class or division of people or things having particular shared characteristics"/> <definition value="A class or division of people or things having particular shared characteristics"/> <min value="1"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category"/> <min value="1"/> <max value="*"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/shr-core-Category-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value"/> <short value="Code representing a class or division of people or things having particular shared characteristics"/> <definition value="Code representing a class or division of people or things having particular shared characteristics"/> <alias value="codeableConcept"/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.id"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.extension"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.system"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in the code."/> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/> <requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://hl7.org/fhir/observation-category"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.version"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.code"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/> <requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="laboratory"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules of the system."/> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.userSelected"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.category.value.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.anatomicalLocation"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.anatomicalLocation"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C1545955"/> </code> <short value="A location or structure in the body, including tissues, regions, cavities, and spaces; for example, right elbow, or left ventricle of the heart."/> <definition value="A location or structure in the body, including tissues, regions, cavities, and spaces; for example, right elbow, or left ventricle of the heart. CIMI Alignment: In CIMI V0.0.4, AnatomicalLocation has no parent class. This appears to have been an oversight, and the parent should have been Entity, as modeled here."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.anatomicalLocation"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-AnatomicalLocation-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.breastSpecimen"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.breastSpecimen"/> <short value="Specimen resulting from biopsy or excision of breast and surrounding tissue."/> <definition value="Specimen resulting from biopsy or excision of breast and surrounding tissue."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.breastSpecimen"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastSpecimen-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.deltaFlag"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.deltaFlag"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C1705241"/> </code> <short value="Indicator of significant change (delta) from the last or previous measurement."/> <definition value="Indicator of significant change (delta) from the last or previous measurement."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.deltaFlag"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-DeltaFlag-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.precondition"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.precondition"/> <short value="A description of the conditions or context of an observation; for example, under sedation, fasting or post-exercise."/> <definition value="A description of the conditions or context of an observation; for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.precondition"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Precondition-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.referenceRange"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.referenceRange"/> <code> <system value="http://ncimeta.nci.nih.gov"/> <code value="C0883335"/> </code> <short value="The usual or acceptable range for a test result."/> <definition value="The usual or acceptable range for a test result."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.referenceRange"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-ReferenceRange-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent"/> <short value="A simplified, non-separable evaluation consisting of a finding code (represented by the Concept), value (or exception value), reference range, and interpretation."/> <definition value="A simplified, non-separable evaluation consisting of a finding code (represented by the Concept), value (or exception value), reference range, and interpretation. The subject of the evaluation component is the same as in the parent evaluation."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent"/> <min value="0"/> <max value="1"/> </base> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.tubuleFormationScore"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.tubuleFormationScore"/> <code> <system value="http://snomed.info/sct"/> <code value="371470008"/> </code> <short value="A comparison between structures formed by the tumor cells and those formed by normal cells. Scored 1 to 3 with 3 being the most abnormal."/> <definition value="A comparison between structures formed by the tumor cells and those formed by normal cells. Scored 1 to 3 with 3 being the most abnormal."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.tubuleFormationScore"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-TubuleFormationScore-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.nuclearPleomorphismScore"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.nuclearPleomorphismScore"/> <code> <system value="http://snomed.info/sct"/> <code value="371471007"/> </code> <short value="How large and varied the nuclei of the tumor cells are. Scored 1 to 3, with 3 being the most pleomorphism."/> <definition value="How large and varied the nuclei of the tumor cells are. Scored 1 to 3, with 3 being the most pleomorphism."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.nuclearPleomorphismScore"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-NuclearPleomorphismScore-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.mitoticCountScore"> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.mitoticCountScore"/> <code> <system value="http://snomed.info/sct"/> <code value="371472000"/> </code> <short value="How fast the tumor cells are growing and dividing, determined from the number of mitotic cells present. Scored 1 to 3, with 3 being the most mitotic cells."/> <definition value="How fast the tumor cells are growing and dividing, determined from the number of mitotic cells present. Scored 1 to 3, with 3 being the most mitotic cells. We are seeking feedback on the value of representing the mitotic rate as a value rather than coded ranges."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.evaluationResultTopic.evaluationComponent.mitoticCountScore"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MitoticCountScore-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.recordedContext"> <path value="oncology-BreastCancerHistologicGrade-model.recordedContext"/> <short value="Context for an evaluation result, used to indicate an evaluation has been made."/> <definition value="Context for an evaluation result, used to indicate an evaluation has been made. For example, measurement of blood pressure that has been made simply exists (although the value can be present or absent, accurate or inaccurate). The RecordedContext indicates the information presented stands on its own as presented. It can also apply to clinical notes. CIMI Alignment: The RecordedContext class did not exist in CIMI V0.0.4, but CIMI has recently added it."/> <alias value="statementContext"/> <min value="1"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.recordedContext"/> <min value="1"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-RecordedContext-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.encounter"> <path value="oncology-BreastCancerHistologicGrade-model.encounter"/> <short value="An abstract class that represents an encounter class. This class has been stubbed out to limit the scope of this implementation guide to classes relevant to this ballot concerning breast cancer."/> <definition value="An abstract class that represents an encounter class. This class has been stubbed out to limit the scope of this implementation guide to classes relevant to this ballot concerning breast cancer."/> <min value="0"/> <max value="1"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.encounter"/> <min value="0"/> <max value="1"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Encounter-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.members"> <path value="oncology-BreastCancerHistologicGrade-model.members"/> <short value="Members represent the elements of a group of a related but independent evaluations."/> <definition value="Members represent the elements of a group of a related but independent evaluations. Examples are the measurements that compose a complete blood count (CBC), or the elements of a pathology report. Each member is an independent evaluation, but the grouping reflects a composite lab order, shared specimen, or a single report author. Typically the Category and Reason are not given for individual findings that are part of the panel, but rather given at the level of the panel itself. Although the proper place to define Members this might be in EvaluationResultTopic, it cannot be defined there because the value references EvaluationResultRecorded, which is a clinical statement class. CIMI Alignment: CIMI V0.0.4 does not have this attribute and uses CompoundClinicalStatement to create panels. Compared to having a separate class, the current representation closer alignment with FHIR and greater flexibility (related observations can be added to any observation)."/> <min value="0"/> <max value="0"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.members"/> <min value="0"/> <max value="0"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-Members-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService"/> <short value="A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes."/> <definition value="A code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes."/> <min value="0"/> <max value="*"/> <base> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService"/> <min value="0"/> <max value="*"/> </base> <type> <code value="http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-DiagnosticService-model"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value"/> <short value="Code representing a code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes."/> <definition value="Code representing a code that classifies the clinical discipline, department or diagnostic service that created the report (e.g. cardiology, biochemistry, hematology, MRI). This is used for searching, sorting and display purposes."/> <alias value="codeableConcept"/> <min value="1"/> <max value="1"/> <base> <path value="cimi-statement-DiagnosticService-model.value"/> <min value="1"/> <max value="1"/> </base> <type> <code value="Coding"/> </type> <mustSupport value="false"/> <isModifier value="false"/> <isSummary value="false"/> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.id"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.id"/> <representation value="xmlAttr"/> <short value="xml:id (or equivalent in JSON)"/> <definition value="unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/> <min value="0"/> <max value="1"/> <base> <path value="Element.id"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.extension"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.extension"/> <slicing> <discriminator> <type value="value"/> <path value="url"/> </discriminator> <description value="Extensions are always sliced by (at least) url"/> <rules value="open"/> </slicing> <short value="Additional Content defined by implementations"/> <definition value="May be used to represent additional information that is not part of the basic definition of the element. In order 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/> <comment value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/> <alias value="extensions"/> <alias value="user content"/> <min value="0"/> <max value="*"/> <base> <path value="Element.extension"/> <min value="0"/> <max value="*"/> </base> <type> <code value="Extension"/> </type> <mapping> <identity value="rim"/> <map value="n/a"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.system"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.system"/> <short value="Identity of the terminology system"/> <definition value="The identification of the code system that defines the meaning of the symbol in the code."/> <comment value="The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously."/> <requirements value="Need to be unambiguous about the source of the definition of the symbol."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.system"/> <min value="0"/> <max value="1"/> </base> <type> <code value="uri"/> </type> <fixedUri value="http://hl7.org/fhir/us/breastcancer/CodeSystem/cimi-statement-DiagnosticServiceCS"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.3"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystem"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.version"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.version"/> <short value="Version of the system - if relevant"/> <definition value="The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged."/> <comment value="Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.version"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.7"/> </mapping> <mapping> <identity value="rim"/> <map value="./codeSystemVersion"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.code"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.code"/> <short value="Symbol in syntax defined by the system"/> <definition value="A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination)."/> <requirements value="Need to refer to a particular code in the system."/> <min value="1"/> <max value="1"/> <base> <path value="Coding.code"/> <min value="0"/> <max value="1"/> </base> <type> <code value="code"/> </type> <fixedCode value="pathology"/> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.1"/> </mapping> <mapping> <identity value="rim"/> <map value="./code"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.display"> <extension url="http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable"> <valueBoolean value="true"/> </extension> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.display"/> <short value="Representation defined by the system"/> <definition value="A representation of the meaning of the code in the system, following the rules of the system."/> <requirements value="Need to be able to carry a human-readable meaning of the code for readers that do not know the system."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.display"/> <min value="0"/> <max value="1"/> </base> <type> <code value="string"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="C*E.2 - but note this is not well followed"/> </mapping> <mapping> <identity value="rim"/> <map value="CV.displayName"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName"/> </mapping> </element> <element id="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.userSelected"> <path value="oncology-BreastCancerHistologicGrade-model.diagnosticService.value.userSelected"/> <short value="If this coding was chosen directly by the user"/> <definition value="Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays)."/> <comment value="Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely."/> <requirements value="This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing."/> <min value="0"/> <max value="1"/> <base> <path value="Coding.userSelected"/> <min value="0"/> <max value="1"/> </base> <type> <code value="boolean"/> </type> <isSummary value="true"/> <mapping> <identity value="v2"/> <map value="Sometimes implied by being first"/> </mapping> <mapping> <identity value="rim"/> <map value="CD.codingRationale"/> </mapping> <mapping> <identity value="orim"/> <map value="fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]"/> </mapping> </element> </differential> </StructureDefinition>