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

BreastCancerPresenceStatementProfile

 

The official URL for this profile is: 

http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-BreastCancerPresenceStatement

Diagnosis of cancer originating in the tissues of the breast, and potentially spread to other organs of the body.

The BreastCancerPresenceStatement is a subclass of ConditionPresenceStatement, which is a departure from CIMI. In CIMI, this would be a archetype of ClinicalStatement combining a BreastCancerConditionTopic with the ConditionPresenceContext. This would require definition of BreastCancerConditionTopic in the reference model, follwed by introduction of constraints on Value, Category, Stage, and MorphologyBehavior in the corresponding archetype.

CIMI Alignment (and question for reviewers): The Topic of this statement is 'Neoplasm of the breast', not 'Assertion', with the logic that the topic of the statement is more specific than 'Assertion'. The result (the value) gives the particular type (histologic type) of the condition. Does this make sense?

This profile builds on US Core Condition (a.k.a Problem) Profile.

This profile was published on Sun Apr 01 00:00:00 AEDT 2018 as a draft by The HL7 Cancer Interoperability Group sponsored by Clinical Interoperability Council Work Group (CIC).

View the corresponding BreastCancerPresenceStatementModel logical model.

Summary

Mandatory: 0 element (1 nested mandatory element)
Prohibited: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

BC Mapping Source

This structure represents the following BC mapping definition:

oncology.BreastCancerPresenceStatement maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition:
  ConditionTopic.CodeableConcept maps to code
  ConditionTopic.Category maps to category
  ConditionPresenceContext.ClinicalStatus maps to clinicalStatus
  ConditionPresenceContext.VerificationStatus maps to verificationStatus
  ConditionPresenceContext.Onset maps to onset[x]
  ConditionPresenceContext.Abatement maps to abatement[x]
  constrain bodySite to 0..0
  ConditionPresenceContext.Severity maps to severity
  Stage maps to stage
  Stage.CodeableConcept maps to stage.summary
  Stage.StageDetail maps to stage.assessment
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition BC BreastCancerPresenceStatement Profile
... cimi-Encounter-extension 0..1(Complex)BC Encounter Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Encounter-extension
... oncology-MorphologyBehavior-extension 0..1CodeableConceptBC MorphologyBehavior Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MorphologyBehavior-extension
.... valueCodeableConcept Binding: MorphologyBehaviorVS (required)
... clinicalStatus 1..1
... severity Binding: Condition/Diagnosis Severity (required)
... code Binding: BreastCancerTypeVS (required)
... bodySite 0..0
... onset[x] dateTime, Age, Period, RangeProfile, string
... abatement[x] dateTime, Age, boolean, Period, RangeProfile, string
... stage
.... assessment 0..1Reference(BC BreastCancerStage Profile)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition I0..*BC BreastCancerPresenceStatement Profile
us-core-1: A code in Condition.category SHOULD be from US Core Condition Category Codes value set.
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... cimi-Encounter-extension 0..1(Complex)BC Encounter Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Encounter-extension
... oncology-MorphologyBehavior-extension 0..1CodeableConceptBC MorphologyBehavior Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MorphologyBehavior-extension
.... id 0..1stringxml:id (or equivalent in JSON)
.... url 1..1uri"http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MorphologyBehavior-extension"
.... valueCodeableConcept 1..1CodeableConceptValue of extension
Binding: MorphologyBehaviorVS (required)
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!SΣI1..1codeactive | recurrence | inactive | remission | resolved
Binding: Condition Clinical Status Codes (required)
... verificationStatus ?!SΣI1..1codeprovisional | differential | confirmed | refuted | entered-in-error | unknown
Binding: ConditionVerificationStatus (required)
... category S1..*CodeableConceptproblem-list-item | encounter-diagnosis
Binding: US Core Condition Category Codes (preferred)
... severity 0..1CodeableConceptSubjective severity of condition
Binding: Condition/Diagnosis Severity (required)
... code SΣ1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: BreastCancerTypeVS (required)
... subject SΣ1..1Reference(US Core Patient Profile)Who has the condition?
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter or episode when condition first asserted
... onset[x] Σ0..1dateTime, Age, Period, RangeProfile, stringEstimated or actual date, date-time, or age
... abatement[x] I0..1dateTime, Age, boolean, Period, RangeProfile, stringIf/when in resolution/remission
... assertedDate Σ0..1dateTimeDate record was believed accurate
... asserter Σ0..1Reference(Practitioner | Patient | RelatedPerson)Person who asserts this condition
... stage I0..1BackboneElementStage/grade, usually assessed formally
con-1: Stage SHALL have summary or assessment
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... summary I0..1CodeableConceptSimple summary (disease specific)
Binding: Condition Stage (example)
.... assessment I0..1Reference(BC BreastCancerStage Profile)Formal record of assessment
... evidence I0..*BackboneElementSupporting evidence
con-2: evidence SHALL have code or details
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code ΣI0..*CodeableConceptManifestation/symptom
Binding: Manifestation and Symptom Codes (example)
.... detail ΣI0..*Reference(Resource)Supporting information found elsewhere
... note 0..*AnnotationAdditional information about the Condition

doco Documentation for this format

Summary

Mandatory: 0 element (1 nested mandatory element)
Prohibited: 1 element

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

BC Mapping Source

This structure represents the following BC mapping definition:

oncology.BreastCancerPresenceStatement maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition:
  ConditionTopic.CodeableConcept maps to code
  ConditionTopic.Category maps to category
  ConditionPresenceContext.ClinicalStatus maps to clinicalStatus
  ConditionPresenceContext.VerificationStatus maps to verificationStatus
  ConditionPresenceContext.Onset maps to onset[x]
  ConditionPresenceContext.Abatement maps to abatement[x]
  constrain bodySite to 0..0
  ConditionPresenceContext.Severity maps to severity
  Stage maps to stage
  Stage.CodeableConcept maps to stage.summary
  Stage.StageDetail maps to stage.assessment

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition BC BreastCancerPresenceStatement Profile
... cimi-Encounter-extension 0..1(Complex)BC Encounter Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Encounter-extension
... oncology-MorphologyBehavior-extension 0..1CodeableConceptBC MorphologyBehavior Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MorphologyBehavior-extension
.... valueCodeableConcept Binding: MorphologyBehaviorVS (required)
... clinicalStatus 1..1
... severity Binding: Condition/Diagnosis Severity (required)
... code Binding: BreastCancerTypeVS (required)
... bodySite 0..0
... onset[x] dateTime, Age, Period, RangeProfile, string
... abatement[x] dateTime, Age, boolean, Period, RangeProfile, string
... stage
.... assessment 0..1Reference(BC BreastCancerStage Profile)

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition I0..*BC BreastCancerPresenceStatement Profile
us-core-1: A code in Condition.category SHOULD be from US Core Condition Category Codes value set.
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: Common Languages (extensible)
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... cimi-Encounter-extension 0..1(Complex)BC Encounter Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Encounter-extension
... oncology-MorphologyBehavior-extension 0..1CodeableConceptBC MorphologyBehavior Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MorphologyBehavior-extension
.... id 0..1stringxml:id (or equivalent in JSON)
.... url 1..1uri"http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-MorphologyBehavior-extension"
.... valueCodeableConcept 1..1CodeableConceptValue of extension
Binding: MorphologyBehaviorVS (required)
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal Ids for this condition
... clinicalStatus ?!SΣI1..1codeactive | recurrence | inactive | remission | resolved
Binding: Condition Clinical Status Codes (required)
... verificationStatus ?!SΣI1..1codeprovisional | differential | confirmed | refuted | entered-in-error | unknown
Binding: ConditionVerificationStatus (required)
... category S1..*CodeableConceptproblem-list-item | encounter-diagnosis
Binding: US Core Condition Category Codes (preferred)
... severity 0..1CodeableConceptSubjective severity of condition
Binding: Condition/Diagnosis Severity (required)
... code SΣ1..1CodeableConceptIdentification of the condition, problem or diagnosis
Binding: BreastCancerTypeVS (required)
... subject SΣ1..1Reference(US Core Patient Profile)Who has the condition?
... context Σ0..1Reference(Encounter | EpisodeOfCare)Encounter or episode when condition first asserted
... onset[x] Σ0..1dateTime, Age, Period, RangeProfile, stringEstimated or actual date, date-time, or age
... abatement[x] I0..1dateTime, Age, boolean, Period, RangeProfile, stringIf/when in resolution/remission
... assertedDate Σ0..1dateTimeDate record was believed accurate
... asserter Σ0..1Reference(Practitioner | Patient | RelatedPerson)Person who asserts this condition
... stage I0..1BackboneElementStage/grade, usually assessed formally
con-1: Stage SHALL have summary or assessment
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... summary I0..1CodeableConceptSimple summary (disease specific)
Binding: Condition Stage (example)
.... assessment I0..1Reference(BC BreastCancerStage Profile)Formal record of assessment
... evidence I0..*BackboneElementSupporting evidence
con-2: evidence SHALL have code or details
.... id 0..1stringxml:id (or equivalent in JSON)
.... extension 0..*ExtensionAdditional Content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
.... code ΣI0..*CodeableConceptManifestation/symptom
Binding: Manifestation and Symptom Codes (example)
.... detail ΣI0..*Reference(Resource)Supporting information found elsewhere
... note 0..*AnnotationAdditional information about the Condition

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON, TTL), Schema: XML Schematron

 

Terminology Bindings

PathNameConformanceValueSet
Condition.languageCommon LanguagesextensibleCommon Languages
Condition.extension.valueCodeableConceptMorphologyBehaviorVSrequiredMorphologyBehaviorVS
Condition.clinicalStatusCondition Clinical Status CodesrequiredCondition Clinical Status Codes
Condition.verificationStatusConditionVerificationStatusrequiredConditionVerificationStatus
Condition.categoryUS Core Condition Category CodespreferredUS Core Condition Category Codes
Condition.severityCondition/Diagnosis SeverityrequiredCondition/Diagnosis Severity
Condition.codeBreastCancerTypeVSrequiredBreastCancerTypeVS
Condition.stage.summaryCondition StageexampleCondition Stage
Condition.evidence.codeManifestation and Symptom CodesexampleManifestation and Symptom Codes

 

Constraints

IdPathDetailsRequirements
dom-2ConditionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-1ConditionIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-4ConditionIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-3ConditionIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
con-4ConditionIf condition is abated, then clinicalStatus must be either inactive, resolved, or remission
: abatement.empty() or (abatement as boolean).not() or clinicalStatus='resolved' or clinicalStatus='remission' or clinicalStatus='inactive'
con-3ConditionCondition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error
: verificationStatus='entered-in-error' or clinicalStatus.exists()
us-core-1ConditionA code in Condition.category SHOULD be from US Core Condition Category Codes value set.
: where(category in 'http://hl7.org/fhir/us/core/ValueSet/us-core-condition-category').exists()
ele-1Condition.stageAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
con-1Condition.stageStage SHALL have summary or assessment
: summary.exists() or assessment.exists()
ele-1Condition.evidenceAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())
con-2Condition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()