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

MammaprintRecurrenceScoreProfile

 

The official URL for this profile is:

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

Breast cancer genomic signature assay for 10-year risk of distant recurrence score calculated by Mammaprint.

In the United States, MammaPrint can only be used on cancers that are stage I or stage II, invasive, smaller than 5 centimeters, and estrogen-receptor-positive or -negative. Scores range from -1.0 to +1.0, with scores less than 0 indicating high risk, and scores greater than 0 indicating low risk.

The is currently no LOINC code for Mammaprint test.

This profile builds on US Core Results 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 MammaprintRecurrenceScoreModel logical model.

Summary

Mandatory: 0 element (3 nested mandatory elements)
Fixed Value: 7 elements
Prohibited: 4 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Observation.extension.valueCodeableConcept.coding is sliced based on the value of value:code
  • The element Observation.category.coding is sliced based on the value of value:code
  • The element Observation.code.coding is sliced based on the value of value:code

BC Mapping Source

This structure represents the following BC mapping definition:

oncology.MammaprintRecurrenceScore maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults:
  EvaluationResultTopic.Category maps to category
  EvaluationResultTopic.FindingMethod maps to method
  EvaluationResultTopic.Quantity maps to value[x]
  EvaluationResultTopic.CodeableConcept maps to value[x]
  EvaluationResultTopic.string maps to value[x]
  EvaluationResultTopic.boolean maps to value[x]
  EvaluationResultTopic.Range maps to value[x]
  EvaluationResultTopic.Ratio maps to value[x]
  EvaluationResultTopic.time maps to value[x]
  EvaluationResultTopic.dateTime maps to value[x]
  EvaluationResultTopic.TimePeriod maps to value[x]
  EvaluationResultTopic.TopicCode maps to code
  EvaluationResultTopic.AnatomicalLocation maps to bodySite
  EvaluationResultTopic.Specimen maps to specimen
  EvaluationResultTopic.Interpretation maps to interpretation
  RecordedContext.RelevantTime maps to effective[x]
  RecordedContext.FindingStatus maps to status
  RecordedContext.ExceptionValue maps to dataAbsentReason
  EvaluationResultTopic.ReferenceRange maps to referenceRange
  EvaluationResultTopic.ReferenceRange.Range.LowerBound maps to referenceRange.low
  EvaluationResultTopic.ReferenceRange.Range.UpperBound maps to referenceRange.high
  EvaluationResultTopic.ReferenceRange.Type maps to referenceRange.type
  EvaluationResultTopic.ReferenceRange.ApplicableSubpopulation maps to referenceRange.appliesTo
  EvaluationResultTopic.ReferenceRange.ApplicableAgeRange maps to referenceRange.age
  fix related.type to #has-member
  EvaluationResultTopic.EvaluationComponent maps to component (slice on = coding.code; slice strategy = includes)
  EvaluationResultTopic.EvaluationComponent._Concept maps to component.code
  EvaluationResultTopic.EvaluationComponent.Quantity maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.CodeableConcept maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.string maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.Range maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.Ratio maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.time maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.dateTime maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.TimePeriod maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.ExceptionValue maps to component.dataAbsentReason
  EvaluationResultTopic.EvaluationComponent.Interpretation maps to component.interpretation
  EvaluationResultTopic.EvaluationComponent.ReferenceRange maps to component.referenceRange
  Members.EvaluationResultRecorded maps to related.target (slice at = related; slice on = target.reference.resolve(); slice on type = profile; slice strategy = includes)
  constrain related to 0..0

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation BC MammaprintRecurrenceScore Profile
... cimi-Encounter-extension 0..1(Complex)BC Encounter Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Encounter-extension
... cimi-statement-DiagnosticService-extension 0..*CodeableConceptBC DiagnosticService Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-DiagnosticService-extension
Binding: DiagnosticServiceVS (extensible)
.... valueCodeableConcept
..... coding Slice: Unordered, Open by value:code
..... coding Σ1..1Coding
...... system Fixed Value: http://hl7.org/fhir/us/breastcancer/CodeSystem/cimi-statement-DiagnosticServiceCS
...... code Fixed Value: pathology
... category Binding: Observation Category Codes (extensible)
.... coding Slice: Unordered, Open by value:code
.... coding Σ1..1Coding
..... system Fixed Value: http://hl7.org/fhir/observation-category
..... code Fixed Value: laboratory
... code
.... coding Slice: Unordered, Open by value:code
.... coding Σ1..1Coding
..... system Fixed Value: http://ncimeta.nci.nih.gov
..... code Fixed Value: C2827401
... valueQuantity Quantity
... dataAbsentReason Binding: ExceptionValueVS (required)
... interpretation Binding: MammaprintRiskScoreInterpretationVS (required)
... bodySite 0..0
... method Binding: LOINC Codes (preferred)
... specimen Reference(BC BreastSpecimen Profile)
... referenceRange 0..0
... related 0..0
... component 0..0

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*BC MammaprintRecurrenceScore Profile
us-core-2: If there is no component or related element then either a value[x] or a data absent reason must be present
... 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
... cimi-statement-DiagnosticService-extension 0..*CodeableConceptBC DiagnosticService Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-DiagnosticService-extension
Binding: DiagnosticServiceVS (extensible)
.... id 0..1stringxml:id (or equivalent in JSON)
.... url 1..1uri"http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-DiagnosticService-extension"
.... valueCodeableConcept 1..1CodeableConceptValue of extension
Binding: DiagnosticServiceVS (extensible)
..... id 0..1stringxml:id (or equivalent in JSON)
..... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
..... coding Σ1..1Coding
...... id 0..1stringxml:id (or equivalent in JSON)
...... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/breastcancer/CodeSystem/cimi-statement-DiagnosticServiceCS
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: pathology
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)Fulfills plan, proposal or order
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category SI1..*CodeableConceptClassification of type of observation
Binding: Observation Category Codes (extensible)
us-core-5: Must have a category of 'laboratory' and a code system 'http://hl7.org/fhir/observation-category'
.... id 0..1stringxml:id (or equivalent in JSON)
.... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
.... coding Σ1..1Coding
..... id 0..1stringxml:id (or equivalent in JSON)
..... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/observation-category
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: laboratory
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... code SΣ1..1CodeableConceptLaboratory Test Name
Binding: LOINC Codes (extensible)
.... id 0..1stringxml:id (or equivalent in JSON)
.... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
.... coding Σ1..1Coding
..... id 0..1stringxml:id (or equivalent in JSON)
..... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://ncimeta.nci.nih.gov
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: C2827401
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(US Core Patient Profile)Who and/or what this is about
... context 0..1Reference(Encounter | EpisodeOfCare)Healthcare event during which this observation is made
... effective[x] SΣI0..1dateTime, PeriodClinically relevant time/time-period for observation
us-core-1: Datetime must be at least to day.
... issued Σ0..1instantDate/Time this was made available
... performer Σ0..*Reference(Practitioner | Organization | Patient | RelatedPerson)Who is responsible for the observation
... valueQuantity Σ0..1QuantityResult Value
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: ExceptionValueVS (required)
... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: MammaprintRiskScoreInterpretationVS (required)
... comment 0..1stringComments about result
... method 0..1CodeableConceptHow it was done
Binding: LOINC Codes (preferred)
... specimen 0..1Reference(BC BreastSpecimen Profile)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device

doco Documentation for this format

Summary

Mandatory: 0 element (3 nested mandatory elements)
Fixed Value: 7 elements
Prohibited: 4 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element Observation.extension.valueCodeableConcept.coding is sliced based on the value of value:code
  • The element Observation.category.coding is sliced based on the value of value:code
  • The element Observation.code.coding is sliced based on the value of value:code

BC Mapping Source

This structure represents the following BC mapping definition:

oncology.MammaprintRecurrenceScore maps to http://hl7.org/fhir/us/core/StructureDefinition/us-core-observationresults:
  EvaluationResultTopic.Category maps to category
  EvaluationResultTopic.FindingMethod maps to method
  EvaluationResultTopic.Quantity maps to value[x]
  EvaluationResultTopic.CodeableConcept maps to value[x]
  EvaluationResultTopic.string maps to value[x]
  EvaluationResultTopic.boolean maps to value[x]
  EvaluationResultTopic.Range maps to value[x]
  EvaluationResultTopic.Ratio maps to value[x]
  EvaluationResultTopic.time maps to value[x]
  EvaluationResultTopic.dateTime maps to value[x]
  EvaluationResultTopic.TimePeriod maps to value[x]
  EvaluationResultTopic.TopicCode maps to code
  EvaluationResultTopic.AnatomicalLocation maps to bodySite
  EvaluationResultTopic.Specimen maps to specimen
  EvaluationResultTopic.Interpretation maps to interpretation
  RecordedContext.RelevantTime maps to effective[x]
  RecordedContext.FindingStatus maps to status
  RecordedContext.ExceptionValue maps to dataAbsentReason
  EvaluationResultTopic.ReferenceRange maps to referenceRange
  EvaluationResultTopic.ReferenceRange.Range.LowerBound maps to referenceRange.low
  EvaluationResultTopic.ReferenceRange.Range.UpperBound maps to referenceRange.high
  EvaluationResultTopic.ReferenceRange.Type maps to referenceRange.type
  EvaluationResultTopic.ReferenceRange.ApplicableSubpopulation maps to referenceRange.appliesTo
  EvaluationResultTopic.ReferenceRange.ApplicableAgeRange maps to referenceRange.age
  fix related.type to #has-member
  EvaluationResultTopic.EvaluationComponent maps to component (slice on = coding.code; slice strategy = includes)
  EvaluationResultTopic.EvaluationComponent._Concept maps to component.code
  EvaluationResultTopic.EvaluationComponent.Quantity maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.CodeableConcept maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.string maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.Range maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.Ratio maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.time maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.dateTime maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.TimePeriod maps to component.value[x]
  EvaluationResultTopic.EvaluationComponent.ExceptionValue maps to component.dataAbsentReason
  EvaluationResultTopic.EvaluationComponent.Interpretation maps to component.interpretation
  EvaluationResultTopic.EvaluationComponent.ReferenceRange maps to component.referenceRange
  Members.EvaluationResultRecorded maps to related.target (slice at = related; slice on = target.reference.resolve(); slice on type = profile; slice strategy = includes)
  constrain related to 0..0

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation BC MammaprintRecurrenceScore Profile
... cimi-Encounter-extension 0..1(Complex)BC Encounter Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-Encounter-extension
... cimi-statement-DiagnosticService-extension 0..*CodeableConceptBC DiagnosticService Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-DiagnosticService-extension
Binding: DiagnosticServiceVS (extensible)
.... valueCodeableConcept
..... coding Slice: Unordered, Open by value:code
..... coding Σ1..1Coding
...... system Fixed Value: http://hl7.org/fhir/us/breastcancer/CodeSystem/cimi-statement-DiagnosticServiceCS
...... code Fixed Value: pathology
... category Binding: Observation Category Codes (extensible)
.... coding Slice: Unordered, Open by value:code
.... coding Σ1..1Coding
..... system Fixed Value: http://hl7.org/fhir/observation-category
..... code Fixed Value: laboratory
... code
.... coding Slice: Unordered, Open by value:code
.... coding Σ1..1Coding
..... system Fixed Value: http://ncimeta.nci.nih.gov
..... code Fixed Value: C2827401
... valueQuantity Quantity
... dataAbsentReason Binding: ExceptionValueVS (required)
... interpretation Binding: MammaprintRiskScoreInterpretationVS (required)
... bodySite 0..0
... method Binding: LOINC Codes (preferred)
... specimen Reference(BC BreastSpecimen Profile)
... referenceRange 0..0
... related 0..0
... component 0..0

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Observation I0..*BC MammaprintRecurrenceScore Profile
us-core-2: If there is no component or related element then either a value[x] or a data absent reason must be present
... 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
... cimi-statement-DiagnosticService-extension 0..*CodeableConceptBC DiagnosticService Extension
URL: http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-DiagnosticService-extension
Binding: DiagnosticServiceVS (extensible)
.... id 0..1stringxml:id (or equivalent in JSON)
.... url 1..1uri"http://hl7.org/fhir/us/breastcancer/StructureDefinition/cimi-statement-DiagnosticService-extension"
.... valueCodeableConcept 1..1CodeableConceptValue of extension
Binding: DiagnosticServiceVS (extensible)
..... id 0..1stringxml:id (or equivalent in JSON)
..... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
..... coding Σ1..1Coding
...... id 0..1stringxml:id (or equivalent in JSON)
...... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/us/breastcancer/CodeSystem/cimi-statement-DiagnosticServiceCS
...... version Σ0..1stringVersion of the system - if relevant
...... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: pathology
...... display Σ0..1stringRepresentation defined by the system
...... userSelected Σ0..1booleanIf this coding was chosen directly by the user
..... text Σ0..1stringPlain text representation of the concept
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness Identifier for observation
... basedOn Σ0..*Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)Fulfills plan, proposal or order
... status ?!SΣ1..1coderegistered | preliminary | final | amended +
Binding: ObservationStatus (required)
... category SI1..*CodeableConceptClassification of type of observation
Binding: Observation Category Codes (extensible)
us-core-5: Must have a category of 'laboratory' and a code system 'http://hl7.org/fhir/observation-category'
.... id 0..1stringxml:id (or equivalent in JSON)
.... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
.... coding Σ1..1Coding
..... id 0..1stringxml:id (or equivalent in JSON)
..... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://hl7.org/fhir/observation-category
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: laboratory
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... code SΣ1..1CodeableConceptLaboratory Test Name
Binding: LOINC Codes (extensible)
.... id 0..1stringxml:id (or equivalent in JSON)
.... coding ΣCodingCode defined by a terminology system
Slice: Unordered, Open by value:code
.... coding Σ1..1Coding
..... id 0..1stringxml:id (or equivalent in JSON)
..... system Σ0..1uriIdentity of the terminology system
Fixed Value: http://ncimeta.nci.nih.gov
..... version Σ0..1stringVersion of the system - if relevant
..... code Σ0..1codeSymbol in syntax defined by the system
Fixed Value: C2827401
..... display Σ0..1stringRepresentation defined by the system
..... userSelected Σ0..1booleanIf this coding was chosen directly by the user
.... text Σ0..1stringPlain text representation of the concept
... subject SΣ1..1Reference(US Core Patient Profile)Who and/or what this is about
... context 0..1Reference(Encounter | EpisodeOfCare)Healthcare event during which this observation is made
... effective[x] SΣI0..1dateTime, PeriodClinically relevant time/time-period for observation
us-core-1: Datetime must be at least to day.
... issued Σ0..1instantDate/Time this was made available
... performer Σ0..*Reference(Practitioner | Organization | Patient | RelatedPerson)Who is responsible for the observation
... valueQuantity Σ0..1QuantityResult Value
... dataAbsentReason SI0..1CodeableConceptWhy the result is missing
Binding: ExceptionValueVS (required)
... interpretation 0..1CodeableConceptHigh, low, normal, etc.
Binding: MammaprintRiskScoreInterpretationVS (required)
... comment 0..1stringComments about result
... method 0..1CodeableConceptHow it was done
Binding: LOINC Codes (preferred)
... specimen 0..1Reference(BC BreastSpecimen Profile)Specimen used for this observation
... device 0..1Reference(Device | DeviceMetric)(Measurement) Device

doco Documentation for this format

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

 

Terminology Bindings

PathNameConformanceValueSet
Observation.languageCommon LanguagesextensibleCommon Languages
Observation.extension.valueCodeableConceptDiagnosticServiceVSextensibleDiagnosticServiceVS
Observation.statusObservationStatusrequiredObservationStatus
Observation.categoryObservation Category CodesextensibleObservation Category Codes
Observation.codeLOINC CodesextensibleLOINC Codes
Observation.dataAbsentReasonExceptionValueVSrequiredExceptionValueVS
Observation.interpretationMammaprintRiskScoreInterpretationVSrequiredMammaprintRiskScoreInterpretationVS
Observation.methodLOINC CodespreferredLOINC Codes
Observation.referenceRange.typeObservation Reference Range Meaning CodesextensibleObservation Reference Range Meaning Codes
Observation.referenceRange.appliesToObservation Reference Range Applies To CodesextensibleObservation Reference Range Applies To Codes
Observation.related.typeObservationRelationshipTyperequiredObservationRelationshipType
Observation.component.codeLOINC CodesexampleLOINC Codes
Observation.component.dataAbsentReasonExceptionValueVSrequiredExceptionValueVS
Observation.component.interpretationMammaprintRiskScoreInterpretationVSrequiredMammaprintRiskScoreInterpretationVS
Observation.component.referenceRange.typeObservation Reference Range Meaning CodesextensibleObservation Reference Range Meaning Codes
Observation.component.referenceRange.appliesToObservation Reference Range Applies To CodesexampleObservation Reference Range Applies To Codes

 

Constraints

IdPathDetailsRequirements
dom-2ObservationIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-1ObservationIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-4ObservationIf 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-3ObservationIf 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()
obs-7ObservationIf code is the same as a component code then the value element associated with the code SHALL NOT be present
: value.empty() or code!=component.code
obs-6ObservationdataAbsentReason SHALL only be present if Observation.value[x] is not present
: dataAbsentReason.empty() or value.empty()
us-core-2ObservationIf there is no component or related element then either a value[x] or a data absent reason must be present
: (component.empty() and related.empty()) implies (dataAbsentReason or value)
us-core-5Observation.categoryMust have a category of 'laboratory' and a code system 'http://hl7.org/fhir/observation-category'
: where(coding.system='http://hl7.org/fhir/observation-category' and coding.code='laboratory').exists()
us-core-1Observation.effective[x]Datetime must be at least to day.
: ($this as dateTime).toString().length() >= 8