HL7 FHIR® Implementation Guide: Breast Cancer Data, Release 1 - US Realm (Draft for Comment)
This page is part of the Breast Cancer Data Logical Models and FHIR Profiles (v0.1.0: STU 1 Draft) based on FHIR R3. . For a full list of available versions, see the Directory of published versions 
The official URL for this logical model is:
http://hl7.org/fhir/us/breastcancer/StructureDefinition/oncology-ProgesteroneReceptorStatus-model
Progesterone receptor status is a factor in determining prognosis and treatment options. The value is the percentage of cells that test (stain) positive for the presence of a receptor. The interpretation of positive or negative (found in the interpretation property) is based on the staining percentage, and may take into account the staining intensity.
Based on discussion with Cancer Interoperability Group subject matter experts, there was insufficient rationale to include the following components in the data model: StainingControl, PrimaryAntibody, Allred Score (both total and component scores). We are seeking feedback on whether or not those components should be included in this model.
We are seeking feedback if it is better to put the positive/negative status in Value or Interpretation. The current approach is that positive/negative designation is a value, even though that value is (in fact) an interpretation of evidence (NuclearPositivity and AverageStainingIntensity).
This logical model was published on Sun Apr 01 00:00:00 AEDT 2018 as a draft by The HL7 Cancer Interoperability Group sponsored by Clinical Interoperability Council Work Group (CIC).
View the corresponding ProgesteroneReceptorStatusProfile profile.
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  oncology-ProgesteroneReceptorStatus-model | 0..* | |||
  evaluationResultTopic | 1..1 | BackboneElement | The base class, independent of context, for evaluations (measurements, tests, or questions) and a value containing the result (answer). | |
 valueCodeableConcept | 0..1 | Coding | A set of codes drawn from different coding systems, representing the same concept. Binding: PositiveNegativeVS (required) | |
 topicCode | 1..1 | TopicCodeModel | The concept representing the finding or action that is the topic of the statement. | |
 value | 1..1 | Coding | Progesterone receptor [Interpretation] in Tissue | |
  system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://loinc.org |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: 16113-3 |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| findingMethod | 0..1 | FindingMethodModel | The technique used to create the finding; for example, the specific imaging technique, lab test code, or assessment vehicle. | |
| interpretation | 0..1 | InterpretationModel | A clinical interpretation of a finding. | |
| category | 1..* | CategoryModel | A class or division of people or things having particular shared characteristics | |
| value | 1..1 | Coding | Code representing a class or division of people or things having particular shared characteristics | |
| system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/observation-category |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: laboratory |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| breastSpecimen | 0..1 | BreastSpecimenModel | Specimen resulting from biopsy or excision of breast and surrounding tissue. | |
| deltaFlag | 0..1 | DeltaFlagModel | Indicator of significant change (delta) from the last or previous measurement. | |
| evaluationComponent | 0..1 | A simplified, non-separable evaluation consisting of a finding code (represented by the Concept), value (or exception value), reference range, and interpretation. | ||
| nuclearPositivity | 0..1 | NuclearPositivityModel | The percentage of cells that test (stain) positive for the presence of a receptor. | |
| averageStainingIntensity | 0..1 | AverageStainingIntensityModel | The degree or magnitude of staining (nuclear positivity) across cells in the specimen. | |
| recordedContext | 1..1 | RecordedContextModel | Context for an evaluation result, used to indicate an evaluation has been made. | |
| encounter | 0..1 | EncounterModel | 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. | |
| diagnosticService | 0..* | DiagnosticServiceModel | 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. | |
| value | 1..1 | Coding | 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. | |
| system | Σ | 1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/breastcancer/CodeSystem/cimi-statement-DiagnosticServiceCS |
| version | Σ | 0..1 | string | Version of the system - if relevant |
| code | Σ | 1..1 | code | Symbol in syntax defined by the system Fixed Value: pathology |
| display | Σ | 0..1 | string | Representation defined by the system |
| userSelected | Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| Documentation for this format | ||||
Downloads: StructureDefinition: (XML, JSON, TTL)
| Path | Name | Conformance | ValueSet |
| oncology-ProgesteroneReceptorStatus-model.evaluationResultTopic.valueCodeableConcept | PositiveNegativeVS | required | PositiveNegativeVS |