Onconova Implementation Guide
0.2.0 - ci-build

Onconova Implementation Guide - Local Development build (v0.2.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Karnofsky Performance Status Profile

Official URL: http://onconova.github.io/fhir/StructureDefinition/onconova-Karnofsky-performance-status Version: 0.2.0
Active as of 2025-10-17 Computable Name: OnconovaKarnofskyPerformanceStatus

A profile representing the Karnofsky performance status score for a cancer patient.

Adds minimal constraints to the mCODE KarnofskyPerformanceStatus profile to account for Onconova specifics.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* KarnofskyPerformanceStatus(4.0.0) Measurements and simple assertions
Constraints: obs-6, obs-7, us-core-2, o-obs-req-1, o-obs-req-2
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... basedOn Σ 0..* Reference(ServiceRequest | CarePlan) Not used in this profile
... status ?!SΣ 1..1 code (USCDI) registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Required Pattern: final
... Slices for category S 1..* CodeableConcept (USCDI) Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
Binding: USCoreClinicalResultObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... code SΣ 1..1 CodeableConcept (USCDI) Clinical Test or Procedure Name
Binding: LOINCCodes (extensible)
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 89243-0
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(Cancer Patient Profile(0.2.0)) (USCDI) Who and/or what the observation is about
... focus Σ 0..* Reference(Primary Cancer Condition Profile(0.2.0)) Not used in this profile
... encounter Σ 0..1 Reference(Encounter) Not used in this profile
... effective[x] SΣC 0..1 dateTime S (USCDI) Clinically relevant time/time-period for observation
Constraints: us-core-1
... issued Σ 0..1 instant Not used in this profile
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Not used in this profile
... value[x] SΣC 0..1 integer (USCDI) Result Value
Constraints: us-core-3
... dataAbsentReason SC 0..1 CodeableConcept Not used in this profile
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: LOINC Answer List LL4986-7 (required)
... method 0..1 CodeableConcept Not used in this profile
Binding: ObservationMethods (example): Methods for simple observations.
... referenceRange C 0..* BackboneElement Not used in this profile
Constraints: obs-3
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Not used in this profile

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Clinical Result Observation Category 📍6.1.0 US Core v6.1
Observation.code Base extensible LOINC Codes 📍4.0.1 FHIR Std.
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base required ​ LOINC Answer Codes for LL4986-7 (missing link) 📦 unknown?
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If 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-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error Observation.implicitRules, Observation.modifierExtension, Observation.basedOn, Observation.partOf, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.focus, Observation.encounter, Observation.effective[x], Observation.issued, Observation.performer, Observation.value[x], Observation.dataAbsentReason, Observation.interpretation, Observation.method, Observation.referenceRange, Observation.referenceRange.modifierExtension, Observation.derivedFrom All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error Observation.modifierExtension, Observation.referenceRange.modifierExtension Must have either extensions or value[x], not both extension.exists() != value.exists()
o-obs-req-1 error Observation The subject element is required and must be provided. subject.exists() and subject.resolve().is(Patient)
o-obs-req-2 error Observation The effectiveDateTime element is required and must be provided. effectiveDateTime.exists() and effectiveDateTime.hasValue()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
us-core-1 error Observation.effective[x] Datetime must be at least to day. $this is DateTime implies $this.toString().length() >= 10
us-core-2 error Observation If there is no component or hasMember element then either a value[x] or a data absent reason must be present (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
us-core-3 error Observation.value[x] SHALL use UCUM for coded quantity units. value.ofType(Quantity).system.empty() or value.ofType(Quantity).system = 'http://unitsofmeasure.org'

This structure is derived from KarnofskyPerformanceStatus

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* KarnofskyPerformanceStatus(4.0.0) Measurements and simple assertions
... basedOn 0..* Reference(ServiceRequest | CarePlan) Not used in this profile
... partOf 0..* Reference(Procedure) Not used in this profile
... status 1..1 code (USCDI) registered | preliminary | final | amended +
Required Pattern: final
... focus 0..* Reference(Primary Cancer Condition Profile(0.2.0)) Not used in this profile
... encounter 0..1 Reference(Encounter) Not used in this profile
... effective[x] 0..1 dateTime (USCDI) Clinically relevant time/time-period for observation
... issued 0..1 instant Not used in this profile
... performer 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Not used in this profile
... dataAbsentReason 0..1 CodeableConcept Not used in this profile
... method 0..1 CodeableConcept Not used in this profile
... referenceRange 0..* BackboneElement Not used in this profile
... derivedFrom 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Not used in this profile

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
o-obs-req-1 error Observation The subject element is required and must be provided. subject.exists() and subject.resolve().is(Patient)
o-obs-req-2 error Observation The effectiveDateTime element is required and must be provided. effectiveDateTime.exists() and effectiveDateTime.hasValue()
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* KarnofskyPerformanceStatus(4.0.0) Measurements and simple assertions
Constraints: obs-6, obs-7, us-core-2, o-obs-req-1, o-obs-req-2
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(ServiceRequest | CarePlan) Not used in this profile
... partOf Σ 0..* Reference(Procedure) Not used in this profile
... status ?!SΣ 1..1 code (USCDI) registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Required Pattern: final
... Slices for category S 1..* CodeableConcept (USCDI) Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
Binding: USCoreClinicalResultObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... code SΣ 1..1 CodeableConcept (USCDI) Clinical Test or Procedure Name
Binding: LOINCCodes (extensible)
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 89243-0
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(Cancer Patient Profile(0.2.0)) (USCDI) Who and/or what the observation is about
... focus Σ 0..* Reference(Primary Cancer Condition Profile(0.2.0)) Not used in this profile
... encounter Σ 0..1 Reference(Encounter) Not used in this profile
... effective[x] SΣC 0..1 dateTime S (USCDI) Clinically relevant time/time-period for observation
Constraints: us-core-1
... issued Σ 0..1 instant Not used in this profile
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Not used in this profile
... value[x] SΣC 0..1 integer (USCDI) Result Value
Constraints: us-core-3
... dataAbsentReason SC 0..1 CodeableConcept Not used in this profile
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: LOINC Answer List LL4986-7 (required)
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Not used in this profile
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept Not used in this profile
Binding: ObservationMethods (example): Methods for simple observations.
... specimen 0..1 Reference(Specimen) Not used in this profile
... device 0..1 Reference(Device | DeviceMetric) Not used in this profile
... referenceRange C 0..* BackboneElement Not used in this profile
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Not used in this profile
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Not used in this profile
... component Σ 0..* BackboneElement Not used in this profile
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Clinical Result Observation Category 📍6.1.0 US Core v6.1
Observation.code Base extensible LOINC Codes 📍4.0.1 FHIR Std.
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base required ​ LOINC Answer Codes for LL4986-7 (missing link) 📦 unknown?
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If 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-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error Observation.meta, Observation.implicitRules, Observation.language, Observation.text, Observation.extension, Observation.modifierExtension, Observation.identifier, Observation.basedOn, Observation.partOf, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.focus, Observation.encounter, Observation.effective[x], Observation.issued, Observation.performer, Observation.value[x], Observation.dataAbsentReason, Observation.interpretation, Observation.note, Observation.bodySite, Observation.method, Observation.specimen, Observation.device, Observation.referenceRange, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.referenceRange.low, Observation.referenceRange.high, Observation.referenceRange.type, Observation.referenceRange.appliesTo, Observation.referenceRange.age, Observation.referenceRange.text, Observation.hasMember, Observation.derivedFrom, Observation.component, Observation.component.extension, Observation.component.modifierExtension, Observation.component.code, Observation.component.value[x], Observation.component.dataAbsentReason, Observation.component.interpretation, Observation.component.referenceRange All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error Observation.extension, Observation.modifierExtension, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.component.extension, Observation.component.modifierExtension Must have either extensions or value[x], not both extension.exists() != value.exists()
o-obs-req-1 error Observation The subject element is required and must be provided. subject.exists() and subject.resolve().is(Patient)
o-obs-req-2 error Observation The effectiveDateTime element is required and must be provided. effectiveDateTime.exists() and effectiveDateTime.hasValue()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
us-core-1 error Observation.effective[x] Datetime must be at least to day. $this is DateTime implies $this.toString().length() >= 10
us-core-2 error Observation If there is no component or hasMember element then either a value[x] or a data absent reason must be present (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
us-core-3 error Observation.value[x] SHALL use UCUM for coded quantity units. value.ofType(Quantity).system.empty() or value.ofType(Quantity).system = 'http://unitsofmeasure.org'

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* KarnofskyPerformanceStatus(4.0.0) Measurements and simple assertions
Constraints: obs-6, obs-7, us-core-2, o-obs-req-1, o-obs-req-2
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... basedOn Σ 0..* Reference(ServiceRequest | CarePlan) Not used in this profile
... status ?!SΣ 1..1 code (USCDI) registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Required Pattern: final
... Slices for category S 1..* CodeableConcept (USCDI) Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
Binding: USCoreClinicalResultObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... code SΣ 1..1 CodeableConcept (USCDI) Clinical Test or Procedure Name
Binding: LOINCCodes (extensible)
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 89243-0
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(Cancer Patient Profile(0.2.0)) (USCDI) Who and/or what the observation is about
... focus Σ 0..* Reference(Primary Cancer Condition Profile(0.2.0)) Not used in this profile
... encounter Σ 0..1 Reference(Encounter) Not used in this profile
... effective[x] SΣC 0..1 dateTime S (USCDI) Clinically relevant time/time-period for observation
Constraints: us-core-1
... issued Σ 0..1 instant Not used in this profile
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Not used in this profile
... value[x] SΣC 0..1 integer (USCDI) Result Value
Constraints: us-core-3
... dataAbsentReason SC 0..1 CodeableConcept Not used in this profile
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: LOINC Answer List LL4986-7 (required)
... method 0..1 CodeableConcept Not used in this profile
Binding: ObservationMethods (example): Methods for simple observations.
... referenceRange C 0..* BackboneElement Not used in this profile
Constraints: obs-3
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Not used in this profile

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Clinical Result Observation Category 📍6.1.0 US Core v6.1
Observation.code Base extensible LOINC Codes 📍4.0.1 FHIR Std.
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base required ​ LOINC Answer Codes for LL4986-7 (missing link) 📦 unknown?
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If 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-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error Observation.implicitRules, Observation.modifierExtension, Observation.basedOn, Observation.partOf, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.focus, Observation.encounter, Observation.effective[x], Observation.issued, Observation.performer, Observation.value[x], Observation.dataAbsentReason, Observation.interpretation, Observation.method, Observation.referenceRange, Observation.referenceRange.modifierExtension, Observation.derivedFrom All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error Observation.modifierExtension, Observation.referenceRange.modifierExtension Must have either extensions or value[x], not both extension.exists() != value.exists()
o-obs-req-1 error Observation The subject element is required and must be provided. subject.exists() and subject.resolve().is(Patient)
o-obs-req-2 error Observation The effectiveDateTime element is required and must be provided. effectiveDateTime.exists() and effectiveDateTime.hasValue()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
us-core-1 error Observation.effective[x] Datetime must be at least to day. $this is DateTime implies $this.toString().length() >= 10
us-core-2 error Observation If there is no component or hasMember element then either a value[x] or a data absent reason must be present (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
us-core-3 error Observation.value[x] SHALL use UCUM for coded quantity units. value.ofType(Quantity).system.empty() or value.ofType(Quantity).system = 'http://unitsofmeasure.org'

Differential View

This structure is derived from KarnofskyPerformanceStatus

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* KarnofskyPerformanceStatus(4.0.0) Measurements and simple assertions
... basedOn 0..* Reference(ServiceRequest | CarePlan) Not used in this profile
... partOf 0..* Reference(Procedure) Not used in this profile
... status 1..1 code (USCDI) registered | preliminary | final | amended +
Required Pattern: final
... focus 0..* Reference(Primary Cancer Condition Profile(0.2.0)) Not used in this profile
... encounter 0..1 Reference(Encounter) Not used in this profile
... effective[x] 0..1 dateTime (USCDI) Clinically relevant time/time-period for observation
... issued 0..1 instant Not used in this profile
... performer 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Not used in this profile
... dataAbsentReason 0..1 CodeableConcept Not used in this profile
... method 0..1 CodeableConcept Not used in this profile
... referenceRange 0..* BackboneElement Not used in this profile
... derivedFrom 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Not used in this profile

doco Documentation for this format

Constraints

Id Grade Path(s) Description Expression
o-obs-req-1 error Observation The subject element is required and must be provided. subject.exists() and subject.resolve().is(Patient)
o-obs-req-2 error Observation The effectiveDateTime element is required and must be provided. effectiveDateTime.exists() and effectiveDateTime.hasValue()

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* KarnofskyPerformanceStatus(4.0.0) Measurements and simple assertions
Constraints: obs-6, obs-7, us-core-2, o-obs-req-1, o-obs-req-2
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(ServiceRequest | CarePlan) Not used in this profile
... partOf Σ 0..* Reference(Procedure) Not used in this profile
... status ?!SΣ 1..1 code (USCDI) registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
Required Pattern: final
... Slices for category S 1..* CodeableConcept (USCDI) Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:us-core S 0..* CodeableConcept (USCDI) Classification of type of observation
Binding: USCoreClinicalResultObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
... code SΣ 1..1 CodeableConcept (USCDI) Clinical Test or Procedure Name
Binding: LOINCCodes (extensible)
Required Pattern: At least the following
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
..... version 0..1 string Version of the system - if relevant
..... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 89243-0
..... display 0..1 string Representation defined by the system
..... userSelected 0..1 boolean If this coding was chosen directly by the user
.... text 0..1 string Plain text representation of the concept
... subject SΣ 1..1 Reference(Cancer Patient Profile(0.2.0)) (USCDI) Who and/or what the observation is about
... focus Σ 0..* Reference(Primary Cancer Condition Profile(0.2.0)) Not used in this profile
... encounter Σ 0..1 Reference(Encounter) Not used in this profile
... effective[x] SΣC 0..1 dateTime S (USCDI) Clinically relevant time/time-period for observation
Constraints: us-core-1
... issued Σ 0..1 instant Not used in this profile
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Not used in this profile
... value[x] SΣC 0..1 integer (USCDI) Result Value
Constraints: us-core-3
... dataAbsentReason SC 0..1 CodeableConcept Not used in this profile
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation S 0..* CodeableConcept High, low, normal, etc.
Binding: LOINC Answer List LL4986-7 (required)
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Not used in this profile
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method 0..1 CodeableConcept Not used in this profile
Binding: ObservationMethods (example): Methods for simple observations.
... specimen 0..1 Reference(Specimen) Not used in this profile
... device 0..1 Reference(Device | DeviceMetric) Not used in this profile
... referenceRange C 0..* BackboneElement Not used in this profile
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Not used in this profile
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Not used in this profile
... component Σ 0..* BackboneElement Not used in this profile
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... code Σ 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] Σ 0..1 Actual component result
..... valueQuantity Quantity
..... valueCodeableConcept CodeableConcept
..... valueString string
..... valueBoolean boolean
..... valueInteger integer
..... valueRange Range
..... valueRatio Ratio
..... valueSampledData SampledData
..... valueTime time
..... valueDateTime dateTime
..... valuePeriod Period
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Clinical Result Observation Category 📍6.1.0 US Core v6.1
Observation.code Base extensible LOINC Codes 📍4.0.1 FHIR Std.
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base required ​ LOINC Answer Codes for LL4986-7 (missing link) 📦 unknown?
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base example Observation Methods 📍4.0.1 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍4.0.1 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍4.0.1 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍4.0.1 FHIR Std.
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If 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-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error Observation.meta, Observation.implicitRules, Observation.language, Observation.text, Observation.extension, Observation.modifierExtension, Observation.identifier, Observation.basedOn, Observation.partOf, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.focus, Observation.encounter, Observation.effective[x], Observation.issued, Observation.performer, Observation.value[x], Observation.dataAbsentReason, Observation.interpretation, Observation.note, Observation.bodySite, Observation.method, Observation.specimen, Observation.device, Observation.referenceRange, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.referenceRange.low, Observation.referenceRange.high, Observation.referenceRange.type, Observation.referenceRange.appliesTo, Observation.referenceRange.age, Observation.referenceRange.text, Observation.hasMember, Observation.derivedFrom, Observation.component, Observation.component.extension, Observation.component.modifierExtension, Observation.component.code, Observation.component.value[x], Observation.component.dataAbsentReason, Observation.component.interpretation, Observation.component.referenceRange All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error Observation.extension, Observation.modifierExtension, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.component.extension, Observation.component.modifierExtension Must have either extensions or value[x], not both extension.exists() != value.exists()
o-obs-req-1 error Observation The subject element is required and must be provided. subject.exists() and subject.resolve().is(Patient)
o-obs-req-2 error Observation The effectiveDateTime element is required and must be provided. effectiveDateTime.exists() and effectiveDateTime.hasValue()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
us-core-1 error Observation.effective[x] Datetime must be at least to day. $this is DateTime implies $this.toString().length() >= 10
us-core-2 error Observation If there is no component or hasMember element then either a value[x] or a data absent reason must be present (component.empty() and hasMember.empty()) implies (dataAbsentReason.exists() or value.exists())
us-core-3 error Observation.value[x] SHALL use UCUM for coded quantity units. value.ofType(Quantity).system.empty() or value.ofType(Quantity).system = 'http://unitsofmeasure.org'

 

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