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

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Resource Profile: Cancer Stage Profile

A profile representing the cancer stage for a cancer patient.

It constrains the mCODE CancerStage profile to include specific constraints and extensions relevant to Onconova.

Conformance:

Observation resources representing a cancer staging in the scope of Onconova SHALL conform to this profile. Any resource intended to conform to this profile SHOULD populate meta.profile accordingly.

Usages:

• CapabilityStatements using this Profile: Onconova FHIR REST Server Capability Statement
• This Profile is not used by any profiles in this Implementation Guide

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.

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	CancerStage	assessment observation Constraints: obs-6, obs-7, o-stg-req-1, o-stg-req-2, o-stg-req-3, o-stg-breslow
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	Not used in this profile Binding: ObservationStatus (required): Codes providing the status of an observation.
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: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	The type of stage information reported. Binding: Cancer Stage Type Value Set (preferred)
subject	SOΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who and/or what the observation is about Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
focus	SOΣ	1..*	Reference(Primary Cancer Condition Profile)	The cancer condition associated with staging assessment. Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
encounter	Σ	0..1	Reference(Encounter)	Not used in this profile
effective[x]	SOΣ	1..1	dateTime S	(USCDI) Clinically relevant time/time-period for observation Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
issued	Σ	0..1	instant	Not used in this profile
performer	SΣ	0..*	Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile)	Not used in this profile
value[x]	SOΣC	1..1	CodeableConcept S	The value of the stage Binding: Cancer Stage Value Set (preferred) Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
Slices for extension				Content/Rules for all slices
extension:breslowDepth	SO	0..1	Quantity	Cancer Stage Breslow Depth URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-cancer-stage-breslow-depth Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
interpretation		0..*	CodeableConcept	Not used in this profile Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
bodySite		0..1	CodeableConcept	Not used in this profile Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method	SO	0..1	CodeableConcept	The staging system used. Binding: Cancer Staging Method Value Set (preferred) Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
specimen		0..1	Reference(Specimen)	Not used in this profile
Slices for component	Σ	0..*	BackboneElement	Component results Slice: Unordered, Open by value:code
component:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of prognostic factor Binding: Cancer Staging Prognostic Factors Types (preferred)
component:ulceration	SOΣ	0..1	BackboneElement	Presence of ulceration Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of prognostic factor Binding: Cancer Staging Prognostic Factors Types (preferred) 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: 105600-1
display		1..1	string	Representation defined by the system Fixed Value: Ulceration status [Presence] in Tissue
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	SΣ	0..1	CodeableConcept	Prognostic factor value Binding: https://loinc.org/LL4443-9 (required)
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 Simple Observation Category	📦6.1.0	US Core v6.1
Observation.code	Base	preferred	Cancer Stage Type Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.value[x]	Base	preferred	Cancer Stage Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.
Observation.bodySite	Base	example	SNOMED CT Body Structures	📦4.0.1	FHIR Std.
Observation.method	Base	preferred	Cancer Staging Method Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.component.​code	Base	preferred	Cancer Staging Prognostic Factors Types	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.component:ulceration.​code	Base	preferred	Cancer Staging Prognostic Factors Types	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.component:ulceration.​value[x]	Base	required	https://loinc.org/LL4443-9	Not State	Unknown

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	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
o-stg-breslow	error	Observation	For Breslow stages, the exact Breslow depth must be provided.	code.coding.code = '106243009' implies value.extension('https://onconova.github.io/fhir/StructureDefinition/onconova-ext-cancer-stage-breslow-depth').valueQuantity.value.hasValue()
o-stg-req-1	error	Observation	The subject element is required and must be provided.	subject.exists()
o-stg-req-2	error	Observation	The effectiveDateTime element is required and must be provided.	effectiveDateTime.exists() and effectiveDateTime.hasValue()
o-stg-req-3	error	Observation	The valueCodeableConcept element is required and must be provided.	valueCodeableConcept.exists() and valueCodeableConcept.coding.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()

This structure is derived from CancerStage

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	CancerStage	assessment observation Constraints: o-stg-req-1, o-stg-req-2, o-stg-req-3, o-stg-breslow
status		1..1	code	Not used in this profile
subject	O	1..1	Reference(Cancer Patient Profile)	(USCDI) Who and/or what the observation is about Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
focus	O	1..*	Reference(Primary Cancer Condition Profile)	The cancer condition associated with staging assessment. Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
encounter		0..1	Reference(Encounter)	Not used in this profile
effective[x]	O	1..1	dateTime	(USCDI) Clinically relevant time/time-period for observation Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
issued		0..1	instant	Not used in this profile
performer		0..*	Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile)	Not used in this profile
value[x]	O	1..1	CodeableConcept	The value of the stage Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
Slices for extension				Content/Rules for all slices
extension:breslowDepth	SO	0..1	Quantity	Cancer Stage Breslow Depth URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-cancer-stage-breslow-depth Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
interpretation		0..*	CodeableConcept	Not used in this profile
bodySite		0..1	CodeableConcept	Not used in this profile
method	O	0..1	CodeableConcept	The staging system used. Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
specimen		0..1	Reference(Specimen)	Not used in this profile
Slices for component		0..*	BackboneElement	Component results Slice: Unordered, Open by value:code
component:ulceration	SO	0..1	BackboneElement	Presence of ulceration Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
code	S	1..1	CodeableConcept	Type of prognostic factor Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 105600-1
display		1..1	string	Representation defined by the system Fixed Value: Ulceration status [Presence] in Tissue
value[x]	S	0..1	CodeableConcept	Prognostic factor value Binding: https://loinc.org/LL4443-9 (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.component:ulceration.​value[x]	Base	required	https://loinc.org/LL4443-9	Not State	Unknown

Constraints

Id	Grade	Path(s)	Description	Expression
o-stg-breslow	error	Observation	For Breslow stages, the exact Breslow depth must be provided.	code.coding.code = '106243009' implies value.extension('https://onconova.github.io/fhir/StructureDefinition/onconova-ext-cancer-stage-breslow-depth').valueQuantity.value.hasValue()
o-stg-req-1	error	Observation	The subject element is required and must be provided.	subject.exists()
o-stg-req-2	error	Observation	The effectiveDateTime element is required and must be provided.	effectiveDateTime.exists() and effectiveDateTime.hasValue()
o-stg-req-3	error	Observation	The valueCodeableConcept element is required and must be provided.	valueCodeableConcept.exists() and valueCodeableConcept.coding.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	CancerStage	assessment observation Constraints: obs-6, obs-7, o-stg-req-1, o-stg-req-2, o-stg-req-3, o-stg-breslow
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 Bindings Purpose 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
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	Not used in this profile Binding: ObservationStatus (required): Codes providing the status of an observation.
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: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	The type of stage information reported. Binding: Cancer Stage Type Value Set (preferred)
subject	SOΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who and/or what the observation is about Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
focus	SOΣ	1..*	Reference(Primary Cancer Condition Profile)	The cancer condition associated with staging assessment. Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
encounter	Σ	0..1	Reference(Encounter)	Not used in this profile
effective[x]	SOΣ	1..1	dateTime S	(USCDI) Clinically relevant time/time-period for observation Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
issued	Σ	0..1	instant	Not used in this profile
performer	SΣ	0..*	Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile)	Not used in this profile
value[x]	SOΣC	1..1	CodeableConcept S	The value of the stage Binding: Cancer Stage Value Set (preferred) Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:breslowDepth	SO	0..1	Quantity	Cancer Stage Breslow Depth URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-cancer-stage-breslow-depth Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	Not used in this profile Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
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	SO	0..1	CodeableConcept	The staging system used. Binding: Cancer Staging Method Value Set (preferred) Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	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)	Prognostic factors contributing to stage determination.
derivedFrom	Σ	0..*	Reference(Observation | US Core DocumentReference Profile | US Core QuestionnaireResponse Profile | ImagingStudy | Media | MolecularSequence)	(USCDI) US Core Profiles or other resource the observation is made from
Slices for component	Σ	0..*	BackboneElement	Component results Slice: Unordered, Open by value:code
component:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of prognostic factor Binding: Cancer Staging Prognostic Factors Types (preferred)
value[x]	Σ	0..1	CodeableConcept	Prognostic factor value Binding: Cancer Staging Prognostic Factors Value (preferred)
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
component:ulceration	SOΣ	0..1	BackboneElement	Presence of ulceration Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of prognostic factor Binding: Cancer Staging Prognostic Factors Types (preferred) 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: 105600-1
display		1..1	string	Representation defined by the system Fixed Value: Ulceration status [Presence] in Tissue
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	SΣ	0..1	CodeableConcept	Prognostic factor value Binding: https://loinc.org/LL4443-9 (required)
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
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 Simple Observation Category	📦6.1.0	US Core v6.1
Observation.code	Base	preferred	Cancer Stage Type Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.value[x]	Base	preferred	Cancer Stage Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📦4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.
Observation.bodySite	Base	example	SNOMED CT Body Structures	📦4.0.1	FHIR Std.
Observation.method	Base	preferred	Cancer Staging Method Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
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	preferred	Cancer Staging Prognostic Factors Types	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.component.​value[x]	Base	preferred	Cancer Staging Prognostic Factors Value	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📦4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.
Observation.component:ulceration.​code	Base	preferred	Cancer Staging Prognostic Factors Types	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.component:ulceration.​value[x]	Base	required	https://loinc.org/LL4443-9	Not State	Unknown
Observation.component:ulceration.​dataAbsentReason	Base	extensible	DataAbsentReason	📦4.0.1	FHIR Std.
Observation.component:ulceration.​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	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
o-stg-breslow	error	Observation	For Breslow stages, the exact Breslow depth must be provided.	code.coding.code = '106243009' implies value.extension('https://onconova.github.io/fhir/StructureDefinition/onconova-ext-cancer-stage-breslow-depth').valueQuantity.value.hasValue()
o-stg-req-1	error	Observation	The subject element is required and must be provided.	subject.exists()
o-stg-req-2	error	Observation	The effectiveDateTime element is required and must be provided.	effectiveDateTime.exists() and effectiveDateTime.hasValue()
o-stg-req-3	error	Observation	The valueCodeableConcept element is required and must be provided.	valueCodeableConcept.exists() and valueCodeableConcept.coding.exists()
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()

This structure is derived from CancerStage

Summary

Mandatory: 3 elements
Must-Support: 4 elements

Structures

This structure refers to these other structures:

• Cancer Patient Profile (http://onconova.github.io/fhir/StructureDefinition/onconova-cancer-patient)
• Primary Cancer Condition Profile (http://onconova.github.io/fhir/StructureDefinition/onconova-primary-cancer-condition)

Extensions

This structure refers to these extensions:

• http://onconova.github.io/fhir/StructureDefinition/onconova-ext-cancer-stage-breslow-depth

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.component

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	CancerStage	assessment observation Constraints: obs-6, obs-7, o-stg-req-1, o-stg-req-2, o-stg-req-3, o-stg-breslow
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	Not used in this profile Binding: ObservationStatus (required): Codes providing the status of an observation.
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: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	The type of stage information reported. Binding: Cancer Stage Type Value Set (preferred)
subject	SOΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who and/or what the observation is about Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
focus	SOΣ	1..*	Reference(Primary Cancer Condition Profile)	The cancer condition associated with staging assessment. Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
encounter	Σ	0..1	Reference(Encounter)	Not used in this profile
effective[x]	SOΣ	1..1	dateTime S	(USCDI) Clinically relevant time/time-period for observation Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
issued	Σ	0..1	instant	Not used in this profile
performer	SΣ	0..*	Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile)	Not used in this profile
value[x]	SOΣC	1..1	CodeableConcept S	The value of the stage Binding: Cancer Stage Value Set (preferred) Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
Slices for extension				Content/Rules for all slices
extension:breslowDepth	SO	0..1	Quantity	Cancer Stage Breslow Depth URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-cancer-stage-breslow-depth Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
interpretation		0..*	CodeableConcept	Not used in this profile Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
bodySite		0..1	CodeableConcept	Not used in this profile Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method	SO	0..1	CodeableConcept	The staging system used. Binding: Cancer Staging Method Value Set (preferred) Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
specimen		0..1	Reference(Specimen)	Not used in this profile
Slices for component	Σ	0..*	BackboneElement	Component results Slice: Unordered, Open by value:code
component:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of prognostic factor Binding: Cancer Staging Prognostic Factors Types (preferred)
component:ulceration	SOΣ	0..1	BackboneElement	Presence of ulceration Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of prognostic factor Binding: Cancer Staging Prognostic Factors Types (preferred) 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: 105600-1
display		1..1	string	Representation defined by the system Fixed Value: Ulceration status [Presence] in Tissue
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	SΣ	0..1	CodeableConcept	Prognostic factor value Binding: https://loinc.org/LL4443-9 (required)
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 Simple Observation Category	📦6.1.0	US Core v6.1
Observation.code	Base	preferred	Cancer Stage Type Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.value[x]	Base	preferred	Cancer Stage Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.
Observation.bodySite	Base	example	SNOMED CT Body Structures	📦4.0.1	FHIR Std.
Observation.method	Base	preferred	Cancer Staging Method Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.component.​code	Base	preferred	Cancer Staging Prognostic Factors Types	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.component:ulceration.​code	Base	preferred	Cancer Staging Prognostic Factors Types	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.component:ulceration.​value[x]	Base	required	https://loinc.org/LL4443-9	Not State	Unknown

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	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
o-stg-breslow	error	Observation	For Breslow stages, the exact Breslow depth must be provided.	code.coding.code = '106243009' implies value.extension('https://onconova.github.io/fhir/StructureDefinition/onconova-ext-cancer-stage-breslow-depth').valueQuantity.value.hasValue()
o-stg-req-1	error	Observation	The subject element is required and must be provided.	subject.exists()
o-stg-req-2	error	Observation	The effectiveDateTime element is required and must be provided.	effectiveDateTime.exists() and effectiveDateTime.hasValue()
o-stg-req-3	error	Observation	The valueCodeableConcept element is required and must be provided.	valueCodeableConcept.exists() and valueCodeableConcept.coding.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()

Differential View

This structure is derived from CancerStage

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	CancerStage	assessment observation Constraints: o-stg-req-1, o-stg-req-2, o-stg-req-3, o-stg-breslow
status		1..1	code	Not used in this profile
subject	O	1..1	Reference(Cancer Patient Profile)	(USCDI) Who and/or what the observation is about Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
focus	O	1..*	Reference(Primary Cancer Condition Profile)	The cancer condition associated with staging assessment. Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
encounter		0..1	Reference(Encounter)	Not used in this profile
effective[x]	O	1..1	dateTime	(USCDI) Clinically relevant time/time-period for observation Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
issued		0..1	instant	Not used in this profile
performer		0..*	Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile)	Not used in this profile
value[x]	O	1..1	CodeableConcept	The value of the stage Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
Slices for extension				Content/Rules for all slices
extension:breslowDepth	SO	0..1	Quantity	Cancer Stage Breslow Depth URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-cancer-stage-breslow-depth Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
interpretation		0..*	CodeableConcept	Not used in this profile
bodySite		0..1	CodeableConcept	Not used in this profile
method	O	0..1	CodeableConcept	The staging system used. Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
specimen		0..1	Reference(Specimen)	Not used in this profile
Slices for component		0..*	BackboneElement	Component results Slice: Unordered, Open by value:code
component:ulceration	SO	0..1	BackboneElement	Presence of ulceration Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
code	S	1..1	CodeableConcept	Type of prognostic factor Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 105600-1
display		1..1	string	Representation defined by the system Fixed Value: Ulceration status [Presence] in Tissue
value[x]	S	0..1	CodeableConcept	Prognostic factor value Binding: https://loinc.org/LL4443-9 (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.component:ulceration.​value[x]	Base	required	https://loinc.org/LL4443-9	Not State	Unknown

Constraints

Id	Grade	Path(s)	Description	Expression
o-stg-breslow	error	Observation	For Breslow stages, the exact Breslow depth must be provided.	code.coding.code = '106243009' implies value.extension('https://onconova.github.io/fhir/StructureDefinition/onconova-ext-cancer-stage-breslow-depth').valueQuantity.value.hasValue()
o-stg-req-1	error	Observation	The subject element is required and must be provided.	subject.exists()
o-stg-req-2	error	Observation	The effectiveDateTime element is required and must be provided.	effectiveDateTime.exists() and effectiveDateTime.hasValue()
o-stg-req-3	error	Observation	The valueCodeableConcept element is required and must be provided.	valueCodeableConcept.exists() and valueCodeableConcept.coding.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	CancerStage	assessment observation Constraints: obs-6, obs-7, o-stg-req-1, o-stg-req-2, o-stg-req-3, o-stg-breslow
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 Bindings Purpose 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
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!SΣ	1..1	code	Not used in this profile Binding: ObservationStatus (required): Codes providing the status of an observation.
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: US Core Simple Observation Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	The type of stage information reported. Binding: Cancer Stage Type Value Set (preferred)
subject	SOΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who and/or what the observation is about Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
focus	SOΣ	1..*	Reference(Primary Cancer Condition Profile)	The cancer condition associated with staging assessment. Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
encounter	Σ	0..1	Reference(Encounter)	Not used in this profile
effective[x]	SOΣ	1..1	dateTime S	(USCDI) Clinically relevant time/time-period for observation Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
issued	Σ	0..1	instant	Not used in this profile
performer	SΣ	0..*	Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile | PractitionerRole | US Core CareTeam Profile | US Core RelatedPerson Profile)	Not used in this profile
value[x]	SOΣC	1..1	CodeableConcept S	The value of the stage Binding: Cancer Stage Value Set (preferred) Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:breslowDepth	SO	0..1	Quantity	Cancer Stage Breslow Depth URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-cancer-stage-breslow-depth Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	Not used in this profile Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
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	SO	0..1	CodeableConcept	The staging system used. Binding: Cancer Staging Method Value Set (preferred) Obligations Actor SHALL:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
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
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	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)	Prognostic factors contributing to stage determination.
derivedFrom	Σ	0..*	Reference(Observation | US Core DocumentReference Profile | US Core QuestionnaireResponse Profile | ImagingStudy | Media | MolecularSequence)	(USCDI) US Core Profiles or other resource the observation is made from
Slices for component	Σ	0..*	BackboneElement	Component results Slice: Unordered, Open by value:code
component:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of prognostic factor Binding: Cancer Staging Prognostic Factors Types (preferred)
value[x]	Σ	0..1	CodeableConcept	Prognostic factor value Binding: Cancer Staging Prognostic Factors Value (preferred)
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
component:ulceration	SOΣ	0..1	BackboneElement	Presence of ulceration Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	SΣ	1..1	CodeableConcept	Type of prognostic factor Binding: Cancer Staging Prognostic Factors Types (preferred) 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: 105600-1
display		1..1	string	Representation defined by the system Fixed Value: Ulceration status [Presence] in Tissue
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]	SΣ	0..1	CodeableConcept	Prognostic factor value Binding: https://loinc.org/LL4443-9 (required)
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
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 Simple Observation Category	📦6.1.0	US Core v6.1
Observation.code	Base	preferred	Cancer Stage Type Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.value[x]	Base	preferred	Cancer Stage Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.dataAbsentReason	Base	extensible	DataAbsentReason	📦4.0.1	FHIR Std.
Observation.interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.
Observation.bodySite	Base	example	SNOMED CT Body Structures	📦4.0.1	FHIR Std.
Observation.method	Base	preferred	Cancer Staging Method Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
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	preferred	Cancer Staging Prognostic Factors Types	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.component.​value[x]	Base	preferred	Cancer Staging Prognostic Factors Value	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📦4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.
Observation.component:ulceration.​code	Base	preferred	Cancer Staging Prognostic Factors Types	📦4.0.0	minimal Common Oncology Data Elements v4.0
Observation.component:ulceration.​value[x]	Base	required	https://loinc.org/LL4443-9	Not State	Unknown
Observation.component:ulceration.​dataAbsentReason	Base	extensible	DataAbsentReason	📦4.0.1	FHIR Std.
Observation.component:ulceration.​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	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
o-stg-breslow	error	Observation	For Breslow stages, the exact Breslow depth must be provided.	code.coding.code = '106243009' implies value.extension('https://onconova.github.io/fhir/StructureDefinition/onconova-ext-cancer-stage-breslow-depth').valueQuantity.value.hasValue()
o-stg-req-1	error	Observation	The subject element is required and must be provided.	subject.exists()
o-stg-req-2	error	Observation	The effectiveDateTime element is required and must be provided.	effectiveDateTime.exists() and effectiveDateTime.hasValue()
o-stg-req-3	error	Observation	The valueCodeableConcept element is required and must be provided.	valueCodeableConcept.exists() and valueCodeableConcept.coding.exists()
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()

This structure is derived from CancerStage

Summary

Mandatory: 3 elements
Must-Support: 4 elements

Structures

This structure refers to these other structures:

• Cancer Patient Profile (http://onconova.github.io/fhir/StructureDefinition/onconova-cancer-patient)
• Primary Cancer Condition Profile (http://onconova.github.io/fhir/StructureDefinition/onconova-primary-cancer-condition)

Extensions

This structure refers to these extensions:

• http://onconova.github.io/fhir/StructureDefinition/onconova-ext-cancer-stage-breslow-depth

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.component

Other representations of profile: CSV, Excel, Schematron