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

• Content
• Detailed Descriptions
• Mappings
• JSON

Resource Profile: Secondary Cancer Condition Profile

A profile recording the a secondary neoplasm, including location and the date of onset of metastases. A secondary cancer results from the spread (metastasization) of cancer from its original site (Definition from: NCI Dictionary of Cancer Terms).

It constrains the mCODE SecondaryCancerCCondition profile to constrain the terminologies of the cancer topography and morphology extensions to use exclusively ICD-O-3 codes.

Conformance:

Condition resources representing a metastatic neoplastic entity in the scope of Onconova SHALL conform to this profile. Any resource intended to conform to this profile SHOULD populate meta.profile accordingly.

Usages:

• Refer to this Profile: Molecular Tumor Board Molecular Comparison, Imaging Disease Status Profile, Medication Administration Profile, Radiotherapy Summary Profile... Show 2 more, Surgical Procedure Profile and Tumor Board Review Profile
• CapabilityStatements using this Profile: Onconova FHIR REST Server Capability Statement

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
Condition	C	0..*	SecondaryCancerCondition	Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5, o-con-req-1, o-con-req-2, o-con-req-3, o-con-req-4
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension	S	1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:assertedDate	SO	0..1	dateTime	Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:histologyMorphologyBehavior	SO	1..1	(Complex)	Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior"
value[x]		1..1	CodeableConcept	Value of extension Binding: ICD-O-3 Morphology Behavior Value Set (required)
extension:relatedPrimaryCancerCondition	SO	0..1	(Complex)	Conditions associated with this condition URL: http://hl7.org/fhir/StructureDefinition/condition-related Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-related"
value[x]		1..1	Reference(Primary Cancer Condition Profile)	Value of extension
extension:differentiation	SO	0..1	CodeableConcept	Histological Differentiation URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-histological-differentiation Binding: ICD-O-3 Differentiations Value Set (required) Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
clinicalStatus	?!SΣC	0..1	CodeableConcept	(USCDI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus	?!SΣC	0..1	CodeableConcept	Not used in this profile Binding: ConditionVerificationStatus (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core	S	1..*	CodeableConcept	(USCDI) problem-list-item | health-concern Binding: US Core Problem or Health Concern (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment	S	0..*	CodeableConcept	(USCDI) USCDI Health Status/Assessments Data Class Binding: US Core Screening Assessment Condition Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
severity		0..1	CodeableConcept	Not used in this profile Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	SΣ	1..1	CodeableConcept	(USCDI) Identification of the condition, problem or diagnosis Binding: Secondary Cancer Disorder Value Set (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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 128462008
display		1..1	string	Representation defined by the system Fixed Value: Secondary malignant neoplastic disease
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
bodySite	SOΣ	1..1	CodeableConcept	Anatomical location, if relevant Binding: ICD-O-3 Topographies Value Set (required) Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
Slices for extension				Content/Rules for all slices
extension:locationQualifier	S	0..*	CodeableConcept	Not used in this profile URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (required)
extension:lateralityQualifier	SO	0..1	CodeableConcept	Laterality Qualifier Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier Binding: Laterality Qualifier Value Set (required) Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
subject	SOΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who has the condition? Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
encounter	Σ	0..1	Reference(Encounter)	Not used in this profile
onset[x]	SΣ	0..1		(USCDI) Estimated or actual date, date-time, or age
onsetDateTime			dateTime S
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
abatement[x]	SC	0..1		(USCDI) When in resolution/remission
abatementDateTime			dateTime S
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	SΣ	0..1	dateTime	Not used in this profile
recorder	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Not used in this profile
asserter	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Not used in this profile
evidence	C	0..*	BackboneElement	Not used in this profile Constraints: con-2
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Condition.extension:histologyMorphologyBehavior.​value[x]	Base	required	ICD-O-3 Morphology Behavior Value Set	📦0.2.0	This IG
Condition.clinicalStatus	Base	required	Condition Clinical Status Codes	📦4.0.1	FHIR Std.
Condition.verificationStatus	Base	required	ConditionVerificationStatus	📦4.0.1	FHIR Std.
Condition.category	Base	extensible	Condition Category Codes	📦4.0.1	FHIR Std.
Condition.category:us-core	Base	required	US Core Problem or Health Concern	📦6.1.0	US Core v6.1
Condition.category:screening-assessment	Base	required	US Core Screening Assessment Condition Category	📦6.1.0	US Core v6.1
Condition.severity	Base	preferred	Condition/Diagnosis Severity	📦4.0.1	FHIR Std.
Condition.code	Base	extensible	Secondary Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Condition.bodySite	Base	required	ICD-O-3 Topographies Value Set	📦0.2.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
con-2	error	Condition.evidence	evidence SHALL have code or details	code.exists() or detail.exists()
con-3	best practice	Condition	Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item	clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4	error	Condition	If condition is abated, then clinicalStatus must be either inactive, resolved, or remission	abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5	error	Condition	Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error	verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2	error	Condition	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Condition	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	Condition	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	Condition	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Condition	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-con-req-1	error	Condition	The subject element is required and must be provided.	subject.exists()
o-con-req-2	error	Condition	The assertedDate extension is required and must be provided.	extension('http://hl7.org/fhir/StructureDefinition/condition-assertedDate').exists()
o-con-req-3	error	Condition	The bodySite element is required and must be provided.	bodySite.exists() and bodySite.coding.exists()
o-con-req-4	error	Condition	The histologyMorphologyBehavior extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior').exists()

This structure is derived from SecondaryCancerCondition

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition	C	0..*	SecondaryCancerCondition	Detailed information about conditions, problems or diagnoses Constraints: o-con-req-1, o-con-req-2, o-con-req-3, o-con-req-4
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:assertedDate	O	0..1	ConditionAssertedDate(5.2.0)	Date the condition was first asserted Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:histologyMorphologyBehavior	O	1..1	HistologyMorphologyBehavior	Histology-Morphology-Behavior Extension Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
value[x]		1..1	CodeableConcept	Value of extension Binding: ICD-O-3 Morphology Behavior Value Set (required)
extension:relatedPrimaryCancerCondition	O	0..1	ConditionRelated(5.2.0)	Conditions associated with this condition Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
value[x]		1..1	Reference(Primary Cancer Condition Profile)	Value of extension
extension:differentiation	SO	0..1	CodeableConcept	Histological Differentiation URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-histological-differentiation Binding: ICD-O-3 Differentiations Value Set (required) Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
verificationStatus		0..1	CodeableConcept	Not used in this profile
severity		0..1	CodeableConcept	Not used in this profile
code		1..1	CodeableConcept	(USCDI) Identification of the condition, problem or diagnosis 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://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 128462008
display		1..1	string	Representation defined by the system Fixed Value: Secondary malignant neoplastic disease
bodySite	O	1..1	CodeableConcept	Anatomical location, if relevant Binding: ICD-O-3 Topographies Value Set (required) Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
Slices for extension				Content/Rules for all slices
extension:locationQualifier		0..*	BodyLocationQualifier	Not used in this profile
extension:lateralityQualifier	O	0..1	LateralityQualifier	Laterality Qualifier Extension Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
subject	O	1..1	Reference(Cancer Patient Profile)	(USCDI) Who has the condition? Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
encounter		0..1	Reference(Encounter)	Not used in this profile
recordedDate		0..1	dateTime	Not used in this profile
recorder		0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Not used in this profile
asserter		0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Not used in this profile
evidence		0..*	BackboneElement	Not used in this profile
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Condition.extension:histologyMorphologyBehavior.​value[x]	Base	required	ICD-O-3 Morphology Behavior Value Set	📦0.2.0	This IG
Condition.bodySite	Base	required	ICD-O-3 Topographies Value Set	📦0.2.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
o-con-req-1	error	Condition	The subject element is required and must be provided.	subject.exists()
o-con-req-2	error	Condition	The assertedDate extension is required and must be provided.	extension('http://hl7.org/fhir/StructureDefinition/condition-assertedDate').exists()
o-con-req-3	error	Condition	The bodySite element is required and must be provided.	bodySite.exists() and bodySite.coding.exists()
o-con-req-4	error	Condition	The histologyMorphologyBehavior extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior').exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition	C	0..*	SecondaryCancerCondition	Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5, o-con-req-1, o-con-req-2, o-con-req-3, o-con-req-4
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
Slices for extension	S	1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:assertedDate	SO	0..1	dateTime	Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:histologyMorphologyBehavior	SO	1..1	(Complex)	Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior"
value[x]		1..1	CodeableConcept	Value of extension Binding: ICD-O-3 Morphology Behavior Value Set (required)
extension:relatedPrimaryCancerCondition	SO	0..1	(Complex)	Conditions associated with this condition URL: http://hl7.org/fhir/StructureDefinition/condition-related Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
id		0..1	id	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-related"
value[x]		1..1	Reference(Primary Cancer Condition Profile)	Value of extension
extension:differentiation	SO	0..1	CodeableConcept	Histological Differentiation URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-histological-differentiation Binding: ICD-O-3 Differentiations Value Set (required) Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this condition
clinicalStatus	?!SΣC	0..1	CodeableConcept	(USCDI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus	?!SΣC	0..1	CodeableConcept	Not used in this profile Binding: ConditionVerificationStatus (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core	S	1..*	CodeableConcept	(USCDI) problem-list-item | health-concern Binding: US Core Problem or Health Concern (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment	S	0..*	CodeableConcept	(USCDI) USCDI Health Status/Assessments Data Class Binding: US Core Screening Assessment Condition Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
severity		0..1	CodeableConcept	Not used in this profile Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	SΣ	1..1	CodeableConcept	(USCDI) Identification of the condition, problem or diagnosis Binding: Secondary Cancer Disorder Value Set (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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 128462008
display		1..1	string	Representation defined by the system Fixed Value: Secondary malignant neoplastic disease
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
bodySite	SOΣ	1..1	CodeableConcept	Anatomical location, if relevant Binding: ICD-O-3 Topographies Value Set (required) 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:locationQualifier	S	0..*	CodeableConcept	Not used in this profile URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (required)
extension:lateralityQualifier	SO	0..1	CodeableConcept	Laterality Qualifier Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier Binding: Laterality Qualifier Value Set (required) Obligations Actor SHOULD: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
subject	SOΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who has the condition? Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
encounter	Σ	0..1	Reference(Encounter)	Not used in this profile
onset[x]	SΣ	0..1		(USCDI) Estimated or actual date, date-time, or age
onsetDateTime			dateTime S
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
abatement[x]	SC	0..1		(USCDI) When in resolution/remission
abatementDateTime			dateTime S
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	SΣ	0..1	dateTime	Not used in this profile
recorder	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Not used in this profile
asserter	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Not used in this profile
stage	C	0..*	BackboneElement	Not used in this profile Constraints: con-1
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
summary	C	0..1	CodeableConcept	Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).
assessment	C	0..*	Reference(ClinicalImpression | DiagnosticReport | Observation)	Formal record of assessment
type		0..1	CodeableConcept	Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
evidence	C	0..*	BackboneElement	Not used in this profile Constraints: con-2
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	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: Cancer Disease Status Evidence Type Value Set (required)
detail	ΣC	0..*	Reference(Resource)	Supporting information found elsewhere
note		0..*	Annotation	Additional information about the Condition
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Condition.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Condition.extension:histologyMorphologyBehavior.​value[x]	Base	required	ICD-O-3 Morphology Behavior Value Set	📦0.2.0	This IG
Condition.clinicalStatus	Base	required	Condition Clinical Status Codes	📦4.0.1	FHIR Std.
Condition.verificationStatus	Base	required	ConditionVerificationStatus	📦4.0.1	FHIR Std.
Condition.category	Base	extensible	Condition Category Codes	📦4.0.1	FHIR Std.
Condition.category:us-core	Base	required	US Core Problem or Health Concern	📦6.1.0	US Core v6.1
Condition.category:screening-assessment	Base	required	US Core Screening Assessment Condition Category	📦6.1.0	US Core v6.1
Condition.severity	Base	preferred	Condition/Diagnosis Severity	📦4.0.1	FHIR Std.
Condition.code	Base	extensible	Secondary Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Condition.bodySite	Base	required	ICD-O-3 Topographies Value Set	📦0.2.0	This IG
Condition.stage.summary	Base	example	Condition Stage	📦4.0.1	FHIR Std.
Condition.stage.type	Base	example	Condition Stage Type	📦4.0.1	FHIR Std.
Condition.evidence.code	Base	required	Cancer Disease Status Evidence Type Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0

Constraints

Id	Grade	Path(s)	Description	Expression
con-1	error	Condition.stage	Stage SHALL have summary or assessment	summary.exists() or assessment.exists()
con-2	error	Condition.evidence	evidence SHALL have code or details	code.exists() or detail.exists()
con-3	best practice	Condition	Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item	clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4	error	Condition	If condition is abated, then clinicalStatus must be either inactive, resolved, or remission	abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5	error	Condition	Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error	verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2	error	Condition	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Condition	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	Condition	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	Condition	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Condition	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-con-req-1	error	Condition	The subject element is required and must be provided.	subject.exists()
o-con-req-2	error	Condition	The assertedDate extension is required and must be provided.	extension('http://hl7.org/fhir/StructureDefinition/condition-assertedDate').exists()
o-con-req-3	error	Condition	The bodySite element is required and must be provided.	bodySite.exists() and bodySite.coding.exists()
o-con-req-4	error	Condition	The histologyMorphologyBehavior extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior').exists()

This structure is derived from SecondaryCancerCondition

Summary

Mandatory: 3 elements
Must-Support: 1 element

Structures

This structure refers to these other structures:

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

Extensions

This structure refers to these extensions:

• http://onconova.github.io/fhir/StructureDefinition/onconova-ext-histological-differentiation

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition	C	0..*	SecondaryCancerCondition	Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5, o-con-req-1, o-con-req-2, o-con-req-3, o-con-req-4
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension	S	1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:assertedDate	SO	0..1	dateTime	Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:histologyMorphologyBehavior	SO	1..1	(Complex)	Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior"
value[x]		1..1	CodeableConcept	Value of extension Binding: ICD-O-3 Morphology Behavior Value Set (required)
extension:relatedPrimaryCancerCondition	SO	0..1	(Complex)	Conditions associated with this condition URL: http://hl7.org/fhir/StructureDefinition/condition-related Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-related"
value[x]		1..1	Reference(Primary Cancer Condition Profile)	Value of extension
extension:differentiation	SO	0..1	CodeableConcept	Histological Differentiation URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-histological-differentiation Binding: ICD-O-3 Differentiations Value Set (required) Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
clinicalStatus	?!SΣC	0..1	CodeableConcept	(USCDI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus	?!SΣC	0..1	CodeableConcept	Not used in this profile Binding: ConditionVerificationStatus (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core	S	1..*	CodeableConcept	(USCDI) problem-list-item | health-concern Binding: US Core Problem or Health Concern (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment	S	0..*	CodeableConcept	(USCDI) USCDI Health Status/Assessments Data Class Binding: US Core Screening Assessment Condition Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
severity		0..1	CodeableConcept	Not used in this profile Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	SΣ	1..1	CodeableConcept	(USCDI) Identification of the condition, problem or diagnosis Binding: Secondary Cancer Disorder Value Set (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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 128462008
display		1..1	string	Representation defined by the system Fixed Value: Secondary malignant neoplastic disease
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
bodySite	SOΣ	1..1	CodeableConcept	Anatomical location, if relevant Binding: ICD-O-3 Topographies Value Set (required) Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
Slices for extension				Content/Rules for all slices
extension:locationQualifier	S	0..*	CodeableConcept	Not used in this profile URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (required)
extension:lateralityQualifier	SO	0..1	CodeableConcept	Laterality Qualifier Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier Binding: Laterality Qualifier Value Set (required) Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
subject	SOΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who has the condition? Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
encounter	Σ	0..1	Reference(Encounter)	Not used in this profile
onset[x]	SΣ	0..1		(USCDI) Estimated or actual date, date-time, or age
onsetDateTime			dateTime S
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
abatement[x]	SC	0..1		(USCDI) When in resolution/remission
abatementDateTime			dateTime S
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	SΣ	0..1	dateTime	Not used in this profile
recorder	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Not used in this profile
asserter	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Not used in this profile
evidence	C	0..*	BackboneElement	Not used in this profile Constraints: con-2
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Condition.extension:histologyMorphologyBehavior.​value[x]	Base	required	ICD-O-3 Morphology Behavior Value Set	📦0.2.0	This IG
Condition.clinicalStatus	Base	required	Condition Clinical Status Codes	📦4.0.1	FHIR Std.
Condition.verificationStatus	Base	required	ConditionVerificationStatus	📦4.0.1	FHIR Std.
Condition.category	Base	extensible	Condition Category Codes	📦4.0.1	FHIR Std.
Condition.category:us-core	Base	required	US Core Problem or Health Concern	📦6.1.0	US Core v6.1
Condition.category:screening-assessment	Base	required	US Core Screening Assessment Condition Category	📦6.1.0	US Core v6.1
Condition.severity	Base	preferred	Condition/Diagnosis Severity	📦4.0.1	FHIR Std.
Condition.code	Base	extensible	Secondary Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Condition.bodySite	Base	required	ICD-O-3 Topographies Value Set	📦0.2.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
con-2	error	Condition.evidence	evidence SHALL have code or details	code.exists() or detail.exists()
con-3	best practice	Condition	Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item	clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4	error	Condition	If condition is abated, then clinicalStatus must be either inactive, resolved, or remission	abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5	error	Condition	Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error	verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2	error	Condition	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Condition	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	Condition	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	Condition	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Condition	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-con-req-1	error	Condition	The subject element is required and must be provided.	subject.exists()
o-con-req-2	error	Condition	The assertedDate extension is required and must be provided.	extension('http://hl7.org/fhir/StructureDefinition/condition-assertedDate').exists()
o-con-req-3	error	Condition	The bodySite element is required and must be provided.	bodySite.exists() and bodySite.coding.exists()
o-con-req-4	error	Condition	The histologyMorphologyBehavior extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior').exists()

Differential View

This structure is derived from SecondaryCancerCondition

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition	C	0..*	SecondaryCancerCondition	Detailed information about conditions, problems or diagnoses Constraints: o-con-req-1, o-con-req-2, o-con-req-3, o-con-req-4
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:assertedDate	O	0..1	ConditionAssertedDate(5.2.0)	Date the condition was first asserted Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:histologyMorphologyBehavior	O	1..1	HistologyMorphologyBehavior	Histology-Morphology-Behavior Extension Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
value[x]		1..1	CodeableConcept	Value of extension Binding: ICD-O-3 Morphology Behavior Value Set (required)
extension:relatedPrimaryCancerCondition	O	0..1	ConditionRelated(5.2.0)	Conditions associated with this condition Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
value[x]		1..1	Reference(Primary Cancer Condition Profile)	Value of extension
extension:differentiation	SO	0..1	CodeableConcept	Histological Differentiation URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-histological-differentiation Binding: ICD-O-3 Differentiations Value Set (required) Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
verificationStatus		0..1	CodeableConcept	Not used in this profile
severity		0..1	CodeableConcept	Not used in this profile
code		1..1	CodeableConcept	(USCDI) Identification of the condition, problem or diagnosis 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://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 128462008
display		1..1	string	Representation defined by the system Fixed Value: Secondary malignant neoplastic disease
bodySite	O	1..1	CodeableConcept	Anatomical location, if relevant Binding: ICD-O-3 Topographies Value Set (required) Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
Slices for extension				Content/Rules for all slices
extension:locationQualifier		0..*	BodyLocationQualifier	Not used in this profile
extension:lateralityQualifier	O	0..1	LateralityQualifier	Laterality Qualifier Extension Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
subject	O	1..1	Reference(Cancer Patient Profile)	(USCDI) Who has the condition? Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
encounter		0..1	Reference(Encounter)	Not used in this profile
recordedDate		0..1	dateTime	Not used in this profile
recorder		0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Not used in this profile
asserter		0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Not used in this profile
evidence		0..*	BackboneElement	Not used in this profile
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Condition.extension:histologyMorphologyBehavior.​value[x]	Base	required	ICD-O-3 Morphology Behavior Value Set	📦0.2.0	This IG
Condition.bodySite	Base	required	ICD-O-3 Topographies Value Set	📦0.2.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
o-con-req-1	error	Condition	The subject element is required and must be provided.	subject.exists()
o-con-req-2	error	Condition	The assertedDate extension is required and must be provided.	extension('http://hl7.org/fhir/StructureDefinition/condition-assertedDate').exists()
o-con-req-3	error	Condition	The bodySite element is required and must be provided.	bodySite.exists() and bodySite.coding.exists()
o-con-req-4	error	Condition	The histologyMorphologyBehavior extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior').exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Condition	C	0..*	SecondaryCancerCondition	Detailed information about conditions, problems or diagnoses Constraints: con-3, con-4, con-5, o-con-req-1, o-con-req-2, o-con-req-3, o-con-req-4
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
Slices for extension	S	1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:assertedDate	SO	0..1	dateTime	Date the condition was first asserted URL: http://hl7.org/fhir/StructureDefinition/condition-assertedDate Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
extension:histologyMorphologyBehavior	SO	1..1	(Complex)	Histology-Morphology-Behavior Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior"
value[x]		1..1	CodeableConcept	Value of extension Binding: ICD-O-3 Morphology Behavior Value Set (required)
extension:relatedPrimaryCancerCondition	SO	0..1	(Complex)	Conditions associated with this condition URL: http://hl7.org/fhir/StructureDefinition/condition-related Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
id		0..1	id	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"http://hl7.org/fhir/StructureDefinition/condition-related"
value[x]		1..1	Reference(Primary Cancer Condition Profile)	Value of extension
extension:differentiation	SO	0..1	CodeableConcept	Histological Differentiation URL: http://onconova.github.io/fhir/StructureDefinition/onconova-ext-histological-differentiation Binding: ICD-O-3 Differentiations Value Set (required) Obligations Actor SHOULD:populate-if-known Creator (Onconova) SHOULD:persist Consumer (Onconova)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	External Ids for this condition
clinicalStatus	?!SΣC	0..1	CodeableConcept	(USCDI) active | recurrence | relapse | inactive | remission | resolved Binding: ConditionClinicalStatusCodes (required)
verificationStatus	?!SΣC	0..1	CodeableConcept	Not used in this profile Binding: ConditionVerificationStatus (required)
Slices for category	S	1..*	CodeableConcept	(USCDI) category codes Slice: Unordered, Open by pattern:$this Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.
category:us-core	S	1..*	CodeableConcept	(USCDI) problem-list-item | health-concern Binding: US Core Problem or Health Concern (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:screening-assessment	S	0..*	CodeableConcept	(USCDI) USCDI Health Status/Assessments Data Class Binding: US Core Screening Assessment Condition Category (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
severity		0..1	CodeableConcept	Not used in this profile Binding: Condition/DiagnosisSeverity (preferred): A subjective assessment of the severity of the condition as evaluated by the clinician.
code	SΣ	1..1	CodeableConcept	(USCDI) Identification of the condition, problem or diagnosis Binding: Secondary Cancer Disorder Value Set (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://snomed.info/sct
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 128462008
display		1..1	string	Representation defined by the system Fixed Value: Secondary malignant neoplastic disease
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
bodySite	SOΣ	1..1	CodeableConcept	Anatomical location, if relevant Binding: ICD-O-3 Topographies Value Set (required) 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:locationQualifier	S	0..*	CodeableConcept	Not used in this profile URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-body-location-qualifier Binding: Body Location Qualifier Value Set (required)
extension:lateralityQualifier	SO	0..1	CodeableConcept	Laterality Qualifier Extension URL: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-laterality-qualifier Binding: Laterality Qualifier Value Set (required) Obligations Actor SHOULD: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
subject	SOΣ	1..1	Reference(Cancer Patient Profile)	(USCDI) Who has the condition? Obligations Actor SHALL:populate Creator (Onconova) SHOULD:persist Consumer (Onconova)
encounter	Σ	0..1	Reference(Encounter)	Not used in this profile
onset[x]	SΣ	0..1		(USCDI) Estimated or actual date, date-time, or age
onsetDateTime			dateTime S
onsetAge			Age
onsetPeriod			Period
onsetRange			Range
onsetString			string
abatement[x]	SC	0..1		(USCDI) When in resolution/remission
abatementDateTime			dateTime S
abatementAge			Age
abatementPeriod			Period
abatementRange			Range
abatementString			string
recordedDate	SΣ	0..1	dateTime	Not used in this profile
recorder	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Not used in this profile
asserter	Σ	0..1	Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)	Not used in this profile
stage	C	0..*	BackboneElement	Not used in this profile Constraints: con-1
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
summary	C	0..1	CodeableConcept	Simple summary (disease specific) Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).
assessment	C	0..*	Reference(ClinicalImpression | DiagnosticReport | Observation)	Formal record of assessment
type		0..1	CodeableConcept	Kind of staging Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).
evidence	C	0..*	BackboneElement	Not used in this profile Constraints: con-2
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	ΣC	0..*	CodeableConcept	Manifestation/symptom Binding: Cancer Disease Status Evidence Type Value Set (required)
detail	ΣC	0..*	Reference(Resource)	Supporting information found elsewhere
note		0..*	Annotation	Additional information about the Condition
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Condition.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Condition.extension:histologyMorphologyBehavior.​value[x]	Base	required	ICD-O-3 Morphology Behavior Value Set	📦0.2.0	This IG
Condition.clinicalStatus	Base	required	Condition Clinical Status Codes	📦4.0.1	FHIR Std.
Condition.verificationStatus	Base	required	ConditionVerificationStatus	📦4.0.1	FHIR Std.
Condition.category	Base	extensible	Condition Category Codes	📦4.0.1	FHIR Std.
Condition.category:us-core	Base	required	US Core Problem or Health Concern	📦6.1.0	US Core v6.1
Condition.category:screening-assessment	Base	required	US Core Screening Assessment Condition Category	📦6.1.0	US Core v6.1
Condition.severity	Base	preferred	Condition/Diagnosis Severity	📦4.0.1	FHIR Std.
Condition.code	Base	extensible	Secondary Cancer Disorder Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0
Condition.bodySite	Base	required	ICD-O-3 Topographies Value Set	📦0.2.0	This IG
Condition.stage.summary	Base	example	Condition Stage	📦4.0.1	FHIR Std.
Condition.stage.type	Base	example	Condition Stage Type	📦4.0.1	FHIR Std.
Condition.evidence.code	Base	required	Cancer Disease Status Evidence Type Value Set	📦4.0.0	minimal Common Oncology Data Elements v4.0

Constraints

Id	Grade	Path(s)	Description	Expression
con-1	error	Condition.stage	Stage SHALL have summary or assessment	summary.exists() or assessment.exists()
con-2	error	Condition.evidence	evidence SHALL have code or details	code.exists() or detail.exists()
con-3	best practice	Condition	Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item	clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4	error	Condition	If condition is abated, then clinicalStatus must be either inactive, resolved, or remission	abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5	error	Condition	Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error	verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2	error	Condition	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Condition	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	Condition	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	Condition	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Condition	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-con-req-1	error	Condition	The subject element is required and must be provided.	subject.exists()
o-con-req-2	error	Condition	The assertedDate extension is required and must be provided.	extension('http://hl7.org/fhir/StructureDefinition/condition-assertedDate').exists()
o-con-req-3	error	Condition	The bodySite element is required and must be provided.	bodySite.exists() and bodySite.coding.exists()
o-con-req-4	error	Condition	The histologyMorphologyBehavior extension is required and must be provided.	extension('http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-histology-morphology-behavior').exists()

This structure is derived from SecondaryCancerCondition

Summary

Mandatory: 3 elements
Must-Support: 1 element

Structures

This structure refers to these other structures:

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

Extensions

This structure refers to these extensions:

• http://onconova.github.io/fhir/StructureDefinition/onconova-ext-histological-differentiation

Other representations of profile: CSV, Excel, Schematron