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
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Resource Profile: TNM Primary Tumor Category

A profile representing the TNM primary tumor category for a cancer patient.

This profile extends the base mCODE TNMPrimaryTumorCategory profile to include specific constraints and extensions relevant to Onconova.

Usages:

• Refer to this Profile: TNM Stage Group
• CapabilityStatements using this Profile: Onconova FHIR REST 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
Observation	C	0..*	TNMPrimaryTumorCategory(4.0.0)	assessment observation Constraints: obs-6, obs-7, o-stg-req-1, o-stg-req-2, o-stg-req-3
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
status	?!SΣ	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:us-core	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: USCoreSimpleObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	(USCDI) Type of observation (code / type) Binding: TNMPrimaryTumorStagingTypeVS (4.0.0) (preferred) Additional Bindings Purpose TNMPrimaryTumorStagingTypeMaxVS (4.0.0) Max Binding
subject	SΣ	1..1	Reference(Cancer Patient Profile(0.2.0))	(USCDI) Who and/or what the observation is about
focus	SΣ	0..*	Reference(Primary Cancer Condition Profile(4.0.0))	The cancer condition associated with TNM category.
effective[x]	SΣ	0..1	dateTime S	(USCDI) Clinically relevant time/time-period for observation
performer	SΣ	0..*	Reference(US Core Practitioner Profile(6.1.0) | US Core Organization Profile(6.1.0) | US Core Patient Profile(6.1.0) | PractitionerRole | US Core CareTeam Profile(6.1.0) | US Core RelatedPerson Profile(6.1.0))	(USCDI) Who is responsible for the observation
value[x]	SΣC	0..1	CodeableConcept S	(USCDI) Actual result Binding: TNMPrimaryTumorCategories (0.2.0) (required)
method	S	1..1	CodeableConcept	The staging system used. Binding: TNMStagingMethodVS (4.0.0) (extensible)
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	TNM Primary Tumor Staging Type Value Set	📍4.0.0	minimal Common Oncology Data Elements v4.0
Observation.value[x]	Base	required	TNM Primary Tumor Categories	📍0.2.0	This IG
Observation.method	Base	extensible	TNM Staging Method Value Set	📍4.0.0	minimal Common Oncology Data Elements v4.0

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	Observation.implicitRules, Observation.modifierExtension, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.focus, Observation.effective[x], Observation.performer, Observation.value[x], Observation.method	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Observation.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()
o-stg-req-1	error	Observation	The subject element is required and must be provided.	subject.exists() and subject.resolve().is(Patient)
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 TNMPrimaryTumorCategory

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	TNMPrimaryTumorCategory(4.0.0)	assessment observation
status		1..1	code	(USCDI) registered | preliminary | final | amended + Required Pattern: final
subject		1..1	Reference(Cancer Patient Profile(0.2.0))	(USCDI) Who and/or what the observation is about
effective[x]		0..1	dateTime	(USCDI) Clinically relevant time/time-period for observation
value[x]		0..1	CodeableConcept	(USCDI) Actual result Binding: TNMPrimaryTumorCategories (0.2.0) (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.value[x]	Base	required	TNM Primary Tumor Categories	📍0.2.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
o-stg-req-1	error	Observation	The subject element is required and must be provided.	subject.exists() and subject.resolve().is(Patient)
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..*	TNMPrimaryTumorCategory(4.0.0)	assessment observation Constraints: obs-6, obs-7, o-stg-req-1, o-stg-req-2, o-stg-req-3
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 Constraints: ext-1
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(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	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:us-core	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: USCoreSimpleObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	(USCDI) Type of observation (code / type) Binding: TNMPrimaryTumorStagingTypeVS (4.0.0) (preferred) Additional Bindings Purpose TNMPrimaryTumorStagingTypeMaxVS (4.0.0) Max Binding
subject	SΣ	1..1	Reference(Cancer Patient Profile(0.2.0))	(USCDI) Who and/or what the observation is about
focus	SΣ	0..*	Reference(Primary Cancer Condition Profile(4.0.0))	The cancer condition associated with TNM category.
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣ	0..1	dateTime S	(USCDI) Clinically relevant time/time-period for observation
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(US Core Practitioner Profile(6.1.0) | US Core Organization Profile(6.1.0) | US Core Patient Profile(6.1.0) | PractitionerRole | US Core CareTeam Profile(6.1.0) | US Core RelatedPerson Profile(6.1.0))	(USCDI) Who is responsible for the observation
value[x]	SΣC	0..1	CodeableConcept S	(USCDI) Actual result Binding: TNMPrimaryTumorCategories (0.2.0) (required)
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	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method	S	1..1	CodeableConcept	The staging system used. Binding: TNMStagingMethodVS (4.0.0) (extensible)
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	Not used in this profile
referenceRange	C	0..*	BackboneElement	Not used in this profile Constraints: obs-3
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
low	C	0..1	SimpleQuantity(4.0.1)	Low Range, if relevant
high	C	0..1	SimpleQuantity(4.0.1)	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Not used in this profile
derivedFrom	Σ	0..*	Reference(Observation | US Core DocumentReference Profile(6.1.0) | US Core QuestionnaireResponse Profile(6.1.0) | ImagingStudy | Media | MolecularSequence)	(USCDI) US Core Profiles or other resource the observation is made from
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
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	TNM Primary Tumor Staging Type Value Set	📍4.0.0	minimal Common Oncology Data Elements v4.0
Observation.value[x]	Base	required	TNM Primary Tumor Categories	📍0.2.0	This IG
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	extensible	TNM 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	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	Observation.meta, Observation.implicitRules, Observation.language, Observation.text, Observation.extension, Observation.modifierExtension, Observation.identifier, Observation.basedOn, Observation.partOf, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.focus, Observation.encounter, Observation.effective[x], Observation.issued, Observation.performer, Observation.value[x], Observation.dataAbsentReason, Observation.interpretation, Observation.note, Observation.bodySite, Observation.method, Observation.specimen, Observation.device, Observation.referenceRange, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.referenceRange.low, Observation.referenceRange.high, Observation.referenceRange.type, Observation.referenceRange.appliesTo, Observation.referenceRange.age, Observation.referenceRange.text, Observation.hasMember, Observation.derivedFrom, Observation.component, Observation.component.extension, Observation.component.modifierExtension, Observation.component.code, Observation.component.value[x], Observation.component.dataAbsentReason, Observation.component.interpretation, Observation.component.referenceRange	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Observation.extension, Observation.modifierExtension, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.component.extension, Observation.component.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()
o-stg-req-1	error	Observation	The subject element is required and must be provided.	subject.exists() and subject.resolve().is(Patient)
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 TNMPrimaryTumorCategory

Summary

Structures

This structure refers to these other structures:

• Cancer Patient Profile (http://onconova.github.io/fhir/StructureDefinition/onconova-cancer-patient|0.2.0)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	TNMPrimaryTumorCategory(4.0.0)	assessment observation Constraints: obs-6, obs-7, o-stg-req-1, o-stg-req-2, o-stg-req-3
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
status	?!SΣ	1..1	code	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:us-core	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: USCoreSimpleObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	(USCDI) Type of observation (code / type) Binding: TNMPrimaryTumorStagingTypeVS (4.0.0) (preferred) Additional Bindings Purpose TNMPrimaryTumorStagingTypeMaxVS (4.0.0) Max Binding
subject	SΣ	1..1	Reference(Cancer Patient Profile(0.2.0))	(USCDI) Who and/or what the observation is about
focus	SΣ	0..*	Reference(Primary Cancer Condition Profile(4.0.0))	The cancer condition associated with TNM category.
effective[x]	SΣ	0..1	dateTime S	(USCDI) Clinically relevant time/time-period for observation
performer	SΣ	0..*	Reference(US Core Practitioner Profile(6.1.0) | US Core Organization Profile(6.1.0) | US Core Patient Profile(6.1.0) | PractitionerRole | US Core CareTeam Profile(6.1.0) | US Core RelatedPerson Profile(6.1.0))	(USCDI) Who is responsible for the observation
value[x]	SΣC	0..1	CodeableConcept S	(USCDI) Actual result Binding: TNMPrimaryTumorCategories (0.2.0) (required)
method	S	1..1	CodeableConcept	The staging system used. Binding: TNMStagingMethodVS (4.0.0) (extensible)
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	TNM Primary Tumor Staging Type Value Set	📍4.0.0	minimal Common Oncology Data Elements v4.0
Observation.value[x]	Base	required	TNM Primary Tumor Categories	📍0.2.0	This IG
Observation.method	Base	extensible	TNM Staging Method Value Set	📍4.0.0	minimal Common Oncology Data Elements v4.0

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	Observation.implicitRules, Observation.modifierExtension, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.focus, Observation.effective[x], Observation.performer, Observation.value[x], Observation.method	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Observation.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()
o-stg-req-1	error	Observation	The subject element is required and must be provided.	subject.exists() and subject.resolve().is(Patient)
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 TNMPrimaryTumorCategory

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	TNMPrimaryTumorCategory(4.0.0)	assessment observation
status		1..1	code	(USCDI) registered | preliminary | final | amended + Required Pattern: final
subject		1..1	Reference(Cancer Patient Profile(0.2.0))	(USCDI) Who and/or what the observation is about
effective[x]		0..1	dateTime	(USCDI) Clinically relevant time/time-period for observation
value[x]		0..1	CodeableConcept	(USCDI) Actual result Binding: TNMPrimaryTumorCategories (0.2.0) (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.value[x]	Base	required	TNM Primary Tumor Categories	📍0.2.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
o-stg-req-1	error	Observation	The subject element is required and must be provided.	subject.exists() and subject.resolve().is(Patient)
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..*	TNMPrimaryTumorCategory(4.0.0)	assessment observation Constraints: obs-6, obs-7, o-stg-req-1, o-stg-req-2, o-stg-req-3
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 Constraints: ext-1
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored Constraints: ext-1
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(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	(USCDI) registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation. Required Pattern: final
Slices for category	S	1..*	CodeableConcept	(USCDI) Classification of type of observation Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:us-core	S	0..*	CodeableConcept	(USCDI) Classification of type of observation Binding: USCoreSimpleObservationCategory (6.1.0) (required): Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
code	SΣ	1..1	CodeableConcept	(USCDI) Type of observation (code / type) Binding: TNMPrimaryTumorStagingTypeVS (4.0.0) (preferred) Additional Bindings Purpose TNMPrimaryTumorStagingTypeMaxVS (4.0.0) Max Binding
subject	SΣ	1..1	Reference(Cancer Patient Profile(0.2.0))	(USCDI) Who and/or what the observation is about
focus	SΣ	0..*	Reference(Primary Cancer Condition Profile(4.0.0))	The cancer condition associated with TNM category.
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	SΣ	0..1	dateTime S	(USCDI) Clinically relevant time/time-period for observation
issued	Σ	0..1	instant	Date/Time this version was made available
performer	SΣ	0..*	Reference(US Core Practitioner Profile(6.1.0) | US Core Organization Profile(6.1.0) | US Core Patient Profile(6.1.0) | PractitionerRole | US Core CareTeam Profile(6.1.0) | US Core RelatedPerson Profile(6.1.0))	(USCDI) Who is responsible for the observation
value[x]	SΣC	0..1	CodeableConcept S	(USCDI) Actual result Binding: TNMPrimaryTumorCategories (0.2.0) (required)
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	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method	S	1..1	CodeableConcept	The staging system used. Binding: TNMStagingMethodVS (4.0.0) (extensible)
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	Not used in this profile
referenceRange	C	0..*	BackboneElement	Not used in this profile Constraints: obs-3
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
low	C	0..1	SimpleQuantity(4.0.1)	Low Range, if relevant
high	C	0..1	SimpleQuantity(4.0.1)	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Not used in this profile
derivedFrom	Σ	0..*	Reference(Observation | US Core DocumentReference Profile(6.1.0) | US Core QuestionnaireResponse Profile(6.1.0) | ImagingStudy | Media | MolecularSequence)	(USCDI) US Core Profiles or other resource the observation is made from
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Constraints: ext-1
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized Constraints: ext-1
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
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	TNM Primary Tumor Staging Type Value Set	📍4.0.0	minimal Common Oncology Data Elements v4.0
Observation.value[x]	Base	required	TNM Primary Tumor Categories	📍0.2.0	This IG
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	extensible	TNM 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	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	Observation.meta, Observation.implicitRules, Observation.language, Observation.text, Observation.extension, Observation.modifierExtension, Observation.identifier, Observation.basedOn, Observation.partOf, Observation.status, Observation.category, Observation.category:us-core, Observation.code, Observation.subject, Observation.focus, Observation.encounter, Observation.effective[x], Observation.issued, Observation.performer, Observation.value[x], Observation.dataAbsentReason, Observation.interpretation, Observation.note, Observation.bodySite, Observation.method, Observation.specimen, Observation.device, Observation.referenceRange, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.referenceRange.low, Observation.referenceRange.high, Observation.referenceRange.type, Observation.referenceRange.appliesTo, Observation.referenceRange.age, Observation.referenceRange.text, Observation.hasMember, Observation.derivedFrom, Observation.component, Observation.component.extension, Observation.component.modifierExtension, Observation.component.code, Observation.component.value[x], Observation.component.dataAbsentReason, Observation.component.interpretation, Observation.component.referenceRange	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	Observation.extension, Observation.modifierExtension, Observation.referenceRange.extension, Observation.referenceRange.modifierExtension, Observation.component.extension, Observation.component.modifierExtension	Must have either extensions or value[x], not both	extension.exists() != value.exists()
o-stg-req-1	error	Observation	The subject element is required and must be provided.	subject.exists() and subject.resolve().is(Patient)
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 TNMPrimaryTumorCategory

Summary

Structures

This structure refers to these other structures:

• Cancer Patient Profile (http://onconova.github.io/fhir/StructureDefinition/onconova-cancer-patient|0.2.0)

Other representations of profile: CSV, Excel, Schematron