Onconova Implementation Guide
0.2.0 - ci-build

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

Resource Profile: TNM Stage Group

Official URL: http://onconova.github.io/fhir/StructureDefinition/onconova-tnm-stage-group Version: 0.2.0
Active as of 2025-10-17 Computable Name: OnconovaTNMStageGroup

A profile representing the TNM stage group for a cancer patient.

It extends the base mCODE TNMStageGroup profile to expand the TNM subcategories and include specific constraints and extensions relevant to Onconova.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* TNMStageGroup(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
.... 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 The type of stage information reported.
Binding: TNMStageGroupStagingTypeVS (4.0.0) (preferred)
Additional BindingsPurpose
TNMStageGroupStagingTypeMaxVS (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 1..1 Reference(Primary Cancer Condition Profile(4.0.0)) The cancer condition associated with staging assessment.
... 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 The stage group
Binding: TNMStageGroupVS (4.0.0) (preferred)
Additional BindingsPurpose
TNMStageGroupMaxVS (4.0.0) Max Binding
... method S 1..1 CodeableConcept The staging system used.
Binding: TNMStagingMethodVS (4.0.0) (extensible)
... Slices for hasMember SΣ 0..* Reference(Parent for T, N, and M Categories.(4.0.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
Slice: Unordered, Open by profile:$this.resolve()
.... hasMember:TNMCategory SΣ 0..3 Reference(TNM Primary Tumor Category(0.2.0) | TNM Distant Metastases Category(0.2.0) | TNM Regional Nodes Category(0.2.0)) Prognostic factors contributing to stage determination.
.... hasMember:lymphaticInvasionCategory SΣ 0..1 Reference(TNM Lymphatic Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:perineuralInvasionCategory SΣ 0..1 Reference(TNM Perineural Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:residualTumorCategory SΣ 0..1 Reference(TNM Residual Tumor Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:serumTumorMarkerLevelCategory SΣ 0..1 Reference(Serum Tumor Marker Level Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:gradeCategory SΣ 0..1 Reference(TNM Grade Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:venousInvasionCategory SΣ 0..1 Reference(Venous Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📍6.1.0 US Core v6.1
Observation.code Base preferred TNM Stage Group Staging Type Value Set 📍4.0.0 minimal Common Oncology Data Elements v4.0
Observation.value[x] Base preferred TNM Stage Group Value Set 📍4.0.0 minimal Common Oncology Data Elements v4.0
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, Observation.hasMember, Observation.hasMember:TNMCategory, Observation.hasMember:lymphaticInvasionCategory, Observation.hasMember:perineuralInvasionCategory, Observation.hasMember:residualTumorCategory, Observation.hasMember:serumTumorMarkerLevelCategory, Observation.hasMember:gradeCategory, Observation.hasMember:venousInvasionCategory 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 TNMStageGroup

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* TNMStageGroup(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
... Slices for hasMember Content/Rules for all slices
.... hasMember:TNMCategory 0..3 Reference(TNM Primary Tumor Category(0.2.0) | TNM Distant Metastases Category(0.2.0) | TNM Regional Nodes Category(0.2.0)) Prognostic factors contributing to stage determination.
.... hasMember:lymphaticInvasionCategory 0..1 Reference(TNM Lymphatic Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:perineuralInvasionCategory 0..1 Reference(TNM Perineural Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:residualTumorCategory 0..1 Reference(TNM Residual Tumor Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:serumTumorMarkerLevelCategory 0..1 Reference(Serum Tumor Marker Level Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:gradeCategory 0..1 Reference(TNM Grade Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:venousInvasionCategory 0..1 Reference(Venous Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.

doco Documentation for this format

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()
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* TNMStageGroup(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 BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(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 The type of stage information reported.
Binding: TNMStageGroupStagingTypeVS (4.0.0) (preferred)
Additional BindingsPurpose
TNMStageGroupStagingTypeMaxVS (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 1..1 Reference(Primary Cancer Condition Profile(4.0.0)) The cancer condition associated with staging assessment.
... 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 The stage group
Binding: TNMStageGroupVS (4.0.0) (preferred)
Additional BindingsPurpose
TNMStageGroupMaxVS (4.0.0) Max Binding
... 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
... Slices for hasMember SΣ 0..* Reference(Parent for T, N, and M Categories.(4.0.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
Slice: Unordered, Open by profile:$this.resolve()
.... hasMember:TNMCategory SΣ 0..3 Reference(TNM Primary Tumor Category(0.2.0) | TNM Distant Metastases Category(0.2.0) | TNM Regional Nodes Category(0.2.0)) Prognostic factors contributing to stage determination.
.... hasMember:lymphaticInvasionCategory SΣ 0..1 Reference(TNM Lymphatic Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:perineuralInvasionCategory SΣ 0..1 Reference(TNM Perineural Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:residualTumorCategory SΣ 0..1 Reference(TNM Residual Tumor Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:serumTumorMarkerLevelCategory SΣ 0..1 Reference(Serum Tumor Marker Level Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:gradeCategory SΣ 0..1 Reference(TNM Grade Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:venousInvasionCategory SΣ 0..1 Reference(Venous Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
... 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 Not used in this profile
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... code Σ 1..1 CodeableConcept Type of prognostic factor
Binding: CancerStagingPrognosticFactorTypeVS (4.0.0) (preferred)
.... value[x] Σ 0..1 CodeableConcept Prognostic factor value
Binding: CancerStagingPrognosticFactorValueVS (4.0.0) (preferred)
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📍6.1.0 US Core v6.1
Observation.code Base preferred TNM Stage Group Staging Type Value Set 📍4.0.0 minimal Common Oncology Data Elements v4.0
Observation.value[x] Base preferred TNM Stage Group Value Set 📍4.0.0 minimal Common Oncology Data Elements v4.0
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base 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 preferred Cancer Staging Prognostic Factors Types 📍4.0.0 minimal Common Oncology Data Elements v4.0
Observation.component.​value[x] Base preferred Cancer Staging Prognostic Factors Value 📍4.0.0 minimal Common Oncology Data Elements v4.0
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

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.hasMember:TNMCategory, Observation.hasMember:lymphaticInvasionCategory, Observation.hasMember:perineuralInvasionCategory, Observation.hasMember:residualTumorCategory, Observation.hasMember:serumTumorMarkerLevelCategory, Observation.hasMember:gradeCategory, Observation.hasMember:venousInvasionCategory, 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()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* TNMStageGroup(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
.... 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 The type of stage information reported.
Binding: TNMStageGroupStagingTypeVS (4.0.0) (preferred)
Additional BindingsPurpose
TNMStageGroupStagingTypeMaxVS (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 1..1 Reference(Primary Cancer Condition Profile(4.0.0)) The cancer condition associated with staging assessment.
... 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 The stage group
Binding: TNMStageGroupVS (4.0.0) (preferred)
Additional BindingsPurpose
TNMStageGroupMaxVS (4.0.0) Max Binding
... method S 1..1 CodeableConcept The staging system used.
Binding: TNMStagingMethodVS (4.0.0) (extensible)
... Slices for hasMember SΣ 0..* Reference(Parent for T, N, and M Categories.(4.0.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
Slice: Unordered, Open by profile:$this.resolve()
.... hasMember:TNMCategory SΣ 0..3 Reference(TNM Primary Tumor Category(0.2.0) | TNM Distant Metastases Category(0.2.0) | TNM Regional Nodes Category(0.2.0)) Prognostic factors contributing to stage determination.
.... hasMember:lymphaticInvasionCategory SΣ 0..1 Reference(TNM Lymphatic Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:perineuralInvasionCategory SΣ 0..1 Reference(TNM Perineural Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:residualTumorCategory SΣ 0..1 Reference(TNM Residual Tumor Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:serumTumorMarkerLevelCategory SΣ 0..1 Reference(Serum Tumor Marker Level Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:gradeCategory SΣ 0..1 Reference(TNM Grade Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:venousInvasionCategory SΣ 0..1 Reference(Venous Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📍6.1.0 US Core v6.1
Observation.code Base preferred TNM Stage Group Staging Type Value Set 📍4.0.0 minimal Common Oncology Data Elements v4.0
Observation.value[x] Base preferred TNM Stage Group Value Set 📍4.0.0 minimal Common Oncology Data Elements v4.0
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, Observation.hasMember, Observation.hasMember:TNMCategory, Observation.hasMember:lymphaticInvasionCategory, Observation.hasMember:perineuralInvasionCategory, Observation.hasMember:residualTumorCategory, Observation.hasMember:serumTumorMarkerLevelCategory, Observation.hasMember:gradeCategory, Observation.hasMember:venousInvasionCategory 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 TNMStageGroup

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* TNMStageGroup(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
... Slices for hasMember Content/Rules for all slices
.... hasMember:TNMCategory 0..3 Reference(TNM Primary Tumor Category(0.2.0) | TNM Distant Metastases Category(0.2.0) | TNM Regional Nodes Category(0.2.0)) Prognostic factors contributing to stage determination.
.... hasMember:lymphaticInvasionCategory 0..1 Reference(TNM Lymphatic Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:perineuralInvasionCategory 0..1 Reference(TNM Perineural Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:residualTumorCategory 0..1 Reference(TNM Residual Tumor Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:serumTumorMarkerLevelCategory 0..1 Reference(Serum Tumor Marker Level Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:gradeCategory 0..1 Reference(TNM Grade Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:venousInvasionCategory 0..1 Reference(Venous Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.

doco Documentation for this format

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* TNMStageGroup(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 BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(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 The type of stage information reported.
Binding: TNMStageGroupStagingTypeVS (4.0.0) (preferred)
Additional BindingsPurpose
TNMStageGroupStagingTypeMaxVS (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 1..1 Reference(Primary Cancer Condition Profile(4.0.0)) The cancer condition associated with staging assessment.
... 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 The stage group
Binding: TNMStageGroupVS (4.0.0) (preferred)
Additional BindingsPurpose
TNMStageGroupMaxVS (4.0.0) Max Binding
... 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
... Slices for hasMember SΣ 0..* Reference(Parent for T, N, and M Categories.(4.0.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
Slice: Unordered, Open by profile:$this.resolve()
.... hasMember:TNMCategory SΣ 0..3 Reference(TNM Primary Tumor Category(0.2.0) | TNM Distant Metastases Category(0.2.0) | TNM Regional Nodes Category(0.2.0)) Prognostic factors contributing to stage determination.
.... hasMember:lymphaticInvasionCategory SΣ 0..1 Reference(TNM Lymphatic Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:perineuralInvasionCategory SΣ 0..1 Reference(TNM Perineural Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:residualTumorCategory SΣ 0..1 Reference(TNM Residual Tumor Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:serumTumorMarkerLevelCategory SΣ 0..1 Reference(Serum Tumor Marker Level Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:gradeCategory SΣ 0..1 Reference(TNM Grade Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
.... hasMember:venousInvasionCategory SΣ 0..1 Reference(Venous Invasion Category(0.2.0)) Element containing the T, N, and M categories as references to separate T, N, M observations. The referenced resources are observations leading to the Stage Group reported in the current resource.
... 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 Not used in this profile
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... code Σ 1..1 CodeableConcept Type of prognostic factor
Binding: CancerStagingPrognosticFactorTypeVS (4.0.0) (preferred)
.... value[x] Σ 0..1 CodeableConcept Prognostic factor value
Binding: CancerStagingPrognosticFactorValueVS (4.0.0) (preferred)
.... dataAbsentReason C 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.category:us-core Base required US Core Simple Observation Category 📍6.1.0 US Core v6.1
Observation.code Base preferred TNM Stage Group Staging Type Value Set 📍4.0.0 minimal Common Oncology Data Elements v4.0
Observation.value[x] Base preferred TNM Stage Group Value Set 📍4.0.0 minimal Common Oncology Data Elements v4.0
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base 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 preferred Cancer Staging Prognostic Factors Types 📍4.0.0 minimal Common Oncology Data Elements v4.0
Observation.component.​value[x] Base preferred Cancer Staging Prognostic Factors Value 📍4.0.0 minimal Common Oncology Data Elements v4.0
Observation.component.​dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.

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.hasMember:TNMCategory, Observation.hasMember:lymphaticInvasionCategory, Observation.hasMember:perineuralInvasionCategory, Observation.hasMember:residualTumorCategory, Observation.hasMember:serumTumorMarkerLevelCategory, Observation.hasMember:gradeCategory, Observation.hasMember:venousInvasionCategory, 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()

 

Other representations of profile: CSV, Excel, Schematron