Implementation Guide for Astacus project
0.0.1 - ci-build France flag

Implementation Guide for Astacus project - Local Development build (v0.0.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: AstacusSecondaryCancerCondition - Detailed Descriptions

Draft as of 2024-05-23 Maturity Level: 4

Definitions for the astacus-secondary-cancer-condition resource profile.

Guidance on how to interpret the contents of this table can be found here

0. Condition
2. Condition.extension
Must Supporttrue
4. Condition.extension:histologyMorphologyBehavior
Slice NamehistologyMorphologyBehavior
Control0..1
TypeExtension(Histology-Morphology-Behavior Extension) (Extension Type: CodeableConcept)
Must Supporttrue
6. Condition.extension:relatedPrimaryCancerCondition
Slice NamerelatedPrimaryCancerCondition
Definition

A reference to the primary cancer condition that provides context for this resource.

ShortRelated Primary Cancer Condition
Control0..1
TypeExtension(Condition Related) (Extension Type: Reference(Condition))
Must Supporttrue
8. Condition.extension:relatedPrimaryCancerCondition.value[x]
TypeReference(French Primary Cancer Condition Profile)
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
10. Condition.category
Pattern Value{
  "coding" : [{
    "system" : "http://terminology.hl7.org/CodeSystem/condition-category",
    "code" : "problem-list-item"
  }]
}
12. Condition.code
BindingUnless not suitable, these codes SHALL be taken from Secondary Cancer Disorder Value Set
(extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-secondary-cancer-disorder-vs)
14. Condition.bodySite
BindingUnless not suitable, these codes SHALL be taken from Cancer Body Location Value Set
(extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-body-location-vs)
16. Condition.bodySite.extension:locationQualifier
Slice NamelocationQualifier
Definition

General location qualifier (excluding laterality) for this bodySite

ShortGeneral location qualifier (excluding laterality) for this bodySite
Control0..*
TypeExtension(Body Location Qualifier Extension) (Extension Type: CodeableConcept)
18. Condition.bodySite.extension:lateralityQualifier
Slice NamelateralityQualifier
Definition

Laterality qualifier for this bodySite

ShortLaterality qualifier for this bodySite
Control0..1
TypeExtension(Laterality Qualifier Extension) (Extension Type: CodeableConcept)
20. Condition.subject
TypeReference(Astacus Cancer Patient Profile)
22. Condition.stage
Definition

Not used in this profile

ShortNot used in this profile
24. Condition.evidence
26. Condition.evidence.code
BindingThe codes SHALL be taken from Cancer Disease Status Evidence Type Value Set
(required to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disease-status-evidence-type-vs)

Guidance on how to interpret the contents of this table can be found here

0. Condition
Definition

A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.

ShortDetailed information about conditions, problems or diagnoses
Control0..*
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-4: 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-3: 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-6: A resource should have narrative for robust management (text.`div`.exists())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
con-5: 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())
con-4: 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-3: 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())
2. Condition.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
This element is affected by the following invariants: ele-1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Condition.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
This element is affected by the following invariants: ele-1
TypeExtension
Must Supporttrue
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Condition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 6. Condition.extension:histologyMorphologyBehavior
    Slice NamehistologyMorphologyBehavior
    Definition

    An extension describing the morphologic and behavioral characteristics of the cancer.

    ShortHistology-Morphology-Behavior Extension
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Histology-Morphology-Behavior Extension) (Extension Type: CodeableConcept)
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    8. Condition.extension:relatedPrimaryCancerCondition
    Slice NamerelatedPrimaryCancerCondition
    Definition

    A reference to the primary cancer condition that provides context for this resource.

    ShortRelated Primary Cancer Condition
    Comments

    When the relationship is specified, use the more specific extension, such as condition-dueTo, condition-occurredFollowing, or condition-part of.

    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Condition Related) (Extension Type: Reference(Condition))
    Must Supporttrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. Condition.extension:relatedPrimaryCancerCondition.extension
    Definition

    An Extension


    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    ShortExtensionAdditional content defined by implementations
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..0*
    This element is affected by the following invariants: ele-1
    TypeExtension
    Is Modifierfalse
    Summaryfalse
    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingThis element introduces a set of slices on Condition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 12. Condition.extension:relatedPrimaryCancerCondition.url
      Definition

      Source of the definition for the extension code - a logical name or a URL.

      Shortidentifies the meaning of the extension
      Comments

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Control1..1
      Typeuri
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      Fixed Valuehttp://hl7.org/fhir/StructureDefinition/condition-related
      14. Condition.extension:relatedPrimaryCancerCondition.value[x]
      Definition

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).


      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      ShortValue of extension
      Control10..1
      This element is affected by the following invariants: ext-1, ele-1
      TypeReference(French Primary Cancer Condition Profile), date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      16. Condition.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      This element is affected by the following invariants: ele-1
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Standard StatusNormative (from Trial Use)
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on Condition.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 18. Condition.clinicalStatus
        Definition

        The clinical status of the condition.

        Shortactive | recurrence | relapse | inactive | remission | resolved
        Comments

        The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

        Control0..1
        This element is affected by the following invariants: ele-1, con-3, con-4, con-5
        BindingThe codes SHALL be taken from ConditionClinicalStatusCodeshttp://hl7.org/fhir/ValueSet/condition-clinical|4.0.1
        (required to http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1)

        The clinical status of the condition or diagnosis.

        TypeCodeableConcept
        Is Modifiertrue because This element is labeled as a modifier because the status contains codes that mark the condition as no longer active.
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. Condition.verificationStatus
        Definition

        The verification status to support the clinical status of the condition.

        Shortunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
        Comments

        verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status. The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

        Control0..1
        This element is affected by the following invariants: ele-1, con-3, con-5
        BindingThe codes SHALL be taken from ConditionVerificationStatushttp://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1
        (required to http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1)

        The verification status to support or decline the clinical status of the condition or diagnosis.

        TypeCodeableConcept
        Is Modifiertrue because This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. Condition.category
        Definition

        A category assigned to the condition.

        Shortproblem-list-item | encounter-diagnosis
        Comments

        The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

        Control0..*
        This element is affected by the following invariants: ele-1
        BindingUnless not suitable, these codes SHALL be taken from ConditionCategoryCodeshttp://hl7.org/fhir/ValueSet/condition-category
        (extensible to http://hl7.org/fhir/ValueSet/condition-category)

        A category assigned to the condition.

        TypeCodeableConcept
        Pattern Value{
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/condition-category",
            "code" : "problem-list-item"
          }]
        }
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. Condition.code
        Definition

        Identification of the condition, problem or diagnosis.

        ShortIdentification of the condition, problem or diagnosis
        Comments

        Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

        Control0..1
        This element is affected by the following invariants: ele-1
        BindingUnless not suitable, these codes SHALL be taken from For example codes, see Secondary Cancer Disorder Value Sethttp://hl7.org/fhir/ValueSet/condition-code
        (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-secondary-cancer-disorder-vs)
        TypeCodeableConcept
        Summarytrue
        Requirements

        0..1 to account for primarily narrative only resources.

        Alternate Namestype
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. Condition.bodySite
        Definition

        The anatomical location where this condition manifests itself.

        ShortAnatomical location, if relevant
        Comments

        Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

        Control0..*
        This element is affected by the following invariants: ele-1
        BindingUnless not suitable, these codes SHALL be taken from For example codes, see Cancer Body Location Value Sethttp://hl7.org/fhir/ValueSet/body-site
        (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-body-location-vs)
        TypeCodeableConcept
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. Condition.bodySite.extension:locationQualifier
        Slice NamelocationQualifier
        Definition

        General location qualifier (excluding laterality) for this bodySite

        ShortGeneral location qualifier (excluding laterality) for this bodySite
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension(Body Location Qualifier Extension) (Extension Type: CodeableConcept)
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        30. Condition.bodySite.extension:lateralityQualifier
        Slice NamelateralityQualifier
        Definition

        Laterality qualifier for this bodySite

        ShortLaterality qualifier for this bodySite
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeExtension(Laterality Qualifier Extension) (Extension Type: CodeableConcept)
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        32. Condition.subject
        Definition

        Indicates the patient or group who the condition record is associated with.

        ShortWho has the condition?
        Comments

        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

        Control1..1
        This element is affected by the following invariants: ele-1
        TypeReference(Astacus Cancer Patient Profile, Patient, Group)
        Summarytrue
        Requirements

        Group is typically used for veterinary or public health use cases.

        Alternate Namespatient
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
        34. Condition.abatement[x]
        Definition

        The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate.

        ShortWhen in resolution/remission
        Comments

        There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid. When abatementString exists, it implies the condition is abated.

        Control0..1
        This element is affected by the following invariants: ele-1, con-4
        TypeChoice of: dateTime, Age, Period, Range, string
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. Condition.stage
        Definition

        Not used in this profile


        Clinical stage or grade of a condition. May include formal severity assessments.

        ShortNot used in this profileStage/grade, usually assessed formally
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeBackboneElement
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        con-1: Stage SHALL have summary or assessment (summary.exists() or assessment.exists())
        38. Condition.stage.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

        Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

        ShortExtensions that cannot be ignored even if unrecognized
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
        Summarytrue
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content, modifiers
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        40. Condition.stage.summary
        Definition

        A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific.

        ShortSimple summary (disease specific)
        Comments

        Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

        Control0..1
        This element is affected by the following invariants: ele-1, con-1
        BindingFor example codes, see ConditionStagehttp://hl7.org/fhir/ValueSet/condition-stage
        (example to http://hl7.org/fhir/ValueSet/condition-stage)

        Codes describing condition stages (e.g. Cancer stages).

        TypeCodeableConcept
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. Condition.stage.assessment
        Definition

        Reference to a formal record of the evidence on which the staging assessment is based.

        ShortFormal record of assessment
        Comments

        References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

        Control0..*
        This element is affected by the following invariants: ele-1, con-1
        TypeReference(ClinicalImpression, DiagnosticReport, Observation)
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))

        Guidance on how to interpret the contents of this table can be found here

        0. Condition
        Definition

        A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.

        ShortDetailed information about conditions, problems or diagnoses
        Control0..*
        Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
        dom-4: 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-3: 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-6: A resource should have narrative for robust management (text.`div`.exists())
        dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
        con-5: 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())
        con-4: 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-3: 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())
        2. Condition.id
        Definition

        The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

        ShortLogical id of this artifact
        Comments

        The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

        Control0..1
        Typeid
        Summarytrue
        4. Condition.meta
        Definition

        The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

        ShortMetadata about the resource
        Control0..1
        This element is affected by the following invariants: ele-1
        TypeMeta
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        6. Condition.implicitRules
        Definition

        A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

        ShortA set of rules under which this content was created
        Comments

        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

        Control0..1
        This element is affected by the following invariants: ele-1
        Typeuri
        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        8. Condition.language
        Definition

        The base language in which the resource is written.

        ShortLanguage of the resource content
        Comments

        Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

        Control0..1
        This element is affected by the following invariants: ele-1
        BindingThe codes SHOULD be taken from CommonLanguages
        (preferred to http://hl7.org/fhir/ValueSet/languages)

        A human language.

        Additional BindingsPurpose
        AllLanguagesMax Binding
        Typecode
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        10. Condition.text
        Definition

        A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

        ShortText summary of the resource, for human interpretation
        Comments

        Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

        Control0..1
        This element is affected by the following invariants: ele-1
        TypeNarrative
        Alternate Namesnarrative, html, xhtml, display
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        12. Condition.contained
        Definition

        These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

        ShortContained, inline Resources
        Comments

        This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

        Control0..*
        TypeResource
        Alternate Namesinline resources, anonymous resources, contained resources
        14. Condition.extension
        Definition

        An Extension

        ShortExtension
        Control0..*
        This element is affected by the following invariants: ele-1
        TypeExtension
        Must Supporttrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on Condition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 16. Condition.extension:histologyMorphologyBehavior
          Slice NamehistologyMorphologyBehavior
          Definition

          An extension describing the morphologic and behavioral characteristics of the cancer.

          ShortHistology-Morphology-Behavior Extension
          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Histology-Morphology-Behavior Extension) (Extension Type: CodeableConcept)
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          18. Condition.extension:relatedPrimaryCancerCondition
          Slice NamerelatedPrimaryCancerCondition
          Definition

          A reference to the primary cancer condition that provides context for this resource.

          ShortRelated Primary Cancer Condition
          Comments

          When the relationship is specified, use the more specific extension, such as condition-dueTo, condition-occurredFollowing, or condition-part of.

          Control0..1
          This element is affected by the following invariants: ele-1
          TypeExtension(Condition Related) (Extension Type: Reference(Condition))
          Must Supporttrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          20. Condition.extension:relatedPrimaryCancerCondition.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          This element is affected by the following invariants: ele-1
          Typeid
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          22. Condition.extension:relatedPrimaryCancerCondition.extension
          Definition

          An Extension

          ShortExtension
          Control0..0
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on Condition.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 24. Condition.extension:relatedPrimaryCancerCondition.url
            Definition

            Source of the definition for the extension code - a logical name or a URL.

            Shortidentifies the meaning of the extension
            Comments

            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

            Control1..1
            Typeuri
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            Fixed Valuehttp://hl7.org/fhir/StructureDefinition/condition-related
            26. Condition.extension:relatedPrimaryCancerCondition.value[x]
            Definition

            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

            ShortValue of extension
            Control1..1
            This element is affected by the following invariants: ext-1
            TypeReference(French Primary Cancer Condition Profile)
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            28. Condition.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            This element is affected by the following invariants: ele-1
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Standard StatusNormative (from Trial Use)
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on Condition.modifierExtension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 30. Condition.identifier
              Definition

              Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

              ShortExternal Ids for this condition
              Comments

              This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              This element is affected by the following invariants: ele-1
              TypeIdentifier
              Summarytrue
              Requirements

              Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              32. Condition.clinicalStatus
              Definition

              The clinical status of the condition.

              Shortactive | recurrence | relapse | inactive | remission | resolved
              Comments

              The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

              Control0..1
              This element is affected by the following invariants: ele-1, con-3, con-4, con-5
              BindingThe codes SHALL be taken from ConditionClinicalStatusCodes
              (required to http://hl7.org/fhir/ValueSet/condition-clinical|4.0.1)

              The clinical status of the condition or diagnosis.

              TypeCodeableConcept
              Is Modifiertrue because This element is labeled as a modifier because the status contains codes that mark the condition as no longer active.
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              34. Condition.verificationStatus
              Definition

              The verification status to support the clinical status of the condition.

              Shortunconfirmed | provisional | differential | confirmed | refuted | entered-in-error
              Comments

              verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status. The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

              Control0..1
              This element is affected by the following invariants: ele-1, con-3, con-5
              BindingThe codes SHALL be taken from ConditionVerificationStatus
              (required to http://hl7.org/fhir/ValueSet/condition-ver-status|4.0.1)

              The verification status to support or decline the clinical status of the condition or diagnosis.

              TypeCodeableConcept
              Is Modifiertrue because This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              36. Condition.category
              Definition

              A category assigned to the condition.

              Shortproblem-list-item | encounter-diagnosis
              Comments

              The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

              Control0..*
              This element is affected by the following invariants: ele-1
              BindingUnless not suitable, these codes SHALL be taken from ConditionCategoryCodes
              (extensible to http://hl7.org/fhir/ValueSet/condition-category)

              A category assigned to the condition.

              TypeCodeableConcept
              Pattern Value{
                "coding" : [{
                  "system" : "http://terminology.hl7.org/CodeSystem/condition-category",
                  "code" : "problem-list-item"
                }]
              }
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              38. Condition.severity
              Definition

              A subjective assessment of the severity of the condition as evaluated by the clinician.

              ShortSubjective severity of condition
              Comments

              Coding of the severity with a terminology is preferred, where possible.

              Control0..1
              This element is affected by the following invariants: ele-1
              BindingThe codes SHOULD be taken from Condition/DiagnosisSeverity
              (preferred to http://hl7.org/fhir/ValueSet/condition-severity)

              A subjective assessment of the severity of the condition as evaluated by the clinician.

              TypeCodeableConcept
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              40. Condition.code
              Definition

              Identification of the condition, problem or diagnosis.

              ShortIdentification of the condition, problem or diagnosis
              Comments

              Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

              Control0..1
              This element is affected by the following invariants: ele-1
              BindingUnless not suitable, these codes SHALL be taken from Secondary Cancer Disorder Value Set
              (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-secondary-cancer-disorder-vs)
              TypeCodeableConcept
              Summarytrue
              Requirements

              0..1 to account for primarily narrative only resources.

              Alternate Namestype
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              42. Condition.bodySite
              Definition

              The anatomical location where this condition manifests itself.

              ShortAnatomical location, if relevant
              Comments

              Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

              Control0..*
              This element is affected by the following invariants: ele-1
              BindingUnless not suitable, these codes SHALL be taken from Cancer Body Location Value Set
              (extensible to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-body-location-vs)
              TypeCodeableConcept
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              44. Condition.bodySite.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              XML FormatIn the XML format, this property is represented as an attribute.
              46. Condition.bodySite.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              This element is affected by the following invariants: ele-1
              TypeExtension
              Standard StatusNormative (from Trial Use)
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on Condition.bodySite.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 48. Condition.bodySite.extension:locationQualifier
                Slice NamelocationQualifier
                Definition

                General location qualifier (excluding laterality) for this bodySite

                ShortGeneral location qualifier (excluding laterality) for this bodySite
                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension(Body Location Qualifier Extension) (Extension Type: CodeableConcept)
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                50. Condition.bodySite.extension:lateralityQualifier
                Slice NamelateralityQualifier
                Definition

                Laterality qualifier for this bodySite

                ShortLaterality qualifier for this bodySite
                Control0..1
                This element is affected by the following invariants: ele-1
                TypeExtension(Laterality Qualifier Extension) (Extension Type: CodeableConcept)
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                52. Condition.bodySite.coding
                Definition

                A reference to a code defined by a terminology system.

                ShortCode defined by a terminology system
                Comments

                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                Control0..*
                This element is affected by the following invariants: ele-1
                TypeCoding
                Summarytrue
                Requirements

                Allows for alternative encodings within a code system, and translations to other code systems.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                54. Condition.bodySite.text
                Definition

                A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                ShortPlain text representation of the concept
                Comments

                Very often the text is the same as a displayName of one of the codings.

                Control0..1
                This element is affected by the following invariants: ele-1
                Typestring
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Requirements

                The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                56. Condition.subject
                Definition

                Indicates the patient or group who the condition record is associated with.

                ShortWho has the condition?
                Comments

                References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                Control1..1
                This element is affected by the following invariants: ele-1
                TypeReference(Astacus Cancer Patient Profile)
                Summarytrue
                Requirements

                Group is typically used for veterinary or public health use cases.

                Alternate Namespatient
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                58. Condition.encounter
                Definition

                The Encounter during which this Condition was created or to which the creation of this record is tightly associated.

                ShortEncounter created as part of
                Comments

                This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. This record indicates the encounter this particular record is associated with. In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known".

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeReference(Encounter)
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                60. Condition.onset[x]
                Definition

                Estimated or actual date or date-time the condition began, in the opinion of the clinician.

                ShortEstimated or actual date, date-time, or age
                Comments

                Age is generally used when the patient reports an age at which the Condition began to occur.

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeChoice of: dateTime, Age, Period, Range, string
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                62. Condition.abatement[x]
                Definition

                The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate.

                ShortWhen in resolution/remission
                Comments

                There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid. When abatementString exists, it implies the condition is abated.

                Control0..1
                This element is affected by the following invariants: ele-1, con-4
                TypeChoice of: dateTime, Age, Period, Range, string
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                64. Condition.recordedDate
                Definition

                The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date.

                ShortDate record was first recorded
                Control0..1
                This element is affected by the following invariants: ele-1
                TypedateTime
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                66. Condition.recorder
                Definition

                Individual who recorded the record and takes responsibility for its content.

                ShortWho recorded the condition
                Comments

                References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeReference(Practitioner, PractitionerRole, Patient, RelatedPerson)
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                68. Condition.asserter
                Definition

                Individual who is making the condition statement.

                ShortPerson who asserts this condition
                Comments

                References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                Control0..1
                This element is affected by the following invariants: ele-1
                TypeReference(Practitioner, PractitionerRole, Patient, RelatedPerson)
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                70. Condition.stage
                Definition

                Not used in this profile

                ShortNot used in this profile
                Control0..*
                This element is affected by the following invariants: ele-1
                TypeBackboneElement
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                con-1: Stage SHALL have summary or assessment (summary.exists() or assessment.exists())
                72. Condition.stage.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                XML FormatIn the XML format, this property is represented as an attribute.
                74. Condition.stage.extension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                This element is affected by the following invariants: ele-1
                TypeExtension
                Standard StatusNormative (from Trial Use)
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on Condition.stage.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 76. Condition.stage.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  78. Condition.stage.summary
                  Definition

                  A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific.

                  ShortSimple summary (disease specific)
                  Comments

                  Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                  Control0..1
                  This element is affected by the following invariants: ele-1, con-1
                  BindingFor example codes, see ConditionStage
                  (example to http://hl7.org/fhir/ValueSet/condition-stage)

                  Codes describing condition stages (e.g. Cancer stages).

                  TypeCodeableConcept
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  80. Condition.stage.assessment
                  Definition

                  Reference to a formal record of the evidence on which the staging assessment is based.

                  ShortFormal record of assessment
                  Comments

                  References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                  Control0..*
                  This element is affected by the following invariants: ele-1, con-1
                  TypeReference(ClinicalImpression, DiagnosticReport, Observation)
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                  82. Condition.stage.type
                  Definition

                  The kind of staging, such as pathological or clinical staging.

                  ShortKind of staging
                  Comments

                  Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                  Control0..1
                  This element is affected by the following invariants: ele-1
                  BindingFor example codes, see ConditionStageType
                  (example to http://hl7.org/fhir/ValueSet/condition-stage-type)

                  Codes describing the kind of condition staging (e.g. clinical or pathological).

                  TypeCodeableConcept
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  84. Condition.evidence
                  Definition

                  Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the condition.

                  ShortSupporting evidence
                  Comments

                  The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeBackboneElement
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  con-2: evidence SHALL have code or details (code.exists() or detail.exists())
                  86. Condition.evidence.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  Typestring
                  XML FormatIn the XML format, this property is represented as an attribute.
                  88. Condition.evidence.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension
                  Standard StatusNormative (from Trial Use)
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on Condition.evidence.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 90. Condition.evidence.modifierExtension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                    ShortExtensions that cannot be ignored even if unrecognized
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeExtension
                    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                    Summarytrue
                    Requirements

                    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                    Alternate Namesextensions, user content, modifiers
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    92. Condition.evidence.code
                    Definition

                    A manifestation or symptom that led to the recording of this condition.

                    ShortManifestation/symptom
                    Comments

                    Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

                    Control0..*
                    This element is affected by the following invariants: ele-1, con-2
                    BindingThe codes SHALL be taken from Cancer Disease Status Evidence Type Value Set
                    (required to http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disease-status-evidence-type-vs)
                    TypeCodeableConcept
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    94. Condition.evidence.detail
                    Definition

                    Links to other relevant information, including pathology reports.

                    ShortSupporting information found elsewhere
                    Comments

                    References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

                    Control0..*
                    This element is affected by the following invariants: ele-1, con-2
                    TypeReference(Resource)
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ref-1: SHALL have a contained resource if a local reference is provided (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')))
                    96. Condition.note
                    Definition

                    Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis.

                    ShortAdditional information about the Condition
                    Comments

                    For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).

                    Control0..*
                    This element is affected by the following invariants: ele-1
                    TypeAnnotation
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))