MII IG Kerndatensatz-Modul Molekulargenetischer Befundbericht
2027.0.0-ballot.1 -
Germany
This page is part of the MII IG Kerndatensatz-Modul Molekulargenetischer Befundbericht (v2027.0.0-ballot.1: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Version 2026.0.0 of this module moved from Clinical Genomics Reporting STU2 to STU3. This page states what changed and how to move existing data across. It addresses sites that already produce data against the 2025 line.
There are no StructureMaps here, deliberately. Data integration at a Data Integration Center runs on its own ETL, and a FHIR mapping engine is rarely part of it. A StructureMap would describe a transformation most sites could not execute. What follows is the mapping stated declaratively — implementable in whatever technology your pipeline already uses.
| Profile | STU2 | STU3 |
|---|---|---|
| UntersuchteRegion | …/StructureDefinition/region-studied |
removed — see GenomicStudy below |
| ErgebnisZusammenfassung | own Observation | removed — folded into DiagnosticReport.conclusionCode |
| Variante | …/variant |
…/variant — unchanged base, components renamed |
| Mikrosatelliteninstabilität | directly from Observation |
via MII_PR_MolGen_MolekularerBiomarker |
| Mutationslast | directly from Observation |
via MII_PR_MolGen_MolekularerBiomarker |
| MolekulareKonsequenz | — | new, from …/molecular-consequence |
| GenomicStudy | — | new, from …/genomic-study (a Procedure) |
| GenomicStudyAnalysis | — | new, from …/genomic-study-analysis (a Procedure) |
Note the two levels on the biomarkers: MSI and Mutationslast do not derive from the
STU3 molecular-biomarker directly. They derive from this module's
MII_PR_MolGen_MolekularerBiomarker, and that is what derives from STU3. The practical
consequence is the same — see the category requirement below — but a profile binding
written against the STU3 canonical will not match.
Slice names changed; in an instance you identify a component by its code, so most of
this is invisible in the data:
| Component | LOINC | What changed |
|---|---|---|
| DNA change (c.HGVS) | 48004-6 |
unchanged |
| Transcript reference | 51958-7 |
unchanged |
| Amino acid change | 48005-3 |
unchanged |
| Amino acid change type | 48006-1 |
removed from the profile |
| Molecular consequence | various | moved to a separate MolekulareKonsequenz observation |
Three slices gained a representative- prefix — coding-hgvs, transcript-ref-seq
and protein-hgvs. This matters only where you reference slices by name, for example in
your own derived profiles or in FHIRPath; instance data is unaffected.
Because both now sit under a biomarker profile, they require a second category
alongside laboratory:
"category": [
{ "coding": [{ "system": "http://terminology.hl7.org/CodeSystem/observation-category",
"code": "laboratory", "display": "Laboratory" }] },
{ "coding": [{ "system": "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
"code": "biomarker-category",
"display": "A characterization of a given biomarker observation." }] }
]
Note the second system: the biomarker category comes from the Clinical Genomics
tbd-codes-cs, not from observation-category. STU3 requires both slices at
1..1, so an instance carrying only laboratory fails validation. This is the single
most common failure when moving 2025-line data forward.
STU2 recorded which regions were examined as components on one Observation. STU3
replaces this with a Procedure pair: a GenomicStudy that orchestrates, and one or more
GenomicStudyAnalysis steps carrying the detail.
Before:
{
"resourceType": "Observation",
"meta": { "profile": ["…/mii-pr-molgen-untersuchte-region"] },
"component": [{
"code": { "coding": [{ "code": "48018-6" }] },
"valueCodeableConcept": { "coding": [{ "code": "HGNC:1097", "display": "BRAF" }] }
}]
}
After — the studied region moves into the genomic-study-analysis-regions
extension of an analysis step:
{
"resourceType": "Procedure",
"meta": { "profile": ["…/mii-pr-molgen-genomic-study-analysis"] },
"extension": [{
"url": ".../genomic-study-analysis-regions",
"extension": [{
"url": "studied",
"valueCodeableConcept": { "coding": [{ "code": "HGNC:1097", "display": "BRAF" }] }
}]
}]
}
The minimum viable migration is exactly this: one analysis step per former
UntersuchteRegion, carrying the same gene codes. Everything else GenomicStudyAnalysis
offers — sequencer and pipeline as Device, method type, read depth and coverage,
specimen, input and output files — is optional, and worth adding only where your source
system actually holds it.
Note that regions-studied is what lets a query tell not found from not looked for.
If your STU2 data recorded examined regions, carry them across; dropping them loses that
distinction.
Before: a separate Observation referenced from DiagnosticReport.result.
{ "resourceType": "DiagnosticReport",
"result": [{ "reference": "Observation/ergebnis-zusammenfassung-1" }] }
{ "resourceType": "Observation", "id": "ergebnis-zusammenfassung-1",
"valueCodeableConcept": { "coding": [{ "code": "LA6576-8", "display": "Positive" }] } }
After: the code moves onto the report itself and the Observation disappears.
{ "resourceType": "DiagnosticReport",
"conclusionCode": [{ "coding": [{ "code": "LA6576-8", "display": "Positive" }] }] }
Remember to remove the now-dangling result entry, not just to add the
conclusionCode.
Only relevant if you reference slice names. In instance data nothing changes, because
components are identified by code:
| STU2 slice | STU3 slice |
|---|---|
coding-hgvs |
representative-coding-hgvs |
transcript-ref-seq |
representative-transcript-ref-seq |
protein-hgvs |
representative-protein-hgvs |
Before you start
untersuchte-region or ergebnis-zusammenfassung in
meta.profile — those are the two that cannot be migrated mechanically.While migrating
category to MSI and Mutationslast instances.DiagnosticReport.conclusionCode and
delete the Observation and its result reference.Afterwards
untersuchte-region,
ergebnis-zusammenfassung, region-studied — before declaring the migration done.