Empfindlichkeit beschreibt das Ergebnis der phänotypischen Resistenztestung eines Erregers gegenüber antimikrobiellen Substanzen unter Bezug auf ein Normsystem.

Die Resistenz eines bereits identifizierten Erregers gegen eine einzelne Substanz wird hier abgebildet, etwa ein linezolidresistenter Enterococcus über 29258-1 |Linezolid [Susceptibility]| mit interpretation R; der Negativfall ist interpretation S. Der zielgerichtete Nachweis eines resistenten Erregers als solchen gehört dagegen in die Nachweisprofile — siehe Profilauswahl und Abgrenzung.

Kategorie, Norm und Untersuchungscode

Ein Ergebnis kann als Messwert oder als Kategorie angegeben werden. Steht die Kategorie im Wert, sitzt die Norm, aus der sie gebildet wurde, an derselben Stelle: valueCodeableConcept.extension[Norm] ist 1..1. Steht die Kategorie stattdessen in Observation.interpretation — der übliche Fall neben einer gemessenen MHK —, sitzt die Norm dort, interpretation.extension[Norm], ebenfalls 1..1. So oder so kann eine Kategorie nicht berichtet werden, ohne das Regelwerk zu nennen, aus dem sie stammt, und sie muss nicht mehr doppelt geschrieben werden, nur damit die Norm einen Platz hat.

Zwei Abweichungen von der europäischen Abstimmung seien hier benannt. Sie verlangt Untersuchungscodes ohne präkoordiniertes Verfahren, und dieser Leitfaden bevorzugt sie ebenfalls — 100044-7 |Cefcapene [Susceptibility]| statt der Variante „… by Broth dilution", weil das Verfahren nach Observation.method gehört. Die methodentragenden Codes bleiben aber zulässig, weil Labore bereits so kodieren; welche bevorzugt sind, sagt der code-Kurztext. Und eine kategoriale Angabe in value[x] ist überhaupt zugelassen, was die Abstimmung für den Fall regelt, dass kein Messwert vorliegt.

Stellung in der diagnostischen Kette

Die Empfindlichkeitstestung folgt der Identifizierung des Erregers, den sie bewertet, und verweist über die triggeredBy-Extension mit type = reflex auf sie zurück. Fand keine eigene Identifizierung statt, weil der Nachweis bereits erregerspezifisch war, verweist sie unmittelbar auf diesen Nachweis.

Resistenzkategorie-Status und MRGN-Klasse stehen am Ende der Kette und verweisen über derivedFrom auf die Empfindlichkeitsbefunde, aus denen sie abgeleitet wurden, nicht über triggeredBy: Sie sind fachliche Ableitungen und keine ausgelöste Folgediagnostik.

Ein Antibiogramm zusammenfassen

Ein Antibiogramm ist nicht ein Ergebnis, sondern viele — je getestete Substanz eine Observation dieses Profils. Die HL7 EU Lab Semantic Workgroup bindet sie über eine Organizer-Observation zusammen: eine Observation, die den Panel-Code 29576-6 |Bacterial susceptibility panel| trägt und selbst kein value[x], und die über Observation.hasMember auf die Einzelergebnisse und über triggeredBy auf die Identifizierung verweist, der sie folgte.

Der Organizer ist in diesem Modul nicht profiliert. Observation.hasMember steht unbeschränkt aus dem Laborbefund-Basisprofil zur Verfügung, und ein Organizer-Profil erzeugte eine eigene Canonical für etwas, das FHIR bereits regelt. Für ihn gibt es entsprechend kein Profil unter den Zielen, die DiagnosticReport.result zulässt; dort werden die Einzelergebnisse unmittelbar referenziert. Profilauswahl und Abgrenzung beschreibt das Muster und die Arbeitsteilung zwischen hasMember, triggeredBy und derivedFrom.

Beispiele

Beispiel (minimal):

mii-exa-mikrobio-empfindlichkeit

• Schlüsselelemente-Tabelle
• Differential-Tabelle
• Snapshot-Tabelle
• Statistiken/Referenzen
• Alle

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	MII_PR_Labor_Laboruntersuchung	Measurements and simple assertions Constraints: obs-7, obs-6, mii-lab-2, empfindlichkeit-messwert-sollte-bewertet-sein
id	SΣ	0..1	id	Logical id of this artifact
meta	SΣ	0..1	Meta	Metadata about the resource
source	SΣ	0..1	uri	Identifies where the resource comes from
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:triggeredBy-r5	S	0..*	(Complex)	R5: Triggering observation(s) (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:observation		1..1	Extension	Triggering observation.
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Triggering observation
extension:type		1..1	Extension	Beschreibt die Art der Auslösung einer Untersuchung im diagnostischen Zusammenhang; insbesondere kennzeichnet der Wert „reflex“ eine durch das Ergebnis einer vorangegangenen Untersuchung ausgelöste Folgediagnostik.
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"type"
value[x]		1..1	code	reflex | repeat | re-run Binding: R5ObservationTriggeredbytypeForR4 (0.1.0) (required): The type of TriggeredBy Observation.
extension:reason		0..1	Extension	R5: Reason that the observation was triggered (new)
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"reason"
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
Slices for modifierExtension	?!S	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url
modifierExtension:interpretationsbeeinflussendeEigenschaft	?!S	0..*	Coding	Interpretationsbeeinflussende interpretationsbeeinflussendeEigenschaft URL: https://www.medizininformatik-initiative.de/fhir/core/modul-labor/StructureDefinition/InterpretationsbeeinflussendeEigenschaft Binding: MII VS Labor Interpretationsbeeinflussende Eigenschaften SNOMEDCT (extensible)
Slices for identifier	SΣ	1..*	Identifier	Identifikator Slice: Unordered, Open by pattern:type
identifier:analyseBefundCode	SΣ	1..1	Identifier	Analyse-Befund-Code
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	1..1	CodeableConcept	Description of identifier Binding: MII VS Labor Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
text		0..1	string	Plain text representation of the concept
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: OBI
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
Slices for coding				Content/Rules for all slices
coding:observationInstanceV2	SΣ	1..1	Coding	Code defined by a terminology system
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: OBI
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
assigner	SΣC	1..1	Reference(Organization)	Organization that issued id (may be just text) Constraints: ref-1
basedOn	SΣC	0..*	Reference(ServiceRequest)	Basiert auf Constraints: ref-1
status	?!SΣ	1..1	code	Status Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	2..*	CodeableConcept	Kategorie Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:observation-category	S	1..1	CodeableConcept	Labor-Kategorie Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:mibi-category	S	1..1	CodeableConcept	Mikrobiologie-Kategorie Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MB
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Bevorzugt LOINC-Codes OHNE praekoordiniertes Verfahren, z. B. 100044-7 'Cefcapene [Susceptibility]' und nicht die '... by Broth dilution'-Variante — das Verfahren gehoert nach Observation.method. Das EU-Datenmodell markiert diese methodenfreie Menge als 'methodless:true' und Preferred. Ebenso bevorzugt ohne praekoordinierte Specimentype-Angabe (System = XXX); der Specimentype wird separat ueber Specimen.type kodiert. NICHT hierher gehoeren Codes mit der Methode 'Genotyping', etwa 103958-5 'Ofloxacin [Susceptibility] by Genotype': Dieses Profil verlangt ein Grenzwert-Regelwerk in interpretation.extension[Norm], und eine genotypische Vorhersage beruht auf keinem. Sie gehoert nach MII_PR_Mikrobio_Voraussichtliche_Empfindlichkeit. Binding: MII VS Mikrobio Empfindlichkeit Phenotyp [LOINC] (extensible)
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:All Slices				Content/Rules for all slices
system	SΣ	1..1	uri	Identity of the terminology system
version	SΣ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	SΣ	0..1	string	Representation defined by the system
coding:loinc	SΣ	0..*	Coding	Code defined by a terminology system Binding: Results Laboratory/Pathology Observation - IPS (extensible): Intensional Value Set Definition: LOINC { { STATUS in {ACTIVE} CLASSTYPE in {1} CLASS exclude {CHALSKIN, H&P.HX.LAB, H&P.HX, NR STATS, PATH.PROTOCOLS.*} } } Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		0..1	code	Symbol in syntax defined by the system
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
subject	SΣC	1..1	Reference(Patient | Group | Device | Location)	Subjekt Constraints: ref-1
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
encounter	SΣC	0..1	Reference(Encounter)	Fall oder Kontakt Constraints: ref-1
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
effective[x]	SΣC	1..1	dateTime	Untersuchungszeitpunkt Constraints: mii-lab-1
Slices for extension				Content/Rules for all slices
extension:QuelleKlinischesBezugsdatum	S	0..1	Coding	Quelle klinisches Bezugsdatum URL: https://www.medizininformatik-initiative.de/fhir/core/modul-labor/StructureDefinition/QuelleKlinischesBezugsdatum Binding: MII VS Labor Quelle klinisches Bezugsdatum (required)
issued	SΣ	0..1	instant	Dokumentationsdatum
Slices for value[x]	SΣC	0..1		Messwert Slice: Unordered, Closed by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
value[x]:valueQuantity	SΣC	0..1	Quantity	Actual result
Slices for extension				Content/Rules for all slices
extension:pqTranslation	D	0..*	Quantity	Same quantity with different units URL: http://hl7.org/fhir/StructureDefinition/extension-quantity-translation
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
Slices for extension				Content/Rules for all slices
extension:quantityPrecision	SD	0..1	integer	Explicit precision (number of significant decimal places) URL: http://hl7.org/fhir/StructureDefinition/quantity-precision
comparator	?!SΣ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded form of the unit Binding: MII VS Mikrobio Empfindlichkeit Einheiten [UCUM] (extensible)
value[x]:valueCodeableConcept	SΣC	0..1	CodeableConcept	Die Empfindlichkeitskategorie, wenn kein Messwert vorliegt. Aus derselben Liste wie interpretation, weil beide dasselbe aussagen; sind beide angegeben, muessen sie dieselbe Kategorie nennen. Die Norm steht dann an derjenigen Stelle, an der die Kategorie steht — hier in valueCodeableConcept.extension[Norm]. Binding: MII VS Mikrobio Susceptibility (extensible)
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:Norm	S	1..1	CodeableConcept	Extension URL: https://www.medizininformatik-initiative.de/fhir/modul-mikrobio/StructureDefinition/mii-ex-mikrobio-empfindlichkeit-norm Binding: MII VS Mikrobio Susceptibility Norm (required)
coding	SΣ	1..*	Coding	Code defined by a terminology system
system	SΣ	1..1	uri	Identity of the terminology system
version	SΣ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
value[x]:valueRange	SΣC	0..1	Range	Actual result
value[x]:valueRatio	SΣC	0..1	Ratio	Actual result
dataAbsentReason	SC	0..1	CodeableConcept	Grund für fehlende Daten Binding: MII VS Mikrobio Data Absent Reason (extensible)
interpretation	S	0..*	CodeableConcept	Interpretation Binding: MII VS Mikrobio Susceptibility (extensible)
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:Norm	S	1..1	CodeableConcept	Extension URL: https://www.medizininformatik-initiative.de/fhir/modul-mikrobio/StructureDefinition/mii-ex-mikrobio-empfindlichkeit-norm Binding: MII VS Mikrobio Susceptibility Norm (required)
note	S	0..*	Annotation	Hinweis
method	S	0..1	CodeableConcept	Untersuchungsmethode Binding: MII VS Mikrobio Empfindlichkeit Methode [SNOMED] (extensible)
coding	SΣ	0..*	Coding	Code defined by a terminology system
system	SΣ	1..1	uri	Identity of the terminology system
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	SΣ	0..1	string	Representation defined by the system
specimen	SC	1..1	Reference(MII PR Mikrobio Probe)	Probenmaterial Constraints: ref-1
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
device	SC	0..1	Reference(Device | DeviceMetric)	Gerät Constraints: ref-1
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
referenceRange	SC	0..*	BackboneElement	Referenzbereich Constraints: obs-3
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	SC	0..1	SimpleQuantity	Low Range, if relevant Constraints: qty-3, sqty-1
high	SC	0..1	SimpleQuantity	High Range, if relevant Constraints: qty-3, sqty-1
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.extension:triggeredBy-r5.​extension:type.value[x]	Base	required	Cross-version ValueSet R5.TriggeredBytype for use in FHIR R4	📍0.1.0	Extensions for Using Data Elements from FHIR R5 in FHIR R4 v0.1
Observation.identifier:analyseBefundCode.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Observation.identifier:analyseBefundCode.​type	Base	extensible	MII VS Labor Identifier Type Codes	📦2027.0.0-ballot	MII IG Laborbefund v2027.0
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📦4.0.1	FHIR Std.
Observation.category:observation-category	Base	preferred	Observation Category Codes	📦4.0.1	FHIR Std.
Observation.category:mibi-category	Base	preferred	Observation Category Codes	📦4.0.1	FHIR Std.
Observation.code	Base	extensible	MII VS Mikrobio Empfindlichkeit Phenotyp [LOINC]	📦2027.0.0-ballot2	This IG
Observation.code.coding:loinc	Base	extensible	Results Laboratory/Pathology Observation - IPS	📦2.0.1	This IG
Observation.value[x]:valueQuantity.​comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Observation.value[x]:valueQuantity.​code	Base	extensible	MII VS Mikrobio Empfindlichkeit Einheiten [UCUM]	📦2027.0.0-ballot2	This IG
Observation.value[x]:valueCodeableConcept	Base	extensible	MII VS Mikrobio Susceptibility	📦2027.0.0-ballot2	This IG
Observation.dataAbsentReason	Base	extensible	MII VS Mikrobio Data Absent Reason	📦2027.0.0-ballot2	This IG
Observation.interpretation	Base	extensible	MII VS Mikrobio Susceptibility	📦2027.0.0-ballot2	This IG
Observation.method	Base	extensible	MII VS Mikrobio Empfindlichkeit Methode [SNOMED]	📦2027.0.0-ballot2	This IG

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	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
empfindlichkeit-messwert-sollte-bewertet-sein	warning	Observation	Where the result is a measured value, an interpretation SHOULD be given. It may be absent where no breakpoints are defined for the organism and agent.	value.ofType(Quantity).exists() implies interpretation.exists()
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
mii-lab-1	error	Observation.effective[x]	Datetime must be at least to day	($this as dateTime).hasValue() implies ($this as dateTime).toString().length() >= 8
mii-lab-2	error	Observation	Falls kein Laborwert verfügbar ist, muss eine dataAbsentReason angegeben werden	hasMember.exists() or value.exists() or dataAbsentReason.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()
qty-3	error	Observation.referenceRange.low, Observation.referenceRange.high	If a code for the unit is present, the system SHALL also be present	code.empty() or system.exists()
ref-1	error	Observation.identifier:analyseBefundCode.assigner, Observation.basedOn, Observation.subject, Observation.encounter, Observation.specimen, Observation.device	SHALL have a contained resource if a local reference is provided	reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
sqty-1	error	Observation.referenceRange.low, Observation.referenceRange.high	The comparator is not used on a SimpleQuantity	comparator.empty()

Diese Struktur ist abgeleitet von MII_PR_Labor_Laboruntersuchung

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	MII_PR_Labor_Laboruntersuchung	Measurements and simple assertions Constraints: empfindlichkeit-messwert-sollte-bewertet-sein
Slices for extension				Content/Rules for all slices
extension:triggeredBy-r5	S	0..*	(Complex)	R5: Triggering observation(s) (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
Slices for extension				Content/Rules for all slices
extension:observation		1..1	Extension	Triggering observation.
extension:type		1..1	Extension	Beschreibt die Art der Auslösung einer Untersuchung im diagnostischen Zusammenhang; insbesondere kennzeichnet der Wert „reflex“ eine durch das Ergebnis einer vorangegangenen Untersuchung ausgelöste Folgediagnostik.
category		2..*	CodeableConcept	Kategorie
Slices for category				Content/Rules for all slices
category:mibi-category	S	1..1	CodeableConcept	Mikrobiologie-Kategorie Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MB
code		1..1	CodeableConcept	Bevorzugt LOINC-Codes OHNE praekoordiniertes Verfahren, z. B. 100044-7 'Cefcapene [Susceptibility]' und nicht die '... by Broth dilution'-Variante — das Verfahren gehoert nach Observation.method. Das EU-Datenmodell markiert diese methodenfreie Menge als 'methodless:true' und Preferred. Ebenso bevorzugt ohne praekoordinierte Specimentype-Angabe (System = XXX); der Specimentype wird separat ueber Specimen.type kodiert. NICHT hierher gehoeren Codes mit der Methode 'Genotyping', etwa 103958-5 'Ofloxacin [Susceptibility] by Genotype': Dieses Profil verlangt ein Grenzwert-Regelwerk in interpretation.extension[Norm], und eine genotypische Vorhersage beruht auf keinem. Sie gehoert nach MII_PR_Mikrobio_Voraussichtliche_Empfindlichkeit. Binding: MII VS Mikrobio Empfindlichkeit Phenotyp [LOINC] (extensible)
value[x]		0..1		Messwert
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
Slices for value[x]				Content/Rules for all slices
value[x]:valueQuantity		0..1	Quantity	Actual result
code		1..1	code	Coded form of the unit Binding: MII VS Mikrobio Empfindlichkeit Einheiten [UCUM] (extensible)
value[x]:valueCodeableConcept		0..1	CodeableConcept	Die Empfindlichkeitskategorie, wenn kein Messwert vorliegt. Aus derselben Liste wie interpretation, weil beide dasselbe aussagen; sind beide angegeben, muessen sie dieselbe Kategorie nennen. Die Norm steht dann an derjenigen Stelle, an der die Kategorie steht — hier in valueCodeableConcept.extension[Norm]. Binding: MII VS Mikrobio Susceptibility (extensible)
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:Norm	S	1..1	CodeableConcept	Extension URL: https://www.medizininformatik-initiative.de/fhir/modul-mikrobio/StructureDefinition/mii-ex-mikrobio-empfindlichkeit-norm Binding: MII VS Mikrobio Susceptibility Norm (required)
dataAbsentReason		0..1	CodeableConcept	Grund für fehlende Daten Binding: MII VS Mikrobio Data Absent Reason (extensible)
interpretation		0..*	CodeableConcept	Interpretation Binding: MII VS Mikrobio Susceptibility (extensible)
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:Norm	S	1..1	CodeableConcept	Extension URL: https://www.medizininformatik-initiative.de/fhir/modul-mikrobio/StructureDefinition/mii-ex-mikrobio-empfindlichkeit-norm Binding: MII VS Mikrobio Susceptibility Norm (required)
method		0..1	CodeableConcept	Untersuchungsmethode Binding: MII VS Mikrobio Empfindlichkeit Methode [SNOMED] (extensible)
specimen		1..1	Reference(MII PR Mikrobio Probe)	Probenmaterial
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.code	Base	extensible	MII VS Mikrobio Empfindlichkeit Phenotyp [LOINC]	📦2027.0.0-ballot2	This IG
Observation.value[x]:valueQuantity.​code	Base	extensible	MII VS Mikrobio Empfindlichkeit Einheiten [UCUM]	📦2027.0.0-ballot2	This IG
Observation.value[x]:valueCodeableConcept	Base	extensible	MII VS Mikrobio Susceptibility	📦2027.0.0-ballot2	This IG
Observation.dataAbsentReason	Base	extensible	MII VS Mikrobio Data Absent Reason	📦2027.0.0-ballot2	This IG
Observation.interpretation	Base	extensible	MII VS Mikrobio Susceptibility	📦2027.0.0-ballot2	This IG
Observation.method	Base	extensible	MII VS Mikrobio Empfindlichkeit Methode [SNOMED]	📦2027.0.0-ballot2	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
empfindlichkeit-messwert-sollte-bewertet-sein	warning	Observation	Where the result is a measured value, an interpretation SHOULD be given. It may be absent where no breakpoints are defined for the organism and agent.	value.ofType(Quantity).exists() implies interpretation.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation	C	0..*	MII_PR_Labor_Laboruntersuchung	Measurements and simple assertions Constraints: obs-7, obs-6, mii-lab-2, empfindlichkeit-messwert-sollte-bewertet-sein
id	SΣ	0..1	id	Logical id of this artifact
meta	SΣ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	SΣ	0..1	uri	Identifies where the resource comes from
profile	SΣ	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:triggeredBy-r5	S	0..*	(Complex)	R5: Triggering observation(s) (new) URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy
id		0..1	string	Unique id for inter-element referencing
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:observation		1..1	Extension	Triggering observation.
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"observation"
value[x]		1..1	Reference(Observation)	Triggering observation
extension:type		1..1	Extension	Beschreibt die Art der Auslösung einer Untersuchung im diagnostischen Zusammenhang; insbesondere kennzeichnet der Wert „reflex“ eine durch das Ergebnis einer vorangegangenen Untersuchung ausgelöste Folgediagnostik.
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"type"
value[x]		1..1	code	reflex | repeat | re-run Binding: R5ObservationTriggeredbytypeForR4 (0.1.0) (required): The type of TriggeredBy Observation.
extension:reason		0..1	Extension	R5: Reason that the observation was triggered (new)
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"reason"
value[x]		0..1	string	Reason that the observation was triggered
url		1..1	uri	"http://hl7.org/fhir/5.0/StructureDefinition/extension-Observation.triggeredBy"
Slices for modifierExtension	?!S	0..*	Extension	Extensions that cannot be ignored Slice: Unordered, Open by value:url
modifierExtension:interpretationsbeeinflussendeEigenschaft	?!S	0..*	Coding	Interpretationsbeeinflussende interpretationsbeeinflussendeEigenschaft URL: https://www.medizininformatik-initiative.de/fhir/core/modul-labor/StructureDefinition/InterpretationsbeeinflussendeEigenschaft Binding: MII VS Labor Interpretationsbeeinflussende Eigenschaften SNOMEDCT (extensible)
Slices for identifier	SΣ	1..*	Identifier	Identifikator Slice: Unordered, Open by pattern:type
identifier:analyseBefundCode	SΣ	1..1	Identifier	Analyse-Befund-Code
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	SΣ	1..1	CodeableConcept	Description of identifier Binding: MII VS Labor Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	SΣ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: OBI
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
Slices for coding				Content/Rules for all slices
coding:observationInstanceV2	SΣ	1..1	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system Fixed Value: OBI
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
system	SΣ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	SΣ	1..1	string	The value that is unique Example General: 123456
period	ΣC	0..1	Period	Time period when id is/was valid for use Constraints: per-1
assigner	SΣC	1..1	Reference(Organization)	Organization that issued id (may be just text) Constraints: ref-1
basedOn	SΣC	0..*	Reference(ServiceRequest)	Basiert auf Constraints: ref-1
partOf	ΣC	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event Constraints: ref-1
status	?!SΣ	1..1	code	Status Binding: ObservationStatus (required): Codes providing the status of an observation.
Slices for category	S	2..*	CodeableConcept	Kategorie Slice: Unordered, Open by pattern:$this Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
category:observation-category	S	1..1	CodeableConcept	Labor-Kategorie Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: laboratory
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
category:mibi-category	S	1..1	CodeableConcept	Mikrobiologie-Kategorie Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0074
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MB
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code	SΣ	1..1	CodeableConcept	Bevorzugt LOINC-Codes OHNE praekoordiniertes Verfahren, z. B. 100044-7 'Cefcapene [Susceptibility]' und nicht die '... by Broth dilution'-Variante — das Verfahren gehoert nach Observation.method. Das EU-Datenmodell markiert diese methodenfreie Menge als 'methodless:true' und Preferred. Ebenso bevorzugt ohne praekoordinierte Specimentype-Angabe (System = XXX); der Specimentype wird separat ueber Specimen.type kodiert. NICHT hierher gehoeren Codes mit der Methode 'Genotyping', etwa 103958-5 'Ofloxacin [Susceptibility] by Genotype': Dieses Profil verlangt ein Grenzwert-Regelwerk in interpretation.extension[Norm], und eine genotypische Vorhersage beruht auf keinem. Sie gehoert nach MII_PR_Mikrobio_Voraussichtliche_Empfindlichkeit. Binding: MII VS Mikrobio Empfindlichkeit Phenotyp [LOINC] (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	SΣ	0..*	Coding	Code defined by a terminology system Slice: Unordered, Open by pattern:$this
coding:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system
version	SΣ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	SΣ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
coding:loinc	SΣ	0..*	Coding	Code defined by a terminology system Binding: Results Laboratory/Pathology Observation - IPS (extensible): Intensional Value Set Definition: LOINC { { STATUS in {ACTIVE} CLASSTYPE in {1} CLASS exclude {CHALSKIN, H&P.HX.LAB, H&P.HX, NR STATS, PATH.PROTOCOLS.*} } } Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://loinc.org
version		0..1	string	Version of the system - if relevant
code		0..1	code	Symbol in syntax defined by the system
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣC	1..1	Reference(Patient | Group | Device | Location)	Subjekt Constraints: ref-1
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
focus	ΣC	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record Constraints: ref-1
encounter	SΣC	0..1	Reference(Encounter)	Fall oder Kontakt Constraints: ref-1
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
effective[x]	SΣC	1..1	dateTime	Untersuchungszeitpunkt Constraints: mii-lab-1
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
extension:QuelleKlinischesBezugsdatum	S	0..1	Coding	Quelle klinisches Bezugsdatum URL: https://www.medizininformatik-initiative.de/fhir/core/modul-labor/StructureDefinition/QuelleKlinischesBezugsdatum Binding: MII VS Labor Quelle klinisches Bezugsdatum (required)
value		0..1	dateTime	Primitive value for dateTime
issued	SΣ	0..1	instant	Dokumentationsdatum
performer	ΣC	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Constraints: ref-1
Slices for value[x]	SΣC	0..1		Messwert Slice: Unordered, Closed by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
value[x]:valueQuantity	SΣC	0..1	Quantity	Actual result
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:pqTranslation	D	0..*	Quantity	Same quantity with different units URL: http://hl7.org/fhir/StructureDefinition/extension-quantity-translation
value	SΣ	1..1	decimal	Numerical value (with implicit precision)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:quantityPrecision	SD	0..1	integer	Explicit precision (number of significant decimal places) URL: http://hl7.org/fhir/StructureDefinition/quantity-precision
value		0..1	decimal	Primitive value for decimal
comparator	?!SΣ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	SΣ	1..1	string	Unit representation
system	SΣC	1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code	SΣ	1..1	code	Coded form of the unit Binding: MII VS Mikrobio Empfindlichkeit Einheiten [UCUM] (extensible)
value[x]:valueCodeableConcept	SΣC	0..1	CodeableConcept	Die Empfindlichkeitskategorie, wenn kein Messwert vorliegt. Aus derselben Liste wie interpretation, weil beide dasselbe aussagen; sind beide angegeben, muessen sie dieselbe Kategorie nennen. Die Norm steht dann an derjenigen Stelle, an der die Kategorie steht — hier in valueCodeableConcept.extension[Norm]. Binding: MII VS Mikrobio Susceptibility (extensible)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:Norm	S	1..1	CodeableConcept	Extension URL: https://www.medizininformatik-initiative.de/fhir/modul-mikrobio/StructureDefinition/mii-ex-mikrobio-empfindlichkeit-norm Binding: MII VS Mikrobio Susceptibility Norm (required)
coding	SΣ	1..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system
version	SΣ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value[x]:valueRange	SΣC	0..1	Range	Actual result
value[x]:valueRatio	SΣC	0..1	Ratio	Actual result
dataAbsentReason	SC	0..1	CodeableConcept	Grund für fehlende Daten Binding: MII VS Mikrobio Data Absent Reason (extensible)
interpretation	S	0..*	CodeableConcept	Interpretation Binding: MII VS Mikrobio Susceptibility (extensible)
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:Norm	S	1..1	CodeableConcept	Extension URL: https://www.medizininformatik-initiative.de/fhir/modul-mikrobio/StructureDefinition/mii-ex-mikrobio-empfindlichkeit-norm Binding: MII VS Mikrobio Susceptibility Norm (required)
coding	Σ	0..*	Coding	Code defined by a terminology system
text	Σ	0..1	string	Plain text representation of the concept
note	S	0..*	Annotation	Hinweis
method	S	0..1	CodeableConcept	Untersuchungsmethode Binding: MII VS Mikrobio Empfindlichkeit Methode [SNOMED] (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	SΣ	0..*	Coding	Code defined by a terminology system
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	SΣ	1..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	1..1	code	Symbol in syntax defined by the system
display	SΣ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
specimen	SC	1..1	Reference(MII PR Mikrobio Probe)	Probenmaterial Constraints: ref-1
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
device	SC	0..1	Reference(Device | DeviceMetric)	Gerät Constraints: ref-1
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
referenceRange	SC	0..*	BackboneElement	Referenzbereich Constraints: obs-3
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
low	SC	0..1	SimpleQuantity	Low Range, if relevant Constraints: qty-3, sqty-1
high	SC	0..1	SimpleQuantity	High Range, if relevant Constraints: qty-3, sqty-1
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	C	0..1	Range	Applicable age range, if relevant Constraints: rng-2
text		0..1	string	Text based reference range in an observation
hasMember	ΣC	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group Constraints: ref-1
derivedFrom	ΣC	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from Constraints: ref-1
component	Σ	0..*	BackboneElement	Component results
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.meta.security	Base	extensible	SecurityLabels	📦4.0.1	FHIR Std.
Observation.meta.tag	Base	example	Common Tags	📦4.0.1	FHIR Std.
Observation.language	Base	preferred	Common Languages	📦4.0.1	FHIR Std.
Observation.extension:triggeredBy-r5.​extension:type.value[x]	Base	required	Cross-version ValueSet R5.TriggeredBytype for use in FHIR R4	📍0.1.0	Extensions for Using Data Elements from FHIR R5 in FHIR R4 v0.1
Observation.identifier:analyseBefundCode.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Observation.identifier:analyseBefundCode.​type	Base	extensible	MII VS Labor Identifier Type Codes	📦2027.0.0-ballot	MII IG Laborbefund v2027.0
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📦4.0.1	FHIR Std.
Observation.category:observation-category	Base	preferred	Observation Category Codes	📦4.0.1	FHIR Std.
Observation.category:mibi-category	Base	preferred	Observation Category Codes	📦4.0.1	FHIR Std.
Observation.code	Base	extensible	MII VS Mikrobio Empfindlichkeit Phenotyp [LOINC]	📦2027.0.0-ballot2	This IG
Observation.code.coding:loinc	Base	extensible	Results Laboratory/Pathology Observation - IPS	📦2.0.1	This IG
Observation.subject.​type	Base	extensible	ResourceType	📦4.0.1	FHIR Std.
Observation.encounter.​type	Base	extensible	ResourceType	📦4.0.1	FHIR Std.
Observation.value[x]:valueQuantity.​comparator	Base	required	QuantityComparator	📍4.0.1	FHIR Std.
Observation.value[x]:valueQuantity.​code	Base	extensible	MII VS Mikrobio Empfindlichkeit Einheiten [UCUM]	📦2027.0.0-ballot2	This IG
Observation.value[x]:valueCodeableConcept	Base	extensible	MII VS Mikrobio Susceptibility	📦2027.0.0-ballot2	This IG
Observation.dataAbsentReason	Base	extensible	MII VS Mikrobio Data Absent Reason	📦2027.0.0-ballot2	This IG
Observation.interpretation	Base	extensible	MII VS Mikrobio Susceptibility	📦2027.0.0-ballot2	This IG
Observation.method	Base	extensible	MII VS Mikrobio Empfindlichkeit Methode [SNOMED]	📦2027.0.0-ballot2	This IG
Observation.specimen.​type	Base	extensible	ResourceType	📦4.0.1	FHIR Std.
Observation.device.type	Base	extensible	ResourceType	📦4.0.1	FHIR Std.
Observation.referenceRange.​type	Base	preferred	Observation Reference Range Meaning Codes	📦4.0.1	FHIR Std.
Observation.referenceRange.​appliesTo	Base	example	Observation Reference Range Applies To Codes	📦4.0.1	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📦4.0.1	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📦4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📦4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Observation	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Observation	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Observation	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
empfindlichkeit-messwert-sollte-bewertet-sein	warning	Observation	Where the result is a measured value, an interpretation SHOULD be given. It may be absent where no breakpoints are defined for the organism and agent.	value.ofType(Quantity).exists() implies interpretation.exists()
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
mii-lab-1	error	Observation.effective[x]	Datetime must be at least to day	($this as dateTime).hasValue() implies ($this as dateTime).toString().length() >= 8
mii-lab-2	error	Observation	Falls kein Laborwert verfügbar ist, muss eine dataAbsentReason angegeben werden	hasMember.exists() or value.exists() or dataAbsentReason.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()
per-1	error	Observation.identifier:analyseBefundCode.period	If present, start SHALL have a lower value than end	start.hasValue().not() or end.hasValue().not() or (start <= end)
qty-3	error	Observation.referenceRange.low, Observation.referenceRange.high	If a code for the unit is present, the system SHALL also be present	code.empty() or system.exists()
ref-1	error	Observation.identifier:analyseBefundCode.assigner, Observation.basedOn, Observation.partOf, Observation.subject, Observation.focus, Observation.encounter, Observation.performer, Observation.specimen, Observation.device, Observation.hasMember, Observation.derivedFrom	SHALL have a contained resource if a local reference is provided	reference.exists() implies (reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) or (reference='#' and %rootResource!=%resource))
rng-2	error	Observation.referenceRange.age	If present, low SHALL have a lower value than high	low.empty() or high.empty() or (low <= high)
sqty-1	error	Observation.referenceRange.low, Observation.referenceRange.high	The comparator is not used on a SimpleQuantity	comparator.empty()