MII IG Kerndatensatz-Modul Molekulares Tumorboard
2027.0.0-ballot.1 - Germany

This page is part of the MII Implementation Guide Molecular Tumor Board (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

Resource Profile: MII PR MTB Behandlungsepisode

Official URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-behandlungsepisode Version: 2027.0.0-ballot.1
Active as of 2026-09-15 Computable Name: MII_PR_MTB_Behandlungsepisode

Aktueller Krankheitszustand und bisherige Behandlungsmaßnahmen

Content

This profile describes the current Behandlungsepisode (treatment episode) including the current health status, prior therapies, molecular pathology report and NGS-Bericht (NGS report).

It serves as a bracket intended to complement the case concept, since the MTB can cover, in addition to the classic in-house patients, each of the following patient journeys:

  • The patient is cared for from beginning to end at the same university hospital, both in accordance with guidelines (oncology) and at the Molekulares Tumorboard (molecular tumor board) (diagnosis, therapy and follow-up)
  • The patient is treated externally in accordance with guidelines, and once those options are exhausted, the remainder of the therapy takes place at the university hospital
  • The patient never presents in person at the university hospital; instead, the case is only discussed at the MTB
  • Arbitrary combinations of prior therapies and subsequent therapies.

Profiling decisions / ballot comment

As an alternative, the use of the EpisodeOfCare resource was considered. However, this is to be regarded rather as an administrative treatment period.

Therefore, using the ClinicalImpression resource seemed more sensible to us, even though the ClinicalImpression here captures a time period and not a point in time. It thus contains references to the state of the patient at the time of inclusion as well as references to the diagnostics and treatments performed and to interdisciplinary conferences for further treatment planning.

Content

Mapping dataset to FHIR

Search parameters

The following search parameters are relevant for this module, including in combination:

  1. The search parameter "_id" MUST be supported:

    Examples:

    GET [base]/ClinicalImpression?_id=12345

    Usage notes: Further information on searching by "_id" can be found in the FHIR base specification - section "Parameters for all resources".

  2. The search parameter "_profile" MUST be supported:

    Examples:

    GET [base]/ClinicalImpression?_profile=https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-behandlungsepisode

    Usage notes: Further information on searching by "_profile" can be found in the FHIR base specification - section "Token Search".

  3. The search parameter "period-end" MUST be supported:

    Examples:

    GET [base]/ClinicalImpression?period-end=eq2025-01-01

    Usage notes: Further information on searching by "period-end" can be found in the FHIR base specification - section "Date Search".

  4. The search parameter "problem" MUST be supported:

    Examples:

    GET [base]/ClinicalImpression?problem=Condition/example

    Usage notes: Further information on searching by "problem" can be found in the FHIR base specification - section "Reference Search".

  5. The search parameter "investigation" MUST be supported:

    Examples:

    GET [base]/ClinicalImpression?investigation=DiagnosticReport/example

    Usage notes: Further information on searching by "investigation" can be found in the FHIR base specification - section "Reference Search".

  6. The search parameter "supporting-info" MUST be supported:

    Examples:

    GET [base]/ClinicalImpression?supporting-info=DiagnosticReport/example

    Usage notes: Further information on searching by "supporting-info" can be found in the FHIR base specification - section "Reference Search".

TODO: SP guideline treatment status extension

Examples

Example: MTB case decision for Kim Musterperson dated 2023-03-28 (see Scenarios)

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots, and their representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ClinicalImpression 0..* ClinicalImpression A clinical assessment performed when planning treatments and management strategies for a patient
... meta SΣ 0..1 Meta Metadata about the resource
.... 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 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:LeitlinienbehandlungStatus S 0..1 Coding MII EX MTB Leitlinienbehandlung Status
URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinienbehandlung-status
... status ?!Σ 1..1 code in-progress | completed | entered-in-error
Binding: ClinicalImpressionStatus (required): The workflow state of a clinical impression.
... subject Σ 1..1 Reference(MII PR Person Patient | MII PR Person Patient (Pseudonymisiert)) Patient or group assessed
... Slices for effective[x] Σ 1..1 Period Time of assessment
Slice: Unordered, Closed by type:$this
.... effective[x]:effectivePeriod SΣ 1..1 Period Treatment Episode Period
..... start ΣC 0..1 dateTime Inclusion Date
..... end SΣC 0..1 dateTime Completion Date
... Slices for problem SΣ 0..* Reference(Condition | AllergyIntolerance) Relevant impressions of patient state
Slice: Unordered, Open by type:$this
.... problem:PrimaertumorDiagnose SΣ 0..1 Reference(MII PR MTB Diagnose Primärtumor | Condition) Primary Tumor Diagnosis
... Slices for investigation 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
Slice: Unordered, Open by value:code.coding
.... investigation:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
.... investigation:KrankengeschichteFamilie S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... coding Σ 1..* Coding Code defined by a terminology system

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://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 416471007
....... display 1..1 string Representation defined by the system
Fixed Value: Family medical history
....... userSelected 0..1 boolean If this coding was chosen directly by the user
..... item 1..1 Reference(MII PR MolGen Familienanamnese | FamilyMemberHistory) Family Medical History
.... investigation:ECOG S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... coding Σ 1..* Coding Code defined by a terminology system

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://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 424122007
....... display 1..1 string Representation defined by the system
Fixed Value: ECOG performance status finding
....... userSelected 0..1 boolean If this coding was chosen directly by the user
..... item 1..1 Reference(MII PR Onkologie Allgemeiner Leistungszustand ECOG | Observation) ECOG
.... investigation:NgsBericht S 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... coding Σ 1..* Coding Code defined by a terminology system

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://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 106221001
....... display 1..1 string Representation defined by the system
Fixed Value: Genetic finding
....... userSelected 0..1 boolean If this coding was chosen directly by the user
..... item 1..1 Reference(MII PR MTB NGS-Bericht | DiagnosticReport) NGS Report
.... investigation:MolekularPathologieBefund S 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... coding Σ 1..* Coding Code defined by a terminology system

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 1..1 code Symbol in syntax defined by the system
Fixed Value: 60568-3
....... display 1..1 string Representation defined by the system
Fixed Value: Pathology synoptic report
....... userSelected 0..1 boolean If this coding was chosen directly by the user
..... item 1..1 Reference(MII PR MTB Molecular Pathology Report | DiagnosticReport) Molecular Pathology Report
.... investigation:Einwilligung S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... coding Σ 1..* Coding Code defined by a terminology system

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 1..1 code Symbol in syntax defined by the system
Fixed Value: 105511-0
....... display 1..1 string Representation defined by the system
Fixed Value: Was consent given
....... userSelected 0..1 boolean If this coding was chosen directly by the user
..... item 1..1 Reference(MII PR MTB Consent) Consent
... Slices for supportingInfo 0..* Reference(Resource) Information supporting the clinical impression
Slice: Unordered, Open by profile:$this.resolve()
.... supportingInfo:Vorbefund S 0..* Reference(DiagnosticReport | Observation) Previous Finding
.... supportingInfo:Vortherapie S 0..* Reference(MII PR MTB Systemische Vortherapie | MII PR Onkologie Strahlentherapie | MII PR Onkologie Operation | MII PR Prozedur Procedure) Prior Therapy
..... Slices for extension Content/Rules for all slices
...... extension:LeitlinieDokumentation S 0..1 (Complex) Guideline Documentation
URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinie-dokumentation
.... supportingInfo:Therapieplan S 0..1 Reference(MII PR MTB Therapieplan | CarePlan) Therapy Plan

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ClinicalImpression.status Base required Clinical Impression Status 📍4.0.1 FHIR Std.
ClinicalImpression.investigation.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:KrankengeschichteFamilie.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:ECOG.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:NgsBericht.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:MolekularPathologieBefund.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:Einwilligung.​code Base example Investigation Type 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ClinicalImpression If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ClinicalImpression 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 ClinicalImpression 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 ClinicalImpression If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ClinicalImpression 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())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ClinicalImpression 0..* ClinicalImpression A clinical assessment performed when planning treatments and management strategies for a patient
... meta S 0..1 Meta Metadata about the resource
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:LeitlinienbehandlungStatus S 0..1 Coding MII EX MTB Leitlinienbehandlung Status
URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinienbehandlung-status
... subject 1..1 Reference(MII PR Person Patient | MII PR Person Patient (Pseudonymisiert)) Patient or group assessed
.... effective[x]:effectivePeriod S 1..1 Period Treatment Episode Period
..... start 0..1 dateTime Inclusion Date
..... end S 0..1 dateTime Completion Date
... Slices for problem S 0..* Reference(Condition | AllergyIntolerance) Relevant impressions of patient state
Slice: Unordered, Open by type:$this
.... problem:PrimaertumorDiagnose S 0..1 Reference(MII PR MTB Diagnose Primärtumor | Condition) Primary Tumor Diagnosis
... Slices for investigation 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
Slice: Unordered, Open by value:code.coding
.... investigation:KrankengeschichteFamilie S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... code
...... coding 1..* Coding Code defined by a terminology system
Required Pattern: At least the following
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 416471007
....... display 1..1 string Representation defined by the system
Fixed Value: Family medical history
..... item 1..1 Reference(MII PR MolGen Familienanamnese | FamilyMemberHistory) Family Medical History
.... investigation:ECOG S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... code
...... coding 1..* Coding Code defined by a terminology system
Required Pattern: At least the following
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 424122007
....... display 1..1 string Representation defined by the system
Fixed Value: ECOG performance status finding
..... item 1..1 Reference(MII PR Onkologie Allgemeiner Leistungszustand ECOG | Observation) ECOG
.... investigation:NgsBericht S 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... code
...... coding 1..* Coding Code defined by a terminology system
Required Pattern: At least the following
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 106221001
....... display 1..1 string Representation defined by the system
Fixed Value: Genetic finding
..... item 1..1 Reference(MII PR MTB NGS-Bericht | DiagnosticReport) NGS Report
.... investigation:MolekularPathologieBefund S 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... code
...... coding 1..* Coding Code defined by a terminology system
Required Pattern: At least the following
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 60568-3
....... display 1..1 string Representation defined by the system
Fixed Value: Pathology synoptic report
..... item 1..1 Reference(MII PR MTB Molecular Pathology Report | DiagnosticReport) Molecular Pathology Report
.... investigation:Einwilligung S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... code
...... coding 1..* Coding Code defined by a terminology system
Required Pattern: At least the following
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 105511-0
....... display 1..1 string Representation defined by the system
Fixed Value: Was consent given
..... item 1..1 Reference(MII PR MTB Consent) Consent
... Slices for supportingInfo 0..* Reference(Resource) Information supporting the clinical impression
Slice: Unordered, Open by profile:$this.resolve()
.... supportingInfo:Vorbefund S 0..* Reference(DiagnosticReport | Observation) Previous Finding
.... supportingInfo:Vortherapie S 0..* Reference(MII PR MTB Systemische Vortherapie | MII PR Onkologie Strahlentherapie | MII PR Onkologie Operation | MII PR Prozedur Procedure) Prior Therapy
..... Slices for extension Content/Rules for all slices
...... extension:LeitlinieDokumentation S 0..1 (Complex) Guideline Documentation
URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinie-dokumentation
.... supportingInfo:Therapieplan S 0..1 Reference(MII PR MTB Therapieplan | CarePlan) Therapy Plan

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ClinicalImpression 0..* ClinicalImpression A clinical assessment performed when planning treatments and management strategies for a patient
... id Σ 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 Σ 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 BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:LeitlinienbehandlungStatus S 0..1 Coding MII EX MTB Leitlinienbehandlung Status
URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinienbehandlung-status
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business identifier
... status ?!Σ 1..1 code in-progress | completed | entered-in-error
Binding: ClinicalImpressionStatus (required): The workflow state of a clinical impression.
... statusReason 0..1 CodeableConcept Reason for current status
Binding Description: (example): Codes identifying the reason for the current state of a clinical impression.
... code Σ 0..1 CodeableConcept Kind of assessment performed
Binding Description: (example): Identifies categories of clinical impressions. This is a place-holder only. It may be removed.
... description Σ 0..1 string Why/how the assessment was performed
... subject Σ 1..1 Reference(MII PR Person Patient | MII PR Person Patient (Pseudonymisiert)) Patient or group assessed
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... Slices for effective[x] Σ 1..1 Period Time of assessment
Slice: Unordered, Closed by type:$this
.... effective[x]:effectivePeriod SΣ 1..1 Period Treatment Episode Period
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... start ΣC 0..1 dateTime Inclusion Date
..... end SΣC 0..1 dateTime Completion Date
... date Σ 0..1 dateTime When the assessment was documented
... assessor Σ 0..1 Reference(Practitioner | PractitionerRole) The clinician performing the assessment
... previous 0..1 Reference(ClinicalImpression) Reference to last assessment
... Slices for problem SΣ 0..* Reference(Condition | AllergyIntolerance) Relevant impressions of patient state
Slice: Unordered, Open by type:$this
.... problem:PrimaertumorDiagnose SΣ 0..1 Reference(MII PR MTB Diagnose Primärtumor | Condition) Primary Tumor Diagnosis
... Slices for investigation 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
Slice: Unordered, Open by value:code.coding
.... investigation: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
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
..... item 0..* Reference(Observation | QuestionnaireResponse | FamilyMemberHistory | DiagnosticReport | RiskAssessment | ImagingStudy | Media) Record of a specific investigation
.... investigation:KrankengeschichteFamilie S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... 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 Σ 1..* Coding Code defined by a terminology system

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://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 416471007
....... display 1..1 string Representation defined by the system
Fixed Value: Family medical history
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... item 1..1 Reference(MII PR MolGen Familienanamnese | FamilyMemberHistory) Family Medical History
.... investigation:ECOG S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... 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 Σ 1..* Coding Code defined by a terminology system

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://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 424122007
....... display 1..1 string Representation defined by the system
Fixed Value: ECOG performance status finding
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... item 1..1 Reference(MII PR Onkologie Allgemeiner Leistungszustand ECOG | Observation) ECOG
.... investigation:NgsBericht S 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... 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 Σ 1..* Coding Code defined by a terminology system

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://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 106221001
....... display 1..1 string Representation defined by the system
Fixed Value: Genetic finding
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... item 1..1 Reference(MII PR MTB NGS-Bericht | DiagnosticReport) NGS Report
.... investigation:MolekularPathologieBefund S 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... 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 Σ 1..* Coding Code defined by a terminology system

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 1..1 code Symbol in syntax defined by the system
Fixed Value: 60568-3
....... display 1..1 string Representation defined by the system
Fixed Value: Pathology synoptic report
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... item 1..1 Reference(MII PR MTB Molecular Pathology Report | DiagnosticReport) Molecular Pathology Report
.... investigation:Einwilligung S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... 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 Σ 1..* Coding Code defined by a terminology system

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 1..1 code Symbol in syntax defined by the system
Fixed Value: 105511-0
....... display 1..1 string Representation defined by the system
Fixed Value: Was consent given
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... item 1..1 Reference(MII PR MTB Consent) Consent
... protocol 0..* uri Clinical Protocol followed
... summary 0..1 string Summary of the assessment
... finding 0..* BackboneElement Possible or likely findings and diagnoses
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... itemCodeableConcept 0..1 CodeableConcept What was found
Binding: Condition/Problem/DiagnosisCodes (example): Identification of the Condition or diagnosis.
.... itemReference 0..1 Reference(Condition | Observation | Media) What was found
.... basis 0..1 string Which investigations support finding
... prognosisCodeableConcept 0..* CodeableConcept Estimate of likely outcome
Binding: ClinicalImpressionPrognosis (example): Prognosis or outlook findings.
... prognosisReference 0..* Reference(RiskAssessment) RiskAssessment expressing likely outcome
... Slices for supportingInfo 0..* Reference(Resource) Information supporting the clinical impression
Slice: Unordered, Open by profile:$this.resolve()
.... supportingInfo:Vorbefund S 0..* Reference(DiagnosticReport | Observation) Previous Finding
.... supportingInfo:Vortherapie S 0..* Reference(MII PR MTB Systemische Vortherapie | MII PR Onkologie Strahlentherapie | MII PR Onkologie Operation | MII PR Prozedur Procedure) Prior Therapy
..... 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:LeitlinieDokumentation S 0..1 (Complex) Guideline Documentation
URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinie-dokumentation
..... reference ΣC 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 Σ 0..1 Identifier Logical reference, when literal reference is not known
..... display Σ 0..1 string Text alternative for the resource
.... supportingInfo:Therapieplan S 0..1 Reference(MII PR MTB Therapieplan | CarePlan) Therapy Plan
... note 0..* Annotation Comments made about the ClinicalImpression

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ClinicalImpression.meta.​security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
ClinicalImpression.meta.​tag Base example Common Tags 📍4.0.1 FHIR Std.
ClinicalImpression.language Base preferred Common Languages 📍4.0.1 FHIR Std.
ClinicalImpression.status Base required Clinical Impression Status 📍4.0.1 FHIR Std.
ClinicalImpression.statusReason Base example Not State Unknown
ClinicalImpression.code Base example Not State Unknown
ClinicalImpression.investigation.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:KrankengeschichteFamilie.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:ECOG.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:NgsBericht.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:MolekularPathologieBefund.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:Einwilligung.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.finding.​itemCodeableConcept Base example Condition/Problem/Diagnosis Codes 📍4.0.1 FHIR Std.
ClinicalImpression.prognosisCodeableConcept Base example Clinical Impression Prognosis 📍4.0.1 FHIR Std.
ClinicalImpression.supportingInfo:Vortherapie.​type Base extensible ResourceType 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ClinicalImpression If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ClinicalImpression 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 ClinicalImpression 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 ClinicalImpression If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ClinicalImpression 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())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Summary

Mandatory: 2 elements(10 nested mandatory elements)
Must-Support: 16 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of ClinicalImpression.effective[x]
  • The element 1 is sliced based on the value of ClinicalImpression.problem
  • The element 1 is sliced based on the value of ClinicalImpression.investigation
  • The element 1 is sliced based on the value of ClinicalImpression.supportingInfo

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ClinicalImpression 0..* ClinicalImpression A clinical assessment performed when planning treatments and management strategies for a patient
... meta SΣ 0..1 Meta Metadata about the resource
.... 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 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:LeitlinienbehandlungStatus S 0..1 Coding MII EX MTB Leitlinienbehandlung Status
URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinienbehandlung-status
... status ?!Σ 1..1 code in-progress | completed | entered-in-error
Binding: ClinicalImpressionStatus (required): The workflow state of a clinical impression.
... subject Σ 1..1 Reference(MII PR Person Patient | MII PR Person Patient (Pseudonymisiert)) Patient or group assessed
... Slices for effective[x] Σ 1..1 Period Time of assessment
Slice: Unordered, Closed by type:$this
.... effective[x]:effectivePeriod SΣ 1..1 Period Treatment Episode Period
..... start ΣC 0..1 dateTime Inclusion Date
..... end SΣC 0..1 dateTime Completion Date
... Slices for problem SΣ 0..* Reference(Condition | AllergyIntolerance) Relevant impressions of patient state
Slice: Unordered, Open by type:$this
.... problem:PrimaertumorDiagnose SΣ 0..1 Reference(MII PR MTB Diagnose Primärtumor | Condition) Primary Tumor Diagnosis
... Slices for investigation 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
Slice: Unordered, Open by value:code.coding
.... investigation:All Slices Content/Rules for all slices
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
.... investigation:KrankengeschichteFamilie S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... coding Σ 1..* Coding Code defined by a terminology system

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://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 416471007
....... display 1..1 string Representation defined by the system
Fixed Value: Family medical history
....... userSelected 0..1 boolean If this coding was chosen directly by the user
..... item 1..1 Reference(MII PR MolGen Familienanamnese | FamilyMemberHistory) Family Medical History
.... investigation:ECOG S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... coding Σ 1..* Coding Code defined by a terminology system

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://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 424122007
....... display 1..1 string Representation defined by the system
Fixed Value: ECOG performance status finding
....... userSelected 0..1 boolean If this coding was chosen directly by the user
..... item 1..1 Reference(MII PR Onkologie Allgemeiner Leistungszustand ECOG | Observation) ECOG
.... investigation:NgsBericht S 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... coding Σ 1..* Coding Code defined by a terminology system

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://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 106221001
....... display 1..1 string Representation defined by the system
Fixed Value: Genetic finding
....... userSelected 0..1 boolean If this coding was chosen directly by the user
..... item 1..1 Reference(MII PR MTB NGS-Bericht | DiagnosticReport) NGS Report
.... investigation:MolekularPathologieBefund S 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... coding Σ 1..* Coding Code defined by a terminology system

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 1..1 code Symbol in syntax defined by the system
Fixed Value: 60568-3
....... display 1..1 string Representation defined by the system
Fixed Value: Pathology synoptic report
....... userSelected 0..1 boolean If this coding was chosen directly by the user
..... item 1..1 Reference(MII PR MTB Molecular Pathology Report | DiagnosticReport) Molecular Pathology Report
.... investigation:Einwilligung S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... coding Σ 1..* Coding Code defined by a terminology system

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 1..1 code Symbol in syntax defined by the system
Fixed Value: 105511-0
....... display 1..1 string Representation defined by the system
Fixed Value: Was consent given
....... userSelected 0..1 boolean If this coding was chosen directly by the user
..... item 1..1 Reference(MII PR MTB Consent) Consent
... Slices for supportingInfo 0..* Reference(Resource) Information supporting the clinical impression
Slice: Unordered, Open by profile:$this.resolve()
.... supportingInfo:Vorbefund S 0..* Reference(DiagnosticReport | Observation) Previous Finding
.... supportingInfo:Vortherapie S 0..* Reference(MII PR MTB Systemische Vortherapie | MII PR Onkologie Strahlentherapie | MII PR Onkologie Operation | MII PR Prozedur Procedure) Prior Therapy
..... Slices for extension Content/Rules for all slices
...... extension:LeitlinieDokumentation S 0..1 (Complex) Guideline Documentation
URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinie-dokumentation
.... supportingInfo:Therapieplan S 0..1 Reference(MII PR MTB Therapieplan | CarePlan) Therapy Plan

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ClinicalImpression.status Base required Clinical Impression Status 📍4.0.1 FHIR Std.
ClinicalImpression.investigation.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:KrankengeschichteFamilie.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:ECOG.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:NgsBericht.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:MolekularPathologieBefund.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:Einwilligung.​code Base example Investigation Type 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ClinicalImpression If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ClinicalImpression 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 ClinicalImpression 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 ClinicalImpression If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ClinicalImpression 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())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ClinicalImpression 0..* ClinicalImpression A clinical assessment performed when planning treatments and management strategies for a patient
... meta S 0..1 Meta Metadata about the resource
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:LeitlinienbehandlungStatus S 0..1 Coding MII EX MTB Leitlinienbehandlung Status
URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinienbehandlung-status
... subject 1..1 Reference(MII PR Person Patient | MII PR Person Patient (Pseudonymisiert)) Patient or group assessed
.... effective[x]:effectivePeriod S 1..1 Period Treatment Episode Period
..... start 0..1 dateTime Inclusion Date
..... end S 0..1 dateTime Completion Date
... Slices for problem S 0..* Reference(Condition | AllergyIntolerance) Relevant impressions of patient state
Slice: Unordered, Open by type:$this
.... problem:PrimaertumorDiagnose S 0..1 Reference(MII PR MTB Diagnose Primärtumor | Condition) Primary Tumor Diagnosis
... Slices for investigation 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
Slice: Unordered, Open by value:code.coding
.... investigation:KrankengeschichteFamilie S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... code
...... coding 1..* Coding Code defined by a terminology system
Required Pattern: At least the following
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 416471007
....... display 1..1 string Representation defined by the system
Fixed Value: Family medical history
..... item 1..1 Reference(MII PR MolGen Familienanamnese | FamilyMemberHistory) Family Medical History
.... investigation:ECOG S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... code
...... coding 1..* Coding Code defined by a terminology system
Required Pattern: At least the following
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 424122007
....... display 1..1 string Representation defined by the system
Fixed Value: ECOG performance status finding
..... item 1..1 Reference(MII PR Onkologie Allgemeiner Leistungszustand ECOG | Observation) ECOG
.... investigation:NgsBericht S 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... code
...... coding 1..* Coding Code defined by a terminology system
Required Pattern: At least the following
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://snomed.info/sct
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 106221001
....... display 1..1 string Representation defined by the system
Fixed Value: Genetic finding
..... item 1..1 Reference(MII PR MTB NGS-Bericht | DiagnosticReport) NGS Report
.... investigation:MolekularPathologieBefund S 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... code
...... coding 1..* Coding Code defined by a terminology system
Required Pattern: At least the following
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 60568-3
....... display 1..1 string Representation defined by the system
Fixed Value: Pathology synoptic report
..... item 1..1 Reference(MII PR MTB Molecular Pathology Report | DiagnosticReport) Molecular Pathology Report
.... investigation:Einwilligung S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... code
...... coding 1..* Coding Code defined by a terminology system
Required Pattern: At least the following
....... system 1..1 uri Identity of the terminology system
Fixed Value: http://loinc.org
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 105511-0
....... display 1..1 string Representation defined by the system
Fixed Value: Was consent given
..... item 1..1 Reference(MII PR MTB Consent) Consent
... Slices for supportingInfo 0..* Reference(Resource) Information supporting the clinical impression
Slice: Unordered, Open by profile:$this.resolve()
.... supportingInfo:Vorbefund S 0..* Reference(DiagnosticReport | Observation) Previous Finding
.... supportingInfo:Vortherapie S 0..* Reference(MII PR MTB Systemische Vortherapie | MII PR Onkologie Strahlentherapie | MII PR Onkologie Operation | MII PR Prozedur Procedure) Prior Therapy
..... Slices for extension Content/Rules for all slices
...... extension:LeitlinieDokumentation S 0..1 (Complex) Guideline Documentation
URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinie-dokumentation
.... supportingInfo:Therapieplan S 0..1 Reference(MII PR MTB Therapieplan | CarePlan) Therapy Plan

doco Documentation for this format

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ClinicalImpression 0..* ClinicalImpression A clinical assessment performed when planning treatments and management strategies for a patient
... id Σ 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 Σ 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 BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:LeitlinienbehandlungStatus S 0..1 Coding MII EX MTB Leitlinienbehandlung Status
URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinienbehandlung-status
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business identifier
... status ?!Σ 1..1 code in-progress | completed | entered-in-error
Binding: ClinicalImpressionStatus (required): The workflow state of a clinical impression.
... statusReason 0..1 CodeableConcept Reason for current status
Binding Description: (example): Codes identifying the reason for the current state of a clinical impression.
... code Σ 0..1 CodeableConcept Kind of assessment performed
Binding Description: (example): Identifies categories of clinical impressions. This is a place-holder only. It may be removed.
... description Σ 0..1 string Why/how the assessment was performed
... subject Σ 1..1 Reference(MII PR Person Patient | MII PR Person Patient (Pseudonymisiert)) Patient or group assessed
... encounter Σ 0..1 Reference(Encounter) Encounter created as part of
... Slices for effective[x] Σ 1..1 Period Time of assessment
Slice: Unordered, Closed by type:$this
.... effective[x]:effectivePeriod SΣ 1..1 Period Treatment Episode Period
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
..... start ΣC 0..1 dateTime Inclusion Date
..... end SΣC 0..1 dateTime Completion Date
... date Σ 0..1 dateTime When the assessment was documented
... assessor Σ 0..1 Reference(Practitioner | PractitionerRole) The clinician performing the assessment
... previous 0..1 Reference(ClinicalImpression) Reference to last assessment
... Slices for problem SΣ 0..* Reference(Condition | AllergyIntolerance) Relevant impressions of patient state
Slice: Unordered, Open by type:$this
.... problem:PrimaertumorDiagnose SΣ 0..1 Reference(MII PR MTB Diagnose Primärtumor | Condition) Primary Tumor Diagnosis
... Slices for investigation 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
Slice: Unordered, Open by value:code.coding
.... investigation: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
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
..... item 0..* Reference(Observation | QuestionnaireResponse | FamilyMemberHistory | DiagnosticReport | RiskAssessment | ImagingStudy | Media) Record of a specific investigation
.... investigation:KrankengeschichteFamilie S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... 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 Σ 1..* Coding Code defined by a terminology system

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://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 416471007
....... display 1..1 string Representation defined by the system
Fixed Value: Family medical history
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... item 1..1 Reference(MII PR MolGen Familienanamnese | FamilyMemberHistory) Family Medical History
.... investigation:ECOG S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... 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 Σ 1..* Coding Code defined by a terminology system

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://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 424122007
....... display 1..1 string Representation defined by the system
Fixed Value: ECOG performance status finding
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... item 1..1 Reference(MII PR Onkologie Allgemeiner Leistungszustand ECOG | Observation) ECOG
.... investigation:NgsBericht S 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... 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 Σ 1..* Coding Code defined by a terminology system

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://snomed.info/sct
....... version 0..1 string Version of the system - if relevant
....... code 1..1 code Symbol in syntax defined by the system
Fixed Value: 106221001
....... display 1..1 string Representation defined by the system
Fixed Value: Genetic finding
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... item 1..1 Reference(MII PR MTB NGS-Bericht | DiagnosticReport) NGS Report
.... investigation:MolekularPathologieBefund S 0..* BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... 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 Σ 1..* Coding Code defined by a terminology system

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 1..1 code Symbol in syntax defined by the system
Fixed Value: 60568-3
....... display 1..1 string Representation defined by the system
Fixed Value: Pathology synoptic report
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... item 1..1 Reference(MII PR MTB Molecular Pathology Report | DiagnosticReport) Molecular Pathology Report
.... investigation:Einwilligung S 0..1 BackboneElement One or more sets of investigations (signs, symptoms, etc.)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... code 1..1 CodeableConcept A name/code for the set
Binding: InvestigationType (example): A name/code for a set of investigations.
...... 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 Σ 1..* Coding Code defined by a terminology system

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 1..1 code Symbol in syntax defined by the system
Fixed Value: 105511-0
....... display 1..1 string Representation defined by the system
Fixed Value: Was consent given
....... userSelected 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... item 1..1 Reference(MII PR MTB Consent) Consent
... protocol 0..* uri Clinical Protocol followed
... summary 0..1 string Summary of the assessment
... finding 0..* BackboneElement Possible or likely findings and diagnoses
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... itemCodeableConcept 0..1 CodeableConcept What was found
Binding: Condition/Problem/DiagnosisCodes (example): Identification of the Condition or diagnosis.
.... itemReference 0..1 Reference(Condition | Observation | Media) What was found
.... basis 0..1 string Which investigations support finding
... prognosisCodeableConcept 0..* CodeableConcept Estimate of likely outcome
Binding: ClinicalImpressionPrognosis (example): Prognosis or outlook findings.
... prognosisReference 0..* Reference(RiskAssessment) RiskAssessment expressing likely outcome
... Slices for supportingInfo 0..* Reference(Resource) Information supporting the clinical impression
Slice: Unordered, Open by profile:$this.resolve()
.... supportingInfo:Vorbefund S 0..* Reference(DiagnosticReport | Observation) Previous Finding
.... supportingInfo:Vortherapie S 0..* Reference(MII PR MTB Systemische Vortherapie | MII PR Onkologie Strahlentherapie | MII PR Onkologie Operation | MII PR Prozedur Procedure) Prior Therapy
..... 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:LeitlinieDokumentation S 0..1 (Complex) Guideline Documentation
URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-leitlinie-dokumentation
..... reference ΣC 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 Σ 0..1 Identifier Logical reference, when literal reference is not known
..... display Σ 0..1 string Text alternative for the resource
.... supportingInfo:Therapieplan S 0..1 Reference(MII PR MTB Therapieplan | CarePlan) Therapy Plan
... note 0..* Annotation Comments made about the ClinicalImpression

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ClinicalImpression.meta.​security Base extensible SecurityLabels 📍4.0.1 FHIR Std.
ClinicalImpression.meta.​tag Base example Common Tags 📍4.0.1 FHIR Std.
ClinicalImpression.language Base preferred Common Languages 📍4.0.1 FHIR Std.
ClinicalImpression.status Base required Clinical Impression Status 📍4.0.1 FHIR Std.
ClinicalImpression.statusReason Base example Not State Unknown
ClinicalImpression.code Base example Not State Unknown
ClinicalImpression.investigation.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:KrankengeschichteFamilie.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:ECOG.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:NgsBericht.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:MolekularPathologieBefund.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.investigation:Einwilligung.​code Base example Investigation Type 📍4.0.1 FHIR Std.
ClinicalImpression.finding.​itemCodeableConcept Base example Condition/Problem/Diagnosis Codes 📍4.0.1 FHIR Std.
ClinicalImpression.prognosisCodeableConcept Base example Clinical Impression Prognosis 📍4.0.1 FHIR Std.
ClinicalImpression.supportingInfo:Vortherapie.​type Base extensible ResourceType 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ClinicalImpression If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ClinicalImpression 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 ClinicalImpression 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 ClinicalImpression If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ClinicalImpression 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())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()

Summary

Mandatory: 2 elements(10 nested mandatory elements)
Must-Support: 16 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of ClinicalImpression.effective[x]
  • The element 1 is sliced based on the value of ClinicalImpression.problem
  • The element 1 is sliced based on the value of ClinicalImpression.investigation
  • The element 1 is sliced based on the value of ClinicalImpression.supportingInfo

 

Other representations of profile: CSV, Excel, Schematron