MII IG Kerndatensatz-Modul Onkologie
2027.0.0-ballot.1 - Germany

This page is part of the MII IG Kerndatensatz-Modul Onkologie (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

Ressourcenprofil: MII PR Onkologie TNM-Klassifikation

Offizielle URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-tnm-klassifikation Version: 2027.0.0-ballot.1
Active Stand: 2026-09-15 Maschinenlesbarer Name: MII_PR_Onko_TNM_Klassifikation

TNM-Klassifikation: Grouper-Profil für Komponenten der TNM-Klassifikation.

Dieses Profil ist das Gruppierungsprofil für eine TNM-Klassifikation in der Onkologie.

Das Profil enthält das Referenzdatum und dient als Ankerpunkt für alle weiteren TNM-Einzelbeobachtungen zu diesem Zeitpunkt. Das Element hasMember enthält Referenzen zu allen verbundenen TNM-Einzelbeobachtungen.

Außerdem wird im Element value das UICC-Staging kodiert, dass von den untergeordneten TNM-Beobachtungen abgeleitet ist.

Erscheinungsformen der TNM-Klassifikation

Eine TNM-Klassifikation tritt im Behandlungsverlauf in verschiedenen Erscheinungsformen auf. Diese werden nicht über den oBDS-Meldeanlass unterschieden, sondern ausschließlich über zwei Achsen der FHIR-Repräsentation:

  1. die Code-Achse des Gruppierungsprofils — Observation.code ist an das ValueSet mii-vs-onko-tnm-klassifikation-typ gebunden und trägt SNOMED CT 399537006 "Clinical TNM stage grouping", 399588009 "Pathologic TNM stage grouping" oder 399703000 "Integrated TNM category";
  2. die Präfix-Modifier der einzelnen Kategorien — das c/p/u-Präfix als Extension auf Observation.code der Kategorie-Beobachtung sowie die UICC-Präfixe y, r und a als modifierExtension an der jeweiligen T-, N- bzw. M-Beobachtung.

Der Meldeanlass ist lediglich der typische Auslöser, aus dem sich die Erscheinungsform ergibt — er ist kein Unterscheidungsmerkmal und wird in der Ressource nicht abgebildet.

(1) Klinisches Staging (typischer Auslöser: Diagnose-Meldung). code = 399537006 "Clinical TNM stage grouping", die Kategorien tragen das c-Präfix. Das UICC-Stadium ist in aller Regel vorhanden, da klinisch alle drei Achsen T, N und M beurteilt werden.

(2) Pathologisches Staging (typischer Auslöser: Pathologie- oder OP-Meldung). code = 399588009 "Pathologic TNM stage grouping", die Kategorien tragen das p-Präfix, bei neoadjuvanter Vorbehandlung zusätzlich den y-Modifier (ypT, ypN). Ein UICC-Stadium wird hier typischerweise nicht angegeben: value ist im Meldungs-Panel bewusst mit 0..1 modelliert, da ein pathologisches Staging allein kein Stadium liefern kann — die M-Kategorie stammt in der Regel aus der klinischen Beurteilung.

(3) Verlauf (typischer Auslöser: Verlaufs-Meldung). Die Erscheinungsform ist variabel. Meist handelt es sich um ein erneutes klinisches Re-Staging (code = clinical), bei oder nach laufender Therapie ergänzt um den y-Modifier. Bei einem Rezidiv kommt der r-Modifier hinzu — dieser hängt am Tumorstatus, nicht am Meldeanlass, und kann daher auch außerhalb einer Verlaufs-Meldung auftreten. Erfolgt im Verlauf eine erneute Operation, kann die Klassifikation auch pathologisch sein.

(4) Synthetisierte bzw. integrierte Klassifikation. Hierfür existiert ein eigenes Profil mii-pr-onko-tnm-klassifikation-synthetisiert mit fixem code = 399703000 "Integrated TNM category". Es führt die Kategorien aus mehreren Quell-Klassifikationen zu einem kohärenten Stand zum Entscheidungszeitpunkt zusammen — auch gemischt, z. B. ypT und ypN aus der Pathologie mit cM aus der Klinik. Das UICC-Stadium ist hier verpflichtend (value 1..1), und derivedFrom referenziert verpflichtend die zugrunde liegenden Quell-Klassifikationen.

Erscheinungsform Observation.code Kategorie-Präfixe UICC-Stadium (value) Profil
Klinisches Staging 399537006 clinical c meist vorhanden mii-pr-onko-tnm-klassifikation
Pathologisches Staging 399588009 pathologic p, yp i. d. R. nicht vorhanden (0..1) mii-pr-onko-tnm-klassifikation
Verlauf clinical, ggf. pathologic c/p, y bei/nach Therapie, r bei Rezidiv variabel mii-pr-onko-tnm-klassifikation
Synthetisiert / integriert 399703000 integrated gemischt (z. B. ypT + cN) verpflichtend (1..1) mii-pr-onko-tnm-klassifikation-synthetisiert

Die Präfixe y, r und a sind als modifierExtension modelliert, weil sie die Interpretation des Kategorie-Wertes verändern: ypT2 ist nicht gleichbedeutend mit pT2. Verarbeitende Systeme müssen diese Extensions kennen und dürfen eine Kategorie nicht ohne Auswertung des Präfixes interpretieren.

Beispiele

mii-exa-onko-tnm-klassifikation-TisN0M0

mii-exa-onko-tnm-klassifikation-uT2a2pN0023i-sncM1

Wie Präfixe, Symbole und Kategoriewerte kodiert werden

Für strukturell ähnlich aussehende Angaben verwendet das Modul bewusst drei verschiedene Mechanismen — maßgeblich ist, ob die Angabe binär, wertetragend oder die Kategorie selbst ist:

Angabe Semantik Abbildung
c/p-Präfix Wie wurde die Kategorie festgestellt? Extension am code der Kategorie
y-, r-, a-Präfix binäres Präfix — trifft zu oder nicht (multimodale Vortherapie, Rezidiv, Autopsie) modifierExtension an der jeweiligen Kategorie (sie verändern die Interpretation des Werts)
(m)-Suffix wertetragend: multiple Primärtumoren, oBDS 8.10 — (m), (2), (3), (4) component[multipleTumoren] an der T-Kategorie (LOINC 42030-7 als Component-Code, Wert aus dem UICC-CodeSystem) — das Suffix ist T-exklusiv
Kategoriewert (T2, N0, M1c …) die Kategorie selbst Dual-Coding im valueCodeableConcept: uicc (1..1) + optional snomed-ct (0..1)

Warum das (m)-Symbol anders aussieht als y/r/a. Es ist kein Präsenz-Flag, sondern trägt eine Ausprägung: Bei (3) sind drei simultane Primärtumoren gemeint. Ein modifierExtension ohne Wert würde diese Information verlieren. Für die Zählvarianten (2)/(3)/(4) existiert zudem kein SNOMED-CT-Äquivalent, weshalb hier — anders als bei den Kategorien — kein Dual-Coding angeboten wird.

Hinweis zu den früheren Symbol-Profilen. Bis einschließlich v2026 gab es für y, r, a und (m) eigene Observation-Profile. Sie sind ab v2027 deprecated (status = retired); die Präfixe y/r/a werden als modifierExtension an den Kategorien geführt, das m-Suffix als Component der T-Kategorie. Bestandsdaten bleiben lesbar, für Neuimplementierungen sind die modifierExtensions zu verwenden.

Usages:

You can also check for usages in the FHIR IG Statistics

Formale Ansichten des Profilinhalts

Beschreibung von Profilen, Differentials, Snapshots und deren Repräsentationen.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
... meta Σ 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
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: MII VS Onkologie TNM Klassifikation Typ (required)
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
... focus SΣ 0..* Reference(MII PR Onkologie Diagnose Primärtumor) What the observation is about, when it is not about the subject of record
... encounter SΣ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] SΣC 0..1 dateTime TNM-Datum
Constraints: tnm-datum
... value[x] SΣC 0..1 CodeableConcept Actual result
Binding: MII VS Onkologie TNM UICC Stadium (required)
.... coding Σ 0..* Coding UICC Stadium
..... system SΣ 1..1 uri Identity of the terminology system
..... code SΣ 1..1 code Symbol in syntax defined by the system
... method S 0..1 CodeableConcept TNM Version
Binding: MII VS Onkologie TNM Version (required)
.... coding Σ 0..* Coding TNM-Version
... specimen S 0..1 Reference(MII PR Onkologie Specimen | Specimen) Specimen used for this observation
... hasMember SΣ 0..* Reference(MII PR Onkologie TNM L-Kategorie | MII PR Onkologie TNM M-Kategorie | MII PR Onkologie TNM m-Symbol | MII PR Onkologie TNM N-Kategorie | MII PR Onkologie TNM T-Kategorie | MII PR Onkologie TNM Pn-Kategorie | MII PR Onkologie TNM S-Kategorie | MII PR Onkologie TNM V-Kategorie | MII PR Onkologie TNM a-Symbol | MII PR Onkologie TNM r-Symbol | MII PR Onkologie TNM y-Symbol) Related resource that belongs to the Observation group

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.code Base required MII VS Onkologie TNM Klassifikation Typ 📦2027.0.0-ballot.1 This IG
Observation.value[x] Base required MII VS Onkologie TNM UICC Stadium 📦2027.0.0-ballot.1 This IG
Observation.method Base required MII VS Onkologie TNM Version 📦2027.0.0-ballot.1 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())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.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()
tnm-datum error Observation.effective[x] TNM Datum: Ein exaktes (taggenaues) Datum ist anzugeben. $this.toString().length() >= 8

Diese Struktur ist abgeleitet von Observation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* Observation Measurements and simple assertions
... meta
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
... status S 1..1 code registered | preliminary | final | amended +
... code S 1..1 CodeableConcept Type of observation (code / type)
Binding: MII VS Onkologie TNM Klassifikation Typ (required)
... focus S 0..* Reference(MII PR Onkologie Diagnose Primärtumor) What the observation is about, when it is not about the subject of record
... encounter S 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] SC 0..1 dateTime TNM-Datum
Constraints: tnm-datum
... value[x] S 0..1 CodeableConcept Actual result
Binding: MII VS Onkologie TNM UICC Stadium (required)
.... coding 0..* Coding UICC Stadium
..... system S 1..1 uri Identity of the terminology system
..... code S 1..1 code Symbol in syntax defined by the system
... method S 0..1 CodeableConcept TNM Version
Binding: MII VS Onkologie TNM Version (required)
.... coding 0..* Coding TNM-Version
... specimen S 0..1 Reference(MII PR Onkologie Specimen | Specimen) Specimen used for this observation
... hasMember S 0..* Reference(MII PR Onkologie TNM L-Kategorie | MII PR Onkologie TNM M-Kategorie | MII PR Onkologie TNM m-Symbol | MII PR Onkologie TNM N-Kategorie | MII PR Onkologie TNM T-Kategorie | MII PR Onkologie TNM Pn-Kategorie | MII PR Onkologie TNM S-Kategorie | MII PR Onkologie TNM V-Kategorie | MII PR Onkologie TNM a-Symbol | MII PR Onkologie TNM r-Symbol | MII PR Onkologie TNM y-Symbol) Related resource that belongs to the Observation group

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.code Base required MII VS Onkologie TNM Klassifikation Typ 📦2027.0.0-ballot.1 This IG
Observation.value[x] Base required MII VS Onkologie TNM UICC Stadium 📦2027.0.0-ballot.1 This IG
Observation.method Base required MII VS Onkologie TNM Version 📦2027.0.0-ballot.1 This IG

Constraints

Id Grade Path(s) Description Expression
tnm-datum error Observation.effective[x] TNM Datum: Ein exaktes (taggenaues) Datum ist anzugeben. $this.toString().length() >= 8
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
... id Σ 0..1 id Logical id of this artifact
... meta Σ 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
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!SΣ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
... category 0..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: MII VS Onkologie TNM Klassifikation Typ (required)
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
... focus SΣ 0..* Reference(MII PR Onkologie Diagnose Primärtumor) What the observation is about, when it is not about the subject of record
... encounter SΣ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] SΣC 0..1 dateTime TNM-Datum
Constraints: tnm-datum
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... value[x] SΣC 0..1 CodeableConcept Actual result
Binding: MII VS Onkologie TNM UICC Stadium (required)
.... 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 0..* Coding UICC Stadium
..... 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 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
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method S 0..1 CodeableConcept TNM Version
Binding: MII VS Onkologie TNM Version (required)
.... 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 0..* Coding TNM-Version
.... text Σ 0..1 string Plain text representation of the concept
... specimen S 0..1 Reference(MII PR Onkologie Specimen | Specimen) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... 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
.... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember SΣ 0..* Reference(MII PR Onkologie TNM L-Kategorie | MII PR Onkologie TNM M-Kategorie | MII PR Onkologie TNM m-Symbol | MII PR Onkologie TNM N-Kategorie | MII PR Onkologie TNM T-Kategorie | MII PR Onkologie TNM Pn-Kategorie | MII PR Onkologie TNM S-Kategorie | MII PR Onkologie TNM V-Kategorie | MII PR Onkologie TNM a-Symbol | MII PR Onkologie TNM r-Symbol | MII PR Onkologie TNM y-Symbol) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
... component Σ 0..* BackboneElement Component results
.... 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 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

doco 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.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base required MII VS Onkologie TNM Klassifikation Typ 📦2027.0.0-ballot.1 This IG
Observation.value[x] Base required MII VS Onkologie TNM UICC Stadium 📦2027.0.0-ballot.1 This IG
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base required MII VS Onkologie TNM Version 📦2027.0.0-ballot.1 This IG
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())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.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()
tnm-datum error Observation.effective[x] TNM Datum: Ein exaktes (taggenaues) Datum ist anzugeben. $this.toString().length() >= 8

Diese Struktur ist abgeleitet von Observation

Summary

Mandatory: 1 element(2 nested mandatory elements)
Must-Support: 13 elements

Structures

This structure refers to these other structures:

Schlüsselelemente-Ansicht

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
... meta Σ 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
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: MII VS Onkologie TNM Klassifikation Typ (required)
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
... focus SΣ 0..* Reference(MII PR Onkologie Diagnose Primärtumor) What the observation is about, when it is not about the subject of record
... encounter SΣ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] SΣC 0..1 dateTime TNM-Datum
Constraints: tnm-datum
... value[x] SΣC 0..1 CodeableConcept Actual result
Binding: MII VS Onkologie TNM UICC Stadium (required)
.... coding Σ 0..* Coding UICC Stadium
..... system SΣ 1..1 uri Identity of the terminology system
..... code SΣ 1..1 code Symbol in syntax defined by the system
... method S 0..1 CodeableConcept TNM Version
Binding: MII VS Onkologie TNM Version (required)
.... coding Σ 0..* Coding TNM-Version
... specimen S 0..1 Reference(MII PR Onkologie Specimen | Specimen) Specimen used for this observation
... hasMember SΣ 0..* Reference(MII PR Onkologie TNM L-Kategorie | MII PR Onkologie TNM M-Kategorie | MII PR Onkologie TNM m-Symbol | MII PR Onkologie TNM N-Kategorie | MII PR Onkologie TNM T-Kategorie | MII PR Onkologie TNM Pn-Kategorie | MII PR Onkologie TNM S-Kategorie | MII PR Onkologie TNM V-Kategorie | MII PR Onkologie TNM a-Symbol | MII PR Onkologie TNM r-Symbol | MII PR Onkologie TNM y-Symbol) Related resource that belongs to the Observation group

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.code Base required MII VS Onkologie TNM Klassifikation Typ 📦2027.0.0-ballot.1 This IG
Observation.value[x] Base required MII VS Onkologie TNM UICC Stadium 📦2027.0.0-ballot.1 This IG
Observation.method Base required MII VS Onkologie TNM Version 📦2027.0.0-ballot.1 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())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.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()
tnm-datum error Observation.effective[x] TNM Datum: Ein exaktes (taggenaues) Datum ist anzugeben. $this.toString().length() >= 8

Differential-Ansicht

Diese Struktur ist abgeleitet von Observation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* Observation Measurements and simple assertions
... meta
.... profile S 0..* canonical(StructureDefinition) Profiles this resource claims to conform to
... status S 1..1 code registered | preliminary | final | amended +
... code S 1..1 CodeableConcept Type of observation (code / type)
Binding: MII VS Onkologie TNM Klassifikation Typ (required)
... focus S 0..* Reference(MII PR Onkologie Diagnose Primärtumor) What the observation is about, when it is not about the subject of record
... encounter S 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] SC 0..1 dateTime TNM-Datum
Constraints: tnm-datum
... value[x] S 0..1 CodeableConcept Actual result
Binding: MII VS Onkologie TNM UICC Stadium (required)
.... coding 0..* Coding UICC Stadium
..... system S 1..1 uri Identity of the terminology system
..... code S 1..1 code Symbol in syntax defined by the system
... method S 0..1 CodeableConcept TNM Version
Binding: MII VS Onkologie TNM Version (required)
.... coding 0..* Coding TNM-Version
... specimen S 0..1 Reference(MII PR Onkologie Specimen | Specimen) Specimen used for this observation
... hasMember S 0..* Reference(MII PR Onkologie TNM L-Kategorie | MII PR Onkologie TNM M-Kategorie | MII PR Onkologie TNM m-Symbol | MII PR Onkologie TNM N-Kategorie | MII PR Onkologie TNM T-Kategorie | MII PR Onkologie TNM Pn-Kategorie | MII PR Onkologie TNM S-Kategorie | MII PR Onkologie TNM V-Kategorie | MII PR Onkologie TNM a-Symbol | MII PR Onkologie TNM r-Symbol | MII PR Onkologie TNM y-Symbol) Related resource that belongs to the Observation group

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Observation.code Base required MII VS Onkologie TNM Klassifikation Typ 📦2027.0.0-ballot.1 This IG
Observation.value[x] Base required MII VS Onkologie TNM UICC Stadium 📦2027.0.0-ballot.1 This IG
Observation.method Base required MII VS Onkologie TNM Version 📦2027.0.0-ballot.1 This IG

Constraints

Id Grade Path(s) Description Expression
tnm-datum error Observation.effective[x] TNM Datum: Ein exaktes (taggenaues) Datum ist anzugeben. $this.toString().length() >= 8

Snapshot-AnsichtView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7
... id Σ 0..1 id Logical id of this artifact
... meta Σ 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
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy) Part of referenced event
... status ?!SΣ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
... category 0..* CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
... code SΣ 1..1 CodeableConcept Type of observation (code / type)
Binding: MII VS Onkologie TNM Klassifikation Typ (required)
... subject SΣ 1..1 Reference(Patient) Who and/or what the observation is about
... focus SΣ 0..* Reference(MII PR Onkologie Diagnose Primärtumor) What the observation is about, when it is not about the subject of record
... encounter SΣ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] SΣC 0..1 dateTime TNM-Datum
Constraints: tnm-datum
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... value[x] SΣC 0..1 CodeableConcept Actual result
Binding: MII VS Onkologie TNM UICC Stadium (required)
.... 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 0..* Coding UICC Stadium
..... 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 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
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..* CodeableConcept High, low, normal, etc.
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note 0..* Annotation Comments about the observation
... bodySite 0..1 CodeableConcept Observed body part
Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
... method S 0..1 CodeableConcept TNM Version
Binding: MII VS Onkologie TNM Version (required)
.... 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 0..* Coding TNM-Version
.... text Σ 0..1 string Plain text representation of the concept
... specimen S 0..1 Reference(MII PR Onkologie Specimen | Specimen) Specimen used for this observation
... device 0..1 Reference(Device | DeviceMetric) (Measurement) Device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... 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
.... low C 0..1 SimpleQuantity(4.0.1) Low Range, if relevant
.... high C 0..1 SimpleQuantity(4.0.1) High Range, if relevant
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text 0..1 string Text based reference range in an observation
... hasMember SΣ 0..* Reference(MII PR Onkologie TNM L-Kategorie | MII PR Onkologie TNM M-Kategorie | MII PR Onkologie TNM m-Symbol | MII PR Onkologie TNM N-Kategorie | MII PR Onkologie TNM T-Kategorie | MII PR Onkologie TNM Pn-Kategorie | MII PR Onkologie TNM S-Kategorie | MII PR Onkologie TNM V-Kategorie | MII PR Onkologie TNM a-Symbol | MII PR Onkologie TNM r-Symbol | MII PR Onkologie TNM y-Symbol) Related resource that belongs to the Observation group
... derivedFrom Σ 0..* Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence) Related measurements the observation is made from
... component Σ 0..* BackboneElement Component results
.... 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 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

doco 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.status Base required ObservationStatus 📍4.0.1 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍4.0.1 FHIR Std.
Observation.code Base required MII VS Onkologie TNM Klassifikation Typ 📦2027.0.0-ballot.1 This IG
Observation.value[x] Base required MII VS Onkologie TNM UICC Stadium 📦2027.0.0-ballot.1 This IG
Observation.dataAbsentReason Base extensible DataAbsentReason 📍4.0.1 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍4.0.1 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍4.0.1 FHIR Std.
Observation.method Base required MII VS Onkologie TNM Version 📦2027.0.0-ballot.1 This IG
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())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.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()
tnm-datum error Observation.effective[x] TNM Datum: Ein exaktes (taggenaues) Datum ist anzugeben. $this.toString().length() >= 8

Diese Struktur ist abgeleitet von Observation

Summary

Mandatory: 1 element(2 nested mandatory elements)
Must-Support: 13 elements

Structures

This structure refers to these other structures:

 

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