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

Resource Profile: MII PR Onkologie TNM-Klassifikation

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

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

This profile is the grouping profile for a TNM classification in oncology.

The profile carries the reference date and serves as the anchor point for all further individual TNM observations at that point in time. The element hasMember contains references to all associated individual TNM observations.

In addition, the element value codes the UICC staging that is derived from the subordinate TNM observations.

Manifestations of the TNM classification

A TNM classification occurs in different manifestations over the course of treatment. These are not distinguished by the oBDS reporting occasion, but exclusively by two axes of the FHIR representation:

  1. the code axis of the grouping profile — Observation.code is bound to the value set mii-vs-onko-tnm-klassifikation-typ and carries SNOMED CT 399537006 "Clinical TNM stage grouping", 399588009 "Pathologic TNM stage grouping" or 399703000 "Integrated TNM category";
  2. the prefix modifiers of the individual categories — the c/p/u prefix as an extension on Observation.code of the category observation, and the UICC prefixes y, r and a as modifierExtension on the respective T, N or M observation.

The reporting occasion is merely the typical trigger from which the manifestation results — it is not a distinguishing feature and is not represented in the resource.

(1) Clinical staging (typical trigger: diagnosis report). code = 399537006 "Clinical TNM stage grouping", the categories carry the c prefix. The UICC stage is present as a rule, because all three axes T, N and M are assessed clinically.

(2) Pathological staging (typical trigger: pathology or surgery report). code = 399588009 "Pathologic TNM stage grouping", the categories carry the p prefix, and in the case of neoadjuvant pretreatment additionally the y modifier (ypT, ypN). A UICC stage is typically not given here: value is deliberately modelled as 0..1 in the report panel, because a pathological staging alone cannot yield a stage — the M category usually originates from the clinical assessment.

(3) Course of disease (typical trigger: follow-up report). The manifestation is variable. Usually this is a renewed clinical re-staging (code = clinical), supplemented by the y modifier during or after ongoing therapy. In the case of a recurrence the r modifier is added — this depends on the tumour status, not on the reporting occasion, and can therefore also occur outside a follow-up report. If a further operation takes place during the course of disease, the classification may also be pathological.

(4) Synthesised or integrated classification. A separate profile mii-pr-onko-tnm-klassifikation-synthetisiert exists for this, with a fixed code = 399703000 "Integrated TNM category". It merges the categories from several source classifications into a coherent state at the time of decision — including mixed cases, e.g. ypT and ypN from pathology together with cM from the clinical assessment. Here the UICC stage is mandatory (value 1..1), and derivedFrom mandatorily references the underlying source classifications.

Manifestation Observation.code Category prefixes UICC stage (value) Profile
Clinical staging 399537006 clinical c usually present mii-pr-onko-tnm-klassifikation
Pathological staging 399588009 pathologic p, yp as a rule not present (0..1) mii-pr-onko-tnm-klassifikation
Course of disease clinical, possibly pathologic c/p, y during/after therapy, r on recurrence variable mii-pr-onko-tnm-klassifikation
Synthesised / integrated 399703000 integrated mixed (e.g. ypT + cN) mandatory (1..1) mii-pr-onko-tnm-klassifikation-synthetisiert

The prefixes y, r and a are modelled as a modifierExtension, because they change the interpretation of the category value: ypT2 is not equivalent to pT2. Processing systems must know these extensions and must not interpret a category without evaluating the prefix.

Examples

mii-exa-onko-tnm-klassifikation-TisN0M0

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

How prefixes, symbols and category values are coded

For statements that look structurally similar the module deliberately uses three different mechanisms — what matters is whether the statement is binary, value-bearing, or the category itself:

Statement Semantics Representation
c/p prefix how was the category established? extension on the category's code
y, r, a prefix binary prefix — applies or not (multimodal pre-treatment, recurrence, autopsy) modifierExtension on the respective category (they change how the value is interpreted)
(m) suffix value-bearing: multiple primary tumours, oBDS 8.10 — (m), (2), (3), (4) component[multipleTumoren] on the T category (LOINC 42030-7 as component code, value from the UICC code system) — the suffix is T-exclusive
category value (T2, N0, M1c …) the category itself dual coding in valueCodeableConcept: uicc (1..1) plus optional snomed-ct (0..1)

Why the (m) symbol looks different from y/r/a. It is not a presence flag but carries a value: (3) means three simultaneous primary tumours. A modifierExtension without a value would lose that information. In addition, no SNOMED CT equivalent exists for the counting variants (2)/(3)/(4), which is why — unlike for the categories — no dual coding is offered here.

Note on the former symbol profiles. Up to and including v2026 there were dedicated Observation profiles for y, r, a and (m). They are deprecated as of v2027 (status = retired); the prefixes y/r/a are carried as modifierExtension on the categories, the m suffix as a component of the T category. Legacy data remains readable; new implementations should use the modifier extensions.

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
.. 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

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

Summary

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

Structures

This structure refers to these other structures:

Key Elements View

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 View

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 ViewView

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

Summary

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

Structures

This structure refers to these other structures:

 

Other representations of profile: CSV, Excel, Schematron