Context

This profile describes a follow-up observation in the context of oncological therapy.

In the oBDS, the follow-up report ("Verlaufsmeldung") is one of several report types. The follow-up report can contain several other report contents. In the present FHIR profiling, follow-up observations are, alongside tumor boards, one of the two decisive resource types used for the temporal modeling of the treatment course.

The correct coding and interpretation of cancer registry follow-up data is not trivial - details can be found in the documentation guide of the Plattform §65c.

https://plattform65c.atlassian.net/wiki/spaces/Dokumentat/pages/75628552/Verlaufsmeldung

Conformance Statements

• A follow-up observation SHOULD have a reference to the primary diagnosis via focus
• A follow-up observation SHOULD additionally contain in value an assessment of the disease progression (PD, PR, MR, etc.), provided this assessment has been made and is present in the data
• A follow-up observation SHOULD furthermore contain in component assessments of the staging of the tumor, the lymph nodes and the distant metastases, provided these have been made and are relevant for the staging
• Since the FHIR profiling does not represent a complete follow-up report, other observations that are relevant for staging in addition to or differing from the TNM criteria mentioned above SHOULD be referenced from the follow-up observation via hasMember. Examples include newly diagnosed distant metastases, additionally performed histologies, or genetic tests carried out later in the course. These observations MAY be taken directly from the oBDS report contents of the respective follow-up report.

Mapping dataset to FHIR

The mapping of the dataset fields is documented in the logical model: MII LM Onkologie.

Mapping Einheitlicher onkologischer Basisdatensatz (oBDS) to FHIR

The oBDS mappings are recorded in the artefact view of this profile: MII PR Onkologie Verlauf.

Examples

mii-exa-onko-verlauf-tumor

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
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
identifier	SΣ	0..*	Identifier	Business Identifier for observation
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
coding	Σ	0..*	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: 396432002
display		1..1	string	Representation defined by the system Fixed Value: Status of regression of tumor (observable entity)
userSelected		0..1	boolean	If this coding was chosen directly by the user
subject	SΣ	1..1	Reference(Patient)	Who and/or what the observation is about
focus	SΣ	1..1	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
Slices for effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
effective[x]:effectiveDateTime	SΣ	0..1	dateTime	Clinically relevant time/time-period for observation
Slices for value[x]	SΣC	0..1	CodeableConcept	Actual result Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (extensible)
coding	Σ	0..*	Coding	Gesamtbeurteilung im Verlauf
system	SΣ	0..1	uri	Identity of the terminology system
code	SΣ	0..1	code	Symbol in syntax defined by the system
hasMember	SΣ	0..*	Reference(MII PR Onkologie Tod | MII PR Onkologie TNM-Klassifikation | MII PR Onkologie Anzahl der untersuchten Lymphknoten | MII PR Onkologie Histologie ICD-O-3 | MII PR Onkologie Fernmetastasen | MII PR Onkologie Residualstatus | MII PR Onkologie Genetische Variante)	Related resource that belongs to the Observation group
Slices for component	SΣ	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code.coding
component:All Slices				Content/Rules for all slices
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.
component:Tumor_Verlauf	SΣ	0..1	BackboneElement	Component results
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.
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
display		1..1	string	Representation defined by the system Fixed Value: Status of residual neoplasm (observable entity)
userSelected		0..1	boolean	If this coding was chosen directly by the user
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 445200009
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Primärtumor (required)
coding	Σ	0..*	Coding	Gesamtbeurteilung Primärtumor im Verlauf
system	SΣ	0..1	uri	Identity of the terminology system
code	SΣ	0..1	code	Symbol in syntax defined by the system
component:Lymphknoten_Verlauf	SΣ	0..1	BackboneElement	Component results
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.
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
display		1..1	string	Representation defined by the system Fixed Value: Presence of metastatic neoplasm in regional lymph node (observable entity)
userSelected		0..1	boolean	If this coding was chosen directly by the user
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 399656008
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Lymphknoten (required)
coding	Σ	0..*	Coding	Gesamtbeurteilung Lymphknoten im Verlauf
system	SΣ	0..1	uri	Identity of the terminology system
code	SΣ	0..1	code	Symbol in syntax defined by the system
component:Fernmetastasen_Verlauf	SΣ	0..1	BackboneElement	Component results
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.
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
display		1..1	string	Representation defined by the system Fixed Value: Status of distant metastasis (observable entity)
userSelected		0..1	boolean	If this coding was chosen directly by the user
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 399608002
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Fernmetastasen (required)
coding	Σ	0..*	Coding	Gesamtbeurteilung Fernmetastasen im Verlauf
system	SΣ	0..1	uri	Identity of the terminology system
code	SΣ	0..1	code	Symbol in syntax defined by the system
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	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.value[x]:valueCodeableConcept	Base	extensible	MII VS Onkologie Verlauf Gesamtbeurteilung	📦2027.0.0-ballot.1	This IG
Observation.component.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:Tumor_Verlauf.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:Tumor_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Primärtumor	📦2027.0.0-ballot.1	This IG
Observation.component:Lymphknoten_Verlauf.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:Lymphknoten_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Lymphknoten	📦2027.0.0-ballot.1	This IG
Observation.component:Fernmetastasen_Verlauf.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:Fernmetastasen_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Fernmetastasen	📦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()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation		0..*	Observation	Measurements and simple assertions
meta
profile	S	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
identifier	S	0..*	Identifier	Business Identifier for observation
code	S	1..1	CodeableConcept	Type of observation (code / type)
coding		0..*	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: 396432002
display		1..1	string	Representation defined by the system Fixed Value: Status of regression of tumor (observable entity)
subject	S	1..1	Reference(Patient)	Who and/or what the observation is about
focus	S	1..1	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
Slices for effective[x]	S	0..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effective[x]:effectiveDateTime	S	0..1	dateTime	Clinically relevant time/time-period for observation
Slices for value[x]	S	0..1	CodeableConcept	Actual result Slice: Unordered, Open by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	Actual result Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (extensible)
coding		0..*	Coding	Gesamtbeurteilung im Verlauf
system	S	0..1	uri	Identity of the terminology system
code	S	0..1	code	Symbol in syntax defined by the system
hasMember	S	0..*	Reference(MII PR Onkologie Tod | MII PR Onkologie TNM-Klassifikation | MII PR Onkologie Anzahl der untersuchten Lymphknoten | MII PR Onkologie Histologie ICD-O-3 | MII PR Onkologie Fernmetastasen | MII PR Onkologie Residualstatus | MII PR Onkologie Genetische Variante)	Related resource that belongs to the Observation group
Slices for component	S	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code.coding
component:Tumor_Verlauf	S	0..1	BackboneElement	Component results
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
display		1..1	string	Representation defined by the system Fixed Value: Status of residual neoplasm (observable entity)
code		0..1	code	Symbol in syntax defined by the system Fixed Value: 445200009
value[x]		0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Primärtumor (required)
coding		0..*	Coding	Gesamtbeurteilung Primärtumor im Verlauf
system	S	0..1	uri	Identity of the terminology system
code	S	0..1	code	Symbol in syntax defined by the system
component:Lymphknoten_Verlauf	S	0..1	BackboneElement	Component results
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
display		1..1	string	Representation defined by the system Fixed Value: Presence of metastatic neoplasm in regional lymph node (observable entity)
code		0..1	code	Symbol in syntax defined by the system Fixed Value: 399656008
value[x]		0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Lymphknoten (required)
coding		0..*	Coding	Gesamtbeurteilung Lymphknoten im Verlauf
system	S	0..1	uri	Identity of the terminology system
code	S	0..1	code	Symbol in syntax defined by the system
component:Fernmetastasen_Verlauf	S	0..1	BackboneElement	Component results
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
display		1..1	string	Representation defined by the system Fixed Value: Status of distant metastasis (observable entity)
code		0..1	code	Symbol in syntax defined by the system Fixed Value: 399608002
value[x]		0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Fernmetastasen (required)
coding		0..*	Coding	Gesamtbeurteilung Fernmetastasen im Verlauf
system	S	0..1	uri	Identity of the terminology system
code	S	0..1	code	Symbol in syntax defined by the system
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.value[x]:valueCodeableConcept	Base	extensible	MII VS Onkologie Verlauf Gesamtbeurteilung	📦2027.0.0-ballot.1	This IG
Observation.component:Tumor_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Primärtumor	📦2027.0.0-ballot.1	This IG
Observation.component:Lymphknoten_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Lymphknoten	📦2027.0.0-ballot.1	This IG
Observation.component:Fernmetastasen_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Fernmetastasen	📦2027.0.0-ballot.1	This IG

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
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 Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	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	?!Σ	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: LOINCCodes (example): Codes identifying names of simple observations.
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	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: 396432002
display		1..1	string	Representation defined by the system Fixed Value: Status of regression of tumor (observable entity)
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(Patient)	Who and/or what the observation is about
focus	SΣ	1..1	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
Slices for effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
effective[x]:effectiveDateTime	SΣ	0..1	dateTime	Clinically relevant time/time-period for observation
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
Slices for value[x]	SΣC	0..1	CodeableConcept	Actual result Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Gesamtbeurteilung im Verlauf
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	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..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		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(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 Tod | MII PR Onkologie TNM-Klassifikation | MII PR Onkologie Anzahl der untersuchten Lymphknoten | MII PR Onkologie Histologie ICD-O-3 | MII PR Onkologie Fernmetastasen | MII PR Onkologie Residualstatus | MII PR Onkologie Genetische Variante)	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
Slices for component	SΣ	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code.coding
component: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	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
component:Tumor_Verlauf	SΣ	0..1	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.
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 Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 445200009
display	Σ	0..1	string	Representation defined by the system Fixed Value: Status of residual neoplasm (observable entity)
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Primärtumor (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	Gesamtbeurteilung Primärtumor im Verlauf
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	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..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 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
component:Lymphknoten_Verlauf	SΣ	0..1	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.
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 Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 399656008
display	Σ	0..1	string	Representation defined by the system Fixed Value: Presence of metastatic neoplasm in regional lymph node (observable entity)
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Lymphknoten (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	Gesamtbeurteilung Lymphknoten im Verlauf
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	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..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 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
component:Fernmetastasen_Verlauf	SΣ	0..1	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.
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 Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 399608002
display	Σ	0..1	string	Representation defined by the system Fixed Value: Status of distant metastasis (observable entity)
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Fernmetastasen (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	Gesamtbeurteilung Fernmetastasen im Verlauf
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	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..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 component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.meta.security	Base	extensible	SecurityLabels	📍4.0.1	FHIR Std.
Observation.meta.tag	Base	example	Common Tags	📍4.0.1	FHIR Std.
Observation.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.value[x]:valueCodeableConcept	Base	extensible	MII VS Onkologie Verlauf Gesamtbeurteilung	📦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	example	Observation Methods	📍4.0.1	FHIR Std.
Observation.referenceRange.​type	Base	preferred	Observation Reference Range Meaning Codes	📍4.0.1	FHIR Std.
Observation.referenceRange.​appliesTo	Base	example	Observation Reference Range Applies To Codes	📍4.0.1	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:Tumor_Verlauf.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:Tumor_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Primärtumor	📦2027.0.0-ballot.1	This IG
Observation.component:Tumor_Verlauf.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:Tumor_Verlauf.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:Lymphknoten_Verlauf.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:Lymphknoten_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Lymphknoten	📦2027.0.0-ballot.1	This IG
Observation.component:Lymphknoten_Verlauf.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:Lymphknoten_Verlauf.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:Fernmetastasen_Verlauf.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:Fernmetastasen_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Fernmetastasen	📦2027.0.0-ballot.1	This IG
Observation.component:Fernmetastasen_Verlauf.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:Fernmetastasen_Verlauf.​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()

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
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
identifier	SΣ	0..*	Identifier	Business Identifier for observation
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	SΣ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
coding	Σ	0..*	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: 396432002
display		1..1	string	Representation defined by the system Fixed Value: Status of regression of tumor (observable entity)
userSelected		0..1	boolean	If this coding was chosen directly by the user
subject	SΣ	1..1	Reference(Patient)	Who and/or what the observation is about
focus	SΣ	1..1	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
Slices for effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
effective[x]:effectiveDateTime	SΣ	0..1	dateTime	Clinically relevant time/time-period for observation
Slices for value[x]	SΣC	0..1	CodeableConcept	Actual result Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (extensible)
coding	Σ	0..*	Coding	Gesamtbeurteilung im Verlauf
system	SΣ	0..1	uri	Identity of the terminology system
code	SΣ	0..1	code	Symbol in syntax defined by the system
hasMember	SΣ	0..*	Reference(MII PR Onkologie Tod | MII PR Onkologie TNM-Klassifikation | MII PR Onkologie Anzahl der untersuchten Lymphknoten | MII PR Onkologie Histologie ICD-O-3 | MII PR Onkologie Fernmetastasen | MII PR Onkologie Residualstatus | MII PR Onkologie Genetische Variante)	Related resource that belongs to the Observation group
Slices for component	SΣ	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code.coding
component:All Slices				Content/Rules for all slices
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.
component:Tumor_Verlauf	SΣ	0..1	BackboneElement	Component results
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.
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
display		1..1	string	Representation defined by the system Fixed Value: Status of residual neoplasm (observable entity)
userSelected		0..1	boolean	If this coding was chosen directly by the user
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 445200009
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Primärtumor (required)
coding	Σ	0..*	Coding	Gesamtbeurteilung Primärtumor im Verlauf
system	SΣ	0..1	uri	Identity of the terminology system
code	SΣ	0..1	code	Symbol in syntax defined by the system
component:Lymphknoten_Verlauf	SΣ	0..1	BackboneElement	Component results
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.
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
display		1..1	string	Representation defined by the system Fixed Value: Presence of metastatic neoplasm in regional lymph node (observable entity)
userSelected		0..1	boolean	If this coding was chosen directly by the user
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 399656008
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Lymphknoten (required)
coding	Σ	0..*	Coding	Gesamtbeurteilung Lymphknoten im Verlauf
system	SΣ	0..1	uri	Identity of the terminology system
code	SΣ	0..1	code	Symbol in syntax defined by the system
component:Fernmetastasen_Verlauf	SΣ	0..1	BackboneElement	Component results
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.
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
display		1..1	string	Representation defined by the system Fixed Value: Status of distant metastasis (observable entity)
userSelected		0..1	boolean	If this coding was chosen directly by the user
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 399608002
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Fernmetastasen (required)
coding	Σ	0..*	Coding	Gesamtbeurteilung Fernmetastasen im Verlauf
system	SΣ	0..1	uri	Identity of the terminology system
code	SΣ	0..1	code	Symbol in syntax defined by the system
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	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.value[x]:valueCodeableConcept	Base	extensible	MII VS Onkologie Verlauf Gesamtbeurteilung	📦2027.0.0-ballot.1	This IG
Observation.component.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:Tumor_Verlauf.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:Tumor_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Primärtumor	📦2027.0.0-ballot.1	This IG
Observation.component:Lymphknoten_Verlauf.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:Lymphknoten_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Lymphknoten	📦2027.0.0-ballot.1	This IG
Observation.component:Fernmetastasen_Verlauf.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:Fernmetastasen_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Fernmetastasen	📦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()

Differential View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Observation		0..*	Observation	Measurements and simple assertions
meta
profile	S	0..*	canonical(StructureDefinition)	Profiles this resource claims to conform to
identifier	S	0..*	Identifier	Business Identifier for observation
code	S	1..1	CodeableConcept	Type of observation (code / type)
coding		0..*	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: 396432002
display		1..1	string	Representation defined by the system Fixed Value: Status of regression of tumor (observable entity)
subject	S	1..1	Reference(Patient)	Who and/or what the observation is about
focus	S	1..1	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
Slices for effective[x]	S	0..1	dateTime, Period, Timing, instant	Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effective[x]:effectiveDateTime	S	0..1	dateTime	Clinically relevant time/time-period for observation
Slices for value[x]	S	0..1	CodeableConcept	Actual result Slice: Unordered, Open by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	Actual result Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (extensible)
coding		0..*	Coding	Gesamtbeurteilung im Verlauf
system	S	0..1	uri	Identity of the terminology system
code	S	0..1	code	Symbol in syntax defined by the system
hasMember	S	0..*	Reference(MII PR Onkologie Tod | MII PR Onkologie TNM-Klassifikation | MII PR Onkologie Anzahl der untersuchten Lymphknoten | MII PR Onkologie Histologie ICD-O-3 | MII PR Onkologie Fernmetastasen | MII PR Onkologie Residualstatus | MII PR Onkologie Genetische Variante)	Related resource that belongs to the Observation group
Slices for component	S	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code.coding
component:Tumor_Verlauf	S	0..1	BackboneElement	Component results
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
display		1..1	string	Representation defined by the system Fixed Value: Status of residual neoplasm (observable entity)
code		0..1	code	Symbol in syntax defined by the system Fixed Value: 445200009
value[x]		0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Primärtumor (required)
coding		0..*	Coding	Gesamtbeurteilung Primärtumor im Verlauf
system	S	0..1	uri	Identity of the terminology system
code	S	0..1	code	Symbol in syntax defined by the system
component:Lymphknoten_Verlauf	S	0..1	BackboneElement	Component results
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
display		1..1	string	Representation defined by the system Fixed Value: Presence of metastatic neoplasm in regional lymph node (observable entity)
code		0..1	code	Symbol in syntax defined by the system Fixed Value: 399656008
value[x]		0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Lymphknoten (required)
coding		0..*	Coding	Gesamtbeurteilung Lymphknoten im Verlauf
system	S	0..1	uri	Identity of the terminology system
code	S	0..1	code	Symbol in syntax defined by the system
component:Fernmetastasen_Verlauf	S	0..1	BackboneElement	Component results
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
display		1..1	string	Representation defined by the system Fixed Value: Status of distant metastasis (observable entity)
code		0..1	code	Symbol in syntax defined by the system Fixed Value: 399608002
value[x]		0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Fernmetastasen (required)
coding		0..*	Coding	Gesamtbeurteilung Fernmetastasen im Verlauf
system	S	0..1	uri	Identity of the terminology system
code	S	0..1	code	Symbol in syntax defined by the system
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Observation.value[x]:valueCodeableConcept	Base	extensible	MII VS Onkologie Verlauf Gesamtbeurteilung	📦2027.0.0-ballot.1	This IG
Observation.component:Tumor_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Primärtumor	📦2027.0.0-ballot.1	This IG
Observation.component:Lymphknoten_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Lymphknoten	📦2027.0.0-ballot.1	This IG
Observation.component:Fernmetastasen_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Fernmetastasen	📦2027.0.0-ballot.1	This IG

Snapshot ViewView

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
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 Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	SΣ	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	?!Σ	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: LOINCCodes (example): Codes identifying names of simple observations.
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	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: 396432002
display		1..1	string	Representation defined by the system Fixed Value: Status of regression of tumor (observable entity)
userSelected		0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	SΣ	1..1	Reference(Patient)	Who and/or what the observation is about
focus	SΣ	1..1	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
Slices for effective[x]	SΣ	0..1		Clinically relevant time/time-period for observation Slice: Unordered, Open by type:$this
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
effective[x]:effectiveDateTime	SΣ	0..1	dateTime	Clinically relevant time/time-period for observation
issued	Σ	0..1	instant	Date/Time this version was made available
performer	Σ	0..*	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation
Slices for value[x]	SΣC	0..1	CodeableConcept	Actual result Slice: Unordered, Closed by type:$this
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result Binding: MII VS Onkologie Verlauf Gesamtbeurteilung (extensible)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Gesamtbeurteilung im Verlauf
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	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..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		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen		0..1	Reference(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 Tod | MII PR Onkologie TNM-Klassifikation | MII PR Onkologie Anzahl der untersuchten Lymphknoten | MII PR Onkologie Histologie ICD-O-3 | MII PR Onkologie Fernmetastasen | MII PR Onkologie Residualstatus | MII PR Onkologie Genetische Variante)	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
Slices for component	SΣ	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code.coding
component: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	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
component:Tumor_Verlauf	SΣ	0..1	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.
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 Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 445200009
display	Σ	0..1	string	Representation defined by the system Fixed Value: Status of residual neoplasm (observable entity)
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Primärtumor (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	Gesamtbeurteilung Primärtumor im Verlauf
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	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..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 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
component:Lymphknoten_Verlauf	SΣ	0..1	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.
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 Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 399656008
display	Σ	0..1	string	Representation defined by the system Fixed Value: Presence of metastatic neoplasm in regional lymph node (observable entity)
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Lymphknoten (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	Gesamtbeurteilung Lymphknoten im Verlauf
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	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..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 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
component:Fernmetastasen_Verlauf	SΣ	0..1	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.
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 Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system Fixed Value: 399608002
display	Σ	0..1	string	Representation defined by the system Fixed Value: Status of distant metastasis (observable entity)
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value[x]	Σ	0..1	CodeableConcept	Actual component result Binding: MII VS Onkologie Verlauf Fernmetastasen (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	Gesamtbeurteilung Fernmetastasen im Verlauf
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	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	SΣ	0..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 component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Observation.meta.security	Base	extensible	SecurityLabels	📍4.0.1	FHIR Std.
Observation.meta.tag	Base	example	Common Tags	📍4.0.1	FHIR Std.
Observation.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Observation.status	Base	required	ObservationStatus	📍4.0.1	FHIR Std.
Observation.category	Base	preferred	Observation Category Codes	📍4.0.1	FHIR Std.
Observation.code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.value[x]:valueCodeableConcept	Base	extensible	MII VS Onkologie Verlauf Gesamtbeurteilung	📦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	example	Observation Methods	📍4.0.1	FHIR Std.
Observation.referenceRange.​type	Base	preferred	Observation Reference Range Meaning Codes	📍4.0.1	FHIR Std.
Observation.referenceRange.​appliesTo	Base	example	Observation Reference Range Applies To Codes	📍4.0.1	FHIR Std.
Observation.component.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:Tumor_Verlauf.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:Tumor_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Primärtumor	📦2027.0.0-ballot.1	This IG
Observation.component:Tumor_Verlauf.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:Tumor_Verlauf.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:Lymphknoten_Verlauf.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:Lymphknoten_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Lymphknoten	📦2027.0.0-ballot.1	This IG
Observation.component:Lymphknoten_Verlauf.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:Lymphknoten_Verlauf.​interpretation	Base	extensible	Observation Interpretation Codes	📍4.0.1	FHIR Std.
Observation.component:Fernmetastasen_Verlauf.​code	Base	example	LOINC Codes	📍4.0.1	FHIR Std.
Observation.component:Fernmetastasen_Verlauf.​value[x]	Base	required	MII VS Onkologie Verlauf Fernmetastasen	📦2027.0.0-ballot.1	This IG
Observation.component:Fernmetastasen_Verlauf.​dataAbsentReason	Base	extensible	DataAbsentReason	📍4.0.1	FHIR Std.
Observation.component:Fernmetastasen_Verlauf.​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()

Summary

Mandatory: 2 elements(3 nested mandatory elements)
Must-Support: 22 elements

Structures

This structure refers to these other structures:

• MII PR Onkologie Diagnose Primärtumor (https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-diagnose-primaertumor)
• MII PR Onkologie Tod (https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-tod)
• MII PR Onkologie TNM-Klassifikation (https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-tnm-klassifikation)
• MII PR Onkologie Anzahl der untersuchten Lymphknoten (https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-anzahl-untersuchte-lymphknoten)
• MII PR Onkologie Histologie ICD-O-3 (https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-histologie-icdo3)
• MII PR Onkologie Fernmetastasen (https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-fernmetastasen)
• MII PR Onkologie Residualstatus (https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-residualstatus)
• MII PR Onkologie Genetische Variante (https://www.medizininformatik-initiative.de/fhir/ext/modul-onko/StructureDefinition/mii-pr-onko-genetische-variante)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.effective[x]
• The element 1 is sliced based on the value of Observation.value[x]
• The element 1 is sliced based on the value of Observation.component