Data Management with FHIR
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Data Management with FHIR - version de développement local (intégration continue v0.1.0) construite par les outils de publication FHIR (HL7® FHIR® Standard). Voir le répertoire des versions publiées

Resource Profile: DMObservationSmokingStatus - Detailed Descriptions

Draft as of 2026-02-05

Definitions for the DMObservationSmokingStatus resource profile.

Des conseils sur l'interprétation du contenu de ce tableau peuvent être trouvésici

0. Observation
Définition

Measurements and simple assertions made about a patient, device or other subject.

CourtMeasurements and simple assertions
Commentaires

Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.

Contrôle0..*
Est modificateurfalse
Doit être pris en charge (Must Support)false
Résuméfalse
Noms alternatifsVital Signs, Measurement, Results, Tests, Obs
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
obs-7: 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())
dm-0: Observation.code 72166-2|Tobacco smoking status or 11367-0|History of Tobacco use SHALL use valueCodeableConcept (code.coding.where(code in '72166-2'|'11367-0').exists() implies value.is(CodeableConcept))
dm-1: For Observation.code 401201003|Cigarette pack-years or 782516008|Number of calculated smoking pack years SHOULD use valueQuantity (code.coding.where(code in '401201003'|'782516008').exists() implies value.is(Quantity))
obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
obs-7: 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())
2. Observation.implicitRules
Définition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

CourtA set of rules under which this content was created
Commentaires

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Contrôle0..1
Typeuri
Est modificateurtrue parce que This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
Résumétrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Observation.modifierExtension
Définition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

CourtExtensions that cannot be ignored
Commentaires

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Contrôle0..*
TypeExtension
Est modificateurtrue parce que Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Résuméfalse
Exigences

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Noms alternatifsextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Observation.status
Définition

The status of the result value.

Courtfinal | entered-in-errorregistered | preliminary | final | amended +
Commentaires

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Contrôle1..1
BindingLes codes DOIVENT (SHALL) être pris de Liste des status pour l'Observation de consommation de tabachttp://hl7.org/fhir/ValueSet/observation-status|4.0.1
(required to https://aphp.github.io/IG-fhir-dm/ValueSet/DMObservationSmokingStatusStatus)
Typecode
Est modificateurtrue parce que This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
Doit être pris en charge (Must Support)true
Résumétrue
Exigences

Need to track the status of individual results. Some results are finalized before the whole report is finalized.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. Observation.category
Définition

A code that classifies the general type of observation being made.

CourtClassification of type of observation
Commentaires

In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

Contrôle10..*
BindingLes codes DEVRAIENT (SHOULD) être pris de ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-category|4.0.1
(preferred to http://hl7.org/fhir/ValueSet/observation-category|4.0.1)

Codes for high level observation categories.

TypeCodeableConcept
Est modificateurfalse
Doit être pris en charge (Must Support)true
Résuméfalse
Exigences

Used for filtering what observations are retrieved and displayed.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingCet élément introduit un ensemble de slices sur Observation.category. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
  • value @ $this
  • 10. Observation.category:SocialHistory
    Nom de la sliceSocialHistory
    Définition

    A code that classifies the general type of observation being made.

    CourtClassification of type of observation
    Commentaires

    In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

    Contrôle10..1*
    BindingLes codes DEVRAIENT (SHOULD) être pris de ObservationCategoryCodeshttp://hl7.org/fhir/ValueSet/observation-category|4.0.1
    (preferred to http://hl7.org/fhir/ValueSet/observation-category|4.0.1)

    Codes for high level observation categories.

    TypeCodeableConcept
    Est modificateurfalse
    Doit être pris en charge (Must Support)true
    Résuméfalse
    Exigences

    Used for filtering what observations are retrieved and displayed.

    Valeur de motif{
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
        "code" : "social-history"
      }]
    }
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    12. Observation.code
    Définition

    Describes what was observed. Sometimes this is called the observation "name".

    CourtSmoking StatusType of observation (code / type)
    Commentaires

    All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

    Contrôle1..1
    Cet élément est affecté par les invariants suivants : eds-0, eds-1
    BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de Pour des exemples de codes, voir Smoking Status Typehttp://hl7.org/fhir/ValueSet/observation-codes|4.0.1
    (extensible to https://aphp.github.io/IG-fhir-dm/ValueSet/DMSmokingStatusType)

    Smoking status type


    Codes identifying names of simple observations.

    TypeCodeableConcept
    Est modificateurfalse
    Doit être pris en charge (Must Support)true
    Résumétrue
    Exigences

    Knowing what kind of observation is being made is essential to understanding the observation.

    Noms alternatifsName
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    14. Observation.subject
    Définition

    The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

    CourtWho and/or what the observation is about
    Commentaires

    One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

    Contrôle10..1
    TypeReference(Patient, Patient, Group, Device, Location)
    Est modificateurfalse
    Doit être pris en charge (Must Support)true
    Résumétrue
    Exigences

    Observations have no value if you don't know who or what they're about.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. Observation.effective[x]
    Définition

    The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

    CourtClinically relevant time/time-period for observation
    Commentaires

    At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

    Contrôle10..1
    TypeChoix de : dateTime, Period, Timing, instant
    Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
    Est modificateurfalse
    Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
    Doit être pris en charge (Must Support)true
    Types qui doivent être pris en charge (Must Support)Aucune règle de prise en charge obligatoire concernant le choix des types/profils
    Résumétrue
    Exigences

    Knowing when an observation was deemed true is important to its relevance as well as determining trends.

    Noms alternatifsOccurrence
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. Observation.value[x]
    Définition

    The information determined as a result of making the observation, if the information has a simple value.

    CourtActual result
    Commentaires

    An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

    Contrôle10..1
    Cet élément est affecté par les invariants suivants : obs-7, eds-0, eds-1
    TypeChoix de : Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
    Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
    Est modificateurfalse
    Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
    Doit être pris en charge (Must Support)true
    Types qui doivent être pris en charge (Must Support)Aucune règle de prise en charge obligatoire concernant le choix des types/profils
    Résumétrue
    Exigences

    An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingCet élément introduit un ensemble de slices sur Observation.value[x]. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
    • type @ $this
    • 20. Observation.value[x]:valueQuantity
      Nom de la slicevalueQuantity
      Définition

      The information determined as a result of making the observation, if the information has a simple value.

      CourtQuantitative ResponseActual result
      Commentaires

      An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

      Contrôle0..1
      Cet élément est affecté par les invariants suivants : obs-7
      BindingLes codes DOIVENT (SHALL) être pris de Pour les codes, voir UnitsOfMeasureCaseSensitive
      (required to http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive)
      TypeQuantity, dateTime, boolean, string, SampledData, Period, Ratio, integer, time, Range, CodeableConcept
      Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
      Est modificateurfalse
      Doit être pris en charge (Must Support)true
      Résumétrue
      Exigences

      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      22. Observation.value[x]:valueCodeableConcept
      Nom de la slicevalueCodeableConcept
      Définition

      The information determined as a result of making the observation, if the information has a simple value.

      CourtCoded ResponseActual result
      Commentaires

      An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

      Contrôle0..1
      Cet élément est affecté par les invariants suivants : obs-7
      BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de Pour les codes, voir Smoking status comprehensive
      (extensible to https://aphp.github.io/IG-fhir-dm/ValueSet/DMSmokingStatusComprehensive)

      Smoking status comprehensive

      TypeCodeableConcept, dateTime, boolean, string, SampledData, Quantity, Period, Ratio, integer, time, Range
      Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
      Est modificateurfalse
      Doit être pris en charge (Must Support)true
      Résumétrue
      Exigences

      An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Des conseils sur l'interprétation du contenu de ce tableau peuvent être trouvésici

      0. Observation
      Doit être pris en charge (Must Support)false
      Noms alternatifsObs, Measurement, Results, Tests
      Invariantsdm-0: Observation.code 72166-2|Tobacco smoking status or 11367-0|History of Tobacco use SHALL use valueCodeableConcept (code.coding.where(code in '72166-2'|'11367-0').exists() implies value.is(CodeableConcept))
      dm-1: For Observation.code 401201003|Cigarette pack-years or 782516008|Number of calculated smoking pack years SHOULD use valueQuantity (code.coding.where(code in '401201003'|'782516008').exists() implies value.is(Quantity))
      2. Observation.status
      Courtfinal | entered-in-error
      BindingLes codes DOIVENT (SHALL) être pris de Liste des status pour l'Observation de consommation de tabac
      (required to https://aphp.github.io/IG-fhir-dm/ValueSet/DMObservationSmokingStatusStatus)
      Doit être pris en charge (Must Support)true
      4. Observation.category
      Contrôle1..?
      Doit être pris en charge (Must Support)true
      SlicingCet élément introduit un ensemble de slices sur Observation.category. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
      • value @ $this
      • 6. Observation.category:SocialHistory
        Nom de la sliceSocialHistory
        Contrôle1..1
        Doit être pris en charge (Must Support)true
        Valeur de motif{
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
            "code" : "social-history"
          }]
        }
        8. Observation.code
        CourtSmoking Status
        BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de Smoking Status Type
        (extensible to https://aphp.github.io/IG-fhir-dm/ValueSet/DMSmokingStatusType)

        Smoking status type

        Doit être pris en charge (Must Support)true
        10. Observation.subject
        Contrôle1..?
        TypeReference(Patient)
        Doit être pris en charge (Must Support)true
        12. Observation.effective[x]
        Contrôle1..?
        TypeChoix de : dateTime, Period, Timing, instant
        Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
        Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
        Doit être pris en charge (Must Support)true
        Types qui doivent être pris en charge (Must Support)Aucune règle de prise en charge obligatoire concernant le choix des types/profils
        14. Observation.value[x]
        Contrôle1..?
        Cet élément est affecté par les invariants suivants : eds-0, eds-1
        Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
        Doit être pris en charge (Must Support)true
        SlicingCet élément introduit un ensemble de slices sur Observation.value[x]. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
        • type @ $this
        • 16. Observation.value[x]:valueQuantity
          Nom de la slicevalueQuantity
          CourtQuantitative Response
          Contrôle0..1
          BindingLes codes DOIVENT (SHALL) être pris de UnitsOfMeasureCaseSensitive
          (required to http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive)
          TypeQuantity
          Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
          Doit être pris en charge (Must Support)true
          18. Observation.value[x]:valueCodeableConcept
          Nom de la slicevalueCodeableConcept
          CourtCoded Response
          Contrôle0..1
          BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de Smoking status comprehensive
          (extensible to https://aphp.github.io/IG-fhir-dm/ValueSet/DMSmokingStatusComprehensive)

          Smoking status comprehensive

          TypeCodeableConcept
          Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
          Doit être pris en charge (Must Support)true

          Des conseils sur l'interprétation du contenu de ce tableau peuvent être trouvésici

          0. Observation
          Définition

          Measurements and simple assertions made about a patient, device or other subject.

          CourtMeasurements and simple assertions
          Commentaires

          Used for simple observations such as device measurements, laboratory atomic results, vital signs, height, weight, smoking status, comments, etc. Other resources are used to provide context for observations such as laboratory reports, etc.

          Contrôle0..*
          Est modificateurfalse
          Doit être pris en charge (Must Support)false
          Résuméfalse
          Noms alternatifsVital Signs, Measurement, Results, Tests, Obs
          Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: 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: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present (dataAbsentReason.empty() or value.empty())
          obs-7: 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())
          dm-0: Observation.code 72166-2|Tobacco smoking status or 11367-0|History of Tobacco use SHALL use valueCodeableConcept (code.coding.where(code in '72166-2'|'11367-0').exists() implies value.is(CodeableConcept))
          dm-1: For Observation.code 401201003|Cigarette pack-years or 782516008|Number of calculated smoking pack years SHOULD use valueQuantity (code.coding.where(code in '401201003'|'782516008').exists() implies value.is(Quantity))
          2. Observation.id
          Définition

          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

          CourtLogical id of this artifact
          Commentaires

          The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

          Contrôle0..1
          Typeid
          Est modificateurfalse
          Résumétrue
          4. Observation.meta
          Définition

          The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

          CourtMetadata about the resource
          Contrôle0..1
          TypeMeta
          Est modificateurfalse
          Résumétrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. Observation.implicitRules
          Définition

          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

          CourtA set of rules under which this content was created
          Commentaires

          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

          Contrôle0..1
          Typeuri
          Est modificateurtrue parce que This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
          Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
          Résumétrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. Observation.language
          Définition

          The base language in which the resource is written.

          CourtLanguage of the resource content
          Commentaires

          Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

          Contrôle0..1
          BindingLes codes DEVRAIENT (SHOULD) être pris de CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

          A human language.

          Bindings AdditionnelsBut
          AllLanguagesBinding Max
          Typecode
          Est modificateurfalse
          Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
          Résuméfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. Observation.text
          Définition

          A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

          CourtText summary of the resource, for human interpretation
          Commentaires

          Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

          Contrôle0..1
          TypeNarrative
          Est modificateurfalse
          Résuméfalse
          Noms alternatifsnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. Observation.contained
          Définition

          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

          CourtContained, inline Resources
          Commentaires

          This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

          Contrôle0..*
          TypeResource
          Est modificateurfalse
          Résuméfalse
          Noms alternatifsinline resources, anonymous resources, contained resources
          14. Observation.extension
          Définition

          May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          CourtAdditional content defined by implementations
          Commentaires

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Contrôle0..*
          TypeExtension
          Est modificateurfalse
          Résuméfalse
          Noms alternatifsextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          16. Observation.modifierExtension
          Définition

          May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          CourtExtensions that cannot be ignored
          Commentaires

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Contrôle0..*
          TypeExtension
          Est modificateurtrue parce que Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Résuméfalse
          Exigences

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Noms alternatifsextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          18. Observation.identifier
          Définition

          A unique identifier assigned to this observation.

          CourtBusiness Identifier for observation
          NoteCeci est un identifiant métier, pas un identifiant de ressource (voir discussion)
          Contrôle0..*
          TypeIdentifier
          Est modificateurfalse
          Résumétrue
          Exigences

          Allows observations to be distinguished and referenced.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          20. Observation.basedOn
          Définition

          A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.

          CourtFulfills plan, proposal or order
          Contrôle0..*
          TypeReference(CarePlan, DeviceRequest, ImmunizationRecommendation, MedicationRequest, NutritionOrder, ServiceRequest)
          Est modificateurfalse
          Résumétrue
          Exigences

          Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.

          Noms alternatifsFulfills
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          22. Observation.partOf
          Définition

          A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.

          CourtPart of referenced event
          Commentaires

          To link an Observation to an Encounter use encounter. See the Notes below for guidance on referencing another Observation.

          Contrôle0..*
          TypeReference(MedicationAdministration, MedicationDispense, MedicationStatement, Procedure, Immunization, ImagingStudy)
          Est modificateurfalse
          Résumétrue
          Noms alternatifsContainer
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          24. Observation.status
          Définition

          The status of the result value.

          Courtfinal | entered-in-error
          Commentaires

          This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

          Contrôle1..1
          BindingLes codes DOIVENT (SHALL) être pris de Liste des status pour l'Observation de consommation de tabac
          (required to https://aphp.github.io/IG-fhir-dm/ValueSet/DMObservationSmokingStatusStatus)
          Typecode
          Est modificateurtrue parce que This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
          Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
          Doit être pris en charge (Must Support)true
          Résumétrue
          Exigences

          Need to track the status of individual results. Some results are finalized before the whole report is finalized.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          26. Observation.category
          Définition

          A code that classifies the general type of observation being made.

          CourtClassification of type of observation
          Commentaires

          In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

          Contrôle1..*
          BindingLes codes DEVRAIENT (SHOULD) être pris de ObservationCategoryCodes
          (preferred to http://hl7.org/fhir/ValueSet/observation-category|4.0.1)

          Codes for high level observation categories.

          TypeCodeableConcept
          Est modificateurfalse
          Doit être pris en charge (Must Support)true
          Résuméfalse
          Exigences

          Used for filtering what observations are retrieved and displayed.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          SlicingCet élément introduit un ensemble de slices sur Observation.category. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
          • value @ $this
          • 28. Observation.category:SocialHistory
            Nom de la sliceSocialHistory
            Définition

            A code that classifies the general type of observation being made.

            CourtClassification of type of observation
            Commentaires

            In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once. The level of granularity is defined by the category concepts in the value set.

            Contrôle1..1
            BindingLes codes DEVRAIENT (SHOULD) être pris de ObservationCategoryCodes
            (preferred to http://hl7.org/fhir/ValueSet/observation-category|4.0.1)

            Codes for high level observation categories.

            TypeCodeableConcept
            Est modificateurfalse
            Doit être pris en charge (Must Support)true
            Résuméfalse
            Exigences

            Used for filtering what observations are retrieved and displayed.

            Valeur de motif{
              "coding" : [{
                "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                "code" : "social-history"
              }]
            }
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            30. Observation.code
            Définition

            Describes what was observed. Sometimes this is called the observation "name".

            CourtSmoking Status
            Commentaires

            All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

            Contrôle1..1
            Cet élément est affecté par les invariants suivants : eds-0, eds-1
            BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de Smoking Status Type
            (extensible to https://aphp.github.io/IG-fhir-dm/ValueSet/DMSmokingStatusType)

            Smoking status type

            TypeCodeableConcept
            Est modificateurfalse
            Doit être pris en charge (Must Support)true
            Résumétrue
            Exigences

            Knowing what kind of observation is being made is essential to understanding the observation.

            Noms alternatifsName
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            32. Observation.subject
            Définition

            The patient, or group of patients, location, or device this observation is about and into whose record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the focus element or the code itself specifies the actual focus of the observation.

            CourtWho and/or what the observation is about
            Commentaires

            One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some context/channel matching technique, and at this point, the observation should be updated.

            Contrôle1..1
            TypeReference(Patient)
            Est modificateurfalse
            Doit être pris en charge (Must Support)true
            Résumétrue
            Exigences

            Observations have no value if you don't know who or what they're about.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            34. Observation.focus
            Définition

            The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

            CourtWhat the observation is about, when it is not about the subject of record
            Commentaires

            Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element. Use specimen if a reference to a specimen is required. If a code is required instead of a resource use either bodysite for bodysites or the standard extension focusCode.

            Contrôle0..*
            TypeReference(Resource)
            Est modificateurfalse
            Résumétrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            36. Observation.encounter
            Définition

            The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.

            CourtHealthcare event during which this observation is made
            Commentaires

            This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).

            Contrôle0..1
            TypeReference(Encounter)
            Est modificateurfalse
            Résumétrue
            Exigences

            For some observations it may be important to know the link between an observation and a particular encounter.

            Noms alternatifsContext
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            38. Observation.effective[x]
            Définition

            The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

            CourtClinically relevant time/time-period for observation
            Commentaires

            At least a date should be present unless this observation is a historical report. For recording imprecise or "fuzzy" times (For example, a blood glucose measurement taken "after breakfast") use the Timing datatype which allow the measurement to be tied to regular life events.

            Contrôle1..1
            TypeChoix de : dateTime, Period
            Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
            Est modificateurfalse
            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
            Doit être pris en charge (Must Support)true
            Types qui doivent être pris en charge (Must Support)Aucune règle de prise en charge obligatoire concernant le choix des types/profils
            Résumétrue
            Exigences

            Knowing when an observation was deemed true is important to its relevance as well as determining trends.

            Noms alternatifsOccurrence
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            40. Observation.issued
            Définition

            The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.

            CourtDate/Time this version was made available
            Commentaires

            For Observations that don’t require review and verification, it may be the same as the lastUpdated time of the resource itself. For Observations that do require review and verification for certain updates, it might not be the same as the lastUpdated time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.

            Contrôle0..1
            Typeinstant
            Est modificateurfalse
            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
            Résumétrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            42. Observation.performer
            Définition

            Who was responsible for asserting the observed value as "true".

            CourtWho is responsible for the observation
            Contrôle0..*
            TypeReference(Practitioner, PractitionerRole, Organization, CareTeam, Patient, RelatedPerson)
            Est modificateurfalse
            Résumétrue
            Exigences

            May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            44. Observation.value[x]
            Définition

            The information determined as a result of making the observation, if the information has a simple value.

            CourtActual result
            Commentaires

            An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

            Contrôle1..1
            Cet élément est affecté par les invariants suivants : obs-7, eds-0, eds-1
            TypeChoix de : Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
            Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
            Est modificateurfalse
            Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
            Doit être pris en charge (Must Support)true
            Types qui doivent être pris en charge (Must Support)Aucune règle de prise en charge obligatoire concernant le choix des types/profils
            Résumétrue
            Exigences

            An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingCet élément introduit un ensemble de slices sur Observation.value[x]. Les slices sontNon ordonné et Open, et peut être différencié en utilisant les discriminateurs suivants :
            • type @ $this
            • 46. Observation.value[x]:valueQuantity
              Nom de la slicevalueQuantity
              Définition

              The information determined as a result of making the observation, if the information has a simple value.

              CourtQuantitative Response
              Commentaires

              An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

              Contrôle0..1
              Cet élément est affecté par les invariants suivants : obs-7
              BindingLes codes DOIVENT (SHALL) être pris de UnitsOfMeasureCaseSensitive
              (required to http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive)
              TypeQuantity
              Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
              Est modificateurfalse
              Doit être pris en charge (Must Support)true
              Résumétrue
              Exigences

              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              48. Observation.value[x]:valueCodeableConcept
              Nom de la slicevalueCodeableConcept
              Définition

              The information determined as a result of making the observation, if the information has a simple value.

              CourtCoded Response
              Commentaires

              An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

              Contrôle0..1
              Cet élément est affecté par les invariants suivants : obs-7
              BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de Smoking status comprehensive
              (extensible to https://aphp.github.io/IG-fhir-dm/ValueSet/DMSmokingStatusComprehensive)

              Smoking status comprehensive

              TypeCodeableConcept
              Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
              Est modificateurfalse
              Doit être pris en charge (Must Support)true
              Résumétrue
              Exigences

              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              50. Observation.dataAbsentReason
              Définition

              Provides a reason why the expected value in the element Observation.value[x] is missing.

              CourtWhy the result is missing
              Commentaires

              Null or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "specimen unsatisfactory".

              The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0. Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.

              Contrôle0..1
              Cet élément est affecté par les invariants suivants : obs-6
              BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de DataAbsentReason
              (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1)

              Codes specifying why the result (Observation.value[x]) is missing.

              TypeCodeableConcept
              Est modificateurfalse
              Résuméfalse
              Exigences

              For many results it is necessary to handle exceptional values in measurements.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              52. Observation.interpretation
              Définition

              A categorical assessment of an observation value. For example, high, low, normal.

              CourtHigh, low, normal, etc.
              Commentaires

              Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

              Contrôle0..*
              BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de ObservationInterpretationCodes
              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1)

              Codes identifying interpretations of observations.

              TypeCodeableConcept
              Est modificateurfalse
              Résuméfalse
              Exigences

              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

              Noms alternatifsAbnormal Flag
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              54. Observation.note
              Définition

              Comments about the observation or the results.

              CourtComments about the observation
              Commentaires

              May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.

              Contrôle0..*
              TypeAnnotation
              Est modificateurfalse
              Résuméfalse
              Exigences

              Need to be able to provide free text additional information.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              56. Observation.bodySite
              Définition

              Indicates the site on the subject's body where the observation was made (i.e. the target site).

              CourtObserved body part
              Commentaires

              Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component.

              If the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension bodySite.

              Contrôle0..1
              BindingPour des exemples de codes, voir SNOMEDCTBodyStructures
              (example to http://hl7.org/fhir/ValueSet/body-site|4.0.1)

              Codes describing anatomical locations. May include laterality.

              TypeCodeableConcept
              Est modificateurfalse
              Résuméfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              58. Observation.method
              Définition

              Indicates the mechanism used to perform the observation.

              CourtHow it was done
              Commentaires

              Only used if not implicit in code for Observation.code.

              Contrôle0..1
              BindingPour des exemples de codes, voir ObservationMethods
              (example to http://hl7.org/fhir/ValueSet/observation-methods|4.0.1)

              Methods for simple observations.

              TypeCodeableConcept
              Est modificateurfalse
              Résuméfalse
              Exigences

              In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              60. Observation.specimen
              Définition

              The specimen that was used when this observation was made.

              CourtSpecimen used for this observation
              Commentaires

              Should only be used if not implicit in code found in Observation.code. Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).

              Contrôle0..1
              TypeReference(Specimen)
              Est modificateurfalse
              Résuméfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              62. Observation.device
              Définition

              The device used to generate the observation data.

              Court(Measurement) Device
              Commentaires

              Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway. Such devices may be documented using the Provenance resource where relevant.

              Contrôle0..1
              TypeReference(Device, DeviceMetric)
              Est modificateurfalse
              Résuméfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              64. Observation.referenceRange
              Définition

              Guidance on how to interpret the value by comparison to a normal or recommended range. Multiple reference ranges are interpreted as an "OR". In other words, to represent two distinct target populations, two referenceRange elements would be used.

              CourtProvides guide for interpretation
              Commentaires

              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

              Contrôle0..*
              TypeBackboneElement
              Est modificateurfalse
              Résuméfalse
              Exigences

              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              obs-3: Must have at least a low or a high or text (low.exists() or high.exists() or text.exists())
              66. Observation.referenceRange.id
              Définition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              CourtUnique id for inter-element referencing
              Contrôle0..1
              Typestring
              Est modificateurfalse
              Format XMLDans le format XML, cette propriété est représentée comme attribut.
              Résuméfalse
              68. Observation.referenceRange.extension
              Définition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              CourtAdditional content defined by implementations
              Commentaires

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Contrôle0..*
              TypeExtension
              Est modificateurfalse
              Résuméfalse
              Noms alternatifsextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              70. Observation.referenceRange.modifierExtension
              Définition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              CourtExtensions that cannot be ignored even if unrecognized
              Commentaires

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Contrôle0..*
              TypeExtension
              Est modificateurtrue parce que Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Résumétrue
              Exigences

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Noms alternatifsextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              72. Observation.referenceRange.low
              Définition

              The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).

              CourtLow Range, if relevant
              Contrôle0..1
              Cet élément est affecté par les invariants suivants : obs-3
              TypeQuantity(SimpleQuantity)
              Est modificateurfalse
              Résuméfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              74. Observation.referenceRange.high
              Définition

              The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).

              CourtHigh Range, if relevant
              Contrôle0..1
              Cet élément est affecté par les invariants suivants : obs-3
              TypeQuantity(SimpleQuantity)
              Est modificateurfalse
              Résuméfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              76. Observation.referenceRange.type
              Définition

              Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.

              CourtReference range qualifier
              Commentaires

              This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed.

              Contrôle0..1
              BindingLes codes DEVRAIENT (SHOULD) être pris de ObservationReferenceRangeMeaningCodes
              (preferred to http://hl7.org/fhir/ValueSet/referencerange-meaning|4.0.1)

              Code for the meaning of a reference range.

              TypeCodeableConcept
              Est modificateurfalse
              Résuméfalse
              Exigences

              Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc., - for proper interpretation.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              78. Observation.referenceRange.appliesTo
              Définition

              Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple appliesTo are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used.

              CourtReference range population
              Commentaires

              This SHOULD be populated if there is more than one range. If this element is not present then the normal population is assumed.

              Contrôle0..*
              BindingPour des exemples de codes, voir ObservationReferenceRangeAppliesToCodes
              (example to http://hl7.org/fhir/ValueSet/referencerange-appliesto|4.0.1)

              Codes identifying the population the reference range applies to.

              TypeCodeableConcept
              Est modificateurfalse
              Résuméfalse
              Exigences

              Need to be able to identify the target population for proper interpretation.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              80. Observation.referenceRange.age
              Définition

              The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

              CourtApplicable age range, if relevant
              Contrôle0..1
              TypeRange
              Est modificateurfalse
              Résuméfalse
              Exigences

              Some analytes vary greatly over age.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              82. Observation.referenceRange.text
              Définition

              Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals".

              CourtText based reference range in an observation
              Contrôle0..1
              Typestring
              Est modificateurfalse
              Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
              Résuméfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              84. Observation.hasMember
              Définition

              This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.

              CourtRelated resource that belongs to the Observation group
              Commentaires

              When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases. For a discussion on the ways Observations can assembled in groups together, see Notes below. Note that a system may calculate results from QuestionnaireResponse into a final score and represent the score as an Observation.

              Contrôle0..*
              TypeReference(Observation, QuestionnaireResponse, MolecularSequence)
              Est modificateurfalse
              Résumétrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              86. Observation.derivedFrom
              Définition

              The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

              CourtRelated measurements the observation is made from
              Commentaires

              All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value. The most common reference will be another Observation. For a discussion on the ways Observations can assembled in groups together, see Notes below.

              Contrôle0..*
              TypeReference(DocumentReference, ImagingStudy, Media, QuestionnaireResponse, Observation, MolecularSequence)
              Est modificateurfalse
              Résumétrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              88. Observation.component
              Définition

              Some observations have multiple component observations. These component observations are expressed as separate code value pairs that share the same attributes. Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.

              CourtComponent results
              Commentaires

              For a discussion on the ways Observations can be assembled in groups together see Notes below.

              Contrôle0..*
              TypeBackboneElement
              Est modificateurfalse
              Résumétrue
              Exigences

              Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable). However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              90. Observation.component.id
              Définition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              CourtUnique id for inter-element referencing
              Contrôle0..1
              Typestring
              Est modificateurfalse
              Format XMLDans le format XML, cette propriété est représentée comme attribut.
              Résuméfalse
              92. Observation.component.extension
              Définition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              CourtAdditional content defined by implementations
              Commentaires

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Contrôle0..*
              TypeExtension
              Est modificateurfalse
              Résuméfalse
              Noms alternatifsextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              94. Observation.component.modifierExtension
              Définition

              May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              CourtExtensions that cannot be ignored even if unrecognized
              Commentaires

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Contrôle0..*
              TypeExtension
              Est modificateurtrue parce que Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
              Résumétrue
              Exigences

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Noms alternatifsextensions, user content, modifiers
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              96. Observation.component.code
              Définition

              Describes what was observed. Sometimes this is called the observation "code".

              CourtType of component observation (code / type)
              Commentaires

              All code-value and component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.

              Contrôle1..1
              BindingPour des exemples de codes, voir LOINCCodes
              (example to http://hl7.org/fhir/ValueSet/observation-codes|4.0.1)

              Codes identifying names of simple observations.

              TypeCodeableConcept
              Est modificateurfalse
              Résumétrue
              Exigences

              Knowing what kind of observation is being made is essential to understanding the observation.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              98. Observation.component.value[x]
              Définition

              The information determined as a result of making the observation, if the information has a simple value.

              CourtActual component result
              Commentaires

              Used when observation has a set of component observations. An observation may have both a value (e.g. an Apgar score) and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

              Contrôle0..1
              TypeChoix de : Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period
              Note [x]VoirChoix de types de donnéespour plus d'informations sur l'utilisation de [x]
              Est modificateurfalse
              Valeur primitiveCet élément primitif peut être présent, absent ou remplacé par une extension
              Résumétrue
              Exigences

              An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              100. Observation.component.dataAbsentReason
              Définition

              Provides a reason why the expected value in the element Observation.component.value[x] is missing.

              CourtWhy the component result is missing
              Commentaires

              "Null" or exceptional values can be represented two ways in FHIR Observations. One way is to simply include them in the value set and represent the exceptions in the value. For example, measurement values for a serology test could be "detected", "not detected", "inconclusive", or "test not done".

              The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values. For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Because of these options, use-case agreements are required to interpret general observations for exceptional values.

              Contrôle0..1
              Cet élément est affecté par les invariants suivants : obs-6
              BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de DataAbsentReason
              (extensible to http://hl7.org/fhir/ValueSet/data-absent-reason|4.0.1)

              Codes specifying why the result (Observation.value[x]) is missing.

              TypeCodeableConcept
              Est modificateurfalse
              Résuméfalse
              Exigences

              For many results it is necessary to handle exceptional values in measurements.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              102. Observation.component.interpretation
              Définition

              A categorical assessment of an observation value. For example, high, low, normal.

              CourtHigh, low, normal, etc.
              Commentaires

              Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result.

              Contrôle0..*
              BindingSauf si inapproprié, ces codes DOIVENT (SHALL) être pris de ObservationInterpretationCodes
              (extensible to http://hl7.org/fhir/ValueSet/observation-interpretation|4.0.1)

              Codes identifying interpretations of observations.

              TypeCodeableConcept
              Est modificateurfalse
              Résuméfalse
              Exigences

              For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.

              Noms alternatifsAbnormal Flag
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              104. Observation.component.referenceRange
              Définition

              Guidance on how to interpret the value by comparison to a normal or recommended range.

              CourtProvides guide for interpretation of component result
              Commentaires

              Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.

              Contrôle0..*
              TypeVoirttp://hl7.org/fhir/StructureDefinition/Observation#Observation.referenceRange
              Est modificateurfalse
              Résuméfalse
              Exigences

              Knowing what values are considered "normal" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))