{
  "resourceType": "StructureDefinition",
  "id": "logicalmodel-Tnmclinicalclassification-R4",
  "url": "http://linkehr.com/fhir/logicalmodel-tnmclinicalclassification-R4",
  "identifier": [
    {
      "system": "openEHR-CKM",
      "value": "openEHR-EHR-CLUSTER.tnm.v1"
    }
  ],
  "version": "0",
  "name": "Tnmclinicalclassification",
  "title": "TNM clinical classification",
  "status": "draft",
  "date": "2024-06-18",
  "publisher": "openEHR",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.veratech.es"
        }
      ]
    }
  ],
  "description": "A framework for the clinical classification and stage grouping of malignancies using the TNM system.",
  "purpose": "To record the clinical classification and stage grouping of malignancies using the TNM system.",
  "fhirVersion": "4.0.0",
  "mapping": [
    {
      "identity": "openEHR",
      "uri": "http://openehr.org",
      "name": "openEHR Mapping"
    },
    {
      "identity": "openEHR-natural",
      "uri": "http://openehr.org",
      "name": "openEHR natural path"
    }
  ],
  "kind": "logical",
  "abstract": false,
  "type": "StructureDefinition",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Element",
  "snapshot": {
    "element": [
      {
        "id": "TNM_clinical_classification",
        "path": "TNM_clinical_classification",
        "short": "TNM clinical classification",
        "definition": "A framework for the clinical classification and stage grouping of malignancies using the TNM system.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Anatomical_site",
        "path": "TNM_clinical_classification.Anatomical_site",
        "short": "Anatomical site",
        "definition": "The anatomical site where the assessed tumour is situated.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Anatomical_site",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Anatomical_site.value",
        "path": "TNM_clinical_classification.Anatomical_site.value",
        "short": "Anatomical site",
        "definition": "The anatomical site where the assessed tumour is situated.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Anatomical_site.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Anatomical_subsite",
        "path": "TNM_clinical_classification.Anatomical_subsite",
        "short": "Anatomical subsite",
        "definition": "The anatomical subsite where the assessed tumour is situated.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Anatomical_subsite",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Anatomical_subsite.value",
        "path": "TNM_clinical_classification.Anatomical_subsite.value",
        "short": "Anatomical subsite",
        "definition": "The anatomical subsite where the assessed tumour is situated.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Anatomical_subsite.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Primary_tumour_(T)",
        "path": "TNM_clinical_classification.Primary_tumour_(T)",
        "short": "Primary tumour (T)",
        "definition": "Assessment of the the extent of the primary tumour.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Primary_tumour_(T)",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Primary_tumour_(T).value",
        "path": "TNM_clinical_classification.Primary_tumour_(T).value",
        "short": "Primary tumour (T)",
        "definition": "Assessment of the the extent of the primary tumour.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Primary_tumour_(T).value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Regional_lymph_nodes_(N)",
        "path": "TNM_clinical_classification.Regional_lymph_nodes_(N)",
        "short": "Regional lymph nodes (N)",
        "definition": "Assessment of the the absence or presence and extent of regional lymph node metastasis.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Regional_lymph_nodes_(N)",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Regional_lymph_nodes_(N).value",
        "path": "TNM_clinical_classification.Regional_lymph_nodes_(N).value",
        "short": "Regional lymph nodes (N)",
        "definition": "Assessment of the the absence or presence and extent of regional lymph node metastasis.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Regional_lymph_nodes_(N).value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Distant_metastasis_(M)",
        "path": "TNM_clinical_classification.Distant_metastasis_(M)",
        "short": "Distant metastasis (M)",
        "definition": "Assessment of the absence or presence of distant metastasis.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Distant_metastasis_(M)",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Distant_metastasis_(M).value",
        "path": "TNM_clinical_classification.Distant_metastasis_(M).value",
        "short": "Distant metastasis (M)",
        "definition": "Assessment of the absence or presence of distant metastasis.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Distant_metastasis_(M).value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Histopathological_grade_(G)",
        "path": "TNM_clinical_classification.Histopathological_grade_(G)",
        "short": "Histopathological grade (G)",
        "definition": "Histopathological grading of the tumour.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Histopathological_grade_(G)",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Histopathological_grade_(G).value",
        "path": "TNM_clinical_classification.Histopathological_grade_(G).value",
        "short": "Histopathological grade (G)",
        "definition": "Histopathological grading of the tumour.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Histopathological_grade_(G).value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Residual_tumour_(R)",
        "path": "TNM_clinical_classification.Residual_tumour_(R)",
        "short": "Residual tumour (R)",
        "definition": "Assessment of the presence of residual tumour after treatment.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Residual_tumour_(R)",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Residual_tumour_(R).value",
        "path": "TNM_clinical_classification.Residual_tumour_(R).value",
        "short": "Residual tumour (R)",
        "definition": "Assessment of the presence of residual tumour after treatment.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Residual_tumour_(R).value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Lymphatic_invasion_(L)",
        "path": "TNM_clinical_classification.Lymphatic_invasion_(L)",
        "short": "Lymphatic invasion (L)",
        "definition": "Assessment of invasion into the lymphatic system.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Lymphatic_invasion_(L)",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Lymphatic_invasion_(L).value",
        "path": "TNM_clinical_classification.Lymphatic_invasion_(L).value",
        "short": "Lymphatic invasion (L)",
        "definition": "Assessment of invasion into the lymphatic system.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Lymphatic_invasion_(L).value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Venous_invasion_(V)",
        "path": "TNM_clinical_classification.Venous_invasion_(V)",
        "short": "Venous invasion (V)",
        "definition": "Assessment of invasion into the venous system.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Venous_invasion_(V)",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Venous_invasion_(V).value",
        "path": "TNM_clinical_classification.Venous_invasion_(V).value",
        "short": "Venous invasion (V)",
        "definition": "Assessment of invasion into the venous system.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Venous_invasion_(V).value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Perineural_invasion_(Pn)",
        "path": "TNM_clinical_classification.Perineural_invasion_(Pn)",
        "short": "Perineural invasion (Pn)",
        "definition": "Assessment of invasion into the space surrounding nerves.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Perineural_invasion_(Pn)",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Perineural_invasion_(Pn).value",
        "path": "TNM_clinical_classification.Perineural_invasion_(Pn).value",
        "short": "Perineural invasion (Pn)",
        "definition": "Assessment of invasion into the space surrounding nerves.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Perineural_invasion_(Pn).value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Multiple_primary_tumours_(m)",
        "path": "TNM_clinical_classification.Multiple_primary_tumours_(m)",
        "short": "Multiple primary tumours (m)",
        "definition": "Presence of multiple simultaneous primary tumours at a single site.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Multiple_primary_tumours_(m)",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Multiple_primary_tumours_(m).value_DV_COUNT",
        "path": "TNM_clinical_classification.Multiple_primary_tumours_(m).value_DV_COUNT",
        "short": "Multiple primary tumours (m)",
        "definition": "Presence of multiple simultaneous primary tumours at a single site.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Multiple_primary_tumours_(m).value_DV_COUNT",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Multiple_primary_tumours_(m).value_DV_BOOLEAN",
        "path": "TNM_clinical_classification.Multiple_primary_tumours_(m).value_DV_BOOLEAN",
        "short": "Multiple primary tumours (m)",
        "definition": "Presence of multiple simultaneous primary tumours at a single site.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Multiple_primary_tumours_(m).value_DV_BOOLEAN",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "boolean"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Multimodality_therapy_(y)",
        "path": "TNM_clinical_classification.Multimodality_therapy_(y)",
        "short": "Multimodality therapy (y)",
        "definition": "Record as True if assessment is performed during or following initial multimodal therapy.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Multimodality_therapy_(y)",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Multimodality_therapy_(y).value",
        "path": "TNM_clinical_classification.Multimodality_therapy_(y).value",
        "short": "Multimodality therapy (y)",
        "definition": "Record as True if assessment is performed during or following initial multimodal therapy.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Multimodality_therapy_(y).value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "boolean"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Recurrent_(r)",
        "path": "TNM_clinical_classification.Recurrent_(r)",
        "short": "Recurrent (r)",
        "definition": "Record as True if assessment is performed for a recurring cancer after a disease-free interval.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Recurrent_(r)",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Recurrent_(r).value",
        "path": "TNM_clinical_classification.Recurrent_(r).value",
        "short": "Recurrent (r)",
        "definition": "Record as True if assessment is performed for a recurring cancer after a disease-free interval.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Recurrent_(r).value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "boolean"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Autopsy_(a)",
        "path": "TNM_clinical_classification.Autopsy_(a)",
        "short": "Autopsy (a)",
        "definition": "Record as True if assessment is performed at postmortem examination.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Autopsy_(a)",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Autopsy_(a).value",
        "path": "TNM_clinical_classification.Autopsy_(a).value",
        "short": "Autopsy (a)",
        "definition": "Record as True if assessment is performed at postmortem examination.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Autopsy_(a).value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "boolean"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Carcinoma_in_situ_(is)",
        "path": "TNM_clinical_classification.Carcinoma_in_situ_(is)",
        "short": "Carcinoma in situ (is)",
        "definition": "Record as True if presence of carcinoma in situ associated with the primary tumour.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Carcinoma_in_situ_(is)",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Carcinoma_in_situ_(is).value",
        "path": "TNM_clinical_classification.Carcinoma_in_situ_(is).value",
        "short": "Carcinoma in situ (is)",
        "definition": "Record as True if presence of carcinoma in situ associated with the primary tumour.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Carcinoma_in_situ_(is).value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "boolean"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.TNM_assessment",
        "path": "TNM_clinical_classification.TNM_assessment",
        "short": "TNM assessment",
        "definition": "Concatenation of 'T', 'N' and 'M' assessments plus any optional assessments of 'G', 'R', 'L', 'V', prefixes and/or suffixes, as applicable.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.TNM_assessment",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.TNM_assessment.value",
        "path": "TNM_clinical_classification.TNM_assessment.value",
        "short": "TNM assessment",
        "definition": "Concatenation of 'T', 'N' and 'M' assessments plus any optional assessments of 'G', 'R', 'L', 'V', prefixes and/or suffixes, as applicable.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.TNM_assessment.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.Stage_grouping",
        "path": "TNM_clinical_classification.Stage_grouping",
        "short": "Stage grouping",
        "definition": "The categorisation of the anatomical stage of the tumour, usually based on TNM assessment.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Stage_grouping",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.Stage_grouping.value",
        "path": "TNM_clinical_classification.Stage_grouping.value",
        "short": "Stage grouping",
        "definition": "The categorisation of the anatomical stage of the tumour, usually based on TNM assessment.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.Stage_grouping.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "TNM_clinical_classification.TNM_Edition",
        "path": "TNM_clinical_classification.TNM_Edition",
        "short": "TNM Edition",
        "definition": "The edition of the TNM classification system used for the assessment.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.TNM_Edition",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "TNM_clinical_classification.TNM_Edition.value",
        "path": "TNM_clinical_classification.TNM_Edition.value",
        "short": "TNM Edition",
        "definition": "The edition of the TNM classification system used for the assessment.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "TNM_clinical_classification.TNM_Edition.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      }
    ]
  }
}