{
  "resourceType": "StructureDefinition",
  "id": "tumor-measurement",
  "url": "https://www.vision-zero-oncology.de/fhir/StructureDefinition/tumor-measurement",
  "name": "TumorMeasurement",
  "title": "Profile Tumor Measurment",
  "status": "draft",
  "description": "Profile for recording measurements of a tumor like the longest diameter or volume. The resource can be used for different measurement methods (e.g. methods in pathology, radiology or physical exams).",
  "fhirVersion": "4.0.1",
  "mapping": [
    {
      "identity": "workflow",
      "uri": "http://hl7.org/fhir/workflow",
      "name": "Workflow Pattern"
    },
    {
      "identity": "sct-concept",
      "uri": "http://snomed.info/conceptdomain",
      "name": "SNOMED CT Concept Domain Binding"
    },
    {
      "identity": "v2",
      "uri": "http://hl7.org/v2",
      "name": "HL7 v2 Mapping"
    },
    {
      "identity": "rim",
      "uri": "http://hl7.org/v3",
      "name": "RIM Mapping"
    },
    {
      "identity": "w5",
      "uri": "http://hl7.org/fhir/fivews",
      "name": "FiveWs Pattern Mapping"
    },
    {
      "identity": "sct-attr",
      "uri": "http://snomed.org/attributebinding",
      "name": "SNOMED CT Attribute Binding"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation",
        "path": "Observation",
        "constraint": [
          {
            "key": "must-have-focus-or-specimen-invariant",
            "severity": "error",
            "human": "Either `focus` OR `specimen` MUST be populated",
            "expression": "(focus.exists() or specimen.exists()) and (focus.exists() and specimen.exists()).not()",
            "source": "https://www.vision-zero-oncology.de/fhir/StructureDefinition/tumor-measurement"
          }
        ]
      },
      {
        "id": "Observation.code",
        "path": "Observation.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "21889-1",
              "system": "http://loinc.org"
            }
          ]
        },
        "mustSupport": true
      },
      {
        "id": "Observation.subject",
        "path": "Observation.subject",
        "short": "The patient whose tumor was measured.",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Patient"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.focus",
        "path": "Observation.focus",
        "short": "Identifies a tumor that has NOT been removed from the body",
        "definition": "Reference to a BodyStructure resource conforming to Tumor.",
        "comment": "Use **only** when the tumor **has not** been removed from the body. If the tumor has been removed, use `specimen` instead and leave `focus` empty.",
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://www.vision-zero-oncology.de/fhir/StructureDefinition/tumor"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.effective[x]",
        "path": "Observation.effective[x]",
        "mustSupport": true
      },
      {
        "id": "Observation.method",
        "path": "Observation.method",
        "short": "Method for measuring the tumor",
        "definition": "Method for measuring the tumor",
        "comment": "Tumors are typically measured via gross pathology after excision, or via diagnostic imaging or physical exam prior to removal. If `specimen` is set, `method` is expected to be a \"gross pathology\" code. If `focus` is set, `method` is expected to be a type of diagnostic imaging or physical exam.",
        "mustSupport": true,
        "binding": {
          "strength": "extensible",
          "valueSet": "https://www.vision-zero-oncology.de/fhir/ValueSet/tumor-measurement-methods"
        }
      },
      {
        "id": "Observation.specimen",
        "path": "Observation.specimen",
        "short": "Identifies a tumor that has been removed from the body",
        "definition": "Reference to a Specimen resource.",
        "comment": "Use **only** when the tumor **has** been removed from the body. If the tumor has been not removed, use `focus` instead and leave `specimen` empty.",
        "mustSupport": true
      },
      {
        "id": "Observation.component",
        "path": "Observation.component",
        "slicing": {
          "discriminator": [
            {
              "type": "pattern",
              "path": "code"
            }
          ],
          "rules": "open"
        },
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Observation.component:longestDimension",
        "path": "Observation.component",
        "sliceName": "longestDimension",
        "short": "Longest tumor dimension (mm)",
        "definition": "The longest tumor dimension in mm.",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation.component:longestDimension.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "33728-7",
              "system": "http://loinc.org"
            }
          ]
        }
      },
      {
        "id": "Observation.component:longestDimension.value[x]",
        "path": "Observation.component.value[x]",
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "binding": {
          "strength": "required",
          "valueSet": "https://www.vision-zero-oncology.de/fhir/ValueSet/tumor-size-units"
        }
      },
      {
        "id": "Observation.component:shortAxis",
        "path": "Observation.component",
        "sliceName": "shortAxis",
        "short": "short axis of the tumor lesion (mm or cm)",
        "definition": "short axis in mm or cm.",
        "min": 0,
        "max": "1"
      },
      {
        "id": "Observation.component:shortAxis.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "code": "33729-5",
              "system": "http://loinc.org",
              "display": "Size additional dimension in Tumor"
            }
          ]
        }
      },
      {
        "id": "Observation.component:shortAxis.value[x]",
        "path": "Observation.component.value[x]",
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "binding": {
          "strength": "required",
          "valueSet": "https://www.vision-zero-oncology.de/fhir/ValueSet/tumor-size-units"
        }
      },
      {
        "id": "Observation.component:area",
        "path": "Observation.component",
        "sliceName": "area",
        "short": "area of the tumor (mm²)",
        "definition": "tumor area in mm².",
        "min": 0,
        "max": "1"
      },
      {
        "id": "Observation.component:area.value[x]",
        "path": "Observation.component.value[x]",
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "binding": {
          "strength": "required",
          "valueSet": "https://www.vision-zero-oncology.de/fhir/ValueSet/tumor-area-units"
        }
      },
      {
        "id": "Observation.component:volume",
        "path": "Observation.component",
        "sliceName": "volume",
        "short": "tumor volume (ml)",
        "definition": "Tumor volume in ml.",
        "min": 0,
        "max": "1"
      },
      {
        "id": "Observation.component:volume.value[x]",
        "path": "Observation.component.value[x]",
        "type": [
          {
            "code": "Quantity"
          }
        ],
        "binding": {
          "strength": "required",
          "valueSet": "https://www.vision-zero-oncology.de/fhir/ValueSet/tumor-volume-units"
        }
      }
    ]
  }
}