Condition

Description

We adapted the Condition resource to capture information on conditions for a Registry.

Title	Canonical
NFDI4Health PR MDS Conditions	https://www.nfdi4health.de/fhir/metadataschema/StructureDefinition/nfdi4health-pr-mds-conditions

References

Reference direction	Title	Path
is referenced by
references to	NFDI4Health_PR_MDS_Group_Actual	subject

NFDI4Health_PR_MDS_Conditions (Condition)

Condition

There are no (further) constraints on this element

Element id

Condition

Short description

Detailed information about conditions, problems or diagnoses

Definition

A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.

Data type

Condition

Constraints

con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item
clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-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()

Mappings

rim: Entity. Role, or Act
workflow: Event
sct-concept: < 243796009 |Situation with explicit context| : 246090004 |Associated finding| = ( ( < 404684003 |Clinical finding| MINUS ( << 420134006 |Propensity to adverse reactions| OR << 473010000 |Hypersensitivity condition| OR << 79899007 |Drug interaction| OR << 69449002 |Drug action| OR << 441742003 |Evaluation finding| OR << 307824009 |Administrative status| OR << 385356007 |Tumor stage finding|)) OR < 272379006 |Event|)
v2: PPR message
rim: Observation[classCode=OBS, moodCode=EVN, code=ASSERTION, value<Diagnosis]

0..1

string

There are no (further) constraints on this element

Element id

Condition.id

Short description

Logical id of this artifact

Definition

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

Comments

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

Data type

string

Meta

There are no (further) constraints on this element

Element id

Condition.meta

Short description

Metadata about the resource

Definition

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.

Data type

Meta

Constraints

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

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

Condition.implicitRules

Short description

A set of rules under which this content was created

Definition

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.

Comments

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.

Data type

uri

Constraints

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

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

Condition.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

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).

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Constraints

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

text

0..1

Narrative

There are no (further) constraints on this element

Element id

Condition.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

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.

Comments

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.

Data type

Narrative

Constraints

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

Mappings

rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

Condition.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

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.

Comments

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.

Data type

Resource

Mappings

rim: N/A

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

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.

Comments

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.

Data type

Extension

Constraints

ele-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()

Mappings

rim: N/A

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

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).

Requirements

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.

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: N/A

identifier

0..*

Identifier

There are no (further) constraints on this element

Element id

Condition.identifier

Short description

External Ids for this condition

Definition

Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

Requirements

Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers.

Comments

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

Data type

Identifier

Constraints

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

Mappings

workflow: Event.identifier
w5: FiveWs.identifier
rim: .id

clinicalStatus

Σ ?! C

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Condition.clinicalStatus

Short description

Definition

The clinical status of the condition.

Comments

The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

Data type

CodeableConcept

Binding

The clinical status of the condition or diagnosis.

ConditionClinicalStatusCodes (required)

Conditions

The cardinality or value of this element may be affected by these constraints: con-3, con-4, con-5

Constraints

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

Mappings

workflow: Event.status
w5: FiveWs.status
sct-concept: < 303105007 |Disease phases|
v2: PRB-14
rim: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value

verificationStatus

Σ ?! C

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Condition.verificationStatus

Short description

Definition

The verification status to support the clinical status of the condition.

Comments

verificationStatus is not required. For example, when a patient has abdominal pain in the ED, there is not likely going to be a verification status. The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

Data type

CodeableConcept

Binding

The verification status to support or decline the clinical status of the condition or diagnosis.

ConditionVerificationStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: con-3, con-5

Constraints

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

Mappings

workflow: Event.status
w5: FiveWs.status
sct-concept: < 410514004 |Finding context value|
v2: PRB-13
rim: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value
sct-attr: 408729009

category

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Condition.category

Short description

problem-list-item | encounter-diagnosis

Definition

A category assigned to the condition.

Comments

The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

Data type

CodeableConcept

Binding

A category assigned to the condition.

ConditionCategoryCodes (extensible)

Constraints

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

Mappings

w5: FiveWs.class
sct-concept: < 404684003 |Clinical finding|
v2: 'problem' if from PRB-3. 'diagnosis' if from DG1 segment in PV1 message
rim: .code

severity

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Condition.severity

Short description

Subjective severity of condition

Definition

A subjective assessment of the severity of the condition as evaluated by the clinician.

Comments

Coding of the severity with a terminology is preferred, where possible.

Data type

CodeableConcept

Binding

A subjective assessment of the severity of the condition as evaluated by the clinician.

Condition/DiagnosisSeverity (preferred)

Constraints

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

Mappings

w5: FiveWs.grade
sct-concept: < 272141005 |Severities|
v2: PRB-26 / ABS-3
rim: Can be pre/post-coordinated into value. Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="severity"].value
sct-attr: 246112005

code

0..1

CodeableConcept

Element id

Condition.code

Short description

Primary health conditions or diseases considered in the [RESOURCE]

Alternate names

type

Definition

Group of items providing information about primary health conditions or diseases considered in the [RESOURCE].

Requirements

0..1 to account for primarily narrative only resources.

Data type

CodeableConcept

Binding

Identification of the condition or diagnosis.

Condition/Problem/DiagnosisCodes (example)

Constraints

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

Mappings

workflow: Event.code
w5: FiveWs.what[x]
sct-concept: code 246090004 |Associated finding| (< 404684003 |Clinical finding| MINUS << 420134006 |Propensity to adverse reactions| MINUS << 473010000 |Hypersensitivity condition| MINUS << 79899007 |Drug interaction| MINUS << 69449002 |Drug action| MINUS << 441742003 |Evaluation finding| MINUS << 307824009 |Administrative status| MINUS << 385356007 |Tumor stage finding|) OR < 413350009 |Finding with explicit context| OR < 272379006 |Event|
v2: PRB-3
rim: .value
sct-attr: 246090004
NFDI4Health: Design.conditions

0..1

string

There are no (further) constraints on this element

Element id

Condition.code.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.code.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

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.

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-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()

Mappings

rim: n/a

coding

0..*

Coding

There are no (further) constraints on this element

Element id

Condition.code.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Data type

Coding

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

Condition.code.coding.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

1..*

Extension

There are no (further) constraints on this element

Element id

Condition.code.coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-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()

Mappings

rim: n/a

codeableConcept

1..1

Extension(Complex)

Element id

Condition.code.coding.extension:codeableConcept

Short description

NFDI4Health Codeable Concept

Alternate names

extensions, user content

Definition

NFDI4Health Representation of Codeable Concept.

Comments

Data type

Extension(Complex)

Extension URL

https://www.nfdi4health.de/fhir/metadataschema/StructureDefinition/nfdi4health-ex-mds-codeableconcept

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-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()

Mappings

rim: n/a
rim: N/A
NFDI4Health: Design.conditions.code

system

0..1

uri

There are no (further) constraints on this element

Element id

Condition.code.coding.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Data type

uri

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

Condition.code.coding.version

Short description

Version of the system - if relevant

Definition

The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

Comments

Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

Data type

string

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

0..1

code

Element id

Condition.code.coding.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Data type

code

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
NFDI4Health: Design.conditions.classification

display

0..1

string

There are no (further) constraints on this element

Element id

Condition.code.coding.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Data type

string

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

Condition.code.coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Data type

boolean

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

1..1

string

Element id

Condition.code.text

Short description

Health condition or disease

Definition

The disease, disorder, syndrome, illness, or injury that is being studied. Conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Requirements

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Comments

Preferably, use terms from terminologies such as SNOMED CT.

Data type

string

Constraints

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

Examples
Example of a health condition

SARS-CoV-2

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
NFDI4Health: Design.conditions.label

bodySite

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

Condition.bodySite

Short description

Anatomical location, if relevant

Definition

The anatomical location where this condition manifests itself.

Comments

Only used if not implicit in code found in Condition.code. If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension bodySite. May be a summary code, or a reference to a very precise definition of the location, or both.

Data type

CodeableConcept

Binding

Codes describing anatomical locations. May include laterality.

SNOMEDCTBodyStructures (example)

Constraints

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

Mappings

sct-concept: < 442083009 |Anatomical or acquired body structure|
rim: .targetBodySiteCode
sct-attr: 363698007

subject

1..1

Reference(NFDI4Health_PR_MDS_Group_Actual)

Element id

Condition.subject

Short description

Who has the condition?

Alternate names

patient

Definition

Indicates the patient or group who the condition record is associated with.

Requirements

Group is typically used for veterinary or public health use cases.

Data type

Reference(NFDI4Health_PR_MDS_Group_Actual)

Constraints

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

Mappings

workflow: Event.subject
w5: FiveWs.subject[x]
v2: PID-3
rim: .participation[typeCode=SBJ].role[classCode=PAT]
w5: FiveWs.subject

encounter

0..1

Reference(Encounter)

There are no (further) constraints on this element

Element id

Condition.encounter

Short description

Encounter created as part of

Definition

The Encounter during which this Condition was created or to which the creation of this record is tightly associated.

Comments

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. This record indicates the encounter this particular record is associated with. In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known".

Data type

Reference(Encounter)

Constraints

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

Mappings

workflow: Event.context
w5: FiveWs.context
v2: PV1-19 (+PV1-54)
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]

onset[x]

0..1

There are no (further) constraints on this element

Element id

Condition.onset[x]

Short description

Estimated or actual date, date-time, or age

Definition

Estimated or actual date or date-time the condition began, in the opinion of the clinician.

Comments

Age is generally used when the patient reports an age at which the Condition began to occur.

Constraints

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

Mappings

workflow: Event.occurrence[x]
w5: FiveWs.init
v2: PRB-16
rim: .effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at onset"].value

onsetDateTime

dateTime

There are no (further) constraints on this element

Data type

dateTime

onsetAge

Age

There are no (further) constraints on this element

Data type

Age

onsetPeriod

Period

There are no (further) constraints on this element

Data type

Period

onsetRange

Range

There are no (further) constraints on this element

Data type

Range

onsetString

string

There are no (further) constraints on this element

Data type

string

abatement[x]

0..1

There are no (further) constraints on this element

Element id

Condition.abatement[x]

Short description

When in resolution/remission

Definition

The date or estimated date that the condition resolved or went into remission. This is called "abatement" because of the many overloaded connotations associated with "remission" or "resolution" - Conditions are never really resolved, but they can abate.

Comments

There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid. When abatementString exists, it implies the condition is abated.

Conditions

The cardinality or value of this element may be affected by these constraints: con-4

Constraints

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

Mappings

w5: FiveWs.done[x]
rim: .effectiveTime.high or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at remission"].value or .inboundRelationship[typeCode=SUBJ]source[classCode=CONC, moodCode=EVN].status=completed

abatementDateTime

dateTime

There are no (further) constraints on this element

Data type

dateTime

abatementAge

Age

There are no (further) constraints on this element

Data type

Age

abatementPeriod

Period

There are no (further) constraints on this element

Data type

Period

abatementRange

Range

There are no (further) constraints on this element

Data type

Range

abatementString

string

There are no (further) constraints on this element

Data type

string

recordedDate

0..1

dateTime

There are no (further) constraints on this element

Element id

Condition.recordedDate

Short description

Date record was first recorded

Definition

The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date.

Data type

dateTime

Constraints

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

Mappings

w5: FiveWs.recorded
v2: REL-11
rim: .participation[typeCode=AUT].time

recorder

0..1

Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)

There are no (further) constraints on this element

Element id

Condition.recorder

Short description

Who recorded the condition

Definition

Individual who recorded the record and takes responsibility for its content.

Data type

Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)

Constraints

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

Mappings

w5: FiveWs.author
rim: .participation[typeCode=AUT].role

asserter

0..1

Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)

There are no (further) constraints on this element

Element id

Condition.asserter

Short description

Person who asserts this condition

Definition

Individual who is making the condition statement.

Data type

Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)

Constraints

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

Mappings

w5: FiveWs.source
v2: REL-7.1 identifier + REL-7.12 type code
rim: .participation[typeCode=INF].role

stage

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Condition.stage

Short description

Stage/grade, usually assessed formally

Definition

Clinical stage or grade of a condition. May include formal severity assessments.

Data type

BackboneElement

Constraints

con-1: Stage SHALL have summary or assessment
summary.exists() or assessment.exists()
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage/grade"]

0..1

string

There are no (further) constraints on this element

Element id

Condition.stage.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.stage.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: n/a

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.stage.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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).

Requirements

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: N/A

summary

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

Condition.stage.summary

Short description

Simple summary (disease specific)

Definition

A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific.

Data type

CodeableConcept

Binding

Codes describing condition stages (e.g. Cancer stages).

ConditionStage (example)

Conditions

The cardinality or value of this element may be affected by these constraints: con-1

Constraints

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

Mappings

sct-concept: < 254291000 |Staging and scales|
v2: PRB-14
rim: .value

assessment

0..*

Reference(ClinicalImpression | DiagnosticReport | Observation)

There are no (further) constraints on this element

Element id

Condition.stage.assessment

Short description

Formal record of assessment

Definition

Reference to a formal record of the evidence on which the staging assessment is based.

Data type

Reference(ClinicalImpression | DiagnosticReport | Observation)

Conditions

The cardinality or value of this element may be affected by these constraints: con-1

Constraints

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

Mappings

rim: .self

type

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

Condition.stage.type

Short description

Kind of staging

Definition

The kind of staging, such as pathological or clinical staging.

Data type

CodeableConcept

Binding

Codes describing the kind of condition staging (e.g. clinical or pathological).

ConditionStageType (example)

Constraints

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

Mappings

rim: ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage type"]

evidence

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Condition.evidence

Short description

Supporting evidence

Definition

Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the condition.

Comments

The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.

Data type

BackboneElement

Constraints

con-2: evidence SHALL have code or details
code.exists() or detail.exists()
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .outboundRelationship[typeCode=SPRT].target[classCode=OBS, moodCode=EVN]

0..1

string

There are no (further) constraints on this element

Element id

Condition.evidence.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.evidence.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: n/a

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.evidence.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: N/A

code

Σ C

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

Condition.evidence.code

Short description

Manifestation/symptom

Definition

A manifestation or symptom that led to the recording of this condition.

Data type

CodeableConcept

Binding

Codes that describe the manifestation or symptoms of a condition.

ManifestationAndSymptomCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: con-2

Constraints

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

Mappings

workflow: Event.reasonCode
w5: FiveWs.why[x]
sct-concept: < 404684003 |Clinical finding|
rim: [code="diagnosis"].value

detail

Σ C

0..*

Reference(Resource)

There are no (further) constraints on this element

Element id

Condition.evidence.detail

Short description

Supporting information found elsewhere

Definition

Links to other relevant information, including pathology reports.

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: con-2

Constraints

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

Mappings

w5: FiveWs.why[x]
rim: .self

note

0..*

Annotation

There are no (further) constraints on this element

Element id

Condition.note

Short description

Additional information about the Condition

Definition

Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis.

Data type

Annotation

Constraints

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

Mappings

workflow: Event.note
v2: NTE child of PRB
rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value

NFDI4Health_PR_MDS_Conditions (Condition)

Condition

There are no (further) constraints on this element

Element id

Condition

Short description

Detailed information about conditions, problems or diagnoses

Definition

A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.

Data type

Condition

Constraints

con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item
clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-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()

Mappings

rim: Entity. Role, or Act
workflow: Event
sct-concept: < 243796009 |Situation with explicit context| : 246090004 |Associated finding| = ( ( < 404684003 |Clinical finding| MINUS ( << 420134006 |Propensity to adverse reactions| OR << 473010000 |Hypersensitivity condition| OR << 79899007 |Drug interaction| OR << 69449002 |Drug action| OR << 441742003 |Evaluation finding| OR << 307824009 |Administrative status| OR << 385356007 |Tumor stage finding|)) OR < 272379006 |Event|)
v2: PPR message
rim: Observation[classCode=OBS, moodCode=EVN, code=ASSERTION, value<Diagnosis]

0..1

string

There are no (further) constraints on this element

Element id

Condition.id

Short description

Logical id of this artifact

Definition

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

Comments

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

Data type

string

Meta

There are no (further) constraints on this element

Element id

Condition.meta

Short description

Metadata about the resource

Definition

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.

Data type

Meta

Constraints

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

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

Condition.implicitRules

Short description

A set of rules under which this content was created

Definition

Comments

Data type

uri

Constraints

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

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

Condition.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Constraints

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

text

0..1

Narrative

There are no (further) constraints on this element

Element id

Condition.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

Comments

Data type

Narrative

Constraints

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

Mappings

rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

Condition.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

Comments

Data type

Resource

Mappings

rim: N/A

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: N/A

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

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

Requirements

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: N/A

identifier

0..*

Identifier

There are no (further) constraints on this element

Element id

Condition.identifier

Short description

External Ids for this condition

Definition

Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

Requirements

Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers.

Comments

Data type

Identifier

Constraints

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

Mappings

workflow: Event.identifier
w5: FiveWs.identifier
rim: .id

clinicalStatus

Σ ?! C

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Condition.clinicalStatus

Short description

Definition

The clinical status of the condition.

Comments

Data type

CodeableConcept

Binding

The clinical status of the condition or diagnosis.

ConditionClinicalStatusCodes (required)

Conditions

The cardinality or value of this element may be affected by these constraints: con-3, con-4, con-5

Constraints

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

Mappings

workflow: Event.status
w5: FiveWs.status
sct-concept: < 303105007 |Disease phases|
v2: PRB-14
rim: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value

verificationStatus

Σ ?! C

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Condition.verificationStatus

Short description

Definition

The verification status to support the clinical status of the condition.

Comments

Data type

CodeableConcept

Binding

The verification status to support or decline the clinical status of the condition or diagnosis.

ConditionVerificationStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: con-3, con-5

Constraints

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

Mappings

workflow: Event.status
w5: FiveWs.status
sct-concept: < 410514004 |Finding context value|
v2: PRB-13
rim: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value
sct-attr: 408729009

category

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Condition.category

Short description

problem-list-item | encounter-diagnosis

Definition

A category assigned to the condition.

Comments

The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

Data type

CodeableConcept

Binding

A category assigned to the condition.

ConditionCategoryCodes (extensible)

Constraints

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

Mappings

w5: FiveWs.class
sct-concept: < 404684003 |Clinical finding|
v2: 'problem' if from PRB-3. 'diagnosis' if from DG1 segment in PV1 message
rim: .code

severity

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Condition.severity

Short description

Subjective severity of condition

Definition

A subjective assessment of the severity of the condition as evaluated by the clinician.

Comments

Coding of the severity with a terminology is preferred, where possible.

Data type

CodeableConcept

Binding

A subjective assessment of the severity of the condition as evaluated by the clinician.

Condition/DiagnosisSeverity (preferred)

Constraints

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

Mappings

w5: FiveWs.grade
sct-concept: < 272141005 |Severities|
v2: PRB-26 / ABS-3
rim: Can be pre/post-coordinated into value. Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="severity"].value
sct-attr: 246112005

code

0..1

CodeableConcept

Element id

Condition.code

Short description

Primary health conditions or diseases considered in the [RESOURCE]

Alternate names

type

Definition

Group of items providing information about primary health conditions or diseases considered in the [RESOURCE].

Requirements

0..1 to account for primarily narrative only resources.

Data type

CodeableConcept

Binding

Identification of the condition or diagnosis.

Condition/Problem/DiagnosisCodes (example)

Constraints

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

Mappings

workflow: Event.code
w5: FiveWs.what[x]
sct-concept: code 246090004 |Associated finding| (< 404684003 |Clinical finding| MINUS << 420134006 |Propensity to adverse reactions| MINUS << 473010000 |Hypersensitivity condition| MINUS << 79899007 |Drug interaction| MINUS << 69449002 |Drug action| MINUS << 441742003 |Evaluation finding| MINUS << 307824009 |Administrative status| MINUS << 385356007 |Tumor stage finding|) OR < 413350009 |Finding with explicit context| OR < 272379006 |Event|
v2: PRB-3
rim: .value
sct-attr: 246090004
NFDI4Health: Design.conditions

0..1

string

There are no (further) constraints on this element

Element id

Condition.code.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.code.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-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()

Mappings

rim: n/a

coding

0..*

Coding

There are no (further) constraints on this element

Element id

Condition.code.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Data type

Coding

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

Condition.code.coding.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

1..*

Extension

There are no (further) constraints on this element

Element id

Condition.code.coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-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()

Mappings

rim: n/a

codeableConcept

1..1

Extension(Complex)

Element id

Condition.code.coding.extension:codeableConcept

Short description

NFDI4Health Codeable Concept

Alternate names

extensions, user content

Definition

NFDI4Health Representation of Codeable Concept.

Comments

Data type

Extension(Complex)

Extension URL

https://www.nfdi4health.de/fhir/metadataschema/StructureDefinition/nfdi4health-ex-mds-codeableconcept

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-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()

Mappings

rim: n/a
rim: N/A
NFDI4Health: Design.conditions.code

system

0..1

uri

There are no (further) constraints on this element

Element id

Condition.code.coding.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

uri

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

Condition.code.coding.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

string

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

0..1

code

Element id

Condition.code.coding.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Data type

code

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
NFDI4Health: Design.conditions.classification

display

0..1

string

There are no (further) constraints on this element

Element id

Condition.code.coding.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Data type

string

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

Condition.code.coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

boolean

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

1..1

string

Element id

Condition.code.text

Short description

Health condition or disease

Definition

The disease, disorder, syndrome, illness, or injury that is being studied. Conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Requirements

Comments

Preferably, use terms from terminologies such as SNOMED CT.

Data type

string

Constraints

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

Examples
Example of a health condition

SARS-CoV-2

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
NFDI4Health: Design.conditions.label

bodySite

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

Condition.bodySite

Short description

Anatomical location, if relevant

Definition

The anatomical location where this condition manifests itself.

Comments

Data type

CodeableConcept

Binding

Codes describing anatomical locations. May include laterality.

SNOMEDCTBodyStructures (example)

Constraints

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

Mappings

sct-concept: < 442083009 |Anatomical or acquired body structure|
rim: .targetBodySiteCode
sct-attr: 363698007

subject

1..1

Reference(NFDI4Health_PR_MDS_Group_Actual)

Element id

Condition.subject

Short description

Who has the condition?

Alternate names

patient

Definition

Indicates the patient or group who the condition record is associated with.

Requirements

Group is typically used for veterinary or public health use cases.

Data type

Reference(NFDI4Health_PR_MDS_Group_Actual)

Constraints

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

Mappings

workflow: Event.subject
w5: FiveWs.subject[x]
v2: PID-3
rim: .participation[typeCode=SBJ].role[classCode=PAT]
w5: FiveWs.subject

encounter

0..1

Reference(Encounter)

There are no (further) constraints on this element

Element id

Condition.encounter

Short description

Encounter created as part of

Definition

The Encounter during which this Condition was created or to which the creation of this record is tightly associated.

Comments

Data type

Reference(Encounter)

Constraints

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

Mappings

workflow: Event.context
w5: FiveWs.context
v2: PV1-19 (+PV1-54)
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]

onset[x]

0..1

There are no (further) constraints on this element

Element id

Condition.onset[x]

Short description

Estimated or actual date, date-time, or age

Definition

Estimated or actual date or date-time the condition began, in the opinion of the clinician.

Comments

Age is generally used when the patient reports an age at which the Condition began to occur.

Constraints

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

Mappings

workflow: Event.occurrence[x]
w5: FiveWs.init
v2: PRB-16
rim: .effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at onset"].value

onsetDateTime

dateTime

There are no (further) constraints on this element

Data type

dateTime

onsetAge

Age

There are no (further) constraints on this element

Data type

Age

onsetPeriod

Period

There are no (further) constraints on this element

Data type

Period

onsetRange

Range

There are no (further) constraints on this element

Data type

Range

onsetString

string

There are no (further) constraints on this element

Data type

string

abatement[x]

0..1

There are no (further) constraints on this element

Element id

Condition.abatement[x]

Short description

When in resolution/remission

Definition

Comments

Conditions

The cardinality or value of this element may be affected by these constraints: con-4

Constraints

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

Mappings

w5: FiveWs.done[x]
rim: .effectiveTime.high or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at remission"].value or .inboundRelationship[typeCode=SUBJ]source[classCode=CONC, moodCode=EVN].status=completed

abatementDateTime

dateTime

There are no (further) constraints on this element

Data type

dateTime

abatementAge

Age

There are no (further) constraints on this element

Data type

Age

abatementPeriod

Period

There are no (further) constraints on this element

Data type

Period

abatementRange

Range

There are no (further) constraints on this element

Data type

Range

abatementString

string

There are no (further) constraints on this element

Data type

string

recordedDate

0..1

dateTime

There are no (further) constraints on this element

Element id

Condition.recordedDate

Short description

Date record was first recorded

Definition

The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date.

Data type

dateTime

Constraints

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

Mappings

w5: FiveWs.recorded
v2: REL-11
rim: .participation[typeCode=AUT].time

recorder

0..1

Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)

There are no (further) constraints on this element

Element id

Condition.recorder

Short description

Who recorded the condition

Definition

Individual who recorded the record and takes responsibility for its content.

Data type

Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)

Constraints

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

Mappings

w5: FiveWs.author
rim: .participation[typeCode=AUT].role

asserter

0..1

Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)

There are no (further) constraints on this element

Element id

Condition.asserter

Short description

Person who asserts this condition

Definition

Individual who is making the condition statement.

Data type

Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)

Constraints

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

Mappings

w5: FiveWs.source
v2: REL-7.1 identifier + REL-7.12 type code
rim: .participation[typeCode=INF].role

stage

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Condition.stage

Short description

Stage/grade, usually assessed formally

Definition

Clinical stage or grade of a condition. May include formal severity assessments.

Data type

BackboneElement

Constraints

con-1: Stage SHALL have summary or assessment
summary.exists() or assessment.exists()
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage/grade"]

0..1

string

There are no (further) constraints on this element

Element id

Condition.stage.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.stage.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: n/a

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.stage.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: N/A

summary

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

Condition.stage.summary

Short description

Simple summary (disease specific)

Definition

A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific.

Data type

CodeableConcept

Binding

Codes describing condition stages (e.g. Cancer stages).

ConditionStage (example)

Conditions

The cardinality or value of this element may be affected by these constraints: con-1

Constraints

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

Mappings

sct-concept: < 254291000 |Staging and scales|
v2: PRB-14
rim: .value

assessment

0..*

Reference(ClinicalImpression | DiagnosticReport | Observation)

There are no (further) constraints on this element

Element id

Condition.stage.assessment

Short description

Formal record of assessment

Definition

Reference to a formal record of the evidence on which the staging assessment is based.

Data type

Reference(ClinicalImpression | DiagnosticReport | Observation)

Conditions

The cardinality or value of this element may be affected by these constraints: con-1

Constraints

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

Mappings

rim: .self

type

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

Condition.stage.type

Short description

Kind of staging

Definition

The kind of staging, such as pathological or clinical staging.

Data type

CodeableConcept

Binding

Codes describing the kind of condition staging (e.g. clinical or pathological).

ConditionStageType (example)

Constraints

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

Mappings

rim: ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage type"]

evidence

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Condition.evidence

Short description

Supporting evidence

Definition

Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the condition.

Comments

The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.

Data type

BackboneElement

Constraints

con-2: evidence SHALL have code or details
code.exists() or detail.exists()
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .outboundRelationship[typeCode=SPRT].target[classCode=OBS, moodCode=EVN]

0..1

string

There are no (further) constraints on this element

Element id

Condition.evidence.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.evidence.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: n/a

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.evidence.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: N/A

code

Σ C

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

Condition.evidence.code

Short description

Manifestation/symptom

Definition

A manifestation or symptom that led to the recording of this condition.

Data type

CodeableConcept

Binding

Codes that describe the manifestation or symptoms of a condition.

ManifestationAndSymptomCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: con-2

Constraints

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

Mappings

workflow: Event.reasonCode
w5: FiveWs.why[x]
sct-concept: < 404684003 |Clinical finding|
rim: [code="diagnosis"].value

detail

Σ C

0..*

Reference(Resource)

There are no (further) constraints on this element

Element id

Condition.evidence.detail

Short description

Supporting information found elsewhere

Definition

Links to other relevant information, including pathology reports.

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: con-2

Constraints

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

Mappings

w5: FiveWs.why[x]
rim: .self

note

0..*

Annotation

There are no (further) constraints on this element

Element id

Condition.note

Short description

Additional information about the Condition

Definition

Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis.

Data type

Annotation

Constraints

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

Mappings

workflow: Event.note
v2: NTE child of PRB
rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value

NFDI4Health_PR_MDS_Conditions (Condition)

Condition

There are no (further) constraints on this element

Element id

Condition

Short description

Detailed information about conditions, problems or diagnoses

Definition

A clinical condition, problem, diagnosis, or other event, situation, issue, or clinical concept that has risen to a level of concern.

Data type

Condition

Constraints

con-3: Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item
clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-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()

Mappings

rim: Entity. Role, or Act
workflow: Event
sct-concept: < 243796009 |Situation with explicit context| : 246090004 |Associated finding| = ( ( < 404684003 |Clinical finding| MINUS ( << 420134006 |Propensity to adverse reactions| OR << 473010000 |Hypersensitivity condition| OR << 79899007 |Drug interaction| OR << 69449002 |Drug action| OR << 441742003 |Evaluation finding| OR << 307824009 |Administrative status| OR << 385356007 |Tumor stage finding|)) OR < 272379006 |Event|)
v2: PPR message
rim: Observation[classCode=OBS, moodCode=EVN, code=ASSERTION, value<Diagnosis]

0..1

string

There are no (further) constraints on this element

Element id

Condition.id

Short description

Logical id of this artifact

Definition

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

Comments

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

Data type

string

Meta

There are no (further) constraints on this element

Element id

Condition.meta

Short description

Metadata about the resource

Definition

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.

Data type

Meta

Constraints

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

implicitRules

Σ ?!

0..1

uri

There are no (further) constraints on this element

Element id

Condition.implicitRules

Short description

A set of rules under which this content was created

Definition

Comments

Data type

uri

Constraints

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

language

0..1

codeBinding

There are no (further) constraints on this element

Element id

Condition.language

Short description

Language of the resource content

Definition

The base language in which the resource is written.

Comments

Data type

code

Binding

A human language.

CommonLanguages (preferred)

Binding extensions

maxValueSet	AllLanguages

Constraints

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

text

0..1

Narrative

There are no (further) constraints on this element

Element id

Condition.text

Short description

Text summary of the resource, for human interpretation

Alternate names

narrative, html, xhtml, display

Definition

Comments

Data type

Narrative

Constraints

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

Mappings

rim: Act.text?

contained

0..*

Resource

There are no (further) constraints on this element

Element id

Condition.contained

Short description

Contained, inline Resources

Alternate names

inline resources, anonymous resources, contained resources

Definition

Comments

Data type

Resource

Mappings

rim: N/A

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: N/A

modifierExtension

?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.modifierExtension

Short description

Extensions that cannot be ignored

Alternate names

extensions, user content

Definition

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

Requirements

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: N/A

identifier

0..*

Identifier

There are no (further) constraints on this element

Element id

Condition.identifier

Short description

External Ids for this condition

Definition

Business identifiers assigned to this condition by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

Requirements

Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers.

Comments

Data type

Identifier

Constraints

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

Mappings

workflow: Event.identifier
w5: FiveWs.identifier
rim: .id

clinicalStatus

Σ ?! C

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Condition.clinicalStatus

Short description

Definition

The clinical status of the condition.

Comments

Data type

CodeableConcept

Binding

The clinical status of the condition or diagnosis.

ConditionClinicalStatusCodes (required)

Conditions

The cardinality or value of this element may be affected by these constraints: con-3, con-4, con-5

Constraints

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

Mappings

workflow: Event.status
w5: FiveWs.status
sct-concept: < 303105007 |Disease phases|
v2: PRB-14
rim: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value

verificationStatus

Σ ?! C

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Condition.verificationStatus

Short description

Definition

The verification status to support the clinical status of the condition.

Comments

Data type

CodeableConcept

Binding

The verification status to support or decline the clinical status of the condition or diagnosis.

ConditionVerificationStatus (required)

Conditions

The cardinality or value of this element may be affected by these constraints: con-3, con-5

Constraints

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

Mappings

workflow: Event.status
w5: FiveWs.status
sct-concept: < 410514004 |Finding context value|
v2: PRB-13
rim: Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value
sct-attr: 408729009

category

0..*

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Condition.category

Short description

problem-list-item | encounter-diagnosis

Definition

A category assigned to the condition.

Comments

The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.

Data type

CodeableConcept

Binding

A category assigned to the condition.

ConditionCategoryCodes (extensible)

Constraints

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

Mappings

w5: FiveWs.class
sct-concept: < 404684003 |Clinical finding|
v2: 'problem' if from PRB-3. 'diagnosis' if from DG1 segment in PV1 message
rim: .code

severity

0..1

CodeableConceptBinding

There are no (further) constraints on this element

Element id

Condition.severity

Short description

Subjective severity of condition

Definition

A subjective assessment of the severity of the condition as evaluated by the clinician.

Comments

Coding of the severity with a terminology is preferred, where possible.

Data type

CodeableConcept

Binding

A subjective assessment of the severity of the condition as evaluated by the clinician.

Condition/DiagnosisSeverity (preferred)

Constraints

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

Mappings

w5: FiveWs.grade
sct-concept: < 272141005 |Severities|
v2: PRB-26 / ABS-3
rim: Can be pre/post-coordinated into value. Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="severity"].value
sct-attr: 246112005

code

0..1

CodeableConcept

Element id

Condition.code

Short description

Primary health conditions or diseases considered in the [RESOURCE]

Alternate names

type

Definition

Group of items providing information about primary health conditions or diseases considered in the [RESOURCE].

Requirements

0..1 to account for primarily narrative only resources.

Data type

CodeableConcept

Binding

Identification of the condition or diagnosis.

Condition/Problem/DiagnosisCodes (example)

Constraints

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

Mappings

workflow: Event.code
w5: FiveWs.what[x]
sct-concept: code 246090004 |Associated finding| (< 404684003 |Clinical finding| MINUS << 420134006 |Propensity to adverse reactions| MINUS << 473010000 |Hypersensitivity condition| MINUS << 79899007 |Drug interaction| MINUS << 69449002 |Drug action| MINUS << 441742003 |Evaluation finding| MINUS << 307824009 |Administrative status| MINUS << 385356007 |Tumor stage finding|) OR < 413350009 |Finding with explicit context| OR < 272379006 |Event|
v2: PRB-3
rim: .value
sct-attr: 246090004
NFDI4Health: Design.conditions

0..1

string

There are no (further) constraints on this element

Element id

Condition.code.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.code.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-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()

Mappings

rim: n/a

coding

0..*

Coding

There are no (further) constraints on this element

Element id

Condition.code.coding

Short description

Code defined by a terminology system

Definition

A reference to a code defined by a terminology system.

Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

Data type

Coding

Constraints

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

Mappings

v2: C*E.1-8, C*E.10-22
rim: union(., ./translation)
orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding

0..1

string

There are no (further) constraints on this element

Element id

Condition.code.coding.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

1..*

Extension

There are no (further) constraints on this element

Element id

Condition.code.coding.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Slicing

Unordered, Open, by url(Value)

Extensions are always sliced by (at least) url

Constraints

ele-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()

Mappings

rim: n/a

codeableConcept

1..1

Extension(Complex)

Element id

Condition.code.coding.extension:codeableConcept

Short description

NFDI4Health Codeable Concept

Alternate names

extensions, user content

Definition

NFDI4Health Representation of Codeable Concept.

Comments

Data type

Extension(Complex)

Extension URL

https://www.nfdi4health.de/fhir/metadataschema/StructureDefinition/nfdi4health-ex-mds-codeableconcept

Conditions

The cardinality or value of this element may be affected by these constraints: ele-1

Constraints

ele-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()

Mappings

rim: n/a
rim: N/A
NFDI4Health: Design.conditions.code

system

0..1

uri

There are no (further) constraints on this element

Element id

Condition.code.coding.system

Short description

Identity of the terminology system

Definition

The identification of the code system that defines the meaning of the symbol in the code.

Requirements

Need to be unambiguous about the source of the definition of the symbol.

Comments

Data type

uri

Constraints

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

Mappings

v2: C*E.3
rim: ./codeSystem
orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem

version

0..1

string

There are no (further) constraints on this element

Element id

Condition.code.coding.version

Short description

Version of the system - if relevant

Definition

Comments

Data type

string

Constraints

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

Mappings

v2: C*E.7
rim: ./codeSystemVersion
orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion

code

0..1

code

Element id

Condition.code.coding.code

Short description

Symbol in syntax defined by the system

Definition

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

Requirements

Need to refer to a particular code in the system.

Data type

code

Constraints

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

Mappings

v2: C*E.1
rim: ./code
orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
NFDI4Health: Design.conditions.classification

display

0..1

string

There are no (further) constraints on this element

Element id

Condition.code.coding.display

Short description

Representation defined by the system

Definition

A representation of the meaning of the code in the system, following the rules of the system.

Requirements

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Data type

string

Constraints

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

Mappings

v2: C*E.2 - but note this is not well followed
rim: CV.displayName
orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName

userSelected

0..1

boolean

There are no (further) constraints on this element

Element id

Condition.code.coding.userSelected

Short description

If this coding was chosen directly by the user

Definition

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

Requirements

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Comments

Data type

boolean

Constraints

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

Mappings

v2: Sometimes implied by being first
rim: CD.codingRationale
orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]

text

1..1

string

Element id

Condition.code.text

Short description

Health condition or disease

Definition

The disease, disorder, syndrome, illness, or injury that is being studied. Conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Requirements

Comments

Preferably, use terms from terminologies such as SNOMED CT.

Data type

string

Constraints

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

Examples
Example of a health condition

SARS-CoV-2

Mappings

v2: C*E.9. But note many systems use C*E.2 for this
rim: ./originalText[mediaType/code="text/plain"]/data
orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
NFDI4Health: Design.conditions.label

bodySite

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

Condition.bodySite

Short description

Anatomical location, if relevant

Definition

The anatomical location where this condition manifests itself.

Comments

Data type

CodeableConcept

Binding

Codes describing anatomical locations. May include laterality.

SNOMEDCTBodyStructures (example)

Constraints

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

Mappings

sct-concept: < 442083009 |Anatomical or acquired body structure|
rim: .targetBodySiteCode
sct-attr: 363698007

subject

1..1

Reference(NFDI4Health_PR_MDS_Group_Actual)

Element id

Condition.subject

Short description

Who has the condition?

Alternate names

patient

Definition

Indicates the patient or group who the condition record is associated with.

Requirements

Group is typically used for veterinary or public health use cases.

Data type

Reference(NFDI4Health_PR_MDS_Group_Actual)

Constraints

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

Mappings

workflow: Event.subject
w5: FiveWs.subject[x]
v2: PID-3
rim: .participation[typeCode=SBJ].role[classCode=PAT]
w5: FiveWs.subject

encounter

0..1

Reference(Encounter)

There are no (further) constraints on this element

Element id

Condition.encounter

Short description

Encounter created as part of

Definition

The Encounter during which this Condition was created or to which the creation of this record is tightly associated.

Comments

Data type

Reference(Encounter)

Constraints

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

Mappings

workflow: Event.context
w5: FiveWs.context
v2: PV1-19 (+PV1-54)
rim: .inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]

onset[x]

0..1

There are no (further) constraints on this element

Element id

Condition.onset[x]

Short description

Estimated or actual date, date-time, or age

Definition

Estimated or actual date or date-time the condition began, in the opinion of the clinician.

Comments

Age is generally used when the patient reports an age at which the Condition began to occur.

Constraints

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

Mappings

workflow: Event.occurrence[x]
w5: FiveWs.init
v2: PRB-16
rim: .effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at onset"].value

onsetDateTime

dateTime

There are no (further) constraints on this element

Data type

dateTime

onsetAge

Age

There are no (further) constraints on this element

Data type

Age

onsetPeriod

Period

There are no (further) constraints on this element

Data type

Period

onsetRange

Range

There are no (further) constraints on this element

Data type

Range

onsetString

string

There are no (further) constraints on this element

Data type

string

abatement[x]

0..1

There are no (further) constraints on this element

Element id

Condition.abatement[x]

Short description

When in resolution/remission

Definition

Comments

Conditions

The cardinality or value of this element may be affected by these constraints: con-4

Constraints

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

Mappings

w5: FiveWs.done[x]
rim: .effectiveTime.high or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at remission"].value or .inboundRelationship[typeCode=SUBJ]source[classCode=CONC, moodCode=EVN].status=completed

abatementDateTime

dateTime

There are no (further) constraints on this element

Data type

dateTime

abatementAge

Age

There are no (further) constraints on this element

Data type

Age

abatementPeriod

Period

There are no (further) constraints on this element

Data type

Period

abatementRange

Range

There are no (further) constraints on this element

Data type

Range

abatementString

string

There are no (further) constraints on this element

Data type

string

recordedDate

0..1

dateTime

There are no (further) constraints on this element

Element id

Condition.recordedDate

Short description

Date record was first recorded

Definition

The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date.

Data type

dateTime

Constraints

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

Mappings

w5: FiveWs.recorded
v2: REL-11
rim: .participation[typeCode=AUT].time

recorder

0..1

Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)

There are no (further) constraints on this element

Element id

Condition.recorder

Short description

Who recorded the condition

Definition

Individual who recorded the record and takes responsibility for its content.

Data type

Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)

Constraints

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

Mappings

w5: FiveWs.author
rim: .participation[typeCode=AUT].role

asserter

0..1

Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)

There are no (further) constraints on this element

Element id

Condition.asserter

Short description

Person who asserts this condition

Definition

Individual who is making the condition statement.

Data type

Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)

Constraints

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

Mappings

w5: FiveWs.source
v2: REL-7.1 identifier + REL-7.12 type code
rim: .participation[typeCode=INF].role

stage

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Condition.stage

Short description

Stage/grade, usually assessed formally

Definition

Clinical stage or grade of a condition. May include formal severity assessments.

Data type

BackboneElement

Constraints

con-1: Stage SHALL have summary or assessment
summary.exists() or assessment.exists()
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage/grade"]

0..1

string

There are no (further) constraints on this element

Element id

Condition.stage.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.stage.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: n/a

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.stage.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: N/A

summary

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

Condition.stage.summary

Short description

Simple summary (disease specific)

Definition

A simple summary of the stage such as "Stage 3". The determination of the stage is disease-specific.

Data type

CodeableConcept

Binding

Codes describing condition stages (e.g. Cancer stages).

ConditionStage (example)

Conditions

The cardinality or value of this element may be affected by these constraints: con-1

Constraints

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

Mappings

sct-concept: < 254291000 |Staging and scales|
v2: PRB-14
rim: .value

assessment

0..*

Reference(ClinicalImpression | DiagnosticReport | Observation)

There are no (further) constraints on this element

Element id

Condition.stage.assessment

Short description

Formal record of assessment

Definition

Reference to a formal record of the evidence on which the staging assessment is based.

Data type

Reference(ClinicalImpression | DiagnosticReport | Observation)

Conditions

The cardinality or value of this element may be affected by these constraints: con-1

Constraints

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

Mappings

rim: .self

type

0..1

CodeableConcept

There are no (further) constraints on this element

Element id

Condition.stage.type

Short description

Kind of staging

Definition

The kind of staging, such as pathological or clinical staging.

Data type

CodeableConcept

Binding

Codes describing the kind of condition staging (e.g. clinical or pathological).

ConditionStageType (example)

Constraints

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

Mappings

rim: ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage type"]

evidence

0..*

BackboneElement

There are no (further) constraints on this element

Element id

Condition.evidence

Short description

Supporting evidence

Definition

Supporting evidence / manifestations that are the basis of the Condition's verification status, such as evidence that confirmed or refuted the condition.

Comments

The evidence may be a simple list of coded symptoms/manifestations, or references to observations or formal assessments, or both.

Data type

BackboneElement

Constraints

con-2: evidence SHALL have code or details
code.exists() or detail.exists()
ele-1: All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())

Mappings

rim: .outboundRelationship[typeCode=SPRT].target[classCode=OBS, moodCode=EVN]

0..1

string

There are no (further) constraints on this element

Element id

Condition.evidence.id

Short description

Unique id for inter-element referencing

Definition

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

Data type

string

Mappings

rim: n/a

extension

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.evidence.extension

Short description

Additional content defined by implementations

Alternate names

extensions, user content

Definition

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: n/a

modifierExtension

Σ ?! C

0..*

Extension

There are no (further) constraints on this element

Element id

Condition.evidence.modifierExtension

Short description

Extensions that cannot be ignored even if unrecognized

Alternate names

extensions, user content, modifiers

Definition

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

Requirements

Comments

Data type

Extension

Constraints

ele-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()

Mappings

rim: N/A

code

Σ C

0..*

CodeableConcept

There are no (further) constraints on this element

Element id

Condition.evidence.code

Short description

Manifestation/symptom

Definition

A manifestation or symptom that led to the recording of this condition.

Data type

CodeableConcept

Binding

Codes that describe the manifestation or symptoms of a condition.

ManifestationAndSymptomCodes (example)

Conditions

The cardinality or value of this element may be affected by these constraints: con-2

Constraints

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

Mappings

workflow: Event.reasonCode
w5: FiveWs.why[x]
sct-concept: < 404684003 |Clinical finding|
rim: [code="diagnosis"].value

detail

Σ C

0..*

Reference(Resource)

There are no (further) constraints on this element

Element id

Condition.evidence.detail

Short description

Supporting information found elsewhere

Definition

Links to other relevant information, including pathology reports.

Data type

Reference(Resource)

Conditions

The cardinality or value of this element may be affected by these constraints: con-2

Constraints

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

Mappings

w5: FiveWs.why[x]
rim: .self

note

0..*

Annotation

There are no (further) constraints on this element

Element id

Condition.note

Short description

Additional information about the Condition

Definition

Additional information about the Condition. This is a general notes/comments entry for description of the Condition, its diagnosis and prognosis.

Data type

Annotation

Constraints

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

Mappings

workflow: Event.note
v2: NTE child of PRB
rim: .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value

{

"resourceType": "StructureDefinition",
"id": "nfdi4health-pr-mds-conditions",
"url": "https://www.nfdi4health.de/fhir/metadataschema/StructureDefinition/nfdi4health-pr-mds-conditions",
"version": "0.9",
"name": "NFDI4Health_PR_MDS_Conditions",
"title": "NFDI4Health PR MDS Conditions",
"status": "draft",
"publisher": "NFDI4Health",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "https://www.nfdi4health.de"
}
]
}
],
"description": "Profile intended to capture information on conditions for a Registry.",
"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"
},
{
"identity": "NFDI4Health",
"name": "NFDI4Health to FHIR Mapping"
}
],
"kind": "resource",
"abstract": false,
"type": "Condition",
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/Condition",
"derivation": "constraint",
"differential": {
"element": [
{
"id": "Condition.code",
"path": "Condition.code",
"short": "Primary health conditions or diseases considered in the [RESOURCE]",
"definition": "Group of items providing information about primary health conditions or diseases considered in the [RESOURCE].",
"mapping": [
{
"identity": "NFDI4Health",
"map": "Design.conditions"
}
]
},
{
"id": "Condition.code.coding.extension",
"path": "Condition.code.coding.extension",
"min": 1
},
{
"id": "Condition.code.coding.extension:codeableConcept",
"path": "Condition.code.coding.extension",
"sliceName": "codeableConcept",
"min": 1,
"max": "1",
"type": [
{
"code": "Extension",
"profile": [
"https://www.nfdi4health.de/fhir/metadataschema/StructureDefinition/nfdi4health-ex-mds-codeableconcept"
]
}
],
"mapping": [
{
"identity": "NFDI4Health",
"map": "Design.conditions.code"
}
]
},
{
"id": "Condition.code.coding.code",
"path": "Condition.code.coding.code",
"mapping": [
{
"identity": "NFDI4Health",
"map": "Design.conditions.classification"
}
]
},
{
"id": "Condition.code.text",
"path": "Condition.code.text",
"short": "Health condition or disease",
"definition": "The disease, disorder, syndrome, illness, or injury that is being studied. Conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.",
"comment": "Preferably, use terms from terminologies such as SNOMED CT.",
"min": 1,
"example": [
{
"label": "Example of a health condition",
"valueString": "SARS-CoV-2"
}
],
"mapping": [
{
"identity": "NFDI4Health",
"map": "Design.conditions.label"
}
]
},
{
"id": "Condition.subject",
"path": "Condition.subject",
"type": [
{
"code": "Reference",
"targetProfile": [
"https://www.nfdi4health.de/fhir/metadataschema/StructureDefinition/nfdi4health-pr-mds-group-actual"
]
}
]
}
]
}

}