{
  "resourceType": "StructureDefinition",
  "id": "cio-Symptom",
  "url": "http://nictiz.nl/fhir/StructureDefinition/cio-Symptom",
  "version": "1.0.0-beta.5",
  "name": "CioSymptom",
  "title": "cio Symptom",
  "status": "draft",
  "publisher": "Nictiz",
  "contact": [
    {
      "name": "Nictiz",
      "telecom": [
        {
          "system": "url",
          "value": "https://www.nictiz.nl",
          "use": "work"
        }
      ]
    }
  ],
  "description": "A symptom is a phenomenon with which a condition in the patient presents itself. This also includes a complaint or a finding, but not additional research, such as laboratory tests, function tests and imaging studies.",
  "purpose": "This Observation resource represents the Symptom building block for implementations following the information standard [CiO](https://informatiestandaarden.nictiz.nl/wiki/Landingspagina_Contra-indicaties_en_Overgevoeligheden). This profile is based on the Dutch zib ('Zorginformatiebouwsteen', i.e. Health and Care Information Model) Symptom that is part of the 2024 prepublication. Therefore it has no dependency on a corresponding nl-core profile and mappings to zib concepts are not defined. Instead mappings to the CiO data set have been added. It is the intention to derive this profile from a more general nl-core-Symptom profile in the future.",
  "copyright": "Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.",
  "fhirVersion": "4.0.1",
  "mapping": [
    {
      "identity": "cio-dataset-200-beta3-20241023",
      "uri": "https://decor.nictiz.nl/pub/cio/cio-html-20241023T071643/ds-2.16.840.1.113883.2.4.3.11.60.26.1.2-2020-04-02T000000.html",
      "name": "ART-DECOR Dataset Contraindications and hypersensitivities 2.0.0-beta.3 20241023"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation",
        "path": "Observation",
        "short": "Symptom",
        "comment": "In order to convey the registration information of a Symptom building block, this profile is used together with an instance conforming to the [cio-RegistrationInformation](http://nictiz.nl/fhir/StructureDefinition/cio-RegistrationInformation) profile wherein `Provenance.target` refers to the Observation resource.\r\n\r\nThis profile is always used together with instances conforming to the [cio-Condition](http://nictiz.nl/fhir/StructureDefinition/cio-Condition) and [cio-Reaction](http://nictiz.nl/fhir/StructureDefinition/cio-Reaction) profiles.\r\n\r\nPlease note that on a functional level, the building block Symptom references the building block Condition, but in FHIR this direction is reversed. Therefore, the concept RelationCondition (cio-dataelement-20-921) is mapped on `Condition.evidence.detail` in the cio-Condition profile instead of in this profile.",
        "alias": [
          "Symptoom"
        ],
        "mapping": [
          {
            "identity": "cio-dataset-200-beta3-20241023",
            "map": "cio-dataelement-20-890",
            "comment": "Symptom"
          }
        ]
      },
      {
        "id": "Observation.extension",
        "path": "Observation.extension",
        "min": 1
      },
      {
        "id": "Observation.extension:medicationHypersensitivityIdentifier",
        "path": "Observation.extension",
        "sliceName": "medicationHypersensitivityIdentifier",
        "min": 1,
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://nictiz.nl/fhir/StructureDefinition/ext-MedicationHypersensitivity.Identifier"
            ]
          }
        ]
      },
      {
        "id": "Observation.extension:medicationHypersensitivityIdentifier.value[x]",
        "path": "Observation.extension.value[x]",
        "mapping": [
          {
            "identity": "cio-dataset-200-beta3-20241023",
            "map": "cio-dataelement-20-888",
            "comment": "IdentificationGMO"
          }
        ]
      },
      {
        "id": "Observation.identifier",
        "path": "Observation.identifier",
        "short": "IdentificationNumber",
        "definition": "Globally unique number that identifies the instantiation of the information model. The number is composed of an identification of the issuer organization and a unique number assigned by this organization.",
        "alias": [
          "Identificatienummer"
        ],
        "min": 1,
        "mapping": [
          {
            "identity": "cio-dataset-200-beta3-20241023",
            "map": "cio-dataelement-20-780",
            "comment": "IdentificationNumber"
          }
        ]
      },
      {
        "id": "Observation.code",
        "path": "Observation.code",
        "short": "SymptomName",
        "definition": "Name and code of the symptom via selection from a code list, based on a standardised coding system.",
        "alias": [
          "SymptoomNaam"
        ],
        "binding": {
          "strength": "required",
          "description": "Identification of the symptom.",
          "valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.26.11.35--20240501114333"
        },
        "mapping": [
          {
            "identity": "cio-dataset-200-beta3-20241023",
            "map": "cio-dataelement-20-901",
            "comment": "SymptomName"
          }
        ]
      },
      {
        "id": "Observation.code.text",
        "path": "Observation.code.text",
        "short": "FurtherSpecificationSymptomName",
        "definition": "More detailed specification of the symptom name that has been selected from the code list, because that list does not (yet) contain the required level of detail.",
        "alias": [
          "NadereSpecificatieSymptoomNaam"
        ],
        "mapping": [
          {
            "identity": "cio-dataset-200-beta3-20241023",
            "map": "cio-dataelement-20-902",
            "comment": "FurtherSpecificationSymptomName"
          }
        ]
      },
      {
        "id": "Observation.subject",
        "path": "Observation.subject",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://hl7.org/fhir/StructureDefinition/Patient",
              "http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient"
            ]
          }
        ]
      },
      {
        "id": "Observation.component",
        "path": "Observation.component",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "code"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:severity",
        "path": "Observation.component",
        "sliceName": "severity",
        "max": "1"
      },
      {
        "id": "Observation.component:severity.code",
        "path": "Observation.component.code",
        "patternCodeableConcept": {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "246112005"
            }
          ]
        }
      },
      {
        "id": "Observation.component:severity.value[x]",
        "path": "Observation.component.value[x]",
        "short": "SymptomSeverity",
        "definition": "Indicates the degree of severity of the symptom at the moment of the CreationDateTime (cio-dataelement-20-783).",
        "alias": [
          "SymptoomErnst"
        ],
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "strength": "required",
          "valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.26.11.34--20240501114150"
        },
        "mapping": [
          {
            "identity": "cio-dataset-200-beta3-20241023",
            "map": "cio-dataelement-20-898",
            "comment": "SymptomSeverity"
          }
        ]
      }
    ]
  }
}