{
  "resourceType": "CodeSystem",
  "id": "npcr-biopsy-results-observation-types",
  "url": "https://npcr.se/fhir/CodeSystem/npcr-biopsy-results-observation-types",
  "name": "NPCRBiopsyResultsObservationTypes",
  "title": "NPCR Biopsy Results Observation Component Types Code System",
  "status": "draft",
  "experimental": false,
  "description": "NPCR-internal code system identifying the component types used across three biopsy-results observation profiles: NPCRBiopsyResultsTargetedBiopsyObservation, NPCRBiopsyResultsSystematicBiopsyObservation, and NPCRBiopsyResultsUnclearBiopsyObservation. Unlike the Gleason score family — where three source-specific profiles share an identical 4-component structure — biopsy results metrics differ by source:\n\n- Targeted biopsies measure: cores count, longest cancer lesion, total biopsy length of the longest-cancer biopsy (plus per-metric missing flags). 6 components total.\n- Systematic biopsies measure: cores count, cores with cancer count, total biopsy length, total cancer length in mm (plus per-metric missing flags). 8 components total.\n- Unclear biopsies (combined targeted + systematic where PAD does not separate) measure the same set as systematic (cores count, cores with cancer, total biopsy length, total cancer length, plus per-metric missing flags). 8 components total — structurally identical to systematic biopsy.\n\nThis shared CodeSystem provides all component codes needed across the three profiles; each profile uses the subset relevant to its source-specific metrics.\n\nNPCR documentation gap rationale: Informationsspecifikation §7 does not provide terminology bindings for biopsy-results variables (same pattern as MR findings, Gleason score). No international code systems (LOINC, SNOMED CT) provide equivalent coverage of this NPCR-specific granularity. This NPCR-internal CodeSystem preserves documentation fidelity by mirroring NPCR Variabelbeskrivning variable structure.\n\nThesis Discussion note: Unlike Gleason (3 parallel source groups + 1 Summary), BiopsyResults has no equivalent 'summary' concept in NPCR — each biopsy source reports its metrics independently, with no cross-source aggregation in INCA. Therefore the BiopsyResults profiles are 3 source-specific profiles with no Summary Observation counterpart.",
  "content": "complete",
  "caseSensitive": true,
  "count": 12,
  "concept": [
    {
      "code": "coresCount",
      "display": "Number of biopsy cores taken",
      "definition": "Total number of biopsy cores taken in the specimen group (Antal tagna biopsikolvar). Used by all three biopsy results profiles. Corresponds to: D_Biop (systematic), D_AntalRiktBio (targeted), D_AntOklarBiop (unclear)."
    },
    {
      "code": "coresCountMissing",
      "display": "Cores count missing indicator",
      "definition": "Boolean flag indicating that the number of biopsy cores is missing (Uppgift saknas om antal tagna biopsikolvar). Used by all three biopsy results profiles. Corresponds to: D_BiopSakn (systematic), D_AntalRiktSaknas (targeted), D_AntOklarSakn (unclear)."
    },
    {
      "code": "coresWithCancerCount",
      "display": "Number of biopsy cores containing cancer",
      "definition": "Number of biopsy cores that contain cancer (Antal biopsikolvar med cancer). Used by systematic and unclear biopsy profiles. Corresponds to: D_BiopCa (systematic), D_OklarBiopCa (unclear). Not applicable to targeted biopsy, which uses longest-cancer and total-biopsy-of-longest metrics instead."
    },
    {
      "code": "coresWithCancerMissing",
      "display": "Cores with cancer count missing indicator",
      "definition": "Boolean flag indicating that the number of cancer-positive cores is missing. Corresponds to: D_BiopCaSakn (systematic), D_OklarBiopCaSakn (unclear)."
    },
    {
      "code": "totalBiopsyLength",
      "display": "Total biopsy length in mm",
      "definition": "Sum of biopsy lengths across all cores in the specimen group, in millimeters (Summa biopsilängd i mm i biopsikolvarna). Used by systematic and unclear biopsy profiles. Corresponds to: D_bioplangd (systematic), D_OklarBiopLangd (unclear)."
    },
    {
      "code": "totalBiopsyLengthMissing",
      "display": "Total biopsy length missing indicator",
      "definition": "Boolean flag indicating that the total biopsy length is missing. Corresponds to: D_bioplangduppgsakn (systematic), D_OklarBioplangduppgsakn (unclear)."
    },
    {
      "code": "totalCancerMm",
      "display": "Total cancer length in mm",
      "definition": "Sum of cancer lengths across all cores in the specimen group, in millimeters (Summa mm cancer i biopsikolvarna). Used by systematic and unclear biopsy profiles. Corresponds to: D_mmcancer (systematic), D_OklarBiopmmcancer (unclear)."
    },
    {
      "code": "totalCancerMmMissing",
      "display": "Total cancer length missing indicator",
      "definition": "Boolean flag indicating that the total cancer length is missing. Corresponds to: D_mmcauppgsakn (systematic), D_OklarBiopmmcauppgsakn (unclear)."
    },
    {
      "code": "longestCancerLength",
      "display": "Longest cancer lesion length in a single biopsy (mm)",
      "definition": "Length of the longest continuous cancer lesion found in a single biopsy core, in millimeters (Längsta cancerhärden i en biopsi). Used only by targeted biopsy profile. Corresponds to: D_LangstCancer. This metric is targeted-specific because MRI-guided targeted sampling aims at specific lesions, making the single longest lesion a clinically meaningful measurement."
    },
    {
      "code": "longestCancerMissing",
      "display": "Longest cancer lesion missing indicator",
      "definition": "Boolean flag indicating that the longest cancer lesion length is missing. Corresponds to: D_LangstCancerSakn."
    },
    {
      "code": "totalBiopsyOfLongest",
      "display": "Total biopsy length of the longest-cancer biopsy (mm)",
      "definition": "Total biopsy length (including benign and malignant tissue) in the core that contains the longest cancer lesion, in millimeters (Total biopsilängd i biopsin med längsta cancerhärden). Used only by targeted biopsy profile. Corresponds to: D_TotBiopsiLangst. Used together with longestCancerLength to compute cancer fraction in the dominant lesion."
    },
    {
      "code": "totalBiopsyOfLongestMissing",
      "display": "Total biopsy of longest missing indicator",
      "definition": "Boolean flag indicating that the total biopsy length of the longest-cancer biopsy is missing. Corresponds to: D_TotBiopsiLangstSakn."
    }
  ]
}