{
  "resourceType": "StructureDefinition",
  "url": "https://npcr.se/fhir/StructureDefinition/npcr-systematic-biopsy",
  "name": "NPCR_Systematic_Biopsy",
  "status": "draft",
  "description": "Extension to record whether systematic prostate biopsies were performed, per NPCR Variabelbeskrivning variable D_SystBiopsi (Systematiska biopsier).\r\n\r\nSource variable: D_SystBiopsi\r\n- Datatyp: Lista (0/1/98)\r\n- Listvärden: 0 = Nej, 1 = Ja, 98 = Uppgift saknas\r\n- Teknisk giltighetstid: 2005-06-30 -\r\n- Obligatorisk: Ja (when D_Vavn = 1)\r\n- Beteende/logik: D_Vavn = 1 → D_SystBiopsi = obligatorisk. At least one of D_RiktBiopsi, D_SystBiopsi, D_OklarBiopsi must equal 1.\r\n\r\nPer NPCR Manual page 16: \"Vanligen tas 10-12 systematiska biopsier i olika sektorer av prostatan. Samtidigt kan även riktade biopsier tas mot förändringar enligt MR. Biopsier som riktas mot en förändring efter enbart TRUL och palpation, (ej efter MR), registreras under systematiska biopsier.\"\r\n\r\nThis extension is bound to Procedure as its only context, specifically intended for use on NPCRBiopsyProcedure instances.\r\n\r\nData type: code, bound (required) to NPCRBiopsyFlagCodes ValueSet. This ValueSet is shared with extensions NPCR_Targeted_Biopsy and NPCR_Unclear_Biopsy because all three variables share the identical 0/1/98 Listvärden pattern in NPCR Variabelbeskrivning — a reusable terminology artifact reflecting a consistent encoding pattern observable across multiple NPCR Lista variables.\r\n\r\nTerminology binding rationale: NPCR documentation does not provide an international code system binding. The extension uses the NPCRBiopsyFlag CodeSystem (0/1/98) to preserve NPCR's internal coded values.",
  "fhirVersion": "4.0.1",
  "kind": "complex-type",
  "abstract": false,
  "context": [
    {
      "type": "element",
      "expression": "Procedure"
    }
  ],
  "type": "Extension",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Extension",
  "derivation": "constraint",
  "snapshot": {
    "element": [
      {
        "id": "Extension",
        "path": "Extension",
        "short": "Optional Extensions Element",
        "definition": "Optional Extension Element - found in all resources.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Extension",
          "min": 0,
          "max": "*"
        },
        "condition": [
          "ele-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "mustSupport": true,
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Extension.id",
        "path": "Extension.id",
        "representation": [
          "xmlAttr"
        ],
        "short": "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.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Element.id",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "string"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
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        ]
      },
      {
        "id": "Extension.extension",
        "path": "Extension.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "description": "Extensions are always sliced by (at least) url",
          "rules": "open"
        },
        "short": "Additional content defined by implementations",
        "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.",
        "comment": "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.",
        "alias": [
          "extensions",
          "user content"
        ],
        "min": 0,
        "max": "0",
        "base": {
          "path": "Element.extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "Extension"
          }
        ],
        "condition": [
          "ele-1"
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        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key": "ext-1",
            "severity": "error",
            "human": "Must have either extensions or value[x], not both",
            "expression": "extension.exists() != value.exists()",
            "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
            "source": "http://hl7.org/fhir/StructureDefinition/Extension"
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        ],
        "mapping": [
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            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Extension.url",
        "path": "Extension.url",
        "representation": [
          "xmlAttr"
        ],
        "short": "identifies the meaning of the extension",
        "definition": "Source of the definition for the extension code - a logical name or a URL.",
        "comment": "The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Extension.url",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl": "uri"
              }
            ],
            "code": "http://hl7.org/fhirpath/System.String"
          }
        ],
        "fixedUri": "https://npcr.se/fhir/StructureDefinition/npcr-systematic-biopsy",
        "mapping": [
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      },
      {
        "id": "Extension.value[x]",
        "path": "Extension.value[x]",
        "short": "Value of extension",
        "definition": "Value of extension - must be one of a constrained set of the data types (see [Extensibility](extensibility.html) for a list).",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Extension.value[x]",
          "min": 0,
          "max": "1"
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        "type": [
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            "code": "code"
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        "condition": [
          "ele-1"
        ],
        "constraint": [
          {
            "key": "ele-1",
            "severity": "error",
            "human": "All FHIR elements must have a @value or children",
            "expression": "hasValue() or (children().count() > id.count())",
            "xpath": "@value|f:*|h:div",
            "source": "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "https://npcr.se/fhir/ValueSet/npcr-biopsy-flag-codes"
        },
        "mapping": [
          {
            "identity": "rim",
            "map": "n/a"
          },
          {
            "identity": "rim",
            "map": "N/A"
          }
        ]
      }
    ]
  },
  "differential": {
    "element": [
      {
        "id": "Extension",
        "path": "Extension",
        "mustSupport": true
      },
      {
        "id": "Extension.extension",
        "path": "Extension.extension",
        "max": "0"
      },
      {
        "id": "Extension.url",
        "path": "Extension.url",
        "fixedUri": "https://npcr.se/fhir/StructureDefinition/npcr-systematic-biopsy"
      },
      {
        "id": "Extension.value[x]",
        "path": "Extension.value[x]",
        "min": 1,
        "type": [
          {
            "code": "code"
          }
        ],
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "https://npcr.se/fhir/ValueSet/npcr-biopsy-flag-codes"
        }
      }
    ]
  }
}