{
  "resourceType": "StructureDefinition",
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  "meta": {
    "lastUpdated": "2020-05-27T14:22:24.354+00:00"
  },
  "url": "http://IQTIG.org/fhir/StructureDefinition/TNMKlassifikation",
  "name": "TNM_Klassifikation",
  "status": "draft",
  "date": "2020-05-27T14:22:24.097999+00:00",
  "publisher": "Institut für Qualitätssicherung und Transparenz im Gesundheitswesen (IQTIG)",
  "contact": [
    {
      "name": "IQTIG",
      "telecom": [
        {
          "system": "url",
          "value": "http://iqtig.org",
          "use": "work"
        }
      ]
    }
  ],
  "description": "Staging von Tumorerkrankungen nach der TNM-Klassifikation.",
  "copyright": "Copyright © 2020, IQTIG, Katharina-Heinroth-Ufer 1, 10787 Berlin",
  "fhirVersion": "4.0.1",
  "mapping": [
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      "identity": "workflow",
      "uri": "http://hl7.org/fhir/workflow",
      "name": "Workflow Pattern"
    },
    {
      "identity": "sct-concept",
      "uri": "http://snomed.info/conceptdomain",
      "name": "SNOMED CT Concept Domain Binding"
    },
    {
      "identity": "v2",
      "uri": "http://hl7.org/v2",
      "name": "HL7 v2 Mapping"
    },
    {
      "identity": "rim",
      "uri": "http://hl7.org/v3",
      "name": "RIM Mapping"
    },
    {
      "identity": "w5",
      "uri": "http://hl7.org/fhir/fivews",
      "name": "FiveWs Pattern Mapping"
    },
    {
      "identity": "sct-attr",
      "uri": "http://snomed.org/attributebinding",
      "name": "SNOMED CT Attribute Binding"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation",
  "derivation": "constraint",
  "differential": {
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        "max": "0"
      },
      {
        "id": "Observation.partOf",
        "path": "Observation.partOf",
        "min": 1,
        "max": "1",
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            "code": "Reference",
            "targetProfile": [
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            ]
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        ],
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          ],
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      },
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        "id": "Observation.subject",
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      },
      {
        "id": "Observation.effective[x]",
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        "short": "Datum des Befund",
        "definition": "Datum des TNM-Befund.",
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          {
            "code": "dateTime"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.issued",
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        "id": "Observation.performer",
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        "id": "Observation.bodySite",
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        "id": "Observation.specimen",
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        "id": "Observation.device",
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        "definition": "Gibt die Ausdehnung des Primärtumors nach pathologischer Beurteilung an",
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        ],
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        "definition": "Pathologische Beurteilung ob Lymphknoten befallen sind",
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        "short": "TNM L-Kategorie",
        "definition": "Gibt die Lymphgefäßinvasion an",
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        ],
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        "binding": {
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        "path": "Observation.component.value[x]",
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        "definition": "Gibt die Veneninvasion an",
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            "code": "CodeableConcept"
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        ],
        "mustSupport": true,
        "binding": {
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        "path": "Observation.component.value[x]",
        "short": "TNM-Pn-Kategorie",
        "definition": "Gibt die Perineuralinvasion an",
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        ],
        "mustSupport": true,
        "binding": {
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      {
        "id": "Observation.component:TNM-S-Kategorie.value[x]",
        "path": "Observation.component.value[x]",
        "short": "TNM-S-Kategorie",
        "definition": "Gibt die Werte des Serumtumormakers an",
        "type": [
          {
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        ],
        "mustSupport": true,
        "binding": {
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        "fixedCode": "59479-6"
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        "id": "Observation.component:TNM-y-Symbol.value[x]",
        "path": "Observation.component.value[x]",
        "short": "TNM-y-Symbol",
        "definition": "Gibt an, ob im Fall einer multimodalen Therapie die Klassifikation während oder nach der Therapie erfolgt ist.",
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            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
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      },
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        "id": "Observation.component:TNM-r-Symbol",
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        "id": "Observation.component:TNM-r-Symbol.code.coding.code",
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        "fixedCode": "21983-2"
      },
      {
        "id": "Observation.component:TNM-r-Symbol.value[x]",
        "path": "Observation.component.value[x]",
        "short": "TNM-r-Symbol",
        "definition": "Gibt an, ob es sich bei dem beurteilten Tumor um ein Rezidiv handelt",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "binding": {
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        "id": "Observation.component:TNM-a-Symbol",
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        "id": "Observation.component:TNM-a-Symbol.value[x]",
        "path": "Observation.component.value[x]",
        "short": "TNM-a-Symbol",
        "definition": "Gibt an, ob die Klassifikation aus Anlass einer Autopsie erfolgte",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "description": "TNM-a-Symbol",
          "valueSet": "http://iqtig.org/fhir/ValueSet/kkr/TNMa_CS\""
        }
      },
      {
        "id": "Observation.component:TNM-a-Symbol.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "max": "0"
      },
      {
        "id": "Observation.component:TNM-a-Symbol.interpretation",
        "path": "Observation.component.interpretation",
        "max": "0"
      },
      {
        "id": "Observation.component:TNM-a-Symbol.referenceRange",
        "path": "Observation.component.referenceRange",
        "max": "0"
      },
      {
        "id": "Observation.component:TNM-m-Symbol",
        "path": "Observation.component",
        "sliceName": "TNM-m-Symbol",
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Observation.component:TNM-m-Symbol.code.coding.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://loinc.org"
      },
      {
        "id": "Observation.component:TNM-m-Symbol.code.coding.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "42030-7"
      },
      {
        "id": "Observation.component:TNM-m-Symbol.value[x]",
        "path": "Observation.component.value[x]",
        "short": "TNM-m-Symbol",
        "definition": "Gibt an, ob multiple Primärtumoren in einem Bereich vorligen",
        "type": [
          {
            "code": "string"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Observation.component:TNM-m-Symbol.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "max": "0"
      },
      {
        "id": "Observation.component:TNM-m-Symbol.interpretation",
        "path": "Observation.component.interpretation",
        "max": "0"
      },
      {
        "id": "Observation.component:TNM-m-Symbol.referenceRange",
        "path": "Observation.component.referenceRange",
        "max": "0"
      },
      {
        "id": "Observation.component:cTNM-T",
        "path": "Observation.component",
        "sliceName": "cTNM-T",
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Observation.component:cTNM-T.extension",
        "path": "Observation.component.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:cTNM-T.extension:cpu-Praefix",
        "path": "Observation.component.extension",
        "sliceName": "cpu-Praefix",
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://iqtig.org/fhir/StructureDefinition/c/p/u-Praefix"
            ]
          }
        ]
      },
      {
        "id": "Observation.component:cTNM-T.code.coding.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://loinc.org"
      },
      {
        "id": "Observation.component:cTNM-T.code.coding.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "21905-5"
      },
      {
        "id": "Observation.component:cTNM-T.value[x]",
        "path": "Observation.component.value[x]",
        "short": "cTNM-T",
        "definition": "Gibt die Ausbreitung des Primärtumors nach einer klinischen Beurteilung an",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "description": "cTM-T",
          "valueSet": "http://iqtig.org/fhir/ValueSet/kkr/TNMT_VS"
        }
      },
      {
        "id": "Observation.component:cTNM-T.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "max": "0"
      },
      {
        "id": "Observation.component:cTNM-T.interpretation",
        "path": "Observation.component.interpretation",
        "max": "0"
      },
      {
        "id": "Observation.component:cTNM-T.referenceRange",
        "path": "Observation.component.referenceRange",
        "max": "0"
      },
      {
        "id": "Observation.component:cTNM-N",
        "path": "Observation.component",
        "sliceName": "cTNM-N",
        "mustSupport": true
      },
      {
        "id": "Observation.component:cTNM-N.extension",
        "path": "Observation.component.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:cTNM-N.extension:cpu-Praefix",
        "path": "Observation.component.extension",
        "sliceName": "cpu-Praefix",
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://iqtig.org/fhir/StructureDefinition/c/p/u-Praefix"
            ]
          }
        ]
      },
      {
        "id": "Observation.component:cTNM-N.code.coding.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://loinc.org"
      },
      {
        "id": "Observation.component:cTNM-N.code.coding.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "21906-3"
      },
      {
        "id": "Observation.component:cTNM-N.value[x]",
        "path": "Observation.component.value[x]",
        "short": "cTNM-N",
        "definition": "Klinsiche Beurteilung, ob Lymphknoten befallen sind",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "description": "cTNM-N",
          "valueSet": "http://iqtig.org/fhir/ValueSet/kkr/TNMN_VS"
        }
      },
      {
        "id": "Observation.component:cTNM-N.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "max": "0"
      },
      {
        "id": "Observation.component:cTNM-N.interpretation",
        "path": "Observation.component.interpretation",
        "max": "0"
      },
      {
        "id": "Observation.component:cTNM-N.referenceRange",
        "path": "Observation.component.referenceRange",
        "max": "0"
      },
      {
        "id": "Observation.component:cTNM-M",
        "path": "Observation.component",
        "sliceName": "cTNM-M",
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Observation.component:cTNM-M.extension",
        "path": "Observation.component.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:cTNM-M.extension:cpu-Paefix",
        "path": "Observation.component.extension",
        "sliceName": "cpu-Paefix",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://iqtig.org/fhir/StructureDefinition/c/p/u-Praefix"
            ]
          }
        ]
      },
      {
        "id": "Observation.component:cTNM-M.code.coding.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://loinc.org"
      },
      {
        "id": "Observation.component:cTNM-M.code.coding.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "21907-1"
      },
      {
        "id": "Observation.component:cTNM-M.value[x]",
        "path": "Observation.component.value[x]",
        "short": "cTNM-M",
        "definition": "Klinische Beurteilung ob Metastasen vorhanden sind",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "description": "cTNM-M",
          "valueSet": "http://iqtig.org/fhir/ValueSet/kkr/TNMM_VS"
        }
      },
      {
        "id": "Observation.component:cTNM-M.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "max": "0"
      },
      {
        "id": "Observation.component:cTNM-M.interpretation",
        "path": "Observation.component.interpretation",
        "max": "0"
      },
      {
        "id": "Observation.component:cTNM-M.referenceRange",
        "path": "Observation.component.referenceRange",
        "max": "0"
      },
      {
        "id": "Observation.component:uTNM-T",
        "path": "Observation.component",
        "sliceName": "uTNM-T",
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Observation.component:uTNM-T.extension",
        "path": "Observation.component.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:uTNM-T.extension:cpu-Praefix",
        "path": "Observation.component.extension",
        "sliceName": "cpu-Praefix",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://iqtig.org/fhir/StructureDefinition/c/p/u-Praefix"
            ]
          }
        ]
      },
      {
        "id": "Observation.component:uTNM-T.code.coding.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://loinc.org"
      },
      {
        "id": "Observation.component:uTNM-T.code.coding.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "21911-3"
      },
      {
        "id": "Observation.component:uTNM-T.value[x]",
        "path": "Observation.component.value[x]",
        "short": "uTNM-T",
        "definition": "Feststellung der Tumorausdehnung erfolgte mittels Ultraschall",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "strength": "required",
          "description": "uTNM-T",
          "valueSet": "http://iqtig.org/fhir/ValueSet/kkr/TNMT_VS"
        }
      },
      {
        "id": "Observation.component:uTNM-T.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "max": "0"
      },
      {
        "id": "Observation.component:uTNM-T.interpretation",
        "path": "Observation.component.interpretation",
        "max": "0"
      },
      {
        "id": "Observation.component:uTNM-T.referenceRange",
        "path": "Observation.component.referenceRange",
        "max": "0"
      },
      {
        "id": "Observation.component:uTNM-N",
        "path": "Observation.component",
        "sliceName": "uTNM-N",
        "mustSupport": true
      },
      {
        "id": "Observation.component:uTNM-N.extension",
        "path": "Observation.component.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:uTNM-N.extension:cpu-Praefix",
        "path": "Observation.component.extension",
        "sliceName": "cpu-Praefix",
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://iqtig.org/fhir/StructureDefinition/c/p/u-Praefix"
            ]
          }
        ]
      },
      {
        "id": "Observation.component:uTNM-N.code.coding.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://loinc.org"
      },
      {
        "id": "Observation.component:uTNM-N.code.coding.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "21912-1"
      },
      {
        "id": "Observation.component:uTNM-N.value[x]",
        "path": "Observation.component.value[x]",
        "short": "uTNM-N",
        "definition": "Beurteilung über Befall der Lymphknoten erfolgte mittels Ultraschall",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "description": "uTNM-N",
          "valueSet": "http://iqtig.org/fhir/ValueSet/kkr/TNMN_VS\""
        }
      },
      {
        "id": "Observation.component:uTNM-N.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "max": "0"
      },
      {
        "id": "Observation.component:uTNM-N.interpretation",
        "path": "Observation.component.interpretation",
        "max": "0"
      },
      {
        "id": "Observation.component:uTNM-N.referenceRange",
        "path": "Observation.component.referenceRange",
        "max": "0"
      },
      {
        "id": "Observation.component:uTNM-M",
        "path": "Observation.component",
        "sliceName": "uTNM-M",
        "mustSupport": true
      },
      {
        "id": "Observation.component:uTNM-M.extension",
        "path": "Observation.component.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        }
      },
      {
        "id": "Observation.component:uTNM-M.extension:cpu-Praefix",
        "path": "Observation.component.extension",
        "sliceName": "cpu-Praefix",
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "http://iqtig.org/fhir/StructureDefinition/c/p/u-Praefix"
            ]
          }
        ]
      },
      {
        "id": "Observation.component:uTNM-M.code.coding.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "http://loinc.org"
      },
      {
        "id": "Observation.component:uTNM-M.code.coding.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "21913-9"
      },
      {
        "id": "Observation.component:uTNM-M.value[x]",
        "path": "Observation.component.value[x]",
        "short": "uTNM-M",
        "definition": "Beurteilung der Metastasen erfolgte durch Ultraschall",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "description": "uTNM-M",
          "valueSet": "http://iqtig.org/fhir/ValueSet/kkr/TNMM_VS"
        }
      },
      {
        "id": "Observation.component:uTNM-M.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "max": "0"
      },
      {
        "id": "Observation.component:uTNM-M.interpretation",
        "path": "Observation.component.interpretation",
        "max": "0"
      },
      {
        "id": "Observation.component:uTNM-M.referenceRange",
        "path": "Observation.component.referenceRange",
        "max": "0"
      }
    ]
  }
}