{
  "resourceType": "StructureDefinition",
  "id": "shr-oncology-EstrogenReceptorStatus",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR EstrogenReceptorStatus Profile</b></p>\n  <p>Estrogen receptor alpha is the predominant estrogen receptor expressed in breast tissue and is overexpressed in around 50% of breast carcinomas. ER status (positive=present or overexpressed; negative=absent) is a factor in determining prognosis and treatment options.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>shr.oncology.EstrogenReceptorStatus maps to Observation:\n  Entry.CreationTime maps to issued\n  RelatedEncounter maps to context\t\n  Subject maps to subject\n  Category maps to category\n  ClinicallyRelevantTime maps to effective[x]\n  FindingMethod maps to method\n  FindingStatus maps to status\n  Quantity maps to value[x]\n  CodeableConcept maps to value[x]\n  string maps to value[x]\n  boolean maps to value[x]\n  Range maps to value[x]\n  Ratio maps to value[x]\n  Attachment maps to value[x]\n  time maps to value[x]\n  dateTime maps to value[x]\n  TimePeriod maps to value[x]\n  IntegerQuantity maps to value[x]\n  ValueAbsentReason maps to dataAbsentReason\n  ObservationCode maps to code\n  BodySite maps to bodySite\n  Specimen maps to specimen\n  Device maps to device\n  Interpretation maps to interpretation\n  Details maps to comment\n  ReferenceRange maps to referenceRange\n  ReferenceRange.Range.LowerBound maps to referenceRange.low\n  ReferenceRange.Range.UpperBound maps to referenceRange.high\n  ReferenceRange.Type maps to referenceRange.type\n  ReferenceRange.ApplicableSubpopulation maps to referenceRange.appliesTo\n  ReferenceRange.ApplicableAgeRange maps to referenceRange.age\n  fix related.type to #has-member\n  ObservationComponent maps to component (slice on = coding.code; slice strategy = includes)\n  ObservationComponent.ObservationCode maps to component.code\n  ObservationComponent.Quantity maps to component.value[x]\n  ObservationComponent.CodeableConcept maps to component.value[x]\n  ObservationComponent.string maps to component.value[x]\n  ObservationComponent.Range maps to component.value[x]\n  ObservationComponent.Ratio maps to component.value[x]\n  ObservationComponent.Attachment maps to component.value[x]\n  ObservationComponent.time maps to component.value[x]\n  ObservationComponent.dateTime maps to component.value[x]\n  ObservationComponent.TimePeriod maps to component.value[x]\n  ObservationComponent.IntegerQuantity maps to component.value[x]\n  ObservationComponent.ValueAbsentReason maps to component.dataAbsentReason\n  ObservationComponent.Interpretation maps to component.interpretation\n  ObservationComponent.ReferenceRange maps to component.referenceRange\n  Members.Observation maps to related.target (slice at = related; slice on = target.reference.resolve(); slice on type = profile; slice strategy = includes)\n</pre></p>\n</div>"
  },
  "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-oncology-EstrogenReceptorStatus",
  "identifier": [
    {
      "system": "http://standardhealthrecord.org",
      "value": "shr.oncology.EstrogenReceptorStatus"
    }
  ],
  "version": "0.0.1",
  "name": "SHR EstrogenReceptorStatus Profile",
  "status": "draft",
  "date": "2017-12-20",
  "publisher": "The MITRE Corporation: Standard Health Record Collaborative",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://standardhealthrecord.org"
        }
      ]
    }
  ],
  "description": "Estrogen receptor alpha is the predominant estrogen receptor expressed in breast tissue and is overexpressed in around 50% of breast carcinomas. ER status (positive=present or overexpressed; negative=absent) is a factor in determining prognosis and treatment options.",
  "purpose": "Observations are a key aspect of healthcare.  This resource is used to capture those that do not require more sophisticated mechanisms.",
  "fhirVersion": "3.0.1",
  "mapping": [
    {
      "identity": "workflow",
      "uri": "http://hl7.org/fhir/workflow",
      "name": "Workflow Mapping"
    },
    {
      "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/w5",
      "name": "W5 Mapping"
    },
    {
      "identity": "sct-attr",
      "uri": "http://snomed.info/sct",
      "name": "SNOMED CT Attribute Binding"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Observation",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Observation",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus",
        "path": "Observation",
        "short": "SHR EstrogenReceptorStatus Profile",
        "definition": "Estrogen receptor alpha is the predominant estrogen receptor expressed in breast tissue and is overexpressed in around 50% of breast carcinomas. ER status (positive=present or overexpressed; negative=absent) is a factor in determining prognosis and treatment options."
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.extension:author",
        "path": "Observation.extension",
        "sliceName": "author",
        "definition": "The person or organization who created the entry and is responsible for (and may certify) the content.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Author-extension"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.extension:informant",
        "path": "Observation.extension",
        "sliceName": "informant",
        "definition": "The person or entity that provided the information in the entry, as distinct from who created the entry, e.g. the subject (patient), medical professional, family member, device or software program.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Informant-extension"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.extension:focalsubject",
        "path": "Observation.extension",
        "sliceName": "focalsubject",
        "definition": "For use when FHIR's subject does not allow the desired type of Subject in the Finding.Subject field.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubject-extension"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.extension:focalsubjectreference",
        "path": "Observation.extension",
        "sliceName": "focalsubjectreference",
        "definition": "For use when FHIR's subject does not allow the desired type of Subject in the Finding.Subject field.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubjectReference-extension"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.extension:evidence",
        "path": "Observation.extension",
        "sliceName": "evidence",
        "definition": "A symptom, observation, or other item, for example, a radiology report, that serves as evidence for the current assessment.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension",
            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-Evidence-extension"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.extension:changeflag",
        "path": "Observation.extension",
        "sliceName": "changeflag",
        "definition": "Indicator of significant change (delta) from the last or previous measurement.",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-ChangeFlag-extension"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.extension:observationqualifier",
        "path": "Observation.extension",
        "sliceName": "observationqualifier",
        "definition": "A description of the conditions or context of an observation, for example, under sedation, fasting or post-exercise. Body position and body site are also qualifiers, but handled separately. A qualifier cannot modify the measurement type; for example, a fasting blood sugar is still a blood sugar.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Extension",
            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-ObservationQualifier-extension"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.category",
        "path": "Observation.category",
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ObservationCategory"
            }
          ],
          "strength": "extensible",
          "description": "Codes for high level observation categories.",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/observation-category"
          }
        }
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.code",
        "path": "Observation.code"
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.code.coding",
        "path": "Observation.code.coding",
        "slicing": {
          "id": "407",
          "discriminator": [
            {
              "type": "value",
              "path": "path"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.code.coding:Fixed_16112-5",
        "path": "Observation.code.coding",
        "sliceName": "Fixed_16112-5",
        "definition": "A reference to a code defined by a terminology system.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Coding"
          }
        ],
        "isSummary": true
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.code.coding:Fixed_16112-5.system",
        "path": "Observation.code.coding.system",
        "fixedUri": "http://loinc.org"
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.code.coding:Fixed_16112-5.code",
        "path": "Observation.code.coding.code",
        "fixedCode": "16112-5"
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.subject",
        "path": "Observation.subject",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-Patient"
          },
          {
            "code": "Reference",
            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-Group"
          },
          {
            "code": "Reference",
            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-device-Device"
          },
          {
            "code": "Reference",
            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Geoposition"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.context",
        "path": "Observation.context",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-encounter-EncounterPerformed"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.issued",
        "path": "Observation.issued",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.value[x]",
        "path": "Observation.value[x]",
        "slicing": {
          "id": "420",
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "ordered": false,
          "rules": "open"
        },
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.valueCodeableConcept:CodeableConcept",
        "path": "Observation.valueCodeableConcept",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "strength": "required",
          "valueSetReference": {
            "reference": "http://standardhealthrecord.org/shr/procedure/vs/PositiveNegativeIndeterminateVS"
          }
        }
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.dataAbsentReason",
        "path": "Observation.dataAbsentReason",
        "binding": {
          "strength": "required",
          "valueSetReference": {
            "reference": "http://standardhealthrecord.org/shr/finding/vs/ValueAbsentReasonVS"
          }
        }
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.interpretation",
        "path": "Observation.interpretation",
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ObservationInterpretation"
            }
          ],
          "strength": "required",
          "description": "Codes identifying interpretations of observations.",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/observation-interpretation"
          }
        }
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.bodySite",
        "path": "Observation.bodySite",
        "binding": {
          "strength": "required",
          "valueSetReference": {
            "reference": "http://standardhealthrecord.org/shr/core/vs/BodySiteVS"
          }
        }
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.specimen",
        "path": "Observation.specimen",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-Specimen"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.device",
        "path": "Observation.device",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-device-Device"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.referenceRange",
        "path": "Observation.referenceRange"
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.referenceRange.low",
        "path": "Observation.referenceRange.low",
        "type": [
          {
            "code": "Quantity",
            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-SimpleQuantity"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.referenceRange.high",
        "path": "Observation.referenceRange.high",
        "type": [
          {
            "code": "Quantity",
            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-SimpleQuantity"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.referenceRange.appliesTo",
        "path": "Observation.referenceRange.appliesTo",
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ObservationRangeType"
            }
          ],
          "strength": "extensible",
          "description": "Codes identifying the population the reference range applies to.",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
          }
        }
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.referenceRange.age",
        "path": "Observation.referenceRange.age",
        "type": [
          {
            "code": "Range",
            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Range"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.related",
        "path": "Observation.related"
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.related.type",
        "path": "Observation.related.type",
        "fixedCode": "has-member"
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.related.target",
        "path": "Observation.related.target",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-Observation"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component",
        "path": "Observation.component",
        "slicing": {
          "id": "408",
          "discriminator": [
            {
              "type": "value",
              "path": "coding.code"
            }
          ],
          "ordered": false,
          "rules": "open"
        },
        "min": 0,
        "max": "1"
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component.value[x]",
        "path": "Observation.component.value[x]",
        "type": [
          {
            "code": "Quantity",
            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-IntegerQuantity"
          },
          {
            "code": "CodeableConcept"
          },
          {
            "code": "string"
          },
          {
            "code": "Range",
            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Range"
          },
          {
            "code": "Ratio",
            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Ratio"
          },
          {
            "code": "Attachment"
          },
          {
            "code": "time"
          },
          {
            "code": "dateTime"
          },
          {
            "code": "Period"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "binding": {
          "strength": "required",
          "valueSetReference": {
            "reference": "http://standardhealthrecord.org/shr/finding/vs/ValueAbsentReasonVS"
          }
        }
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component.interpretation",
        "path": "Observation.component.interpretation",
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ObservationInterpretation"
            }
          ],
          "strength": "required",
          "description": "Codes identifying interpretations of observations.",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/observation-interpretation"
          }
        }
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-NuclearPositivity",
        "path": "Observation.component",
        "sliceName": "shr-oncology-NuclearPositivity",
        "min": 0,
        "max": "1"
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-NuclearPositivity.value[x]",
        "path": "Observation.component.value[x]",
        "type": [
          {
            "code": "Range",
            "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-core-Range"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-NuclearPositivity.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "binding": {
          "strength": "required",
          "valueSetReference": {
            "reference": "http://standardhealthrecord.org/shr/finding/vs/ValueAbsentReasonVS"
          }
        }
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-NuclearPositivity.interpretation",
        "path": "Observation.component.interpretation",
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ObservationInterpretation"
            }
          ],
          "strength": "required",
          "description": "Codes identifying interpretations of observations.",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/observation-interpretation"
          }
        }
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-AverageStainingIntensity",
        "path": "Observation.component",
        "sliceName": "shr-oncology-AverageStainingIntensity",
        "min": 0,
        "max": "1"
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-AverageStainingIntensity.code",
        "path": "Observation.component.code"
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-AverageStainingIntensity.code.coding",
        "path": "Observation.component.code.coding",
        "slicing": {
          "id": "409",
          "discriminator": [
            {
              "type": "value",
              "path": "path"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-AverageStainingIntensity.code.coding:Fixed_29749",
        "path": "Observation.component.code.coding",
        "sliceName": "Fixed_29749",
        "definition": "A reference to a code defined by a terminology system.",
        "min": 0,
        "max": "*",
        "type": [
          {
            "code": "Coding"
          }
        ],
        "isSummary": true
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-AverageStainingIntensity.code.coding:Fixed_29749.system",
        "path": "Observation.component.code.coding.system",
        "fixedUri": "https://sdt.cap.org"
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-AverageStainingIntensity.code.coding:Fixed_29749.code",
        "path": "Observation.component.code.coding.code",
        "fixedCode": "29749"
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-AverageStainingIntensity.value[x]",
        "path": "Observation.component.value[x]",
        "slicing": {
          "id": "415",
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "ordered": false,
          "rules": "open"
        },
        "type": [
          {
            "code": "CodeableConcept"
          }
        ]
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-AverageStainingIntensity.valueCodeableConcept:CodeableConcept",
        "path": "Observation.component.valueCodeableConcept",
        "type": [
          {
            "code": "CodeableConcept"
          }
        ],
        "binding": {
          "strength": "required",
          "valueSetReference": {
            "reference": "http://standardhealthrecord.org/shr/oncology/vs/StainingIntensityVS"
          }
        }
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-AverageStainingIntensity.dataAbsentReason",
        "path": "Observation.component.dataAbsentReason",
        "binding": {
          "strength": "required",
          "valueSetReference": {
            "reference": "http://standardhealthrecord.org/shr/finding/vs/ValueAbsentReasonVS"
          }
        }
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-AverageStainingIntensity.interpretation",
        "path": "Observation.component.interpretation",
        "binding": {
          "extension": [
            {
              "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
              "valueString": "ObservationInterpretation"
            }
          ],
          "strength": "required",
          "description": "Codes identifying interpretations of observations.",
          "valueSetReference": {
            "reference": "http://hl7.org/fhir/ValueSet/observation-interpretation"
          }
        }
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-StainingControl",
        "path": "Observation.component",
        "sliceName": "shr-oncology-StainingControl",
        "min": 0,
        "max": "1"
      },
      {
        "id": "Observation:shr-oncology-EstrogenReceptorStatus.component:shr-oncology-StainingControl.code",
        "path": "Observation.component.code"
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