Tiro.health Implementation Guide
0.1.0 - ci-build

Tiro.health Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Imaging Measurement

Official URL: http://fhir.tiro.health/StructureDefinition/ImagingMeasurement Version: 0.1.0
Draft as of 2026-06-09 Computable Name: ImagingMeasurement

FHIR Observation profile representing a single dimensional measurement (diameter, length, area, volume, circumference, angle, thickness, …) of an anatomical structure or lesion derived from an imaging study.

Typical use cases include tumor diameter on CT (RECIST), aortic annulus diameter on cardiac MRI (pre-TAVR sizing), and prostate volume on TRUS. The category slice is fixed to imaging, locking the profile to image-derived measurements; non-imaging measurements of the same structures (e.g. DRE-estimated prostate volume, physical-exam head circumference) belong on a sibling profile.

openEHR alignment

This profile is mapped against two openEHR archetypes because openEHR aggregates imaging data differently than FHIR:

  • openEHR-EHR-OBSERVATION.imaging_exam_result.v1 — report-level archetype (analogous to FHIR DiagnosticReport). Carries study-wide context: modality, study date, status, source image references.
  • openEHR-EHR-CLUSTER.imaging_exam.v1 — per-body-structure findings archetype, plus its specialisations (e.g. imaging_exam-lymph_node.v0) which add structure-specific quantitative ELEMENTs such as at0.2 Diameter (DV_QUANTITY, mm, up to 3 occurrences for 3 axes).

Inverted aggregation: openEHR nests measurements under a body-structure cluster under a report; FHIR (this profile) keeps one Observation per measurement and uses bodySite/focus to record the structure. The two forms are semantically equivalent — component here corresponds to the multi-occurrence ELEMENT pattern in the openEHR specialisations (e.g. three Diameter occurrences for three axes).

The actual measurement quantity has no node in the base CLUSTER.imaging_exam.v1 — it lives in body-structure specialisations (imaging_exam-lymph_node.v0/items[at0.2], …) — so value[x] maps to the specialisation node, not the base archetype.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, obs-8
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:imaging S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: imaging
...... display 1..1 string Representation defined by the system
Fixed Value: Imaging
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... code SΣC 1..1 CodeableConcept Kind of measurement (diameter, volume, area, length, circumference, angle, thickness, …)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
... focus SΣ 0..* Reference(Resource) The tracked lesion or structure being measured (e.g. a BodyStructure for longitudinal RECIST tracking)
... effective[x] SΣ 0..1 Image acquisition time (not interpretation time)
.... effectiveDateTime dateTime
.... effectivePeriod Period
... value[x] SΣC 1..1 Quantity Actual result
.... comparator ?!Σ 0..1 code < | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
.... system ΣC 0..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
... bodySite SC 0..1 CodeableConcept Anatomical site of the measured structure
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
... method S 0..1 CodeableConcept Imaging modality or measurement technique (CT, MRI, US, PET, …)
Binding: ObservationMethods (example): Methods for simple observations.
... derivedFrom SΣ 0..* Reference(ImagingStudy | ImagingSelection | DocumentReference) Source image, study or report the measurement was taken from
... component ΣC 0..* BackboneElement Paired measurements captured on the same acquisition (e.g. RECIST long + short axis of one lesion)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code SΣC 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] SΣ 1..1 Quantity Actual component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required Observation Status 📍5.0.0 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍5.0.0 FHIR Std.
Observation.category:imaging Base preferred Observation Category Codes 📍5.0.0 FHIR Std.
Observation.code Base example LOINC Codes 📍5.0.0 FHIR Std.
Observation.value[x].​comparator Base required QuantityComparator 📍5.0.0 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍5.0.0 FHIR Std.
Observation.method Base example Observation Methods 📍5.0.0 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍5.0.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
obs-8 error Observation bodyStructure SHALL only be present if Observation.bodySite is not present bodySite.exists() implies bodyStructure.empty()

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* Observation Measurements and simple assertions
... status S 1..1 code registered | preliminary | final | amended +
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
.... category:imaging S 1..1 CodeableConcept Classification of type of observation
Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: imaging
...... display 1..1 string Representation defined by the system
Fixed Value: Imaging
... code S 1..1 CodeableConcept Kind of measurement (diameter, volume, area, length, circumference, angle, thickness, …)
... effective[x] S 0..1 Image acquisition time (not interpretation time)
.... effectiveDateTime dateTime
.... effectivePeriod Period
... value[x] S 1..1 Quantity Actual result
.... system 0..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
... bodySite S 0..1 CodeableConcept Anatomical site of the measured structure
... method S 0..1 CodeableConcept Imaging modality or measurement technique (CT, MRI, US, PET, …)
... derivedFrom S 0..* Reference(ImagingStudy | ImagingSelection | DocumentReference) Source image, study or report the measurement was taken from
... component 0..* BackboneElement Paired measurements captured on the same acquisition (e.g. RECIST long + short axis of one lesion)
.... code S 1..1 CodeableConcept Type of component observation (code / type)
.... value[x] S 1..1 Quantity Actual component result

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, obs-8
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: AllLanguages (required): IETF language tag for a human language
Additional BindingsPurpose
CommonLanguages Starter
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... instantiates[x] Σ 0..1 canonical(ObservationDefinition), Reference(ObservationDefinition) Instantiates FHIR ObservationDefinition
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... triggeredBy 0..* BackboneElement Triggering observation(s)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... observation Σ 1..1 Reference(Observation) Triggering observation
.... type Σ 1..1 code reflex | repeat | re-run
Binding: TriggeredBytype (required): The type of TriggeredBy Observation.
.... reason 0..1 string Reason that the observation was triggered
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy) Part of referenced event
... status ?!SΣ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:imaging S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: imaging
...... display 1..1 string Representation defined by the system
Fixed Value: Imaging
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... code SΣC 1..1 CodeableConcept Kind of measurement (diameter, volume, area, length, circumference, angle, thickness, …)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
... subject Σ 0..1 Reference(Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance | BiologicallyDerivedProduct | NutritionProduct) Who and/or what the observation is about
... focus SΣ 0..* Reference(Resource) The tracked lesion or structure being measured (e.g. a BodyStructure for longitudinal RECIST tracking)
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] SΣ 0..1 Image acquisition time (not interpretation time)
.... effectiveDateTime dateTime
.... effectivePeriod Period
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... value[x] SΣC 1..1 Quantity Actual result
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... value Σ 0..1 decimal Numerical value (with implicit precision)
.... comparator ?!Σ 0..1 code < | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
.... unit Σ 0..1 string Unit representation
.... system ΣC 0..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code ΣC 0..1 code Coded form of the unit
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..* CodeableConcept High, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note 0..* Annotation Comments about the observation
... bodySite SC 0..1 CodeableConcept Anatomical site of the measured structure
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
... bodyStructure C 0..1 Reference(BodyStructure) Observed body structure
... method S 0..1 CodeableConcept Imaging modality or measurement technique (CT, MRI, US, PET, …)
Binding: ObservationMethods (example): Methods for simple observations.
... specimen C 0..1 Reference(Specimen | Group) Specimen used for this observation
Constraints: obs-9
... device 0..1 Reference(Device | DeviceMetric) A reference to the device that generates the measurements or the device settings for the device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity(5.0.0) Low Range, if relevant
.... high C 0..1 SimpleQuantity(5.0.0) High Range, if relevant
.... normalValue 0..1 CodeableConcept Normal value, if relevant
Binding: ObservationReferenceRangeNormalValueCodes (extensible): Codes identifying the normal value of the observation.
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text C 0..1 markdown Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom SΣ 0..* Reference(ImagingStudy | ImagingSelection | DocumentReference) Source image, study or report the measurement was taken from
... component ΣC 0..* BackboneElement Paired measurements captured on the same acquisition (e.g. RECIST long + short axis of one lesion)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code SΣC 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] SΣ 1..1 Quantity Actual component result
.... dataAbsentReason 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base required All Languages 📍5.0.0 FHIR Std.
Observation.triggeredBy.​type Base required triggered Bytype 📍5.0.0 FHIR Std.
Observation.status Base required Observation Status 📍5.0.0 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍5.0.0 FHIR Std.
Observation.category:imaging Base preferred Observation Category Codes 📍5.0.0 FHIR Std.
Observation.code Base example LOINC Codes 📍5.0.0 FHIR Std.
Observation.value[x].​comparator Base required QuantityComparator 📍5.0.0 FHIR Std.
Observation.dataAbsentReason Base extensible Data Absent Reason 📍5.0.0 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍5.0.0 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍5.0.0 FHIR Std.
Observation.method Base example Observation Methods 📍5.0.0 FHIR Std.
Observation.referenceRange.​normalValue Base extensible Observation Reference Range Normal Value Codes 📍5.0.0 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍5.0.0 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍5.0.0 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍5.0.0 FHIR Std.
Observation.component.​dataAbsentReason Base extensible Data Absent Reason 📍5.0.0 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍5.0.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
obs-8 error Observation bodyStructure SHALL only be present if Observation.bodySite is not present bodySite.exists() implies bodyStructure.empty()
obs-9 error Observation.specimen If Observation.specimen is a reference to Group, the group can only have specimens (reference.resolve().exists() and reference.resolve() is Group) implies reference.resolve().member.entity.resolve().all($this is Specimen)

This structure is derived from Observation

Summary

Mandatory: 3 elements(1 nested mandatory element)
Must-Support: 12 elements
Fixed: 1 element

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.category

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, obs-8
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:imaging S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: imaging
...... display 1..1 string Representation defined by the system
Fixed Value: Imaging
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... code SΣC 1..1 CodeableConcept Kind of measurement (diameter, volume, area, length, circumference, angle, thickness, …)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
... focus SΣ 0..* Reference(Resource) The tracked lesion or structure being measured (e.g. a BodyStructure for longitudinal RECIST tracking)
... effective[x] SΣ 0..1 Image acquisition time (not interpretation time)
.... effectiveDateTime dateTime
.... effectivePeriod Period
... value[x] SΣC 1..1 Quantity Actual result
.... comparator ?!Σ 0..1 code < | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
.... system ΣC 0..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
... bodySite SC 0..1 CodeableConcept Anatomical site of the measured structure
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
... method S 0..1 CodeableConcept Imaging modality or measurement technique (CT, MRI, US, PET, …)
Binding: ObservationMethods (example): Methods for simple observations.
... derivedFrom SΣ 0..* Reference(ImagingStudy | ImagingSelection | DocumentReference) Source image, study or report the measurement was taken from
... component ΣC 0..* BackboneElement Paired measurements captured on the same acquisition (e.g. RECIST long + short axis of one lesion)
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code SΣC 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] SΣ 1..1 Quantity Actual component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.status Base required Observation Status 📍5.0.0 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍5.0.0 FHIR Std.
Observation.category:imaging Base preferred Observation Category Codes 📍5.0.0 FHIR Std.
Observation.code Base example LOINC Codes 📍5.0.0 FHIR Std.
Observation.value[x].​comparator Base required QuantityComparator 📍5.0.0 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍5.0.0 FHIR Std.
Observation.method Base example Observation Methods 📍5.0.0 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍5.0.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
obs-8 error Observation bodyStructure SHALL only be present if Observation.bodySite is not present bodySite.exists() implies bodyStructure.empty()

Differential View

This structure is derived from Observation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation 0..* Observation Measurements and simple assertions
... status S 1..1 code registered | preliminary | final | amended +
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
.... category:imaging S 1..1 CodeableConcept Classification of type of observation
Required Pattern: At least the following
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: imaging
...... display 1..1 string Representation defined by the system
Fixed Value: Imaging
... code S 1..1 CodeableConcept Kind of measurement (diameter, volume, area, length, circumference, angle, thickness, …)
... effective[x] S 0..1 Image acquisition time (not interpretation time)
.... effectiveDateTime dateTime
.... effectivePeriod Period
... value[x] S 1..1 Quantity Actual result
.... system 0..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
... bodySite S 0..1 CodeableConcept Anatomical site of the measured structure
... method S 0..1 CodeableConcept Imaging modality or measurement technique (CT, MRI, US, PET, …)
... derivedFrom S 0..* Reference(ImagingStudy | ImagingSelection | DocumentReference) Source image, study or report the measurement was taken from
... component 0..* BackboneElement Paired measurements captured on the same acquisition (e.g. RECIST long + short axis of one lesion)
.... code S 1..1 CodeableConcept Type of component observation (code / type)
.... value[x] S 1..1 Quantity Actual component result

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Observation C 0..* Observation Measurements and simple assertions
Constraints: obs-6, obs-7, obs-8
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: AllLanguages (required): IETF language tag for a human language
Additional BindingsPurpose
CommonLanguages Starter
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier Business Identifier for observation
... instantiates[x] Σ 0..1 canonical(ObservationDefinition), Reference(ObservationDefinition) Instantiates FHIR ObservationDefinition
... basedOn Σ 0..* Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest) Fulfills plan, proposal or order
... triggeredBy 0..* BackboneElement Triggering observation(s)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... observation Σ 1..1 Reference(Observation) Triggering observation
.... type Σ 1..1 code reflex | repeat | re-run
Binding: TriggeredBytype (required): The type of TriggeredBy Observation.
.... reason 0..1 string Reason that the observation was triggered
... partOf Σ 0..* Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy) Part of referenced event
... status ?!SΣ 1..1 code registered | preliminary | final | amended +
Binding: ObservationStatus (required): Codes providing the status of an observation.
... Slices for category S 1..* CodeableConcept Classification of type of observation
Slice: Unordered, Open by pattern:$this
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.
.... category:imaging S 1..1 CodeableConcept Classification of type of observation
Binding: ObservationCategoryCodes (preferred): Codes for high level observation categories.

Required Pattern: At least the following
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
..... coding 1..* Coding Code defined by a terminology system
Fixed Value: (Complex)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
...... system 1..1 uri Identity of the terminology system
Fixed Value: http://terminology.hl7.org/CodeSystem/observation-category
...... version 0..1 string Version of the system - if relevant
...... code 1..1 code Symbol in syntax defined by the system
Fixed Value: imaging
...... display 1..1 string Representation defined by the system
Fixed Value: Imaging
...... userSelected 0..1 boolean If this coding was chosen directly by the user
..... text 0..1 string Plain text representation of the concept
... code SΣC 1..1 CodeableConcept Kind of measurement (diameter, volume, area, length, circumference, angle, thickness, …)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
... subject Σ 0..1 Reference(Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance | BiologicallyDerivedProduct | NutritionProduct) Who and/or what the observation is about
... focus SΣ 0..* Reference(Resource) The tracked lesion or structure being measured (e.g. a BodyStructure for longitudinal RECIST tracking)
... encounter Σ 0..1 Reference(Encounter) Healthcare event during which this observation is made
... effective[x] SΣ 0..1 Image acquisition time (not interpretation time)
.... effectiveDateTime dateTime
.... effectivePeriod Period
... issued Σ 0..1 instant Date/Time this version was made available
... performer Σ 0..* Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson) Who is responsible for the observation
... value[x] SΣC 1..1 Quantity Actual result
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
.... value Σ 0..1 decimal Numerical value (with implicit precision)
.... comparator ?!Σ 0..1 code < | <= | >= | > | ad - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.
.... unit Σ 0..1 string Unit representation
.... system ΣC 0..1 uri System that defines coded unit form
Fixed Value: http://unitsofmeasure.org
.... code ΣC 0..1 code Coded form of the unit
... dataAbsentReason C 0..1 CodeableConcept Why the result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
... interpretation 0..* CodeableConcept High, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
... note 0..* Annotation Comments about the observation
... bodySite SC 0..1 CodeableConcept Anatomical site of the measured structure
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts
... bodyStructure C 0..1 Reference(BodyStructure) Observed body structure
... method S 0..1 CodeableConcept Imaging modality or measurement technique (CT, MRI, US, PET, …)
Binding: ObservationMethods (example): Methods for simple observations.
... specimen C 0..1 Reference(Specimen | Group) Specimen used for this observation
Constraints: obs-9
... device 0..1 Reference(Device | DeviceMetric) A reference to the device that generates the measurements or the device settings for the device
... referenceRange C 0..* BackboneElement Provides guide for interpretation
Constraints: obs-3
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... low C 0..1 SimpleQuantity(5.0.0) Low Range, if relevant
.... high C 0..1 SimpleQuantity(5.0.0) High Range, if relevant
.... normalValue 0..1 CodeableConcept Normal value, if relevant
Binding: ObservationReferenceRangeNormalValueCodes (extensible): Codes identifying the normal value of the observation.
.... type 0..1 CodeableConcept Reference range qualifier
Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
.... appliesTo 0..* CodeableConcept Reference range population
Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
.... age 0..1 Range Applicable age range, if relevant
.... text C 0..1 markdown Text based reference range in an observation
... hasMember Σ 0..* Reference(Observation | QuestionnaireResponse | MolecularSequence) Related resource that belongs to the Observation group
... derivedFrom SΣ 0..* Reference(ImagingStudy | ImagingSelection | DocumentReference) Source image, study or report the measurement was taken from
... component ΣC 0..* BackboneElement Paired measurements captured on the same acquisition (e.g. RECIST long + short axis of one lesion)
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code SΣC 1..1 CodeableConcept Type of component observation (code / type)
Binding: LOINCCodes (example): Codes identifying names of simple observations.
.... value[x] SΣ 1..1 Quantity Actual component result
.... dataAbsentReason 0..1 CodeableConcept Why the component result is missing
Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
.... interpretation 0..* CodeableConcept High, low, normal, etc
Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
.... referenceRange 0..* See referenceRange (Observation) Provides guide for interpretation of component result

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Observation.language Base required All Languages 📍5.0.0 FHIR Std.
Observation.triggeredBy.​type Base required triggered Bytype 📍5.0.0 FHIR Std.
Observation.status Base required Observation Status 📍5.0.0 FHIR Std.
Observation.category Base preferred Observation Category Codes 📍5.0.0 FHIR Std.
Observation.category:imaging Base preferred Observation Category Codes 📍5.0.0 FHIR Std.
Observation.code Base example LOINC Codes 📍5.0.0 FHIR Std.
Observation.value[x].​comparator Base required QuantityComparator 📍5.0.0 FHIR Std.
Observation.dataAbsentReason Base extensible Data Absent Reason 📍5.0.0 FHIR Std.
Observation.interpretation Base extensible Observation Interpretation Codes 📍5.0.0 FHIR Std.
Observation.bodySite Base example SNOMED CT Body Structures 📍5.0.0 FHIR Std.
Observation.method Base example Observation Methods 📍5.0.0 FHIR Std.
Observation.referenceRange.​normalValue Base extensible Observation Reference Range Normal Value Codes 📍5.0.0 FHIR Std.
Observation.referenceRange.​type Base preferred Observation Reference Range Meaning Codes 📍5.0.0 FHIR Std.
Observation.referenceRange.​appliesTo Base example Observation Reference Range Applies To Codes 📍5.0.0 FHIR Std.
Observation.component.​code Base example LOINC Codes 📍5.0.0 FHIR Std.
Observation.component.​dataAbsentReason Base extensible Data Absent Reason 📍5.0.0 FHIR Std.
Observation.component.​interpretation Base extensible Observation Interpretation Codes 📍5.0.0 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error Observation If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Observation If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Observation If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Observation If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Observation A resource should have narrative for robust management text.`div`.exists()
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()
obs-3 error Observation.referenceRange Must have at least a low or a high or text low.exists() or high.exists() or text.exists()
obs-6 error Observation dataAbsentReason SHALL only be present if Observation.value[x] is not present dataAbsentReason.empty() or value.empty()
obs-7 error Observation If Observation.component.code is the same as Observation.code, then Observation.value SHALL NOT be present (the Observation.component.value[x] holds the value). value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()
obs-8 error Observation bodyStructure SHALL only be present if Observation.bodySite is not present bodySite.exists() implies bodyStructure.empty()
obs-9 error Observation.specimen If Observation.specimen is a reference to Group, the group can only have specimens (reference.resolve().exists() and reference.resolve() is Group) implies reference.resolve().member.entity.resolve().all($this is Specimen)

This structure is derived from Observation

Summary

Mandatory: 3 elements(1 nested mandatory element)
Must-Support: 12 elements
Fixed: 1 element

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Observation.category

 

Other representations of profile: CSV, Excel, Schematron