{
  "description": "Observation-related profiles",
  "_filename": "StructureDefinition-obs-haplotype.json",
  "package_name": "hl7.fhir.uv.genomics-reporting",
  "date": "2017-05-20",
  "derivation": "constraint",
  "publisher": "HL7 Clinical Genomics WG",
  "fhirVersion": "3.3.0",
  "name": "Haplotype",
  "mapping": [ {
    "uri": "http://unknown.org/V2-CG-Results",
    "name": "V2-CG-Results",
    "identity": "v2-cg-results"
  }, {
    "uri": "http://hl7.org/fhir/workflow",
    "name": "Workflow Pattern",
    "identity": "workflow"
  }, {
    "uri": "http://snomed.info/conceptdomain",
    "name": "SNOMED CT Concept Domain Binding",
    "identity": "sct-concept"
  }, {
    "uri": "http://hl7.org/v2",
    "name": "HL7 v2 Mapping",
    "identity": "v2"
  }, {
    "uri": "http://hl7.org/v3",
    "name": "RIM Mapping",
    "identity": "rim"
  }, {
    "uri": "http://hl7.org/fhir/fivews",
    "name": "FiveWs Pattern",
    "identity": "w5"
  }, {
    "uri": "http://snomed.info/sct",
    "name": "SNOMED CT Attribute Binding",
    "identity": "sct-attr"
  } ],
  "abstract": false,
  "type": "Observation",
  "experimental": null,
  "resourceType": "StructureDefinition",
  "title": null,
  "package_version": "0.1.0",
  "snapshot": {
    "element": [ {
      "constraint": [ {
        "key": "dom-2",
        "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
        "xpath": "not(parent::f:contained and f:contained)",
        "source": "DomainResource",
        "severity": "error",
        "expression": "contained.contained.empty()"
      }, {
        "key": "dom-1",
        "human": "If the resource is contained in another resource, it SHALL NOT contain any narrative",
        "xpath": "not(parent::f:contained and f:text)",
        "source": "DomainResource",
        "severity": "error",
        "expression": "contained.text.empty()"
      }, {
        "key": "dom-4",
        "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
        "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
        "source": "DomainResource",
        "severity": "error",
        "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
      }, {
        "key": "dom-3",
        "human": "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",
        "xpath": "not(exists(for $contained in f:contained return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
        "source": "DomainResource",
        "severity": "error",
        "expression": "contained.all(('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists())"
      }, {
        "key": "obs-7",
        "human": "If Observation.code is the same as a Observation.component.code then the value element associated with the code SHALL NOT be present",
        "xpath": "not(f:*[starts-with(local-name(.), 'value')] and (for $coding in f:code/f:coding return f:component/f:code/f:coding[f:code/@value=$coding/f:code/@value] [f:system/@value=$coding/f:system/@value]))",
        "source": "Observation",
        "severity": "error",
        "expression": "value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()"
      }, {
        "key": "obs-6",
        "human": "dataAbsentReason SHALL only be present if Observation.value[x] is not present",
        "xpath": "not(exists(f:dataAbsentReason)) or (not(exists(*[starts-with(local-name(.), 'value')])))",
        "source": "Observation",
        "severity": "error",
        "expression": "dataAbsentReason.empty() or value.empty()"
      } ],
      "path": "Observation",
      "min": 0,
      "definition": "A finding that a patient has a specific haplotype.",
      "isModifier": false,
      "short": "Haplotype",
      "mapping": [ {
        "map": "Entity. Role, or Act",
        "identity": "rim"
      }, {
        "map": "Event",
        "identity": "workflow"
      }, {
        "map": "< 363787002 |Observable entity|",
        "identity": "sct-concept"
      }, {
        "map": "OBX",
        "identity": "v2"
      }, {
        "map": "Observation[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "mustSupport": false,
      "alias": [ "Vital Signs", "Measurement", "Results", "Tests" ],
      "max": "*",
      "id": "Observation",
      "comment": "Defines those properties that are common for all findings of genetic characteristics - namely genotype, haplotype and any of the types of variants.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation"
      },
      "isSummary": false
    }, {
      "path": "Observation.id",
      "min": 0,
      "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
      "isModifier": false,
      "short": "Logical id of this artifact",
      "type": [ {
        "code": "id"
      } ],
      "max": "1",
      "id": "Observation.id",
      "comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.id"
      },
      "isSummary": true
    }, {
      "path": "Observation.meta",
      "min": 0,
      "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
      "isModifier": false,
      "short": "Metadata about the resource",
      "type": [ {
        "code": "Meta"
      } ],
      "max": "1",
      "id": "Observation.meta",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.meta"
      },
      "isSummary": true
    }, {
      "path": "Observation.implicitRules",
      "min": 0,
      "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
      "isModifier": true,
      "short": "A set of rules under which this content was created",
      "type": [ {
        "code": "uri"
      } ],
      "max": "1",
      "id": "Observation.implicitRules",
      "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.implicitRules"
      },
      "isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
      "isSummary": true
    }, {
      "path": "Observation.language",
      "min": 0,
      "definition": "The base language in which the resource is written.",
      "isModifier": false,
      "short": "Language of the resource content",
      "type": [ {
        "code": "code"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
          "valueReference": {
            "reference": "http://hl7.org/fhir/ValueSet/all-languages"
          }
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "Language"
        }, {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
          "valueBoolean": true
        } ],
        "description": "A human language.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/languages"
      },
      "max": "1",
      "id": "Observation.language",
      "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Resource.language"
      },
      "isSummary": false
    }, {
      "path": "Observation.text",
      "min": 0,
      "definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.",
      "isModifier": false,
      "short": "Text summary of the resource, for human interpretation",
      "mapping": [ {
        "map": "Act.text?",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Narrative"
      } ],
      "alias": [ "narrative", "html", "xhtml", "display" ],
      "max": "1",
      "id": "Observation.text",
      "condition": [ "dom-1" ],
      "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded in formation is added later.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "DomainResource.text"
      },
      "isSummary": false
    }, {
      "path": "Observation.contained",
      "min": 0,
      "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.",
      "isModifier": false,
      "short": "Contained, inline Resources",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Resource"
      } ],
      "alias": [ "inline resources", "anonymous resources", "contained resources" ],
      "max": "*",
      "id": "Observation.contained",
      "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.contained"
      },
      "isSummary": false
    }, {
      "path": "Observation.extension",
      "min": 0,
      "definition": "An Extension",
      "isModifier": false,
      "short": "Extension",
      "slicing": {
        "id": "3",
        "rules": "open",
        "ordered": false,
        "discriminator": [ {
          "path": "url",
          "type": "value"
        } ]
      },
      "type": [ {
        "code": "Extension"
      } ],
      "max": "*",
      "id": "Observation.extension",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "ext-1",
        "human": "Must have either extensions or value[x], not both",
        "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
        "source": "Extension",
        "severity": "error",
        "expression": "extension.exists() != value.exists()"
      } ],
      "path": "Observation.extension",
      "min": 0,
      "definition": "Allows associating observations to a particular portion of the patient - a fetus, a tumor, a lesion, etc.",
      "isModifier": false,
      "short": "Extension",
      "type": [ {
        "code": "Extension",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/body-structure" ]
      } ],
      "mustSupport": true,
      "sliceName": "bodyStructure",
      "max": "1",
      "id": "Observation.extension:bodystructure",
      "condition": [ "ele-1" ],
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.extension"
      }
    }, {
      "path": "Observation.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Observation.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "DomainResource.modifierExtension"
      },
      "isModifierReason": "Not known why this is labelled a modifier",
      "isSummary": false
    }, {
      "path": "Observation.identifier",
      "requirements": "Allows observations to be distinguished and referenced.",
      "min": 0,
      "definition": "A unique identifier assigned to this observation.",
      "isModifier": false,
      "short": "Business Identifier for observation",
      "mapping": [ {
        "map": "Event.identifier",
        "identity": "workflow"
      }, {
        "map": "FiveWs.identifier",
        "identity": "w5"
      }, {
        "map": "OBX.21  For OBX segments from systems without OBX-21 support a combination of ORC/OBR and OBX must be negotiated between trading partners to uniquely identify the OBX segment. Depending on how V2 has been implemented each of these may be an option: 1) OBR-3 + OBX-3 + OBX-4 or 2) OBR-3 + OBR-4 + OBX-3 + OBX-4 or 2) some other way to uniquely ID the OBR/ORC + OBX-3 + OBX-4.",
        "identity": "v2"
      }, {
        "map": "id",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Identifier"
      } ],
      "max": "*",
      "id": "Observation.identifier",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.identifier"
      },
      "isSummary": true
    }, {
      "path": "Observation.basedOn",
      "requirements": "Allows tracing of authorization for the event and tracking whether proposals/recommendations were acted upon.",
      "min": 0,
      "definition": "A plan, proposal or order that is fulfilled in whole or in part by this event.",
      "isModifier": false,
      "short": "Fulfills plan, proposal or order",
      "mapping": [ {
        "map": "Event.basedOn",
        "identity": "workflow"
      }, {
        "map": "ORC",
        "identity": "v2"
      }, {
        "map": ".inboundRelationship[typeCode=COMP].source[moodCode=EVN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/CarePlan", "http://hl7.org/fhir/StructureDefinition/DeviceRequest", "http://hl7.org/fhir/StructureDefinition/ImmunizationRecommendation", "http://hl7.org/fhir/StructureDefinition/MedicationRequest", "http://hl7.org/fhir/StructureDefinition/NutritionOrder", "http://hl7.org/fhir/StructureDefinition/ServiceRequest" ]
      } ],
      "mustSupport": true,
      "alias": [ "Fulfills" ],
      "max": "*",
      "id": "Observation.basedOn",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.basedOn"
      },
      "isSummary": true
    }, {
      "path": "Observation.partOf",
      "min": 0,
      "definition": "A larger event of which this particular Observation is a component or step.  For example,  an observation as part of a procedure.",
      "isModifier": false,
      "short": "Part of referenced event",
      "mapping": [ {
        "map": "Event.partOf",
        "identity": "workflow"
      }, {
        "map": "Varies by domain",
        "identity": "v2"
      }, {
        "map": ".outboundRelationship[typeCode=FLFS].target",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/MedicationAdministration", "http://hl7.org/fhir/StructureDefinition/MedicationDispense", "http://hl7.org/fhir/StructureDefinition/MedicationStatement", "http://hl7.org/fhir/StructureDefinition/Procedure", "http://hl7.org/fhir/StructureDefinition/Immunization", "http://hl7.org/fhir/StructureDefinition/ImagingStudy" ]
      } ],
      "alias": [ "Container" ],
      "max": "*",
      "id": "Observation.partOf",
      "comment": "To link an Observation to an Encounter use `context`.  See the  [Notes](observation.html#obsgrouping) below for guidance on referencing another Observation.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.partOf"
      },
      "isSummary": true
    }, {
      "path": "Observation.status",
      "requirements": "Need to track the status of individual results. Some results are finalized before the whole report is finalized.",
      "min": 1,
      "definition": "The status of the result value.",
      "isModifier": true,
      "short": "registered | preliminary | final | amended +",
      "mapping": [ {
        "map": "Event.status",
        "identity": "workflow"
      }, {
        "map": "FiveWs.status",
        "identity": "w5"
      }, {
        "map": "< 445584004 |Report by finality status|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-11",
        "identity": "v2"
      }, {
        "map": "status  Amended & Final are differentiated by whether it is the subject of a ControlAct event with a type of \"revise\"",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "code"
      } ],
      "mustSupport": true,
      "extension": [ {
        "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-display-hint",
        "valueString": "default: final"
      } ],
      "binding": {
        "strength": "required",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationStatus"
        } ],
        "description": "Codes providing the status of an observation.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/observation-status"
      },
      "max": "1",
      "id": "Observation.status",
      "comment": "… This should generally be 'completed' or 'revised'.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Observation.status"
      },
      "isModifierReason": "This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid",
      "isSummary": true
    }, {
      "path": "Observation.category",
      "requirements": "Used for filtering what observations are retrieved and displayed.",
      "min": 1,
      "definition": "A code that classifies the general type of observation being made.",
      "isModifier": false,
      "short": "Classification of  type of observation",
      "mapping": [ {
        "map": "FiveWs.class",
        "identity": "w5"
      }, {
        "map": ".outboundRelationship[typeCode=\"COMP].target[classCode=\"LIST\", moodCode=\"EVN\"].code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "preferred",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationCategory"
        } ],
        "description": "Codes for high level observation categories.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/observation-category"
      },
      "max": "*",
      "id": "Observation.category",
      "comment": "… This should be populated with 'lab'.",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "laboratory",
          "system": "http://hl7.org/fhir/observation-category"
        } ]
      },
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.category"
      },
      "isSummary": false
    }, {
      "path": "Observation.code",
      "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
      "min": 1,
      "definition": "Describes what was observed. Sometimes this is called the observation \"name\".",
      "isModifier": false,
      "short": "Type of observation (code / type)",
      "mapping": [ {
        "map": "Event.code",
        "identity": "workflow"
      }, {
        "map": "FiveWs.what[x]",
        "identity": "w5"
      }, {
        "map": "< 363787002 |Observable entity| OR < 386053000 |Evaluation procedure|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-3",
        "identity": "v2"
      }, {
        "map": "code",
        "identity": "rim"
      }, {
        "map": "116680003 |Is a|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationCode"
        } ],
        "description": "Codes identifying names of simple observations.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/observation-codes"
      },
      "alias": [ "Name" ],
      "max": "1",
      "id": "Observation.code",
      "comment": "*All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "84414-2",
          "system": "http://loinc.org"
        } ]
      },
      "base": {
        "max": "1",
        "min": 1,
        "path": "Observation.code"
      },
      "isSummary": true
    }, {
      "path": "Observation.subject",
      "requirements": "Observations have no value if you don't know who or what they're about.",
      "min": 0,
      "definition": "The patient, or group of patients, location, or device whose characteristics (direct or indirect) are described by the observation and into whose record the observation is placed.  Comments: Indirect characteristics may be those of a specimen, fetus, donor,  other observer (for example a relative or EMT), or any observation made about the subject.",
      "isModifier": false,
      "short": "Who and/or what this is about",
      "mapping": [ {
        "map": "Event.subject",
        "identity": "workflow"
      }, {
        "map": "FiveWs.subject[x]",
        "identity": "w5"
      }, {
        "map": "PID-3",
        "identity": "v2"
      }, {
        "map": "participation[typeCode=RTGT] ",
        "identity": "rim"
      }, {
        "map": "FiveWs.subject",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/Group", "http://hl7.org/fhir/StructureDefinition/Location" ]
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Observation.subject",
      "comment": "… This must be the same patient as on the DiagnosticReport unless combining data from multiple fetuses or family members in a single report.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.subject"
      },
      "isSummary": true
    }, {
      "path": "Observation.focus",
      "min": 0,
      "definition": "The actual focus of an observation when it is not the patient of record.  The focus is point of attention when the observation representing something  or someone associated with the patient.  It could be  a  spouse or parent, a fetus or donor.  The focus of an observation could be an existing condition,  an intervention, the subject's diet,  another observation of the subject,  or a body structure such as tumor or implanted device.   An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.",
      "isModifier": false,
      "short": "The \"focal point\" of the observation",
      "mapping": [ {
        "map": "FiveWs.subject[x]",
        "identity": "w5"
      }, {
        "map": "OBX-3",
        "identity": "v2"
      }, {
        "map": "participation[typeCode=SBJ]",
        "identity": "rim"
      }, {
        "map": "FiveWs.subject",
        "identity": "w5"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource" ]
      } ],
      "max": "1",
      "id": "Observation.focus",
      "comment": "Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., \"Blood Glucose\") and does not need to be represented separately using this element.  Use `specimen` if a reference to a specimen is required.  If a code is required instead of a resource use either  `bodysite` for bodysites or the standard extension [focus-code](extension-observation-focus-code.html).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.focus"
      },
      "isSummary": true
    }, {
      "path": "Observation.context",
      "requirements": "For some observations it may be important to know the link between an observation and a particular encounter.",
      "min": 0,
      "definition": "The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.",
      "isModifier": false,
      "short": "Healthcare event during which this observation is made",
      "mapping": [ {
        "map": "Event.context",
        "identity": "workflow"
      }, {
        "map": "FiveWs.context",
        "identity": "w5"
      }, {
        "map": "PV1",
        "identity": "v2"
      }, {
        "map": "inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Encounter", "http://hl7.org/fhir/StructureDefinition/EpisodeOfCare" ]
      } ],
      "alias": [ "Encounter" ],
      "max": "1",
      "id": "Observation.context",
      "comment": "This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter or episode but still be tied to the context of the encounter or episode (e.g. pre-admission laboratory tests).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.context"
      },
      "isSummary": false
    }, {
      "path": "Observation.effective[x]",
      "requirements": "Knowing when an observation was deemed true is important to its relevance as well as determining trends.",
      "min": 0,
      "definition": "The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the \"physiologically relevant time\". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.",
      "isModifier": false,
      "short": "Assessment of overall results",
      "mapping": [ {
        "map": "Event.occurrence[x]",
        "identity": "workflow"
      }, {
        "map": "FiveWs.done[x]",
        "identity": "w5"
      }, {
        "map": "OBX-14, and/or OBX-19 after v2.4  (depends on who observation made)",
        "identity": "v2"
      }, {
        "map": "effectiveTime",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "dateTime"
      }, {
        "code": "Period"
      }, {
        "code": "Timing"
      } ],
      "mustSupport": true,
      "alias": [ "Occurrence" ],
      "max": "1",
      "id": "Observation.effective[x]",
      "comment": "At least a date should be present unless this observation is a historical report.  For recording imprecise or \"fuzzy\" times (For example, a blood glucose measurement taken \"after breakfast\") use the [Timing](datatypes.html#timing) datatype which allow the measurement to be tied to regular life events.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.effective[x]"
      },
      "isSummary": true
    }, {
      "path": "Observation.issued",
      "min": 0,
      "definition": "The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.",
      "isModifier": false,
      "short": "Assessment of deletion/duplication results",
      "mapping": [ {
        "map": "FiveWs.recorded",
        "identity": "w5"
      }, {
        "map": "OBR.22 (or MSH.7), or perhaps OBX-19 (depends on who observation made)",
        "identity": "v2"
      }, {
        "map": "participation[typeCode=AUT].time",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "instant"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Observation.issued",
      "comment": "For Observations that don’t require review and verification, it may be the same as the [`lastUpdated` ](resource-definitions.html#Meta.lastUpdated) time of the resource itself.  For Observations that do require review and verification for certain updates, it might not be the same as the `lastUpdated` time of the resource itself due to a non-clinically significant update that doesn’t require the new version to be reviewed and verified again.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.issued"
      },
      "isSummary": true
    }, {
      "path": "Observation.performer",
      "requirements": "May give a degree of confidence in the observation and also indicates where follow-up questions should be directed.",
      "min": 0,
      "definition": "Summary of all genes, drugs and/or conditions tested for for which there were no significant/reported findings.  Allows indication of what was tested for in a relatively efficient manner.",
      "isModifier": false,
      "short": "Genes, drugs and/or conditions tested with no findings",
      "mapping": [ {
        "map": "Event.performer.actor",
        "identity": "workflow"
      }, {
        "map": "FiveWs.actor",
        "identity": "w5"
      }, {
        "map": "OBX.15 / (Practitioner)  OBX-16,  PRT-5:PRT-4='RO' /  (Device)  OBX-18 , PRT-10:PRT-4='EQUIP' / (Organization)  OBX-23,  PRT-8:PRT-4='PO'",
        "identity": "v2"
      }, {
        "map": "participation[typeCode=PRF]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/Organization", "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson" ]
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Observation.performer",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.performer"
      },
      "isSummary": true
    }, {
      "path": "Observation.value[x]",
      "requirements": "An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.",
      "min": 1,
      "definition": "The information determined as a result of making the observation, if the information has a simple value.",
      "isModifier": false,
      "short": "Haplotype name/code",
      "mapping": [ {
        "map": "< 441742003 |Evaluation finding|",
        "identity": "sct-concept"
      }, {
        "map": "OBX.2, OBX.5, OBX.6",
        "identity": "v2"
      }, {
        "map": "value",
        "identity": "rim"
      }, {
        "map": "363714003 |Interprets|",
        "identity": "sct-attr"
      }, {
        "map": "B.14",
        "identity": "v2-cg-results"
      } ],
      "type": [ {
        "code": "Quantity"
      }, {
        "code": "CodeableConcept"
      }, {
        "code": "string"
      }, {
        "code": "boolean"
      }, {
        "code": "integer"
      }, {
        "code": "Range"
      }, {
        "code": "Ratio"
      }, {
        "code": "SampledData"
      }, {
        "code": "time"
      }, {
        "code": "dateTime"
      }, {
        "code": "Period"
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Observation.value[x]",
      "condition": [ "obs-7" ],
      "comment": "An observation may have; 1)  a single value here, 2)  both a value and a set of related or component values,  or 3)  only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code.  A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.  For additional guidance, see the [Notes section](observation.html#notes) below.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.value[x]"
      },
      "isSummary": true
    }, {
      "path": "Observation.dataAbsentReason",
      "requirements": "For many results it is necessary to handle exceptional values in measurements.",
      "min": 0,
      "definition": "Provides a reason why the expected value in the element Observation.value[x] is missing.",
      "isModifier": false,
      "short": "Why the result is missing",
      "mapping": [ {
        "map": "N/A",
        "identity": "v2"
      }, {
        "map": "value.nullFlavor",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationValueAbsentReason"
        } ],
        "description": "Codes specifying why the result (`Observation.value[x]`) is missing.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/data-absent-reason"
      },
      "max": "1",
      "id": "Observation.dataAbsentReason",
      "condition": [ "obs-6" ],
      "comment": "Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"specimen unsatisfactory\".   \n\nThe alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.dataAbsentReason"
      },
      "isSummary": false
    }, {
      "path": "Observation.interpretation",
      "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
      "min": 0,
      "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
      "isModifier": false,
      "short": "High, low, normal, etc.",
      "mapping": [ {
        "map": "< 260245000 |Findings values|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-8",
        "identity": "v2"
      }, {
        "map": "interpretationCode",
        "identity": "rim"
      }, {
        "map": "363713009 |Has interpretation|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationInterpretation"
        } ],
        "description": "Codes identifying interpretations of observations.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/observation-interpretation"
      },
      "alias": [ "Abnormal Flag" ],
      "max": "1",
      "id": "Observation.interpretation",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.interpretation"
      },
      "isSummary": false
    }, {
      "path": "Observation.comment",
      "requirements": "Need to be able to provide free text additional information.",
      "min": 0,
      "definition": "May include statements about significant, unexpected or unreliable values, or information about the source of the value where this may be relevant to the interpretation of the result.",
      "isModifier": false,
      "short": "Comments about result",
      "mapping": [ {
        "map": "NTE.3 (partner NTE to OBX, or sometimes another (child?) OBX)",
        "identity": "v2"
      }, {
        "map": "subjectOf.observationEvent[code=\"annotation\"].value",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Observation.comment",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.comment"
      },
      "isSummary": false
    }, {
      "path": "Observation.bodySite",
      "min": 0,
      "definition": "Indicates the site on the subject's body where the observation was made (i.e. the target site).",
      "isModifier": false,
      "short": "Observed body part",
      "mapping": [ {
        "map": "< 123037004 |Body structure|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-20",
        "identity": "v2"
      }, {
        "map": "targetSiteCode",
        "identity": "rim"
      }, {
        "map": "718497002 |Inherent location|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "BodySite"
        } ],
        "description": "Codes describing anatomical locations. May include laterality.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/body-site"
      },
      "max": "1",
      "id": "Observation.bodySite",
      "comment": "Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.   \n\nIf the use case requires BodySite to be handled as a separate resource (e.g. to identify and track separately) then use the standard extension[ body-structure](extension-body-structure.html).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.bodySite"
      },
      "isSummary": false
    }, {
      "path": "Observation.method",
      "requirements": "In some cases, method can impact results and is thus used for determining whether results can be compared or determining significance of results.",
      "min": 0,
      "definition": "Indicates the mechanism used to perform the observation.",
      "isModifier": false,
      "short": "How it was done",
      "mapping": [ {
        "map": "OBX-17",
        "identity": "v2"
      }, {
        "map": "methodCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationMethod"
        } ],
        "description": "Methods for simple observations.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/observation-methods"
      },
      "max": "1",
      "id": "Observation.method",
      "comment": "Only used if not implicit in code for Observation.code.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.method"
      },
      "isSummary": false
    }, {
      "path": "Observation.specimen",
      "min": 1,
      "definition": "The specimen examined to determine genetic information.",
      "isModifier": false,
      "short": "Specimen examined",
      "mapping": [ {
        "map": "< 123038009 |Specimen|",
        "identity": "sct-concept"
      }, {
        "map": "SPM segment",
        "identity": "v2"
      }, {
        "map": "participation[typeCode=SPC].specimen",
        "identity": "rim"
      }, {
        "map": "704319004 |Inherent in|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Specimen" ]
      } ],
      "mustSupport": true,
      "max": "1",
      "id": "Observation.specimen",
      "comment": "Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.specimen"
      },
      "isSummary": false
    }, {
      "path": "Observation.device",
      "min": 0,
      "definition": "The device used to generate the observation data.",
      "isModifier": false,
      "short": "(Measurement) Device",
      "mapping": [ {
        "map": "< 49062001 |Device|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-17 / PRT -10",
        "identity": "v2"
      }, {
        "map": "participation[typeCode=DEV]",
        "identity": "rim"
      }, {
        "map": "424226004 |Using device|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Device", "http://hl7.org/fhir/StructureDefinition/DeviceComponent", "http://hl7.org/fhir/StructureDefinition/DeviceMetric" ]
      } ],
      "max": "1",
      "id": "Observation.device",
      "comment": "An extension should be used if further typing of the device is needed.  Devices used to support obtaining an observation can be represented using an extension or the [Provenance](provenance.html) resource. (e.g., a device gateway such as a smart phone).",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.device"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      }, {
        "key": "obs-3",
        "human": "Must have at least a low or a high or text",
        "xpath": "(exists(f:low) or exists(f:high)or exists(f:text))",
        "severity": "error",
        "expression": "low.exists() or high.exists() or text.exists()"
      } ],
      "path": "Observation.referenceRange",
      "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
      "min": 0,
      "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
      "isModifier": false,
      "short": "Provides guide for interpretation",
      "mapping": [ {
        "map": "OBX.7",
        "identity": "v2"
      }, {
        "map": "outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "max": "*",
      "id": "Observation.referenceRange",
      "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.referenceRange"
      },
      "isSummary": false
    }, {
      "path": "Observation.referenceRange.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Observation.referenceRange.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Observation.referenceRange.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Observation.referenceRange.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Observation.referenceRange.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Observation.referenceRange.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "modifierExtension is reserved for use where modifier extensions must be used",
      "isSummary": true
    }, {
      "path": "Observation.referenceRange.low",
      "min": 0,
      "definition": "The value of the low bound of the reference range.  The low bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9). If the low bound is omitted,  it is assumed to be meaningless (e.g. reference range is <=2.3).",
      "isModifier": false,
      "short": "Low Range, if relevant",
      "mapping": [ {
        "map": "OBX-7",
        "identity": "v2"
      }, {
        "map": "value:IVL_PQ.low",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Quantity",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
      } ],
      "max": "1",
      "id": "Observation.referenceRange.low",
      "condition": [ "obs-3" ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.referenceRange.low"
      },
      "isSummary": false
    }, {
      "path": "Observation.referenceRange.high",
      "min": 0,
      "definition": "The value of the high bound of the reference range.  The high bound of the reference range endpoint is inclusive of the value (e.g.  reference range is >=5 - <=9). If the high bound is omitted,  it is assumed to be meaningless (e.g. reference range is >= 2.3).",
      "isModifier": false,
      "short": "High Range, if relevant",
      "mapping": [ {
        "map": "OBX-7",
        "identity": "v2"
      }, {
        "map": "value:IVL_PQ.high",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Quantity",
        "profile": [ "http://hl7.org/fhir/StructureDefinition/SimpleQuantity" ]
      } ],
      "max": "1",
      "id": "Observation.referenceRange.high",
      "condition": [ "obs-3" ],
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.referenceRange.high"
      },
      "isSummary": false
    }, {
      "path": "Observation.referenceRange.type",
      "requirements": "Need to be able to say what kind of reference range this is - normal, recommended, therapeutic, etc.,  - for proper interpretation.",
      "min": 0,
      "definition": "Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range.",
      "isModifier": false,
      "short": "Reference range qualifier",
      "mapping": [ {
        "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-10",
        "identity": "v2"
      }, {
        "map": "interpretationCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationRangeMeaning"
        } ],
        "description": "Code for the meaning of a reference range.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/referencerange-meaning"
      },
      "max": "1",
      "id": "Observation.referenceRange.type",
      "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal range is assumed.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.referenceRange.type"
      },
      "isSummary": false
    }, {
      "path": "Observation.referenceRange.appliesTo",
      "requirements": "Need to be able to identify the target population for proper interpretation.",
      "min": 0,
      "definition": "Codes to indicate the target population this reference range applies to.  For example, a reference range may be based on the normal population or a particular sex or race.",
      "isModifier": false,
      "short": "Reference range population",
      "mapping": [ {
        "map": "< 260245000 |Findings values| OR  \r< 365860008 |General clinical state finding| \rOR \r< 250171008 |Clinical history or observation findings| OR  \r< 415229000 |Racial group| OR \r< 365400002 |Finding of puberty stage| OR\r< 443938003 |Procedure carried out on subject|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-10",
        "identity": "v2"
      }, {
        "map": "interpretationCode",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationRangeType"
        } ],
        "description": "Codes identifying the population the reference range applies to.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/referencerange-appliesto"
      },
      "max": "*",
      "id": "Observation.referenceRange.appliesTo",
      "comment": "This SHOULD be populated if there is more than one range.  If this element is not present then the normal population is assumed.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.referenceRange.appliesTo"
      },
      "isSummary": false
    }, {
      "path": "Observation.referenceRange.age",
      "requirements": "Some analytes vary greatly over age.",
      "min": 0,
      "definition": "The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.",
      "isModifier": false,
      "short": "Applicable age range, if relevant",
      "mapping": [ {
        "map": "outboundRelationship[typeCode=PRCN].targetObservationCriterion[code=\"age\"].value",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Range"
      } ],
      "max": "1",
      "id": "Observation.referenceRange.age",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.referenceRange.age"
      },
      "isSummary": false
    }, {
      "path": "Observation.referenceRange.text",
      "min": 0,
      "definition": "Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation.  An example would be a reference value of \"Negative\" or a list or table of \"normals\".",
      "isModifier": false,
      "short": "Text based reference range in an observation",
      "mapping": [ {
        "map": "OBX-7",
        "identity": "v2"
      }, {
        "map": "value:ST",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "max": "1",
      "id": "Observation.referenceRange.text",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.referenceRange.text"
      },
      "isSummary": false
    }, {
      "path": "Observation.hasMember",
      "min": 0,
      "definition": "This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.",
      "isModifier": false,
      "short": "Related resource that belongs to the Observation group",
      "mapping": [ {
        "map": "Relationships established by OBX-4 usage",
        "identity": "v2"
      }, {
        "map": "outBoundRelationship",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Observation", "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse", "http://hl7.org/fhir/StructureDefinition/Sequence" ]
      } ],
      "max": "*",
      "id": "Observation.hasMember",
      "comment": "When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases.  For a discussion on the ways Observations can assembled in groups together, see [Notes](observation.html#obsgrouping) below.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.hasMember"
      },
      "isSummary": true
    }, {
      "path": "Observation.derivedFrom",
      "min": 0,
      "definition": "The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.",
      "isModifier": false,
      "short": "Related measurements the observation is made from",
      "mapping": [ {
        "map": "Relationships established by OBX-4 usage",
        "identity": "v2"
      }, {
        "map": ".targetObservation",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        }, {
          "path": "resolve().code",
          "type": "pattern"
        } ]
      },
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/DocumentReference", "http://hl7.org/fhir/StructureDefinition/ImagingStudy", "http://hl7.org/fhir/StructureDefinition/Media", "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse", "http://hl7.org/fhir/StructureDefinition/Observation", "http://hl7.org/fhir/StructureDefinition/Sequence" ]
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Observation.derivedFrom",
      "comment": "All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value.  The most common reference will be another Observation.  For a discussion on the ways Observations can assembled in groups together, see [Notes](observation.html#obsgrouping) below.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.derivedFrom"
      },
      "isSummary": true
    }, {
      "path": "Observation.derivedFrom",
      "min": 0,
      "definition": "Sequence that supports the finding.",
      "isModifier": false,
      "short": "Sequence",
      "mapping": [ {
        "map": "Relationships established by OBX-4 usage",
        "identity": "v2"
      }, {
        "map": ".targetObservation",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/sequence" ]
      } ],
      "mustSupport": true,
      "sliceName": "sequence",
      "max": "*",
      "id": "Observation.derivedFrom:sequence",
      "comment": "All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value.  The most common reference will be another Observation.  For a discussion on the ways Observations can assembled in groups together, see [Notes](observation.html#obsgrouping) below.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.derivedFrom"
      },
      "isSummary": true
    }, {
      "path": "Observation.derivedFrom",
      "min": 0,
      "definition": "The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.",
      "isModifier": false,
      "short": "Related measurements the observation is made from",
      "mapping": [ {
        "map": "Relationships established by OBX-4 usage",
        "identity": "v2"
      }, {
        "map": ".targetObservation",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/obs-cytogenic-not", "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/obs-complex-variant", "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/obs-described-variant" ]
      } ],
      "mustSupport": true,
      "sliceName": "mustsupport-derivations",
      "max": "*",
      "id": "Observation.derivedFrom:mustsupport-derivations",
      "comment": "All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value.  The most common reference will be another Observation.  For a discussion on the ways Observations can assembled in groups together, see [Notes](observation.html#obsgrouping) below.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.derivedFrom"
      },
      "isSummary": true
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Observation.component",
      "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
      "min": 0,
      "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
      "isModifier": false,
      "short": "Component results",
      "mapping": [ {
        "map": "containment by OBX-4?",
        "identity": "v2"
      }, {
        "map": "outBoundRelationship[typeCode=COMP]",
        "identity": "rim"
      } ],
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "code",
          "type": "pattern"
        } ]
      },
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "max": "*",
      "id": "Observation.component",
      "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.component"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Observation.component.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Observation.component.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Observation.component.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "modifierExtension is reserved for use where modifier extensions must be used",
      "isSummary": true
    }, {
      "path": "Observation.component.code",
      "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
      "min": 1,
      "definition": "Describes what was observed. Sometimes this is called the observation \"code\".",
      "isModifier": false,
      "short": "Type of component observation (code / type)",
      "mapping": [ {
        "map": "FiveWs.what[x]",
        "identity": "w5"
      }, {
        "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-3",
        "identity": "v2"
      }, {
        "map": "code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationCode"
        } ],
        "description": "Codes identifying names of simple observations.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/observation-codes"
      },
      "max": "1",
      "id": "Observation.component.code",
      "comment": "*All* code-value and  component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.",
      "base": {
        "max": "1",
        "min": 1,
        "path": "Observation.component.code"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.value[x]",
      "requirements": "An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.",
      "min": 0,
      "definition": "The information determined as a result of making the observation, if the information has a simple value.",
      "isModifier": false,
      "short": "Actual component result",
      "mapping": [ {
        "map": "363714003 |Interprets| < 441742003 |Evaluation finding|",
        "identity": "sct-concept"
      }, {
        "map": "OBX.2, OBX.5, OBX.6",
        "identity": "v2"
      }, {
        "map": "value",
        "identity": "rim"
      }, {
        "map": "363714003 |Interprets|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "Quantity"
      }, {
        "code": "CodeableConcept"
      }, {
        "code": "string"
      }, {
        "code": "boolean"
      }, {
        "code": "integer"
      }, {
        "code": "Range"
      }, {
        "code": "Ratio"
      }, {
        "code": "SampledData"
      }, {
        "code": "time"
      }, {
        "code": "dateTime"
      }, {
        "code": "Period"
      } ],
      "max": "1",
      "id": "Observation.component.value[x]",
      "comment": "Used when observation has a set of component observations. An observation may have both a value (e.g. an  Apgar score)  and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.  For additional guidance, see the [Notes section](observation.html#notes) below.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.value[x]"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.dataAbsentReason",
      "requirements": "For many results it is necessary to handle exceptional values in measurements.",
      "min": 0,
      "definition": "Provides a reason why the expected value in the element Observation.component.value[x] is missing.",
      "isModifier": false,
      "short": "Why the component result is missing",
      "mapping": [ {
        "map": "N/A",
        "identity": "v2"
      }, {
        "map": "value.nullFlavor",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationValueAbsentReason"
        } ],
        "description": "Codes specifying why the result (`Observation.value[x]`) is missing.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/data-absent-reason"
      },
      "max": "1",
      "id": "Observation.component.dataAbsentReason",
      "condition": [ "obs-6" ],
      "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\". \n\nThe alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.dataAbsentReason"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.interpretation",
      "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
      "min": 0,
      "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
      "isModifier": false,
      "short": "High, low, normal, etc.",
      "mapping": [ {
        "map": "< 260245000 |Findings values|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-8",
        "identity": "v2"
      }, {
        "map": "interpretationCode",
        "identity": "rim"
      }, {
        "map": "363713009 |Has interpretation|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationInterpretation"
        } ],
        "description": "Codes identifying interpretations of observations.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/observation-interpretation"
      },
      "alias": [ "Abnormal Flag" ],
      "max": "1",
      "id": "Observation.component.interpretation",
      "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use the Observation.interpretation element.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.interpretation"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.referenceRange",
      "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
      "min": 0,
      "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
      "isModifier": false,
      "short": "Provides guide for interpretation of component result",
      "mapping": [ {
        "map": "OBX.7",
        "identity": "v2"
      }, {
        "map": "outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#Observation.referenceRange",
      "max": "*",
      "id": "Observation.component.referenceRange",
      "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.component.referenceRange"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Observation.component",
      "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
      "min": 0,
      "definition": "HUGO Gene Nomenclature Committee (HGNC) identifier for a gene. List the gene(s) examined in full or in part by the study. If the study addresses multiple genes, these can be recorded in one OBX as a list seperated by repeat delimiters or in mulltiple OBX's with one gene per OBX. The recommended coding system will use the HGNC gene symbol as the display text and HGNC gene ID as the code.",
      "isModifier": false,
      "short": "Gene studied ID",
      "mapping": [ {
        "map": "containment by OBX-4?",
        "identity": "v2"
      }, {
        "map": "outBoundRelationship[typeCode=COMP]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "sliceName": "gene-studied",
      "max": "*",
      "id": "Observation.component:gene-studied",
      "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.component"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Observation.component:gene-studied.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Observation.component:gene-studied.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Observation.component:gene-studied.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "modifierExtension is reserved for use where modifier extensions must be used",
      "isSummary": true
    }, {
      "path": "Observation.component.code",
      "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
      "min": 1,
      "definition": "Describes what was observed. Sometimes this is called the observation \"code\".",
      "isModifier": false,
      "short": "Type of component observation (code / type)",
      "mapping": [ {
        "map": "FiveWs.what[x]",
        "identity": "w5"
      }, {
        "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-3",
        "identity": "v2"
      }, {
        "map": "code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationCode"
        } ],
        "description": "Codes identifying names of simple observations.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/observation-codes"
      },
      "max": "1",
      "id": "Observation.component:gene-studied.code",
      "comment": "*All* code-value and  component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "48018-6",
          "system": "http://loinc.org"
        } ]
      },
      "base": {
        "max": "1",
        "min": 1,
        "path": "Observation.component.code"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.value[x]",
      "requirements": "An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.",
      "min": 1,
      "definition": "The information determined as a result of making the observation, if the information has a simple value.",
      "isModifier": false,
      "short": "Actual component result",
      "mapping": [ {
        "map": "363714003 |Interprets| < 441742003 |Evaluation finding|",
        "identity": "sct-concept"
      }, {
        "map": "OBX.2, OBX.5, OBX.6",
        "identity": "v2"
      }, {
        "map": "value",
        "identity": "rim"
      }, {
        "map": "363714003 |Interprets|",
        "identity": "sct-attr"
      }, {
        "map": "A.4",
        "identity": "v2-cg-results"
      } ],
      "type": [ {
        "code": "Quantity"
      }, {
        "code": "CodeableConcept"
      }, {
        "code": "string"
      }, {
        "code": "boolean"
      }, {
        "code": "integer"
      }, {
        "code": "Range"
      }, {
        "code": "Ratio"
      }, {
        "code": "SampledData"
      }, {
        "code": "time"
      }, {
        "code": "dateTime"
      }, {
        "code": "Period"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "example",
        "description": "Binding not yet defined"
      },
      "max": "1",
      "id": "Observation.component:gene-studied.value[x]",
      "comment": "Used when observation has a set of component observations. An observation may have both a value (e.g. an  Apgar score)  and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.  For additional guidance, see the [Notes section](observation.html#notes) below.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.value[x]"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.dataAbsentReason",
      "requirements": "For many results it is necessary to handle exceptional values in measurements.",
      "min": 0,
      "definition": "Provides a reason why the expected value in the element Observation.component.value[x] is missing.",
      "isModifier": false,
      "short": "Why the component result is missing",
      "mapping": [ {
        "map": "N/A",
        "identity": "v2"
      }, {
        "map": "value.nullFlavor",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationValueAbsentReason"
        } ],
        "description": "Codes specifying why the result (`Observation.value[x]`) is missing.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/data-absent-reason"
      },
      "max": "1",
      "id": "Observation.component:gene-studied.dataAbsentReason",
      "condition": [ "obs-6" ],
      "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\". \n\nThe alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.dataAbsentReason"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.interpretation",
      "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
      "min": 0,
      "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
      "isModifier": false,
      "short": "High, low, normal, etc.",
      "mapping": [ {
        "map": "< 260245000 |Findings values|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-8",
        "identity": "v2"
      }, {
        "map": "interpretationCode",
        "identity": "rim"
      }, {
        "map": "363713009 |Has interpretation|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationInterpretation"
        } ],
        "description": "Codes identifying interpretations of observations.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/observation-interpretation"
      },
      "alias": [ "Abnormal Flag" ],
      "max": "1",
      "id": "Observation.component:gene-studied.interpretation",
      "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use the Observation.interpretation element.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.interpretation"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.referenceRange",
      "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
      "min": 0,
      "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
      "isModifier": false,
      "short": "Provides guide for interpretation of component result",
      "mapping": [ {
        "map": "OBX.7",
        "identity": "v2"
      }, {
        "map": "outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#Observation.referenceRange",
      "max": "*",
      "id": "Observation.component:gene-studied.referenceRange",
      "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.component.referenceRange"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Observation.component",
      "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
      "min": 0,
      "definition": "Some observations have multiple component observations.  These component observations are expressed as separate code value pairs that share the same attributes.  Examples include systolic and diastolic component observations for blood pressure measurement and multiple component observations for genetics observations.",
      "isModifier": false,
      "short": "Cytogenetic (chromosome) location",
      "mapping": [ {
        "map": "containment by OBX-4?",
        "identity": "v2"
      }, {
        "map": "outBoundRelationship[typeCode=COMP]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "sliceName": "chromosome-location",
      "max": "*",
      "id": "Observation.component:chromosome-location",
      "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.component"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Observation.component:chromosome-location.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Observation.component:chromosome-location.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Observation.component:chromosome-location.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "modifierExtension is reserved for use where modifier extensions must be used",
      "isSummary": true
    }, {
      "path": "Observation.component.code",
      "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
      "min": 1,
      "definition": "Describes what was observed. Sometimes this is called the observation \"code\".",
      "isModifier": false,
      "short": "Type of component observation (code / type)",
      "mapping": [ {
        "map": "FiveWs.what[x]",
        "identity": "w5"
      }, {
        "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-3",
        "identity": "v2"
      }, {
        "map": "code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationCode"
        } ],
        "description": "Codes identifying names of simple observations.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/observation-codes"
      },
      "max": "1",
      "id": "Observation.component:chromosome-location.code",
      "comment": "*All* code-value and  component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "48001-2",
          "system": "http://loinc.org"
        } ]
      },
      "base": {
        "max": "1",
        "min": 1,
        "path": "Observation.component.code"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.value[x]",
      "requirements": "An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.",
      "min": 1,
      "definition": "The information determined as a result of making the observation, if the information has a simple value.",
      "isModifier": false,
      "short": "Actual component result",
      "mapping": [ {
        "map": "363714003 |Interprets| < 441742003 |Evaluation finding|",
        "identity": "sct-concept"
      }, {
        "map": "OBX.2, OBX.5, OBX.6",
        "identity": "v2"
      }, {
        "map": "value",
        "identity": "rim"
      }, {
        "map": "363714003 |Interprets|",
        "identity": "sct-attr"
      }, {
        "map": "B.17",
        "identity": "v2-cg-results"
      } ],
      "type": [ {
        "code": "Quantity"
      }, {
        "code": "CodeableConcept"
      }, {
        "code": "string"
      }, {
        "code": "boolean"
      }, {
        "code": "integer"
      }, {
        "code": "Range"
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        "code": "Ratio"
      }, {
        "code": "SampledData"
      }, {
        "code": "time"
      }, {
        "code": "dateTime"
      }, {
        "code": "Period"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "example",
        "description": "Binding not yet defined"
      },
      "max": "1",
      "id": "Observation.component:chromosome-location.value[x]",
      "comment": "Used when observation has a set of component observations. An observation may have both a value (e.g. an  Apgar score)  and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.  For additional guidance, see the [Notes section](observation.html#notes) below.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.value[x]"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.dataAbsentReason",
      "requirements": "For many results it is necessary to handle exceptional values in measurements.",
      "min": 0,
      "definition": "Provides a reason why the expected value in the element Observation.component.value[x] is missing.",
      "isModifier": false,
      "short": "Why the component result is missing",
      "mapping": [ {
        "map": "N/A",
        "identity": "v2"
      }, {
        "map": "value.nullFlavor",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationValueAbsentReason"
        } ],
        "description": "Codes specifying why the result (`Observation.value[x]`) is missing.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/data-absent-reason"
      },
      "max": "1",
      "id": "Observation.component:chromosome-location.dataAbsentReason",
      "condition": [ "obs-6" ],
      "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\". \n\nThe alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.dataAbsentReason"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.interpretation",
      "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
      "min": 0,
      "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
      "isModifier": false,
      "short": "High, low, normal, etc.",
      "mapping": [ {
        "map": "< 260245000 |Findings values|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-8",
        "identity": "v2"
      }, {
        "map": "interpretationCode",
        "identity": "rim"
      }, {
        "map": "363713009 |Has interpretation|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationInterpretation"
        } ],
        "description": "Codes identifying interpretations of observations.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/observation-interpretation"
      },
      "alias": [ "Abnormal Flag" ],
      "max": "1",
      "id": "Observation.component:chromosome-location.interpretation",
      "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use the Observation.interpretation element.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.interpretation"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.referenceRange",
      "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
      "min": 0,
      "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
      "isModifier": false,
      "short": "Provides guide for interpretation of component result",
      "mapping": [ {
        "map": "OBX.7",
        "identity": "v2"
      }, {
        "map": "outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#Observation.referenceRange",
      "max": "*",
      "id": "Observation.component:chromosome-location.referenceRange",
      "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.component.referenceRange"
      },
      "isSummary": false
    }, {
      "constraint": [ {
        "key": "ele-1",
        "human": "All FHIR elements must have a @value or children",
        "xpath": "@value|f:*|h:div",
        "source": "Element",
        "severity": "error",
        "expression": "hasValue() | (children().count() > id.count())"
      } ],
      "path": "Observation.component",
      "requirements": "Component observations share the same attributes in the Observation resource as the primary observation and are always treated a part of a single observation (they are not separable).   However, the reference range for the primary observation value is not inherited by the component values and is required when appropriate for each component observation.",
      "min": 0,
      "definition": "This term is used to report a narrative description of the range(s) of DNA sequences examined in this sequencing study. Genetic test reports only rarely include explicit numeric ranges (which would be reported using [LOINC: 51959-5] ) beause they are often proprietary, and more often describe the regions examined in narrative. For example, \"all coding regions and appropriate flanking regions.\" To report the region of interest (e.g., in terms of introns and exons) rather than the specific DNA sequences examined, [LOINC: 47999-8] may be used.",
      "isModifier": false,
      "short": "Description of ranges of DNA sequences examined",
      "mapping": [ {
        "map": "containment by OBX-4?",
        "identity": "v2"
      }, {
        "map": "outBoundRelationship[typeCode=COMP]",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "BackboneElement"
      } ],
      "mustSupport": true,
      "sliceName": "dna-region-name",
      "max": "*",
      "id": "Observation.component:dna-region-name",
      "comment": "For a discussion on the ways Observations can be assembled in groups together see [Notes](observation.html#notes) below.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.component"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.id",
      "min": 0,
      "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
      "isModifier": false,
      "short": "xml:id (or equivalent in JSON)",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "string"
      } ],
      "representation": [ "xmlAttr" ],
      "max": "1",
      "id": "Observation.component:dna-region-name.id",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Element.id"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.extension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
      "isModifier": false,
      "short": "Additional content defined by implementations",
      "mapping": [ {
        "map": "n/a",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content" ],
      "max": "*",
      "id": "Observation.component:dna-region-name.extension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Element.extension"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.modifierExtension",
      "min": 0,
      "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.",
      "isModifier": true,
      "short": "Extensions that cannot be ignored",
      "mapping": [ {
        "map": "N/A",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "Extension"
      } ],
      "alias": [ "extensions", "user content", "modifiers" ],
      "max": "*",
      "id": "Observation.component:dna-region-name.modifierExtension",
      "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "BackboneElement.modifierExtension"
      },
      "isModifierReason": "modifierExtension is reserved for use where modifier extensions must be used",
      "isSummary": true
    }, {
      "path": "Observation.component.code",
      "requirements": "Knowing what kind of observation is being made is essential to understanding the observation.",
      "min": 1,
      "definition": "Describes what was observed. Sometimes this is called the observation \"code\".",
      "isModifier": false,
      "short": "Type of component observation (code / type)",
      "mapping": [ {
        "map": "FiveWs.what[x]",
        "identity": "w5"
      }, {
        "map": "< 363787002 |Observable entity| OR \r< 386053000 |Evaluation procedure|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-3",
        "identity": "v2"
      }, {
        "map": "code",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "example",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationCode"
        } ],
        "description": "Codes identifying names of simple observations.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/observation-codes"
      },
      "max": "1",
      "id": "Observation.component:dna-region-name.code",
      "comment": "*All* code-value and  component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.",
      "patternCodeableConcept": {
        "coding": [ {
          "code": "81293-3",
          "system": "http://loinc.org"
        } ]
      },
      "base": {
        "max": "1",
        "min": 1,
        "path": "Observation.component.code"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.value[x]",
      "requirements": "An observation exists to have a value, though it might not if it is in error, or if it represents a group of observations.",
      "min": 1,
      "definition": "The information determined as a result of making the observation, if the information has a simple value.",
      "isModifier": false,
      "short": "Actual component result",
      "mapping": [ {
        "map": "363714003 |Interprets| < 441742003 |Evaluation finding|",
        "identity": "sct-concept"
      }, {
        "map": "OBX.2, OBX.5, OBX.6",
        "identity": "v2"
      }, {
        "map": "value",
        "identity": "rim"
      }, {
        "map": "363714003 |Interprets|",
        "identity": "sct-attr"
      }, {
        "map": "A.7",
        "identity": "v2-cg-results"
      } ],
      "type": [ {
        "code": "Quantity"
      }, {
        "code": "CodeableConcept"
      }, {
        "code": "string"
      }, {
        "code": "boolean"
      }, {
        "code": "integer"
      }, {
        "code": "Range"
      }, {
        "code": "Ratio"
      }, {
        "code": "SampledData"
      }, {
        "code": "time"
      }, {
        "code": "dateTime"
      }, {
        "code": "Period"
      } ],
      "mustSupport": true,
      "binding": {
        "strength": "example",
        "description": "Binding not yet defined"
      },
      "max": "1",
      "id": "Observation.component:dna-region-name.value[x]",
      "comment": "Used when observation has a set of component observations. An observation may have both a value (e.g. an  Apgar score)  and component observations (the observations from which the Apgar score was derived). If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value.  For additional guidance, see the [Notes section](observation.html#notes) below.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.value[x]"
      },
      "isSummary": true
    }, {
      "path": "Observation.component.dataAbsentReason",
      "requirements": "For many results it is necessary to handle exceptional values in measurements.",
      "min": 0,
      "definition": "Provides a reason why the expected value in the element Observation.component.value[x] is missing.",
      "isModifier": false,
      "short": "Why the component result is missing",
      "mapping": [ {
        "map": "N/A",
        "identity": "v2"
      }, {
        "map": "value.nullFlavor",
        "identity": "rim"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationValueAbsentReason"
        } ],
        "description": "Codes specifying why the result (`Observation.value[x]`) is missing.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/data-absent-reason"
      },
      "max": "1",
      "id": "Observation.component:dna-region-name.dataAbsentReason",
      "condition": [ "obs-6" ],
      "comment": "\"Null\" or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  \"detected\", \"not detected\", \"inconclusive\", or  \"test not done\". \n\nThe alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code \"error\" could be used when the measurement was not completed.  Because of these options, use-case agreements are required to interpret general observations for exceptional values.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.dataAbsentReason"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.interpretation",
      "requirements": "For some results, particularly numeric results, an interpretation is necessary to fully understand the significance of a result.",
      "min": 0,
      "definition": "The assessment made based on the result of the observation.  Intended as a simple compact code often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. Otherwise known as abnormal flag.",
      "isModifier": false,
      "short": "High, low, normal, etc.",
      "mapping": [ {
        "map": "< 260245000 |Findings values|",
        "identity": "sct-concept"
      }, {
        "map": "OBX-8",
        "identity": "v2"
      }, {
        "map": "interpretationCode",
        "identity": "rim"
      }, {
        "map": "363713009 |Has interpretation|",
        "identity": "sct-attr"
      } ],
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "binding": {
        "strength": "extensible",
        "extension": [ {
          "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
          "valueString": "ObservationInterpretation"
        } ],
        "description": "Codes identifying interpretations of observations.",
        "valueSetCanonical": "http://hl7.org/fhir/ValueSet/observation-interpretation"
      },
      "alias": [ "Abnormal Flag" ],
      "max": "1",
      "id": "Observation.component:dna-region-name.interpretation",
      "comment": "The component interpretation applies only to the individual component value.  For an overall interpretation all components together use the Observation.interpretation element.",
      "base": {
        "max": "1",
        "min": 0,
        "path": "Observation.component.interpretation"
      },
      "isSummary": false
    }, {
      "path": "Observation.component.referenceRange",
      "requirements": "Knowing what values are considered \"normal\" can help evaluate the significance of a particular result. Need to be able to provide multiple reference ranges for different contexts.",
      "min": 0,
      "definition": "Guidance on how to interpret the value by comparison to a normal or recommended range.",
      "isModifier": false,
      "short": "Provides guide for interpretation of component result",
      "mapping": [ {
        "map": "OBX.7",
        "identity": "v2"
      }, {
        "map": "outboundRelationship[typeCode=REFV]/target[classCode=OBS, moodCode=EVN]",
        "identity": "rim"
      } ],
      "contentReference": "#Observation.referenceRange",
      "max": "*",
      "id": "Observation.component:dna-region-name.referenceRange",
      "comment": "Most observations only have one generic reference range. Systems MAY choose to restrict to only supplying the relevant reference range based on knowledge about the patient (e.g., specific to the patient's age, gender, weight and other factors), but this might not be possible or appropriate. Whenever more than one reference range is supplied, the differences between them SHOULD be provided in the reference range and/or age properties.",
      "base": {
        "max": "*",
        "min": 0,
        "path": "Observation.component.referenceRange"
      },
      "isSummary": false
    } ]
  },
  "status": "draft",
  "id": "2dcdae69-49b8-4e40-8032-b13cde6ffc59",
  "kind": "resource",
  "url": "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/obs-haplotype",
  "version": "2018may",
  "differential": {
    "element": [ {
      "id": "Observation",
      "path": "Observation",
      "short": "Haplotype",
      "definition": "A finding that a patient has a specific haplotype.",
      "isModifier": false,
      "mustSupport": false
    }, {
      "id": "Observation.code",
      "max": "1",
      "min": 1,
      "path": "Observation.code",
      "type": [ {
        "code": "CodeableConcept"
      } ],
      "isModifier": false,
      "mustSupport": true,
      "patternCodeableConcept": {
        "coding": [ {
          "code": "84414-2",
          "system": "http://loinc.org"
        } ]
      }
    }, {
      "id": "Observation.valueCodeableConcept",
      "max": "1",
      "min": 1,
      "path": "Observation.valueCodeableConcept",
      "short": "Haplotype name/code",
      "mapping": [ {
        "map": "B.14",
        "identity": "v2-cg-results"
      } ],
      "isModifier": false,
      "mustSupport": true
    }, {
      "id": "Observation.derivedFrom",
      "path": "Observation.derivedFrom",
      "slicing": {
        "rules": "open",
        "discriminator": [ {
          "path": "$this",
          "type": "type"
        }, {
          "path": "resolve().code",
          "type": "pattern"
        } ]
      },
      "isModifier": false,
      "mustSupport": true
    }, {
      "id": "Observation.derivedFrom:mustsupport-derivations",
      "max": "*",
      "min": 0,
      "path": "Observation.derivedFrom",
      "type": [ {
        "code": "Reference",
        "targetProfile": [ "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/obs-cytogenic-not", "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/obs-complex-variant", "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/obs-described-variant" ]
      } ],
      "sliceName": "mustsupport-derivations",
      "isModifier": false,
      "mustSupport": true
    } ]
  },
  "baseDefinition": "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/obs-comp-gen-finding"
}