description: 'A clinician''s qualitative judgment on the current trend of the cancer, e.g., whether it is stable, worsening (progressing), or improving (responding). The judgment may be based a single type or multiple kinds of evidence, such as imaging data, assessment of symptoms, tumor markers, laboratory data, etc.\r\n\r\nNote: The LOINC code chosen to represent this observation (LOINC 88040-1, Response to cancer treatment) does not precisely match the meaning of this profile, but it is the closest available LOINC code at the present time. It is acknowledged that the disease status is different than the status of the disease due to treatment, although in the context of an oncologist visit, disease status can mean response to treatment for patients under their care. However, the LOINC code 88041-2 is more granular than the definition of the profile because cancer disease status is observable regardless of whether the patient is under treatment. The plan is to request a new LOINC code that represents cancer disease status, as it is defined here, and replace the current LOINC code with the new code before normative publication of mCODE.'
package_name: hl7.fhir.us.mcode
derivation: constraint
name: CancerDiseaseStatus
type: Observation
elements:
  referenceRange: {index: 22}
  hasMember: {index: 23}
  interpretation: {index: 18}
  specimen: {index: 20}
  value:
    choices: [valueCodeableConcept]
    index: 15
  component: {index: 24}
  extension:
    index: 0
    slicing:
      rules: open
      ordered: false
      discriminator:
      - {path: url, type: value}
      min: null
      slices:
        evidenceType:
          match: {url: null}
          schema:
            type: Extension
            url: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-evidence-type
            index: 1
            elements:
              valueCodeableConcept:
                binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disease-status-evidence-type-vs'}
                index: 2
  effectiveDateTime: {type: dateTime, mustSupport: true, choiceOf: effective, index: 11}
  status: {mustSupport: true, index: 5}
  effective:
    mustSupport: true
    choices: [effectiveDateTime, effectivePeriod]
    index: 10
  code:
    mustSupport: true
    pattern:
      type: CodeableConcept
      value:
        coding:
        - {code: 88040-1, system: 'http://loinc.org'}
    index: 6
  valueCodeableConcept: {type: CodeableConcept, choiceOf: value, index: 16}
  bodySite: {index: 19}
  focus:
    type: Reference
    refers: ['http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-condition-parent']
    index: 8
  device: {index: 21}
  basedOn:
    type: Reference
    refers: ['http://hl7.org/fhir/StructureDefinition/MedicationRequest', 'http://hl7.org/fhir/StructureDefinition/ServiceRequest']
    index: 3
  partOf:
    type: Reference
    refers: ['http://hl7.org/fhir/StructureDefinition/MedicationAdministration', 'http://hl7.org/fhir/StructureDefinition/MedicationStatement', 'http://hl7.org/fhir/StructureDefinition/Procedure']
    index: 4
  subject:
    type: Reference
    mustSupport: true
    refers: ['http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient']
    index: 7
  performer:
    type: Reference
    refers: ['http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner']
    index: 13
  effectivePeriod: {type: Period, mustSupport: true, choiceOf: effective, index: 12}
package_version: 1.0.0
extensions:
  evidenceType:
    url: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-evidence-type
    type: Extension
    index: 1
    elements:
      valueCodeableConcept:
        binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/mcode/ValueSet/mcode-cancer-disease-status-evidence-type-vs'}
        index: 2
class: profile
kind: resource
url: http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-disease-status
base: http://hl7.org/fhir/StructureDefinition/Observation
version: 1.0.0
required: [subject]