Item | DT | Kard | Konf | Beschreibung | Label |
---|
| | | | | (TNMGrading) |
| @classCode
|
| | 0 .. 1 | F | OBS |
| @moodCode
|
| cs | 1 .. 1 | R | |
| CONF | Der Wert von @moodCode muss gewählt werden aus dem Value Set 2.16.840.1.113883.1.11.18943 x_ActMoodDocumentObservation (DYNAMIC) |
|
| @negationInd
|
| bl | 0 .. 1 | | |
| hl7:templateId
|
| II | 1 .. 1 | M | | (TNMGrading) |
| | @root
|
| | 1 .. 1 | F | 2.16.840.1.113883.2.6.60.6.10.36 |
| hl7:templateId
|
| II | 1 .. 1 | R | | (TNMGrading) |
| | @root
|
| | 1 .. 1 | F | 2.16.840.1.113883.10.12.303 |
| hl7:id
|
| II | 0 .. * | | | (TNMGrading) |
| hl7:code
|
| CD | 1 .. 1 | R | | (TNMGrading) |
| | @code
|
| | 1 .. 1 | F | 59541-3 |
| | @codeSystem
|
| | 1 .. 1 | F | 2.16.840.1.113883.6.1 (Logical Observation Identifier Names and Codes) |
| | @displayName
|
| | 1 .. 1 | F | Grade pathology system |
| | @codeSystemName
|
| | 1 .. 1 | F | LOINC |
| hl7:text
|
| ST | 1 .. 1 | R | | (TNMGrading) |
| hl7:statusCode
|
| CS | 0 .. 1 | | | (TNMGrading) |
| CONF | Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.1.11.15933 ActStatus (DYNAMIC) |
|
| hl7:effectiveTime
|
| IVL_TS | 0 .. 1 | | | (TNMGrading) |
| hl7:value
|
| CD | 0 .. 1 | | | (TNMGrading) |
| Constraint |
if grading system is not to recognize from sender, the value set for a 4 tiered grading has to be chosen.
|
| CONF | Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.2.6.60.6.11.32 UICC Grade 4 tiered (DYNAMIC) | oder | Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.2.6.60.6.11.30 UICC Grade 3 tiered (DYNAMIC) | oder | Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.2.6.60.6.11.31 UICC Grade 2 tiered (DYNAMIC) |
|
| hl7:specimen
|
| | 0 .. * | | | (TNMGrading) |
| Beinhaltet |
2.16.840.1.113883.2.6.60.6.10.13 Specimen Identification (DYNAMIC) |
| hl7:author
|
| | 1 .. 1 | R | | (TNMGrading) |
| Beinhaltet |
2.16.840.1.113883.10.12.318 CDA Author (Body) (DYNAMIC) |
| hl7:entryRelationship
|
| | 0 .. * | R | | (TNMGrading) |
| | @typeCode
|
| cs | 1 .. 1 | F | SPRT |
Eingefügt von 2.16.840.1.113883.2.6.60.6.10.9 AP Observation Entry (DYNAMIC) 0..* |
| Constraint | as assessment score for special grading systems
|
| | hl7:observation
|
| | 0 .. * | | | (TNMGrading) |
| | 1 .. 1 | F | OBS |
| cs | 1 .. 1 | F | EVN |
| bl | 0 .. 1 | | |
| | Ziel der Konzept Id(s): |
| II | 1 .. 1 | R | | (TNMGrading) |
| | 1 .. 1 | F | 2.16.840.1.113883.10.12.303 |
| II | 1 .. 1 | M | | (TNMGrading) |
| | 1 .. 1 | F | 2.16.840.1.113883.2.6.60.6.10.9 |
| II | 0 .. * | | | (TNMGrading) |
| CD | 1 .. 1 | M | | (TNMGrading) |
| | 1 .. 1 | F | 2.16.840.1.113883.6.1 (Logical Observation Identifier Names and Codes) |
| | 1 .. 1 | F | LOINC |
| Beispiel | <code code="59847-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Histology and Behavior ICD-O-3"/>
|
| ST | 0 .. 1 | | | (TNMGrading) |
| ED | 0 .. 1 | R | Textual description of the observation, offered by the system
| (TNMGrading) |
| CS | 0 .. 1 | | | (TNMGrading) |
| CONF | Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.1.11.15933 ActStatus (DYNAMIC) |
|
| IVL_TS | 0 .. 1 | R | Date and time the observation has been made, offered by the system | (TNMGrading) |
| CE | 0 .. 1 | | | (TNMGrading) |
| CONF | Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.1.11.16866 ActPriority (DYNAMIC) |
|
| IVL_INT | 0 .. 1 | | | (TNMGrading) |
| CS | 0 .. 1 | | | (TNMGrading) |
| CONF | Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.1.11.11526 HumanLanguage (DYNAMIC) |
|
| CD | 1 .. 1 | R | | (TNMGrading) |
| Constraint | The default data type, cardinalities and value set for the <value> element are dependant of the type of observation.
|
| CONF | Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.2.6.60.6.11.34 AP Observation (DYNAMIC) |
|
| Beispiel | <value code="8500/3" codeSystem="2.16.840.1.113883.6.43.1" codeSystemName="ICD-O-3" displayName="Invasive carcinoma of the breast, no special type"/>
|
| CE | 0 .. * | | | (TNMGrading) |
| CONF | Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.1.11.78 ObservationInterpretation (DYNAMIC) |
|
| CE | 0 .. * | | | (TNMGrading) |
| CONF | Der Wert von @code muss gewählt werden aus dem Value Set 2.16.840.1.113883.1.11.14079 ObservationMethod (DYNAMIC) |
|
| CD | 0 .. * | | | (TNMGrading) |
| | 1 .. 1 | F | 2.16.840.1.113883.5.1052 (Act Site) |
| | 1 .. 1 | M | | (TNMGrading) |
| Constraint | in this entry template only "specimen role" is used with the id given in specimen procedure step entry for that specimen the observation is made on.
|
| Beispiel | Example for specimen referencing <specimen> <!-- which specimen is used for this observation --> <specimenRole> <id root="1.3.6.1.4.1.19376.1.8.1.4.999999" extension="slide_A_1_PR"/> </specimenRole></specimen> |
| Beinhaltet |
2.16.840.1.113883.2.6.60.6.10.13 Specimen Identification (DYNAMIC) |
| | 0 .. * | | | (TNMGrading) |
| Beinhaltet |
1.2.276.0.76.10.90014 CDA Performer (Body) (DYNAMIC) |
| | 0 .. * | | | (TNMGrading) |
| Beinhaltet |
1.2.276.0.76.10.90025 CDA Author (Body) (DYNAMIC) |