HL7 FHIR JP Core ImplementationGuide
2.0.0-dev - ci-build Japan flag

HL7 FHIR JP Core ImplementationGuide - Local Development build (v2.0.0-dev) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: JP Core Condition Profile

項目内容
定義URL http://jpfhir.jp/fhir/core/StructureDefinition/JP_Condition
Version 2.0.0-dev
Name

JP_Condition
Title

JP Core Condition Profile
Status Active ( 2023-10-31 )
Copyright

Copyright FHIR Japanese implementation research working group in Japan Association of Medical Informatics (JAMI) 一般社団法人日本医療情報学会NeXEHRS課題研究会FHIR日本実装検討WG

このプロファイルはConditionリソースに対して、患者の健康状態に関するデータを送受信するための共通の制約と拡張を定めたものである。

本プロファイルは、患者の健康状態とその臨床的な評価を表現するJP_Conditionリソースの記録・更新・検索を行う上で、準拠するべき必須となる要素や、サポートすべき拡張、用語、検索パラメータを定義する。

スコープ

  • JP_Conditionリソースは、患者の健康上の懸念となるレベルに達した、身体的、精神的、社会的な負の状態(condition)や問題（problem／issue）、医療者による診断(diagnosis)、生じたイベント(event)、置かれている状況(situation)、臨床医学的概念(clinical concept)を表現する
  • 健康上の負の状態を表すものであるため、"妊娠"のようにそれが正常なものである場合にはJP_Conditionの対象外である

想定シナリオ

本プロファイルは、以下のようなユースケースを想定する。

  • JP_Conditionリソースの記録・更新・検索

プロファイル定義

Usage:

プロファイル詳細

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

This structure is derived from Condition

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition 0..* Condition Detailed information about conditions, problems or diagnoses. 患者の臨床状態、問題、または診断に関する詳細な情報
... text 0..1 Narrative Text summary of the resource, for human interpretation. このリソースを人間が解釈するためのテキスト要約
... clinicalStatus 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved （アクティブ | 再発 | 再燃 | インアクティブ | 寛解 | 完治）
... verificationStatus 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error（十分に確認されていない | 暫定的 | 鑑別的 | 十分な根拠で存在 | 十分な根拠で否定 | 誤記載）
... category 0..* CodeableConcept problem-list-item | encounter-diagnosis（プロブレムリスト | 一時的な診断）
... severity 0..1 CodeableConcept Subjective severity of condition. この患者状態の重症度。このプロファイルは、HL70421 Severity of Illness Codeで表現
Binding: JP Core Condition Severity ValueSet (preferred)
... code 0..1 CodeableConcept Identification of the condition, problem or diagnosis. この患者状態の識別コード
... bodySite 0..* CodeableConcept Anatomical location, if relevant. もし関連するのであれば、その人体部位
... subject 1..1 Reference(JP Core Patient Profile) Who has the condition? 誰がこの状態を有するか
... encounter 0..1 Reference(JP Core Encounter Profile) Encounter created as part of. この患者状態の記録が作成された受療の状況（外来、入院、救急、在宅など）
... onset[x] 0..1 dateTime, Age, Period, Range, string Estimated or actual date, date-time, or age. この患者状態のオンセット。推定もしくは実際の日付、日時、年齢
... abatement[x] 0..1 dateTime, Age, Period, Range, string When in resolution/remission. この状態はいつ治癒／寛解／軽快したか
... recordedDate 0..1 dateTime Date record was first recorded. この患者状態が初めて記録された日時
... recorder 0..1 Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson) Who recorded the condition. 誰がこの患者状態を記録したか
... asserter 0..1 Reference(JP Core Patient Profile | RelatedPerson | JP Core Practitioner Profile | JP Core PractitionerRole Profile) Person who asserts this condition. この患者状態の情報源
... stage 0..* BackboneElement Stage/grade, usually assessed formally. この患者状態のステージやグレード。通常は正式に評価されたもの
.... assessment 0..* Reference(ClinicalImpression | JP Core DiagnosticReport Common Profile | JP Core Observation Common Profile) Formal record of assessment
... evidence 0..* BackboneElement Supporting evidence. 患者状態の存在に関する根拠
... note 0..* Annotation Additional information about the Condition. この患者状態に関する追加情報

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C 0..* Condition Detailed information about conditions, problems or diagnoses. 患者の臨床状態、問題、または診断に関する詳細な情報
con-3: Condition.clinicalStatus SHOULD be present if verificationStatus is not entered-in-error and category is problem-list-item
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: 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
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... text 0..1 Narrative Text summary of the resource, for human interpretation. このリソースを人間が解釈するためのテキスト要約
ele-1: All FHIR elements must have a @value or children
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... clinicalStatus ?!ΣC 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved （アクティブ | 再発 | 再燃 | インアクティブ | 寛解 | 完治）
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.


ele-1: All FHIR elements must have a @value or children
... verificationStatus ?!ΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error（十分に確認されていない | 暫定的 | 鑑別的 | 十分な根拠で存在 | 十分な根拠で否定 | 誤記載）
Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.


ele-1: All FHIR elements must have a @value or children
... category 0..* CodeableConcept problem-list-item | encounter-diagnosis（プロブレムリスト | 一時的な診断）
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


ele-1: All FHIR elements must have a @value or children
... severity 0..1 CodeableConcept Subjective severity of condition. この患者状態の重症度。このプロファイルは、HL70421 Severity of Illness Codeで表現
Binding: JP Core Condition Severity ValueSet (preferred)
ele-1: All FHIR elements must have a @value or children
... code Σ 0..1 CodeableConcept Identification of the condition, problem or diagnosis. この患者状態の識別コード
Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.


ele-1: All FHIR elements must have a @value or children
... bodySite Σ 0..* CodeableConcept Anatomical location, if relevant. もし関連するのであれば、その人体部位
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts


ele-1: All FHIR elements must have a @value or children
... subject Σ 1..1 Reference(JP Core Patient Profile) Who has the condition? 誰がこの状態を有するか
ele-1: All FHIR elements must have a @value or children
... encounter Σ 0..1 Reference(JP Core Encounter Profile) Encounter created as part of. この患者状態の記録が作成された受療の状況（外来、入院、救急、在宅など）
ele-1: All FHIR elements must have a @value or children
... onset[x] Σ 0..1 Estimated or actual date, date-time, or age. この患者状態のオンセット。推定もしくは実際の日付、日時、年齢
ele-1: All FHIR elements must have a @value or children
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
... abatement[x] C 0..1 When in resolution/remission. この状態はいつ治癒／寛解／軽快したか
ele-1: All FHIR elements must have a @value or children
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
.... abatementString string
... recordedDate Σ 0..1 dateTime Date record was first recorded. この患者状態が初めて記録された日時
ele-1: All FHIR elements must have a @value or children
... recorder Σ 0..1 Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson) Who recorded the condition. 誰がこの患者状態を記録したか
ele-1: All FHIR elements must have a @value or children
... asserter Σ 0..1 Reference(JP Core Patient Profile | RelatedPerson | JP Core Practitioner Profile | JP Core PractitionerRole Profile) Person who asserts this condition. この患者状態の情報源
ele-1: All FHIR elements must have a @value or children
... stage C 0..* BackboneElement Stage/grade, usually assessed formally. この患者状態のステージやグレード。通常は正式に評価されたもの
con-1: Stage SHALL have summary or assessment
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... assessment C 0..* Reference(ClinicalImpression | JP Core DiagnosticReport Common Profile | JP Core Observation Common Profile) Formal record of assessment
ele-1: All FHIR elements must have a @value or children
... evidence C 0..* BackboneElement Supporting evidence. 患者状態の存在に関する根拠
con-2: evidence SHALL have code or details
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... note 0..* Annotation Additional information about the Condition. この患者状態に関する追加情報
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C 0..* Condition Detailed information about conditions, problems or diagnoses. 患者の臨床状態、問題、または診断に関する詳細な情報
con-3: Condition.clinicalStatus SHOULD be present if verificationStatus is not entered-in-error and category is problem-list-item
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): IETF language tag

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation. このリソースを人間が解釈するためのテキスト要約
... contained 0..* Resource Contained, inline Resources
dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Ids for this condition
... clinicalStatus ?!ΣC 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved （アクティブ | 再発 | 再燃 | インアクティブ | 寛解 | 完治）
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.

... verificationStatus ?!ΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error（十分に確認されていない | 暫定的 | 鑑別的 | 十分な根拠で存在 | 十分な根拠で否定 | 誤記載）
Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.

... category 0..* CodeableConcept problem-list-item | encounter-diagnosis（プロブレムリスト | 一時的な診断）
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


... severity 0..1 CodeableConcept Subjective severity of condition. この患者状態の重症度。このプロファイルは、HL70421 Severity of Illness Codeで表現
Binding: JP Core Condition Severity ValueSet (preferred)
... code Σ 0..1 CodeableConcept Identification of the condition, problem or diagnosis. この患者状態の識別コード
Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.

... bodySite Σ 0..* CodeableConcept Anatomical location, if relevant. もし関連するのであれば、その人体部位
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts


... subject Σ 1..1 Reference(JP Core Patient Profile) Who has the condition? 誰がこの状態を有するか
... encounter Σ 0..1 Reference(JP Core Encounter Profile) Encounter created as part of. この患者状態の記録が作成された受療の状況（外来、入院、救急、在宅など）
... onset[x] Σ 0..1 Estimated or actual date, date-time, or age. この患者状態のオンセット。推定もしくは実際の日付、日時、年齢
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
... abatement[x] C 0..1 When in resolution/remission. この状態はいつ治癒／寛解／軽快したか
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
.... abatementString string
... recordedDate Σ 0..1 dateTime Date record was first recorded. この患者状態が初めて記録された日時
... recorder Σ 0..1 Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson) Who recorded the condition. 誰がこの患者状態を記録したか
... asserter Σ 0..1 Reference(JP Core Patient Profile | RelatedPerson | JP Core Practitioner Profile | JP Core PractitionerRole Profile) Person who asserts this condition. この患者状態の情報源
... stage C 0..* BackboneElement Stage/grade, usually assessed formally. この患者状態のステージやグレード。通常は正式に評価されたもの
con-1: Stage SHALL have summary or assessment
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... summary C 0..1 CodeableConcept Simple summary (disease specific)
Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).

.... assessment C 0..* Reference(ClinicalImpression | JP Core DiagnosticReport Common Profile | JP Core Observation Common Profile) Formal record of assessment
.... type 0..1 CodeableConcept Kind of staging
Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).

... evidence C 0..* BackboneElement Supporting evidence. 患者状態の存在に関する根拠
con-2: evidence SHALL have code or details
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code ΣC 0..* CodeableConcept Manifestation/symptom
Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.


.... detail ΣC 0..* Reference(Resource) Supporting information found elsewhere
... note 0..* Annotation Additional information about the Condition. この患者状態に関する追加情報

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Condition.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
http://hl7.org/fhir/ValueSet/condition-clinical|4.3.0
from the FHIR Standard
Condition.verificationStatusrequiredConditionVerificationStatus
http://hl7.org/fhir/ValueSet/condition-ver-status|4.3.0
from the FHIR Standard
Condition.categoryextensibleConditionCategoryCodes
http://hl7.org/fhir/ValueSet/condition-category
from the FHIR Standard
Condition.severitypreferredJP_ConditionSeverity_VS
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionSeverity_VS
from this IG
Condition.codeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
Condition.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Condition.stage.summaryexampleConditionStage
http://hl7.org/fhir/ValueSet/condition-stage
from the FHIR Standard
Condition.stage.typeexampleConditionStageType
http://hl7.org/fhir/ValueSet/condition-stage-type
from the FHIR Standard
Condition.evidence.codeexampleManifestationAndSymptomCodes
http://hl7.org/fhir/ValueSet/manifestation-or-symptom
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
con-1errorCondition.stageStage SHALL have summary or assessment
: summary.exists() or assessment.exists()
con-2errorCondition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()
con-3best practiceConditionCondition.clinicalStatus SHOULD be present if verificationStatus is not entered-in-error and category is problem-list-item
: verificationStatus.empty().not() and verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').exists().not() and category.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-category' and code='problem-list-item').exists() implies clinicalStatus.empty().not()
con-4errorConditionIf condition is abated, then clinicalStatus must be either inactive, resolved, or remission
: abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5errorConditionCondition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2errorConditionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorConditionIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorConditionIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorConditionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceConditionA resource should have narrative for robust management
: text.`div`.exists()
dom-r4bwarningCondition.containedContaining new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
: ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Differential View

This structure is derived from Condition

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition 0..* Condition Detailed information about conditions, problems or diagnoses. 患者の臨床状態、問題、または診断に関する詳細な情報
... text 0..1 Narrative Text summary of the resource, for human interpretation. このリソースを人間が解釈するためのテキスト要約
... clinicalStatus 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved （アクティブ | 再発 | 再燃 | インアクティブ | 寛解 | 完治）
... verificationStatus 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error（十分に確認されていない | 暫定的 | 鑑別的 | 十分な根拠で存在 | 十分な根拠で否定 | 誤記載）
... category 0..* CodeableConcept problem-list-item | encounter-diagnosis（プロブレムリスト | 一時的な診断）
... severity 0..1 CodeableConcept Subjective severity of condition. この患者状態の重症度。このプロファイルは、HL70421 Severity of Illness Codeで表現
Binding: JP Core Condition Severity ValueSet (preferred)
... code 0..1 CodeableConcept Identification of the condition, problem or diagnosis. この患者状態の識別コード
... bodySite 0..* CodeableConcept Anatomical location, if relevant. もし関連するのであれば、その人体部位
... subject 1..1 Reference(JP Core Patient Profile) Who has the condition? 誰がこの状態を有するか
... encounter 0..1 Reference(JP Core Encounter Profile) Encounter created as part of. この患者状態の記録が作成された受療の状況（外来、入院、救急、在宅など）
... onset[x] 0..1 dateTime, Age, Period, Range, string Estimated or actual date, date-time, or age. この患者状態のオンセット。推定もしくは実際の日付、日時、年齢
... abatement[x] 0..1 dateTime, Age, Period, Range, string When in resolution/remission. この状態はいつ治癒／寛解／軽快したか
... recordedDate 0..1 dateTime Date record was first recorded. この患者状態が初めて記録された日時
... recorder 0..1 Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson) Who recorded the condition. 誰がこの患者状態を記録したか
... asserter 0..1 Reference(JP Core Patient Profile | RelatedPerson | JP Core Practitioner Profile | JP Core PractitionerRole Profile) Person who asserts this condition. この患者状態の情報源
... stage 0..* BackboneElement Stage/grade, usually assessed formally. この患者状態のステージやグレード。通常は正式に評価されたもの
.... assessment 0..* Reference(ClinicalImpression | JP Core DiagnosticReport Common Profile | JP Core Observation Common Profile) Formal record of assessment
... evidence 0..* BackboneElement Supporting evidence. 患者状態の存在に関する根拠
... note 0..* Annotation Additional information about the Condition. この患者状態に関する追加情報

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C 0..* Condition Detailed information about conditions, problems or diagnoses. 患者の臨床状態、問題、または診断に関する詳細な情報
con-3: Condition.clinicalStatus SHOULD be present if verificationStatus is not entered-in-error and category is problem-list-item
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: 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
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... text 0..1 Narrative Text summary of the resource, for human interpretation. このリソースを人間が解釈するためのテキスト要約
ele-1: All FHIR elements must have a @value or children
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... clinicalStatus ?!ΣC 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved （アクティブ | 再発 | 再燃 | インアクティブ | 寛解 | 完治）
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.


ele-1: All FHIR elements must have a @value or children
... verificationStatus ?!ΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error（十分に確認されていない | 暫定的 | 鑑別的 | 十分な根拠で存在 | 十分な根拠で否定 | 誤記載）
Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.


ele-1: All FHIR elements must have a @value or children
... category 0..* CodeableConcept problem-list-item | encounter-diagnosis（プロブレムリスト | 一時的な診断）
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


ele-1: All FHIR elements must have a @value or children
... severity 0..1 CodeableConcept Subjective severity of condition. この患者状態の重症度。このプロファイルは、HL70421 Severity of Illness Codeで表現
Binding: JP Core Condition Severity ValueSet (preferred)
ele-1: All FHIR elements must have a @value or children
... code Σ 0..1 CodeableConcept Identification of the condition, problem or diagnosis. この患者状態の識別コード
Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.


ele-1: All FHIR elements must have a @value or children
... bodySite Σ 0..* CodeableConcept Anatomical location, if relevant. もし関連するのであれば、その人体部位
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts


ele-1: All FHIR elements must have a @value or children
... subject Σ 1..1 Reference(JP Core Patient Profile) Who has the condition? 誰がこの状態を有するか
ele-1: All FHIR elements must have a @value or children
... encounter Σ 0..1 Reference(JP Core Encounter Profile) Encounter created as part of. この患者状態の記録が作成された受療の状況（外来、入院、救急、在宅など）
ele-1: All FHIR elements must have a @value or children
... onset[x] Σ 0..1 Estimated or actual date, date-time, or age. この患者状態のオンセット。推定もしくは実際の日付、日時、年齢
ele-1: All FHIR elements must have a @value or children
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
... abatement[x] C 0..1 When in resolution/remission. この状態はいつ治癒／寛解／軽快したか
ele-1: All FHIR elements must have a @value or children
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
.... abatementString string
... recordedDate Σ 0..1 dateTime Date record was first recorded. この患者状態が初めて記録された日時
ele-1: All FHIR elements must have a @value or children
... recorder Σ 0..1 Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson) Who recorded the condition. 誰がこの患者状態を記録したか
ele-1: All FHIR elements must have a @value or children
... asserter Σ 0..1 Reference(JP Core Patient Profile | RelatedPerson | JP Core Practitioner Profile | JP Core PractitionerRole Profile) Person who asserts this condition. この患者状態の情報源
ele-1: All FHIR elements must have a @value or children
... stage C 0..* BackboneElement Stage/grade, usually assessed formally. この患者状態のステージやグレード。通常は正式に評価されたもの
con-1: Stage SHALL have summary or assessment
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... assessment C 0..* Reference(ClinicalImpression | JP Core DiagnosticReport Common Profile | JP Core Observation Common Profile) Formal record of assessment
ele-1: All FHIR elements must have a @value or children
... evidence C 0..* BackboneElement Supporting evidence. 患者状態の存在に関する根拠
con-2: evidence SHALL have code or details
ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... note 0..* Annotation Additional information about the Condition. この患者状態に関する追加情報
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Condition C 0..* Condition Detailed information about conditions, problems or diagnoses. 患者の臨床状態、問題、または診断に関する詳細な情報
con-3: Condition.clinicalStatus SHOULD be present if verificationStatus is not entered-in-error and category is problem-list-item
con-4: If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
con-5: Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): IETF language tag

Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation. このリソースを人間が解釈するためのテキスト要約
... contained 0..* Resource Contained, inline Resources
dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier External Ids for this condition
... clinicalStatus ?!ΣC 0..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved （アクティブ | 再発 | 再燃 | インアクティブ | 寛解 | 完治）
Binding: ConditionClinicalStatusCodes (required): The clinical status of the condition or diagnosis.

... verificationStatus ?!ΣC 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error（十分に確認されていない | 暫定的 | 鑑別的 | 十分な根拠で存在 | 十分な根拠で否定 | 誤記載）
Binding: ConditionVerificationStatus (required): The verification status to support or decline the clinical status of the condition or diagnosis.

... category 0..* CodeableConcept problem-list-item | encounter-diagnosis（プロブレムリスト | 一時的な診断）
Binding: ConditionCategoryCodes (extensible): A category assigned to the condition.


... severity 0..1 CodeableConcept Subjective severity of condition. この患者状態の重症度。このプロファイルは、HL70421 Severity of Illness Codeで表現
Binding: JP Core Condition Severity ValueSet (preferred)
... code Σ 0..1 CodeableConcept Identification of the condition, problem or diagnosis. この患者状態の識別コード
Binding: Condition/Problem/DiagnosisCodes (example): Identification of the condition or diagnosis.

... bodySite Σ 0..* CodeableConcept Anatomical location, if relevant. もし関連するのであれば、その人体部位
Binding: SNOMEDCTBodyStructures (example): SNOMED CT Body site concepts


... subject Σ 1..1 Reference(JP Core Patient Profile) Who has the condition? 誰がこの状態を有するか
... encounter Σ 0..1 Reference(JP Core Encounter Profile) Encounter created as part of. この患者状態の記録が作成された受療の状況（外来、入院、救急、在宅など）
... onset[x] Σ 0..1 Estimated or actual date, date-time, or age. この患者状態のオンセット。推定もしくは実際の日付、日時、年齢
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
... abatement[x] C 0..1 When in resolution/remission. この状態はいつ治癒／寛解／軽快したか
.... abatementDateTime dateTime
.... abatementAge Age
.... abatementPeriod Period
.... abatementRange Range
.... abatementString string
... recordedDate Σ 0..1 dateTime Date record was first recorded. この患者状態が初めて記録された日時
... recorder Σ 0..1 Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson) Who recorded the condition. 誰がこの患者状態を記録したか
... asserter Σ 0..1 Reference(JP Core Patient Profile | RelatedPerson | JP Core Practitioner Profile | JP Core PractitionerRole Profile) Person who asserts this condition. この患者状態の情報源
... stage C 0..* BackboneElement Stage/grade, usually assessed formally. この患者状態のステージやグレード。通常は正式に評価されたもの
con-1: Stage SHALL have summary or assessment
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... summary C 0..1 CodeableConcept Simple summary (disease specific)
Binding: ConditionStage (example): Codes describing condition stages (e.g. Cancer stages).

.... assessment C 0..* Reference(ClinicalImpression | JP Core DiagnosticReport Common Profile | JP Core Observation Common Profile) Formal record of assessment
.... type 0..1 CodeableConcept Kind of staging
Binding: ConditionStageType (example): Codes describing the kind of condition staging (e.g. clinical or pathological).

... evidence C 0..* BackboneElement Supporting evidence. 患者状態の存在に関する根拠
con-2: evidence SHALL have code or details
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... code ΣC 0..* CodeableConcept Manifestation/symptom
Binding: ManifestationAndSymptomCodes (example): Codes that describe the manifestation or symptoms of a condition.


.... detail ΣC 0..* Reference(Resource) Supporting information found elsewhere
... note 0..* Annotation Additional information about the Condition. この患者状態に関する追加情報

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Condition.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
Condition.clinicalStatusrequiredConditionClinicalStatusCodes
http://hl7.org/fhir/ValueSet/condition-clinical|4.3.0
from the FHIR Standard
Condition.verificationStatusrequiredConditionVerificationStatus
http://hl7.org/fhir/ValueSet/condition-ver-status|4.3.0
from the FHIR Standard
Condition.categoryextensibleConditionCategoryCodes
http://hl7.org/fhir/ValueSet/condition-category
from the FHIR Standard
Condition.severitypreferredJP_ConditionSeverity_VS
http://jpfhir.jp/fhir/core/ValueSet/JP_ConditionSeverity_VS
from this IG
Condition.codeexampleCondition/Problem/DiagnosisCodes
http://hl7.org/fhir/ValueSet/condition-code
from the FHIR Standard
Condition.bodySiteexampleSNOMEDCTBodyStructures
http://hl7.org/fhir/ValueSet/body-site
from the FHIR Standard
Condition.stage.summaryexampleConditionStage
http://hl7.org/fhir/ValueSet/condition-stage
from the FHIR Standard
Condition.stage.typeexampleConditionStageType
http://hl7.org/fhir/ValueSet/condition-stage-type
from the FHIR Standard
Condition.evidence.codeexampleManifestationAndSymptomCodes
http://hl7.org/fhir/ValueSet/manifestation-or-symptom
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
con-1errorCondition.stageStage SHALL have summary or assessment
: summary.exists() or assessment.exists()
con-2errorCondition.evidenceevidence SHALL have code or details
: code.exists() or detail.exists()
con-3best practiceConditionCondition.clinicalStatus SHOULD be present if verificationStatus is not entered-in-error and category is problem-list-item
: verificationStatus.empty().not() and verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').exists().not() and category.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-category' and code='problem-list-item').exists() implies clinicalStatus.empty().not()
con-4errorConditionIf condition is abated, then clinicalStatus must be either inactive, resolved, or remission
: abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
con-5errorConditionCondition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
dom-2errorConditionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorConditionIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where(((id.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorConditionIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorConditionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceConditionA resource should have narrative for robust management
: text.`div`.exists()
dom-r4bwarningCondition.containedContaining new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems
: ($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

 

Other representations of profile: CSV, Excel, Schematron

必須要素

本プロファイルに準拠するためには、次の項目の値が存在しなければならない。

  • subject : 本リソースを所有する患者

Extensions定義

本プロファイルで追加定義された拡張はない。

利用方法

OperationおよびSearch Parameter 一覧

Search Parameter一覧

コンフォーマンス パラメータ 型 例
SHALL identifier token GET [base]/Condition?identifier=http://myhospital.com/fhir/condition|123
SHOULD patient reference GET [base]/Condition?patient=Patient/123
MAY patient,onset-date reference,date GET [base]/Condition?patient=Patient/123&onset-date=ge2021-08-24
MAY patient,clinical-status reference,token GET [base]/Condition?patient=Patient/123&clinical-status=active
MAY patient,verification-status reference,token GET [base]/Condition?patient=Patient/123&verification-status=confirmed
MAY patient,category reference,token GET [base]/Condition??patient=Patient/123&category=food
必須検索パラメータ

本プロファイルに準拠するためには、以下の検索パラメータをサポートしなければならない（SHALL）

  1. 検索パラメータidentifierを指定し、レコードIDなどの識別子によりConditionを検索

    GET [base]/Condition?identifier={system|}[token]

    例：

    GET [base]/Condition?identifier=http://myhospital.com/fhir/condition|123

    指定された識別子に一致するConditionリソースを含むBundleを検索する。

推奨検索パラメータ

本プロファイルに準拠するためには、以下の検索パラメータをサポートすることが推奨される（SHOULD）

  1. 検索パラメータpatientを指定し、該当するすべてのConditionを検索

    GET [base]/Condition?patient={reference}

    例：

    GET [base]/Condition?patient=Patient/123

    指定された患者のすべてのConditionリソースを含むBundleを検索する。

追加検索パラメータ

オプションとして次の検索パラメータをサポートすることができる（MAY）

  1. 検索パラメータpatientとdateを指定し、該当するすべてのConditionを検索

    • dateに対する次の比較演算子のサポートを含む: gt,lt,ge,le
    • AND検索のオプションのサポートを含む (例えば.date=[date]&date=[date]]&…)
       GET [base]/Condition?patient={reference}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}

    例：

       GET [base]/Condition?patient=Patient/123&date=ge2021-08-24

    指定された患者および日付のすべてのConditionを含むBundleを検索する。

  2. 検索パラメータpatientとclinical-statusを指定し、該当するすべてのConditionを検索

    • OR検索のサポートを含む(例えば clinical-status={system|}[token],{system|}[token],…)
       GET [base]/Condition?patient={reference}&clinical-status={system|}[token]{,{system|}[token],...}

    例：

       GET [base]/Condition?patient=Patient/123&clinical-status=active

       GET [base]/Condition?patient=Patient/123&clinical-status=http://hl7.org/fhir/ValueSet/condition-clinical|active

    指定された患者およびステータスのすべてのConditionを含むBundleを検索する。

  3. 検索パラメータpatientとverification-statusを指定し、該当するすべてのConditionを検索

    • OR検索のサポートを含む(例えば verification-status={system|}[token],{system|}[token],…)
       GET [base]/Condition?patient={reference}&verification-status={system|}[token]{,{system|}[token],...}

    例：

       GET [base]/Condition?patient=Patient/123&verification-status=confirmed

       GET [base]/Condition?patient=Patient/123&verification-status=http://hl7.org/fhir/ValueSet/condition-ver-status|confirmed

    指定された患者およびステータスのすべてのConditionを含むBundleを検索する。

  4. 検索パラメータpatientとcategoryを指定し、該当するすべてのConditionを検索

    • OR検索のサポートを含む(例えば category={system|}[token],{system|}[token],…)
       GET [base]/Condition?patient={reference}&category={system|}[token]{,{system|}[token],...}

    例：

       GET [base]/Condition?patient=Patient/123&category=claim-diagnosis

       GET [base]/Condition?patient=Patient/123&category=http://hl7.org/fhir/ValueSet/condition-category|claim-diagnosis

    指定された患者およびステータスのすべてのConditionを含むBundleを検索する。

オプション検索パラメータ

本プロファイルで追加定義されたオプション検索パラメータはない。

サンプル

注意事項

  • Condition.codeについての補足。現時点では、患者の状態を包括的に含む適当な日本語用語集がないと考え、基底のValue Setを継承するにとどめている。そのため、本プロファイルを継承するプロファイルがその用途に応じて、MEDIS標準病名マスタやICD-11などをCode SystemとするValue Setを独自に設定することを想定している。

その他、参考文献・リンク等

  1. HL70421 Severity of Illness Code … JAHIS データ交換規約（共通編）Ver1.3 p.119 https://www.jahis.jp/files/user/04_JAHIS%20standard/22-003_JAHIS%20データ交換規約（共通編）Ver.1.3.pdf
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