本プロファイルは、化学療法レジメンの定義情報を表現するJP_PlanDefinition_ChemotherapyRegimen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_PlanDefinition_ChemotherapyRegimenリソースは、化学療法における抗がん剤（注射薬、内服薬）、輸液、支持療法（制吐剤など）の組み合わせと、投与スケジュール、治療期間などを示した計画の情報を表現する。
• 個々の医薬品に関する情報は、JP_ActivityDefinition_ChemotherapyRegimen_Injection および JP_ActivityDefinition_ChemotherapyRegimen_Oralを用いて記述するため、JP_PlanDefinition_ChemotherapyRegimenリソースはcontained要素を用いて、これらのリソースを内包する。
• 化学放射線療法（化学療法と放射線治療の併用）における、放射線治療については、当リソースの対象としない。
• 特定の個人に適用された化学療法レジメンについては、当リソースの対象としない。

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。

• 電子カルテに登録されている化学療法レジメンマスタを他施設に共有する。
• any more

プロファイル定義

• Differential Table
• Key Elements Table
• Snapshot Table
• Terminology Bindings
• Constraints
• Statistics/References
• All

This structure is derived from PlanDefinition

Name	Flags	Card.	Type	Description & Constraints
PlanDefinition		0..*	PlanDefinition	TBD
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:regimenType		0..1	CodeableConcept	【仮】レジメン種別に関する情報 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_PlanDefinition_ChemotherapyRegimen_RegimenType Binding: JP Core PlanDefinition ChemotherapyRegimen RegimenType ValueSet (example)
useContext		0..*	UsageContext	【仮】対象疾患
action
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:timingDaysOfCycle		0..*	(Complex)	Days on which the action should be performed URL: http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle
timing[x]		0..1	Timing	【仮】総サイクル（n日サイクルを n回繰り返す等）
definition[x]		0..1	canonical(JP Core ActivityDefinition ChemotherapyRegimen Injection Profile | JP Core ActivityDefinition ChemotherapyRegimen Oral Profile)	【仮】医薬品情報のActivityDefinitionを参照する
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
PlanDefinition	C	0..*	PlanDefinition	TBD cnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation 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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:regimenType		0..1	CodeableConcept	【仮】レジメン種別に関する情報 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_PlanDefinition_ChemotherapyRegimen_RegimenType Binding: JP Core PlanDefinition ChemotherapyRegimen RegimenType ValueSet (example) ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource ext-1: Must have either extensions or value[x], not both
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
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. ele-1: All FHIR elements must have a @value or children
useContext	Σ	0..*	UsageContext	【仮】対象疾患 ele-1: All FHIR elements must have a @value or children
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
PlanDefinition	C	0..*	PlanDefinition	TBD cnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation
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 Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:regimenType		0..1	CodeableConcept	【仮】レジメン種別に関する情報 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_PlanDefinition_ChemotherapyRegimen_RegimenType Binding: JP Core PlanDefinition ChemotherapyRegimen RegimenType ValueSet (example)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
url	Σ	0..1	uri	Canonical identifier for this plan definition, represented as a URI (globally unique)
identifier	Σ	0..*	Identifier	Additional identifier for the plan definition
version	Σ	0..1	string	Business version of the plan definition
name	ΣC	0..1	string	Name for this plan definition (computer friendly)
title	Σ	0..1	string	Name for this plan definition (human friendly)
subtitle		0..1	string	Subordinate title of the plan definition
type	Σ	0..1	CodeableConcept	order-set | clinical-protocol | eca-rule | workflow-definition Binding: PlanDefinitionType (extensible): The type of PlanDefinition.
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
experimental	Σ	0..1	boolean	For testing purposes, not real usage
subject[x]		0..1		Type of individual the plan definition is focused on Binding: SubjectType (extensible): The possible types of subjects for a plan definition (E.g. Patient, Practitioner, Organization, Location, etc.).
subjectCodeableConcept			CodeableConcept
subjectReference			Reference(Group)
subjectCanonical			canonical(MedicinalProductDefinition | SubstanceDefinition | AdministrableProductDefinition | ManufacturedItemDefinition | PackagedProductDefinition)
date	Σ	0..1	dateTime	Date last changed
publisher	Σ	0..1	string	Name of the publisher (organization or individual)
contact	Σ	0..*	ContactDetail	Contact details for the publisher
description	Σ	0..1	markdown	Natural language description of the plan definition
useContext	Σ	0..*	UsageContext	【仮】対象疾患
jurisdiction	Σ	0..*	CodeableConcept	Intended jurisdiction for plan definition (if applicable) Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.
purpose		0..1	markdown	Why this plan definition is defined
usage		0..1	string	Describes the clinical usage of the plan
copyright		0..1	markdown	Use and/or publishing restrictions
approvalDate		0..1	date	When the plan definition was approved by publisher
lastReviewDate		0..1	date	When the plan definition was last reviewed
effectivePeriod	Σ	0..1	Period	When the plan definition is expected to be used
topic		0..*	CodeableConcept	E.g. Education, Treatment, Assessment Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.
author		0..*	ContactDetail	Who authored the content
editor		0..*	ContactDetail	Who edited the content
reviewer		0..*	ContactDetail	Who reviewed the content
endorser		0..*	ContactDetail	Who endorsed the content
relatedArtifact		0..*	RelatedArtifact	Additional documentation, citations
library		0..*	canonical(Library)	Logic used by the plan definition
goal		0..*	BackboneElement	What the plan is trying to accomplish
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
category		0..1	CodeableConcept	E.g. Treatment, dietary, behavioral Binding: GoalCategory (example): Example codes for grouping goals for filtering or presentation.
description		1..1	CodeableConcept	Code or text describing the goal Binding: SNOMEDCTClinicalFindings (example): Describes goals that can be achieved.
priority		0..1	CodeableConcept	high-priority | medium-priority | low-priority Binding: GoalPriority (preferred): Indicates the level of importance associated with reaching or sustaining a goal.
start		0..1	CodeableConcept	When goal pursuit begins Binding: GoalStartEvent (example): Identifies the types of events that might trigger the start of a goal.
addresses		0..*	CodeableConcept	What does the goal address Binding: Condition/Problem/DiagnosisCodes (example): Identifies problems, conditions, issues, or concerns that goals may address.
documentation		0..*	RelatedArtifact	Supporting documentation for the goal
target		0..*	BackboneElement	Target outcome for the goal
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
measure		0..1	CodeableConcept	The parameter whose value is to be tracked Binding: LOINCCodes (example): Identifies types of parameters that can be tracked to determine goal achievement.
detail[x]		0..1		The target value to be achieved
detailQuantity			Quantity
detailRange			Range
detailCodeableConcept			CodeableConcept
due		0..1	Duration	Reach goal within
action		0..*	BackboneElement	Action defined by the plan
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:timingDaysOfCycle		0..*	(Complex)	Days on which the action should be performed URL: http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
prefix		0..1	string	User-visible prefix for the action (e.g. 1. or A.)
title		0..1	string	User-visible title
description		0..1	string	Brief description of the action
textEquivalent		0..1	string	Static text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system
priority		0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
code		0..*	CodeableConcept	Code representing the meaning of the action or sub-actions Binding: ActionCode (example): Provides examples of actions to be performed.
reason		0..*	CodeableConcept	Why the action should be performed Binding: ActionReasonCode (example): Provides examples of reasons for actions to be performed.
documentation		0..*	RelatedArtifact	Supporting documentation for the intended performer of the action
goalId		0..*	id	What goals this action supports
subject[x]		0..1		Type of individual the action is focused on Binding: SubjectType (extensible): The possible types of subjects for a plan definition (E.g. Patient, Practitioner, Organization, Location, etc.).
subjectCodeableConcept			CodeableConcept
subjectReference			Reference(Group)
subjectCanonical			canonical(Any)
trigger		0..*	TriggerDefinition	When the action should be triggered
condition		0..*	BackboneElement	Whether or not the action is applicable
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
kind		1..1	code	applicability | start | stop Binding: ActionConditionKind (required): Defines the kinds of conditions that can appear on actions.
expression		0..1	Expression	Boolean-valued expression
input		0..*	DataRequirement	Input data requirements
output		0..*	DataRequirement	Output data definition
relatedAction		0..*	BackboneElement	Relationship to another action
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
actionId		1..1	id	What action is this related to
relationship		1..1	code	before-start | before | before-end | concurrent-with-start | concurrent | concurrent-with-end | after-start | after | after-end Binding: ActionRelationshipType (required): Defines the types of relationships between actions.
offset[x]		0..1		Time offset for the relationship
offsetDuration			Duration
offsetRange			Range
timing[x]		0..1	Timing	【仮】総サイクル（n日サイクルを n回繰り返す等）
participant		0..*	BackboneElement	Who should participate in the action
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
type		1..1	code	patient | practitioner | related-person | device Binding: ActionParticipantType (required): The type of participant for the action.
role		0..1	CodeableConcept	E.g. Nurse, Surgeon, Parent Binding: Action Participant Role (example): Defines roles played by participants for the action.
type		0..1	CodeableConcept	create | update | remove | fire-event Binding: ActionType (extensible): The type of action to be performed.
groupingBehavior		0..1	code	visual-group | logical-group | sentence-group Binding: ActionGroupingBehavior (required): Defines organization behavior of a group.
selectionBehavior		0..1	code	any | all | all-or-none | exactly-one | at-most-one | one-or-more Binding: ActionSelectionBehavior (required): Defines selection behavior of a group.
requiredBehavior		0..1	code	must | could | must-unless-documented Binding: ActionRequiredBehavior (required): Defines expectations around whether an action or action group is required.
precheckBehavior		0..1	code	yes | no Binding: ActionPrecheckBehavior (required): Defines selection frequency behavior for an action or group.
cardinalityBehavior		0..1	code	single | multiple Binding: ActionCardinalityBehavior (required): Defines behavior for an action or a group for how many times that item may be repeated.
definition[x]		0..1	canonical(JP Core ActivityDefinition ChemotherapyRegimen Injection Profile | JP Core ActivityDefinition ChemotherapyRegimen Oral Profile)	【仮】医薬品情報のActivityDefinitionを参照する
transform		0..1	canonical(StructureMap)	Transform to apply the template
dynamicValue		0..*	BackboneElement	Dynamic aspects of the definition
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
path		0..1	string	The path to the element to be set dynamically
expression		0..1	Expression	An expression that provides the dynamic value for the customization
action		0..*	See action (PlanDefinition)	A sub-action
Documentation for this format

Differential View

This structure is derived from PlanDefinition

Name	Flags	Card.	Type	Description & Constraints
PlanDefinition		0..*	PlanDefinition	TBD
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:regimenType		0..1	CodeableConcept	【仮】レジメン種別に関する情報 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_PlanDefinition_ChemotherapyRegimen_RegimenType Binding: JP Core PlanDefinition ChemotherapyRegimen RegimenType ValueSet (example)
useContext		0..*	UsageContext	【仮】対象疾患
action
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:timingDaysOfCycle		0..*	(Complex)	Days on which the action should be performed URL: http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle
timing[x]		0..1	Timing	【仮】総サイクル（n日サイクルを n回繰り返す等）
definition[x]		0..1	canonical(JP Core ActivityDefinition ChemotherapyRegimen Injection Profile | JP Core ActivityDefinition ChemotherapyRegimen Oral Profile)	【仮】医薬品情報のActivityDefinitionを参照する
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
PlanDefinition	C	0..*	PlanDefinition	TBD cnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation 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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
extension:regimenType		0..1	CodeableConcept	【仮】レジメン種別に関する情報 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_PlanDefinition_ChemotherapyRegimen_RegimenType Binding: JP Core PlanDefinition ChemotherapyRegimen RegimenType ValueSet (example) ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource ext-1: Must have either extensions or value[x], not both
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
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact. ele-1: All FHIR elements must have a @value or children
useContext	Σ	0..*	UsageContext	【仮】対象疾患 ele-1: All FHIR elements must have a @value or children
Documentation for this format

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
PlanDefinition	C	0..*	PlanDefinition	TBD cnl-0: Name should be usable as an identifier for the module by machine processing applications such as code generation
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 Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
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
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:regimenType		0..1	CodeableConcept	【仮】レジメン種別に関する情報 URL: http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_PlanDefinition_ChemotherapyRegimen_RegimenType Binding: JP Core PlanDefinition ChemotherapyRegimen RegimenType ValueSet (example)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
url	Σ	0..1	uri	Canonical identifier for this plan definition, represented as a URI (globally unique)
identifier	Σ	0..*	Identifier	Additional identifier for the plan definition
version	Σ	0..1	string	Business version of the plan definition
name	ΣC	0..1	string	Name for this plan definition (computer friendly)
title	Σ	0..1	string	Name for this plan definition (human friendly)
subtitle		0..1	string	Subordinate title of the plan definition
type	Σ	0..1	CodeableConcept	order-set | clinical-protocol | eca-rule | workflow-definition Binding: PlanDefinitionType (extensible): The type of PlanDefinition.
status	?!Σ	1..1	code	draft | active | retired | unknown Binding: PublicationStatus (required): The lifecycle status of an artifact.
experimental	Σ	0..1	boolean	For testing purposes, not real usage
subject[x]		0..1		Type of individual the plan definition is focused on Binding: SubjectType (extensible): The possible types of subjects for a plan definition (E.g. Patient, Practitioner, Organization, Location, etc.).
subjectCodeableConcept			CodeableConcept
subjectReference			Reference(Group)
subjectCanonical			canonical(MedicinalProductDefinition | SubstanceDefinition | AdministrableProductDefinition | ManufacturedItemDefinition | PackagedProductDefinition)
date	Σ	0..1	dateTime	Date last changed
publisher	Σ	0..1	string	Name of the publisher (organization or individual)
contact	Σ	0..*	ContactDetail	Contact details for the publisher
description	Σ	0..1	markdown	Natural language description of the plan definition
useContext	Σ	0..*	UsageContext	【仮】対象疾患
jurisdiction	Σ	0..*	CodeableConcept	Intended jurisdiction for plan definition (if applicable) Binding: Jurisdiction ValueSet (extensible): Countries and regions within which this artifact is targeted for use.
purpose		0..1	markdown	Why this plan definition is defined
usage		0..1	string	Describes the clinical usage of the plan
copyright		0..1	markdown	Use and/or publishing restrictions
approvalDate		0..1	date	When the plan definition was approved by publisher
lastReviewDate		0..1	date	When the plan definition was last reviewed
effectivePeriod	Σ	0..1	Period	When the plan definition is expected to be used
topic		0..*	CodeableConcept	E.g. Education, Treatment, Assessment Binding: DefinitionTopic (example): High-level categorization of the definition, used for searching, sorting, and filtering.
author		0..*	ContactDetail	Who authored the content
editor		0..*	ContactDetail	Who edited the content
reviewer		0..*	ContactDetail	Who reviewed the content
endorser		0..*	ContactDetail	Who endorsed the content
relatedArtifact		0..*	RelatedArtifact	Additional documentation, citations
library		0..*	canonical(Library)	Logic used by the plan definition
goal		0..*	BackboneElement	What the plan is trying to accomplish
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
category		0..1	CodeableConcept	E.g. Treatment, dietary, behavioral Binding: GoalCategory (example): Example codes for grouping goals for filtering or presentation.
description		1..1	CodeableConcept	Code or text describing the goal Binding: SNOMEDCTClinicalFindings (example): Describes goals that can be achieved.
priority		0..1	CodeableConcept	high-priority | medium-priority | low-priority Binding: GoalPriority (preferred): Indicates the level of importance associated with reaching or sustaining a goal.
start		0..1	CodeableConcept	When goal pursuit begins Binding: GoalStartEvent (example): Identifies the types of events that might trigger the start of a goal.
addresses		0..*	CodeableConcept	What does the goal address Binding: Condition/Problem/DiagnosisCodes (example): Identifies problems, conditions, issues, or concerns that goals may address.
documentation		0..*	RelatedArtifact	Supporting documentation for the goal
target		0..*	BackboneElement	Target outcome for the goal
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
measure		0..1	CodeableConcept	The parameter whose value is to be tracked Binding: LOINCCodes (example): Identifies types of parameters that can be tracked to determine goal achievement.
detail[x]		0..1		The target value to be achieved
detailQuantity			Quantity
detailRange			Range
detailCodeableConcept			CodeableConcept
due		0..1	Duration	Reach goal within
action		0..*	BackboneElement	Action defined by the plan
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:timingDaysOfCycle		0..*	(Complex)	Days on which the action should be performed URL: http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
prefix		0..1	string	User-visible prefix for the action (e.g. 1. or A.)
title		0..1	string	User-visible title
description		0..1	string	Brief description of the action
textEquivalent		0..1	string	Static text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system
priority		0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
code		0..*	CodeableConcept	Code representing the meaning of the action or sub-actions Binding: ActionCode (example): Provides examples of actions to be performed.
reason		0..*	CodeableConcept	Why the action should be performed Binding: ActionReasonCode (example): Provides examples of reasons for actions to be performed.
documentation		0..*	RelatedArtifact	Supporting documentation for the intended performer of the action
goalId		0..*	id	What goals this action supports
subject[x]		0..1		Type of individual the action is focused on Binding: SubjectType (extensible): The possible types of subjects for a plan definition (E.g. Patient, Practitioner, Organization, Location, etc.).
subjectCodeableConcept			CodeableConcept
subjectReference			Reference(Group)
subjectCanonical			canonical(Any)
trigger		0..*	TriggerDefinition	When the action should be triggered
condition		0..*	BackboneElement	Whether or not the action is applicable
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
kind		1..1	code	applicability | start | stop Binding: ActionConditionKind (required): Defines the kinds of conditions that can appear on actions.
expression		0..1	Expression	Boolean-valued expression
input		0..*	DataRequirement	Input data requirements
output		0..*	DataRequirement	Output data definition
relatedAction		0..*	BackboneElement	Relationship to another action
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
actionId		1..1	id	What action is this related to
relationship		1..1	code	before-start | before | before-end | concurrent-with-start | concurrent | concurrent-with-end | after-start | after | after-end Binding: ActionRelationshipType (required): Defines the types of relationships between actions.
offset[x]		0..1		Time offset for the relationship
offsetDuration			Duration
offsetRange			Range
timing[x]		0..1	Timing	【仮】総サイクル（n日サイクルを n回繰り返す等）
participant		0..*	BackboneElement	Who should participate in the action
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
type		1..1	code	patient | practitioner | related-person | device Binding: ActionParticipantType (required): The type of participant for the action.
role		0..1	CodeableConcept	E.g. Nurse, Surgeon, Parent Binding: Action Participant Role (example): Defines roles played by participants for the action.
type		0..1	CodeableConcept	create | update | remove | fire-event Binding: ActionType (extensible): The type of action to be performed.
groupingBehavior		0..1	code	visual-group | logical-group | sentence-group Binding: ActionGroupingBehavior (required): Defines organization behavior of a group.
selectionBehavior		0..1	code	any | all | all-or-none | exactly-one | at-most-one | one-or-more Binding: ActionSelectionBehavior (required): Defines selection behavior of a group.
requiredBehavior		0..1	code	must | could | must-unless-documented Binding: ActionRequiredBehavior (required): Defines expectations around whether an action or action group is required.
precheckBehavior		0..1	code	yes | no Binding: ActionPrecheckBehavior (required): Defines selection frequency behavior for an action or group.
cardinalityBehavior		0..1	code	single | multiple Binding: ActionCardinalityBehavior (required): Defines behavior for an action or a group for how many times that item may be repeated.
definition[x]		0..1	canonical(JP Core ActivityDefinition ChemotherapyRegimen Injection Profile | JP Core ActivityDefinition ChemotherapyRegimen Oral Profile)	【仮】医薬品情報のActivityDefinitionを参照する
transform		0..1	canonical(StructureMap)	Transform to apply the template
dynamicValue		0..*	BackboneElement	Dynamic aspects of the definition
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
path		0..1	string	The path to the element to be set dynamically
expression		0..1	Expression	An expression that provides the dynamic value for the customization
action		0..*	See action (PlanDefinition)	A sub-action
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
PlanDefinition.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
PlanDefinition.type	extensible	PlanDefinitionType http://hl7.org/fhir/ValueSet/plan-definition-type from the FHIR Standard
PlanDefinition.status	required	PublicationStatus http://hl7.org/fhir/ValueSet/publication-status|4.3.0 from the FHIR Standard
PlanDefinition.subject[x]	extensible	SubjectType http://hl7.org/fhir/ValueSet/subject-type from the FHIR Standard
PlanDefinition.jurisdiction	extensible	Jurisdiction ValueSet http://hl7.org/fhir/ValueSet/jurisdiction from the FHIR Standard
PlanDefinition.topic	example	DefinitionTopic http://hl7.org/fhir/ValueSet/definition-topic from the FHIR Standard
PlanDefinition.goal.category	example	GoalCategory http://hl7.org/fhir/ValueSet/goal-category from the FHIR Standard
PlanDefinition.goal.description	example	SNOMEDCTClinicalFindings http://hl7.org/fhir/ValueSet/clinical-findings from the FHIR Standard
PlanDefinition.goal.priority	preferred	GoalPriority http://hl7.org/fhir/ValueSet/goal-priority from the FHIR Standard
PlanDefinition.goal.start	example	GoalStartEvent http://hl7.org/fhir/ValueSet/goal-start-event from the FHIR Standard
PlanDefinition.goal.addresses	example	Condition/Problem/DiagnosisCodes http://hl7.org/fhir/ValueSet/condition-code from the FHIR Standard
PlanDefinition.goal.target.measure	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
PlanDefinition.action.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.3.0 from the FHIR Standard
PlanDefinition.action.code	example	ActionCode http://hl7.org/fhir/ValueSet/action-code from the FHIR Standard
PlanDefinition.action.reason	example	ActionReasonCode http://hl7.org/fhir/ValueSet/action-reason-code from the FHIR Standard
PlanDefinition.action.subject[x]	extensible	SubjectType http://hl7.org/fhir/ValueSet/subject-type from the FHIR Standard
PlanDefinition.action.condition.kind	required	ActionConditionKind http://hl7.org/fhir/ValueSet/action-condition-kind|4.3.0 from the FHIR Standard
PlanDefinition.action.relatedAction.relationship	required	ActionRelationshipType http://hl7.org/fhir/ValueSet/action-relationship-type|4.3.0 from the FHIR Standard
PlanDefinition.action.participant.type	required	ActionParticipantType http://hl7.org/fhir/ValueSet/action-participant-type|4.3.0 from the FHIR Standard
PlanDefinition.action.participant.role	example	ActionParticipantRole http://terminology.hl7.org/ValueSet/action-participant-role
PlanDefinition.action.type	extensible	ActionType http://hl7.org/fhir/ValueSet/action-type from the FHIR Standard
PlanDefinition.action.groupingBehavior	required	ActionGroupingBehavior http://hl7.org/fhir/ValueSet/action-grouping-behavior|4.3.0 from the FHIR Standard
PlanDefinition.action.selectionBehavior	required	ActionSelectionBehavior http://hl7.org/fhir/ValueSet/action-selection-behavior|4.3.0 from the FHIR Standard
PlanDefinition.action.requiredBehavior	required	ActionRequiredBehavior http://hl7.org/fhir/ValueSet/action-required-behavior|4.3.0 from the FHIR Standard
PlanDefinition.action.precheckBehavior	required	ActionPrecheckBehavior http://hl7.org/fhir/ValueSet/action-precheck-behavior|4.3.0 from the FHIR Standard
PlanDefinition.action.cardinalityBehavior	required	ActionCardinalityBehavior http://hl7.org/fhir/ValueSet/action-cardinality-behavior|4.3.0 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
cnl-0	warning	PlanDefinition	Name should be usable as an identifier for the module by machine processing applications such as code generation : name.exists() implies name.matches('[A-Z]([A-Za-z0-9_]){0,254}')
dom-2	error	PlanDefinition	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	PlanDefinition	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where(((id.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-4	error	PlanDefinition	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	PlanDefinition	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	PlanDefinition	A resource should have narrative for robust management : text.`div`.exists()
dom-r4b	warning	PlanDefinition.contained	Containing 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-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from PlanDefinition

Summary

Structures

This structure refers to these other structures:

• JP Core ActivityDefinition ChemotherapyRegimen Injection Profile (http://jpfhir.jp/fhir/core/StructureDefinition/JP_ActivityDefinition_ChemotherapyRegimen_Injection)
• JP Core ActivityDefinition ChemotherapyRegimen Oral Profile (http://jpfhir.jp/fhir/core/StructureDefinition/JP_ActivityDefinition_ChemotherapyRegimen_Oral)

Extensions

This structure refers to these extensions:

• http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_PlanDefinition_ChemotherapyRegimen_RegimenType
• http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle

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。

• status : 本リソースのステータス (draft

  active

  retired

  unknown)

Extensions定義

本プロファイルで定義された拡張は次の通りである。

用語定義

TBD

制約一覧

本プロファイルで追加定義された制約はない。

項目の追加

本プロファイルで追加された項目は以下の通りである。

• レジメン種別（拡張「JP_PlanDefinition_ChemotherapyRegimen_RegimenType」を使用）
• 相対投与日（拡張「JP_PlanDefinition_ChemotherapyRegimen_TimingDaysOfCycle」を使用）

利用方法

OperationおよびSearch Parameter 一覧

Search Parameter一覧

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PlanDefinitionを検索

   GET [base]/PlanDefinition?identifier={system|}[code]
   

   例：

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

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

推奨検索パラメータ

TBD

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

• 病名（過敏性大腸炎の初期疾患）

注意事項

薬剤の記述方法

注射薬の場合は JP_ActivityDefinition_ChemotherapyRegimen_Injection を、内服薬の場合は JP_ActivityDefinition_ChemotherapyRegimen_Oral を用いて記述する。 1つの薬剤に対して1つのインスタンスを生成し、当リソースのcontained要素に含め、action#definitionCanonicalとの関連付けを行うこと。

「注射薬Ａ+輸液Ｂ」と「内服薬Ｃ」の組み合わせを表現したインスタンス例を示す。 ＊全体像を掴むためのサンプルであるため、薬剤以外の詳細な記述は省略する。

{
  "resourceType" : "PlanDefinition",
  "contained" : [
    {
      "resourceType" : "ActivityDefinition",
      "id" : "1111",
      "contained": [
        {
          "resourceType": "Medication",
          "id": "#1",
          "ingredient": [
            { "itemCodeableConcept": { "text": "注射薬Ａ" } }, 
            { "itemCodeableConcept": { "text": "輸液Ｂ" } }
          ]
        },
      ],
      "productReference": { "reference": "Medication/1" }
    },
    {
      "resourceType" : "ActivityDefinition",
      "id" : "2222",
      "productCodeableConcept" : { "text" : "内服薬Ｃ" }
    }
  ],
  "action" : [
    {
      "action": [
        { "definitionCanonical" : "#1111" },
        { "definitionCanonical" : "#2222" }
      ]
    }
  ]
}

レジメン種別の記述方法

レジメン種別を識別するコードと名称は、PlanDefinitionに対して定義した拡張「JP_PlanDefinition_ChemotherapyRegimen_RegimenType」を使用し、CodeableConcept型を使用して記録する。

"extension": [{
  "url": "http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_PlanDefinition_ChemotherapyRegimen_RegimenType",
  "valueCodeableConcept": {
    "coding": [{ 
      "system": "TBD", 
      "code": "TBD", 
      "display": "mFOLFOX6" 
    }],
    "text": "mFOLFOX6"
  }
}]

適応疾患(がんの種類)の記述方法

TODO: 例えばFOLFOXの場合、「大腸癌」と記述するか、それとも「上行結腸癌」「横行結腸癌」「下行結腸癌」「S状結腸癌」などと細分化して記述するか。また修飾語はJP_Conditionを真似するか。

"useContext": [
  {
    "code": {
      "system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
      "code": "focus"
    },
    "valueCodeableConcept": {
      "coding": [
        {
          "system": "TBD",
          "code": "12345"
        }
      ],
      "text": "〇〇癌"
    }
  }
]

1コースの期間と、サイクル数

投与期間と休薬期間を合わせた1周期(コース)の日数をPlanDefinition.action.timingTiming.repeat.duration要素に記録する。また、コースの繰り返し回数(サイクル数)をPlanDefinition.action.timingTiming.repeat.count要素に記録する。 人間が解釈可能な1コースの期間と、サイクル数のテキスト表現をPlanDefinition.action.textEquivalentに記録する。

「1コース14日を6サイクル繰り返す」のインスタンス例を示す。

"action": [
  {
    "textEquivalent": "1コース14日を6サイクル繰り返す",
    "timingTiming": {
      "repeat": {
        "count": 6,
        "duration": 14,
        "durationUnit": "d"
      }
    }
  }
]

「1コース14日を4〜6サイクル繰り返す」のように、サイクル数に幅がある場合、PlanDefinition.action.timingTiming.repeat.countに繰り返し回数の下限を記録し、PlanDefinition.action.timingTiming.repeat.countMaxに上限を記録する。

"action": [
  {
    "textEquivalent": "1コース14日を4〜6サイクル繰り返す",
    "timingTiming": {
      "repeat": {
        "count": 4,
        "countMax": 6,
        "duration": 14,
        "durationUnit": "d"
      }
    }
  }
]

相対投与日の記述方法

投与開始日からの相対的な投与日を、PlanDefinition.actionに定義した拡張「JP_PlanDefinition_ChemotherapyRegimen_TimingDaysOfCycle」を使用し、integer型を使用して記録する。

「day1 と day8」に投与する場合のインスタンス例を示す。

"action": [{
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle",
      "valueInteger": 1
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle",
      "valueInteger": 8
    }
  ]
}]

投与順序の記述方法

TBD

発行元

その他、参考文献・リンク等

TBD