Kerndatensatz Senologie
0.9.0 - ci-build

Kerndatensatz Senologie - Local Development build (v0.9.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Senologie_Genexpressionstest - Detailed Descriptions

Draft as of 2026-05-04

Definitions for the senologie-genexpressionstest resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. RiskAssessment
Definition

An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood of each outcome.

ShortPotential outcomes for a subject with likelihood
Control0..*
Is Modifierfalse
Summaryfalse
Alternate NamesPrognosis
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
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 (contained.where((('#'+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(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. RiskAssessment.implicitRules
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.

ShortA set of rules under which this content was created
Comments

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.

Control0..1
Typeuri
Is Modifiertrue because 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
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. RiskAssessment.modifierExtension
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 and/or the understanding of the containing element's descendants. 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.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. RiskAssessment.status
Definition

The status of the RiskAssessment, using the same statuses as an Observation.

ShortAbgeschlossene Risikobewertungregistered | preliminary | final | amended +
Control1..1
BindingThe codes SHALL be taken from ObservationStatushttp://hl7.org/fhir/ValueSet/observation-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/observation-status|4.0.1)

The status of the risk assessment; e.g. preliminary, final, amended, etc.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Fixed Valuefinal
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. RiskAssessment.method
Definition

The algorithm, process or mechanism used to evaluate the risk.

ShortArt des GenexpressionstestsEvaluation mechanism
Comments

Oncotype DX, MammaPrint, Prosigna oder EndoPredict

Control10..1
BindingThe codes SHALL be taken from For example codes, see VS Senologie Genexpressionstest
(required to https://www.senologie.org/fhir/ValueSet/vs-senologie-genexpressionstest)
TypeCodeableConcept
Is Modifierfalse
Must Supporttrue
Summarytrue
Requirements

The method can influence the results of the assessment.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. RiskAssessment.subject
Definition

The patient or group the risk assessment applies to.

ShortPatientinWho/what does assessment apply to?
Control1..1
TypeReference(Patient, Patient, Group)
Is Modifierfalse
Must Supporttrue
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. RiskAssessment.occurrence[x]
Definition

The date (and possibly time) the risk assessment was performed.

ShortWhen was assessment made?
Control0..1
TypeChoice of: dateTime, Period
[x] NoteSeeChoice of Data Typesfor further information about how to use [x]
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

The assessment results lose validity the more time elapses from when they are first made.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on RiskAssessment.occurrence[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • type @ $this
  • 14. RiskAssessment.occurrence[x]:occurrenceDateTime
    Slice NameoccurrenceDateTime
    Definition

    The date (and possibly time) the risk assessment was performed.

    ShortDatum der RisikobewertungWhen was assessment made?
    Control0..1
    TypedateTime, Period
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supporttrue
    Summarytrue
    Requirements

    The assessment results lose validity the more time elapses from when they are first made.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    16. RiskAssessment.condition
    Definition

    For assessments or prognosis specific to a particular condition, indicates the condition being assessed.

    ShortZugehörige Mammakarzinom-DiagnoseCondition assessed
    Control0..1
    TypeReference(Condition)
    Is Modifierfalse
    Must Supporttrue
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    18. RiskAssessment.performer
    Definition

    The provider or software application that performed the assessment.

    ShortDurchführendes Labor / ArztWho did assessment?
    Control0..1
    TypeReference(Practitioner, PractitionerRole, Practitioner, PractitionerRole, Device)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    20. RiskAssessment.basis
    Definition

    Indicates the source data considered as part of the assessment (for example, FamilyHistory, Observations, Procedures, Conditions, etc.).

    ShortReferenz zur Score-ObservationInformation used in assessment
    Comments

    Referenz auf Senologie_Genexpressions_Score mit dem numerischen Testergebnis

    Control0..*
    TypeReference(Observation, Resource)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. RiskAssessment.prediction
    Definition

    Describes the expected outcome for the subject.

    ShortRisikoprädiktionOutcome predicted
    Comments

    Multiple repetitions can be used to identify the same type of outcome in different timeframes as well as different types of outcomes.

    Control10..1*
    TypeBackboneElement
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ras-2: Must be <= 100 (probability is decimal implies (probability as decimal) <= 100)
    ras-2: Must be <= 100 (probability is decimal implies (probability as decimal) <= 100)
    24. RiskAssessment.prediction.modifierExtension
    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 and/or the understanding of the containing element's descendants. 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.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    26. RiskAssessment.prediction.outcome
    Definition

    One of the potential outcomes for the patient (e.g. remission, death, a particular condition).

    ShortVorhergesagtes ErgebnisPossible outcome for the subject
    Control0..1
    Binding

    The condition or other outcome; e.g. death, remission, amputation, infection, etc.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    28. RiskAssessment.prediction.outcome.text
    Definition

    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

    ShortRisiko eines FernrezidivsPlain text representation of the concept
    Comments

    Very often the text is the same as a displayName of one of the codings.

    Control0..1
    Typestring
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summarytrue
    Requirements

    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

    Fixed ValueFernrezidiv
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    30. RiskAssessment.prediction.probability[x]
    Definition

    Indicates how likely the outcome is (in the specified timeframe).

    ShortLikelihood of specified outcome
    Comments

    If range is used, it represents the lower and upper bounds of certainty; e.g. 40-60% Decimal values are expressed as percentages as well (max = 100).

    Control0..1
    TypeChoice of: decimal, Range
    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ras-1: low and high must be percentages, if present ((low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum))))
    ras-1: low and high must be percentages, if present ((low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum))))
    SlicingThis element introduces a set of slices on RiskAssessment.prediction.probability[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • type @ $this
    • 32. RiskAssessment.prediction.probability[x]:probabilityDecimal
      Slice NameprobabilityDecimal
      Definition

      Indicates how likely the outcome is (in the specified timeframe).

      ShortFernrezidivrisiko in ProzentLikelihood of specified outcome
      Comments

      10-Jahres-Fernrezidivrisiko als Dezimalwert (z.B. 0.12 für 12%)


      If range is used, it represents the lower and upper bounds of certainty; e.g. 40-60% Decimal values are expressed as percentages as well (max = 100).

      Control0..1
      Typedecimal, Range
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ras-1: low and high must be percentages, if present ((low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum))))
      ras-1: low and high must be percentages, if present ((low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum))))
      34. RiskAssessment.prediction.qualitativeRisk
      Definition

      Indicates how likely the outcome is (in the specified timeframe), expressed as a qualitative value (e.g. low, medium, or high).

      ShortRisikoklasseLikelihood of specified outcome as a qualitative value
      Comments

      Oncotype DX: low (0–10), intermediate (11–25), high (≥26). MammaPrint: low (>0.0), high (≤0.0). Prosigna: low (≤40), intermediate (41–60), high (>60). EndoPredict: low (<3.3), high (≥3.3).

      Control10..1
      BindingThe codes SHALL be taken from For example codes, see VS Senologie Risikoklassehttp://hl7.org/fhir/ValueSet/risk-probability|4.0.1
      (required to https://www.senologie.org/fhir/ValueSet/vs-senologie-risikoklasse)
      TypeCodeableConcept
      Is Modifierfalse
      Must Supporttrue
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. RiskAssessment.prediction.when[x]
      Definition

      Indicates the period of time or age range of the subject to which the specified probability applies.

      ShortTimeframe or age range
      Comments

      If not specified, the risk applies "over the subject's lifespan".

      Control0..1
      TypeChoice of: Period, Range
      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
      Is Modifierfalse
      Summaryfalse
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      SlicingThis element introduces a set of slices on RiskAssessment.prediction.when[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • type @ $this
      • 38. RiskAssessment.prediction.when[x]:whenRange
        Slice NamewhenRange
        Definition

        Indicates the period of time or age range of the subject to which the specified probability applies.

        ShortPrognosezeitraumTimeframe or age range
        Comments

        Typisch 10 Jahre (z.B. low=0, high=10, unit=a)


        If not specified, the risk applies "over the subject's lifespan".

        Control0..1
        TypeRange, Period
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        Is Modifierfalse
        Must Supporttrue
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. RiskAssessment.note
        Definition

        Additional comments about the risk assessment.

        ShortAnmerkungen zur RisikobewertungComments on the risk assessment
        Control0..*
        TypeAnnotation
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

        Guidance on how to interpret the contents of this table can be foundhere

        0. RiskAssessment
        2. RiskAssessment.status
        ShortAbgeschlossene Risikobewertung
        Must Supporttrue
        Fixed Valuefinal
        4. RiskAssessment.method
        ShortArt des Genexpressionstests
        Comments

        Oncotype DX, MammaPrint, Prosigna oder EndoPredict

        Control1..?
        BindingThe codes SHALL be taken from VS Senologie Genexpressionstest
        (required to https://www.senologie.org/fhir/ValueSet/vs-senologie-genexpressionstest)
        Must Supporttrue
        6. RiskAssessment.subject
        ShortPatientin
        TypeReference(Patient)
        Must Supporttrue
        8. RiskAssessment.occurrence[x]
        [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
        SlicingThis element introduces a set of slices on RiskAssessment.occurrence[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • type @ $this
        • 10. RiskAssessment.occurrence[x]:occurrenceDateTime
          Slice NameoccurrenceDateTime
          ShortDatum der Risikobewertung
          Control0..1
          TypedateTime
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          12. RiskAssessment.condition
          ShortZugehörige Mammakarzinom-Diagnose
          Must Supporttrue
          14. RiskAssessment.performer
          ShortDurchführendes Labor / Arzt
          TypeReference(Practitioner, PractitionerRole)
          Must Supporttrue
          Must Support TypesNo must-support rules about the choice of types/profiles
          16. RiskAssessment.basis
          ShortReferenz zur Score-Observation
          Comments

          Referenz auf Senologie_Genexpressions_Score mit dem numerischen Testergebnis

          TypeReference(Observation)
          Must Supporttrue
          18. RiskAssessment.prediction
          ShortRisikoprädiktion
          Control1..1
          Must Supporttrue
          20. RiskAssessment.prediction.outcome
          ShortVorhergesagtes Ergebnis
          Must Supporttrue
          22. RiskAssessment.prediction.outcome.text
          ShortRisiko eines Fernrezidivs
          Fixed ValueFernrezidiv
          24. RiskAssessment.prediction.probability[x]
          [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
          SlicingThis element introduces a set of slices on RiskAssessment.prediction.probability[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • type @ $this
          • 26. RiskAssessment.prediction.probability[x]:probabilityDecimal
            Slice NameprobabilityDecimal
            ShortFernrezidivrisiko in Prozent
            Comments

            10-Jahres-Fernrezidivrisiko als Dezimalwert (z.B. 0.12 für 12%)

            Control0..1
            Typedecimal
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supporttrue
            28. RiskAssessment.prediction.qualitativeRisk
            ShortRisikoklasse
            Comments

            Oncotype DX: low (0–10), intermediate (11–25), high (≥26). MammaPrint: low (>0.0), high (≤0.0). Prosigna: low (≤40), intermediate (41–60), high (>60). EndoPredict: low (<3.3), high (≥3.3).

            Control1..?
            BindingThe codes SHALL be taken from VS Senologie Risikoklasse
            (required to https://www.senologie.org/fhir/ValueSet/vs-senologie-risikoklasse)
            Must Supporttrue
            30. RiskAssessment.prediction.when[x]
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            SlicingThis element introduces a set of slices on RiskAssessment.prediction.when[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • type @ $this
            • 32. RiskAssessment.prediction.when[x]:whenRange
              Slice NamewhenRange
              ShortPrognosezeitraum
              Comments

              Typisch 10 Jahre (z.B. low=0, high=10, unit=a)

              Control0..1
              TypeRange
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Must Supporttrue
              34. RiskAssessment.note
              ShortAnmerkungen zur Risikobewertung

              Guidance on how to interpret the contents of this table can be foundhere

              0. RiskAssessment
              Definition

              An assessment of the likely outcome(s) for a patient or other subject as well as the likelihood of each outcome.

              ShortPotential outcomes for a subject with likelihood
              Control0..*
              Is Modifierfalse
              Summaryfalse
              Alternate NamesPrognosis
              Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
              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 (contained.where((('#'+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(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
              dom-4: 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: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
              dom-6: A resource should have narrative for robust management (text.`div`.exists())
              2. RiskAssessment.id
              Definition

              The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

              ShortLogical id of this artifact
              Comments

              The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

              Control0..1
              Typeid
              Is Modifierfalse
              Summarytrue
              4. RiskAssessment.meta
              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.

              ShortMetadata about the resource
              Control0..1
              TypeMeta
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              6. RiskAssessment.implicitRules
              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.

              ShortA set of rules under which this content was created
              Comments

              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.

              Control0..1
              Typeuri
              Is Modifiertrue because 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
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              8. RiskAssessment.language
              Definition

              The base language in which the resource is written.

              ShortLanguage of the resource content
              Comments

              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).

              Control0..1
              BindingThe codes SHOULD be taken from CommonLanguages
              (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)

              A human language.

              Additional BindingsPurpose
              AllLanguagesMax Binding
              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              10. RiskAssessment.text
              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.

              ShortText summary of the resource, for human interpretation
              Comments

              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 information is added later.

              Control0..1
              TypeNarrative
              Is Modifierfalse
              Summaryfalse
              Alternate Namesnarrative, html, xhtml, display
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              12. RiskAssessment.contained
              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.

              ShortContained, inline Resources
              Comments

              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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

              Control0..*
              TypeResource
              Is Modifierfalse
              Summaryfalse
              Alternate Namesinline resources, anonymous resources, contained resources
              14. RiskAssessment.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the resource. 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.

              ShortAdditional content defined by implementations
              Comments

              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.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              16. RiskAssessment.modifierExtension
              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 and/or the understanding of the containing element's descendants. 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.

              Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

              ShortExtensions that cannot be ignored
              Comments

              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.

              Control0..*
              TypeExtension
              Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
              Summaryfalse
              Requirements

              Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              18. RiskAssessment.identifier
              Definition

              Business identifier assigned to the risk assessment.

              ShortUnique identifier for the assessment
              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..*
              TypeIdentifier
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              20. RiskAssessment.basedOn
              Definition

              A reference to the request that is fulfilled by this risk assessment.

              ShortRequest fulfilled by this assessment
              Control0..1
              TypeReference(Resource)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              22. RiskAssessment.parent
              Definition

              A reference to a resource that this risk assessment is part of, such as a Procedure.

              ShortPart of this occurrence
              Control0..1
              TypeReference(Resource)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              24. RiskAssessment.status
              Definition

              The status of the RiskAssessment, using the same statuses as an Observation.

              ShortAbgeschlossene Risikobewertung
              Control1..1
              BindingThe codes SHALL be taken from ObservationStatus
              (required to http://hl7.org/fhir/ValueSet/observation-status|4.0.1)

              The status of the risk assessment; e.g. preliminary, final, amended, etc.

              Typecode
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Must Supporttrue
              Summarytrue
              Fixed Valuefinal
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              26. RiskAssessment.method
              Definition

              The algorithm, process or mechanism used to evaluate the risk.

              ShortArt des Genexpressionstests
              Comments

              Oncotype DX, MammaPrint, Prosigna oder EndoPredict

              Control1..1
              BindingThe codes SHALL be taken from VS Senologie Genexpressionstest
              (required to https://www.senologie.org/fhir/ValueSet/vs-senologie-genexpressionstest)
              TypeCodeableConcept
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Requirements

              The method can influence the results of the assessment.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              28. RiskAssessment.code
              Definition

              The type of the risk assessment performed.

              ShortType of assessment
              Control0..1
              TypeCodeableConcept
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              30. RiskAssessment.subject
              Definition

              The patient or group the risk assessment applies to.

              ShortPatientin
              Control1..1
              TypeReference(Patient)
              Is Modifierfalse
              Must Supporttrue
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              32. RiskAssessment.encounter
              Definition

              The encounter where the assessment was performed.

              ShortWhere was assessment performed?
              Control0..1
              TypeReference(Encounter)
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              34. RiskAssessment.occurrence[x]
              Definition

              The date (and possibly time) the risk assessment was performed.

              ShortWhen was assessment made?
              Control0..1
              TypeChoice of: dateTime, Period
              [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Requirements

              The assessment results lose validity the more time elapses from when they are first made.

              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              SlicingThis element introduces a set of slices on RiskAssessment.occurrence[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • type @ $this
              • 36. RiskAssessment.occurrence[x]:occurrenceDateTime
                Slice NameoccurrenceDateTime
                Definition

                The date (and possibly time) the risk assessment was performed.

                ShortDatum der Risikobewertung
                Control0..1
                TypedateTime
                [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Must Supporttrue
                Summarytrue
                Requirements

                The assessment results lose validity the more time elapses from when they are first made.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                38. RiskAssessment.condition
                Definition

                For assessments or prognosis specific to a particular condition, indicates the condition being assessed.

                ShortZugehörige Mammakarzinom-Diagnose
                Control0..1
                TypeReference(Condition)
                Is Modifierfalse
                Must Supporttrue
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                40. RiskAssessment.performer
                Definition

                The provider or software application that performed the assessment.

                ShortDurchführendes Labor / Arzt
                Control0..1
                TypeReference(Practitioner, PractitionerRole)
                Is Modifierfalse
                Must Supporttrue
                Must Support TypesNo must-support rules about the choice of types/profiles
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                42. RiskAssessment.reasonCode
                Definition

                The reason the risk assessment was performed.

                ShortWhy the assessment was necessary?
                Control0..*
                TypeCodeableConcept
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                44. RiskAssessment.reasonReference
                Definition

                Resources supporting the reason the risk assessment was performed.

                ShortWhy the assessment was necessary?
                Control0..*
                TypeReference(Condition, Observation, DiagnosticReport, DocumentReference)
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                46. RiskAssessment.basis
                Definition

                Indicates the source data considered as part of the assessment (for example, FamilyHistory, Observations, Procedures, Conditions, etc.).

                ShortReferenz zur Score-Observation
                Comments

                Referenz auf Senologie_Genexpressions_Score mit dem numerischen Testergebnis

                Control0..*
                TypeReference(Observation)
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                48. RiskAssessment.prediction
                Definition

                Describes the expected outcome for the subject.

                ShortRisikoprädiktion
                Comments

                Multiple repetitions can be used to identify the same type of outcome in different timeframes as well as different types of outcomes.

                Control1..1
                TypeBackboneElement
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ras-2: Must be <= 100 (probability is decimal implies (probability as decimal) <= 100)
                50. RiskAssessment.prediction.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                52. RiskAssessment.prediction.extension
                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.

                ShortAdditional content defined by implementations
                Comments

                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.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                54. RiskAssessment.prediction.modifierExtension
                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 and/or the understanding of the containing element's descendants. 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.

                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

                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.

                Control0..*
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                Summarytrue
                Requirements

                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                Alternate Namesextensions, user content, modifiers
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                56. RiskAssessment.prediction.outcome
                Definition

                One of the potential outcomes for the patient (e.g. remission, death, a particular condition).

                ShortVorhergesagtes Ergebnis
                Control0..1
                Binding

                The condition or other outcome; e.g. death, remission, amputation, infection, etc.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supporttrue
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                58. RiskAssessment.prediction.outcome.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                60. RiskAssessment.prediction.outcome.extension
                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.

                ShortAdditional content defined by implementations
                Comments

                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.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on RiskAssessment.prediction.outcome.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 62. RiskAssessment.prediction.outcome.coding
                  Definition

                  A reference to a code defined by a terminology system.

                  ShortCode defined by a terminology system
                  Comments

                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                  Control0..*
                  TypeCoding
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Allows for alternative encodings within a code system, and translations to other code systems.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  64. RiskAssessment.prediction.outcome.text
                  Definition

                  A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                  ShortRisiko eines Fernrezidivs
                  Comments

                  Very often the text is the same as a displayName of one of the codings.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  Requirements

                  The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                  Fixed ValueFernrezidiv
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  66. RiskAssessment.prediction.probability[x]
                  Definition

                  Indicates how likely the outcome is (in the specified timeframe).

                  ShortLikelihood of specified outcome
                  Comments

                  If range is used, it represents the lower and upper bounds of certainty; e.g. 40-60% Decimal values are expressed as percentages as well (max = 100).

                  Control0..1
                  TypeChoice of: decimal, Range
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summaryfalse
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ras-1: low and high must be percentages, if present ((low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum))))
                  SlicingThis element introduces a set of slices on RiskAssessment.prediction.probability[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • type @ $this
                  • 68. RiskAssessment.prediction.probability[x]:probabilityDecimal
                    Slice NameprobabilityDecimal
                    Definition

                    Indicates how likely the outcome is (in the specified timeframe).

                    ShortFernrezidivrisiko in Prozent
                    Comments

                    10-Jahres-Fernrezidivrisiko als Dezimalwert (z.B. 0.12 für 12%)

                    Control0..1
                    Typedecimal
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ras-1: low and high must be percentages, if present ((low.empty() or ((low.code = '%') and (low.system = %ucum))) and (high.empty() or ((high.code = '%') and (high.system = %ucum))))
                    70. RiskAssessment.prediction.qualitativeRisk
                    Definition

                    Indicates how likely the outcome is (in the specified timeframe), expressed as a qualitative value (e.g. low, medium, or high).

                    ShortRisikoklasse
                    Comments

                    Oncotype DX: low (0–10), intermediate (11–25), high (≥26). MammaPrint: low (>0.0), high (≤0.0). Prosigna: low (≤40), intermediate (41–60), high (>60). EndoPredict: low (<3.3), high (≥3.3).

                    Control1..1
                    BindingThe codes SHALL be taken from VS Senologie Risikoklasse
                    (required to https://www.senologie.org/fhir/ValueSet/vs-senologie-risikoklasse)
                    TypeCodeableConcept
                    Is Modifierfalse
                    Must Supporttrue
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    72. RiskAssessment.prediction.relativeRisk
                    Definition

                    Indicates the risk for this particular subject (with their specific characteristics) divided by the risk of the population in general. (Numbers greater than 1 = higher risk than the population, numbers less than 1 = lower risk.).

                    ShortRelative likelihood
                    Control0..1
                    Typedecimal
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summaryfalse
                    Requirements

                    Absolute risk is less meaningful than relative risk.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    74. RiskAssessment.prediction.when[x]
                    Definition

                    Indicates the period of time or age range of the subject to which the specified probability applies.

                    ShortTimeframe or age range
                    Comments

                    If not specified, the risk applies "over the subject's lifespan".

                    Control0..1
                    TypeChoice of: Period, Range
                    [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                    Is Modifierfalse
                    Summaryfalse
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    SlicingThis element introduces a set of slices on RiskAssessment.prediction.when[x]. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • type @ $this
                    • 76. RiskAssessment.prediction.when[x]:whenRange
                      Slice NamewhenRange
                      Definition

                      Indicates the period of time or age range of the subject to which the specified probability applies.

                      ShortPrognosezeitraum
                      Comments

                      Typisch 10 Jahre (z.B. low=0, high=10, unit=a)

                      Control0..1
                      TypeRange
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Must Supporttrue
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      78. RiskAssessment.prediction.rationale
                      Definition

                      Additional information explaining the basis for the prediction.

                      ShortExplanation of prediction
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      80. RiskAssessment.mitigation
                      Definition

                      A description of the steps that might be taken to reduce the identified risk(s).

                      ShortHow to reduce risk
                      Control0..1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summaryfalse
                      Requirements

                      One of the main reasons for assessing risks is to identify whether interventional steps are needed to reduce risk.

                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      82. RiskAssessment.note
                      Definition

                      Additional comments about the risk assessment.

                      ShortAnmerkungen zur Risikobewertung
                      Control0..*
                      TypeAnnotation
                      Is Modifierfalse
                      Summaryfalse
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))