Logisches Modell der drei Kernkonzepte des Leitfadens und ihrer Beziehungen:

• Behandlungsepisode — wer behandelt, in welchem Rahmen (Art, Intention, Zeitraum, verantwortliche Organisation),
• Therapieziel — was erreicht werden soll (Zielart, messbarer Zielwert, Erreichungsgrad),
• Versorgungsplan — welche Maßnahmen geplant sind (Tumorboard-Empfehlung bzw. Behandlungsplan mit den geplanten Anforderungen).

Das Ziel geht dem Plan voraus; der Plan verfolgt das Ziel (verfolgtesZiel) und ist seiner Episode zugeordnet (episode). Zwischen Ziel und Episode gibt es keine direkte Referenz — die Zuordnung ergibt sich implizit über den Plan (siehe schematische Darstellung).

Person, auf die sich Episoden, Ziele und Pläne beziehen (subject aller Ressourcen).

Abgegrenzter Versorgungsabschnitt mit eigener Intention: Therapielinie, Diagnostiklinie, Active Surveillance, Watchful Waiting u. a.

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

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.

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.

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).

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.

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.

Therapielinie (systemisch), lokoregionale Behandlungslinie, Diagnostiklinie, Active Surveillance, Watchful Waiting … (offen/extensible).

Zweck der Episode — das Wozu: kurativ, palliativ, supportiv; bei Diagnostik der Informationsgewinn.

Kontext der Maßnahme im Behandlungsablauf: neoadjuvant, adjuvant, intraoperativ, additiv. Kombinierbar mit der Intention, nicht alternativ zu ihr — eine neoadjuvante Therapie ist in aller Regel kurativ intendiert.

Sequenzielle Phase innerhalb des Konzepts: Induktion, Konsolidierung, Intensivierung, Erhaltung.

Womit behandelt wird: Chemo-, Hormon-, Immuntherapie, Bestrahlung, Operation. Eigenes Merkmal neben der Episodenart; mehrfach belegbar (z. B. Radiochemotherapie).

Beginn und Ende des Versorgungsabschnitts.

Organisation bzw. Team, das die Episode führt (z. B. Tumorzentrum, betreuende Praxis).

Lebenszyklus der Episode: geplant, aktiv, beendet.

Historie der Statuswechsel mit jeweiligem Zeitraum.

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

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.

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.

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).

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.

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.

Der jeweilige Status.

Zeitraum, in dem dieser Status galt.

Für die Episode fallverantwortliche behandelnde Person.

An der Episode beteiligtes Versorgungsteam, z. B. Tumorboard.

Der Episode zugrunde liegende Tumorerkrankung. Für therapeutische Episodenarten verpflichtend, für die Erstdiagnose-Diagnostiklinie optional.

Die der Episode zugrunde liegende Anforderung — Überweisung, Prozedur- oder Medikationsanforderung.

Zählung der systemischen Therapielinie nach EnLiST. Nur bei Episodenart „systemische Therapielinie"; experimentell bis zum Abschluss des ESMO-Road-Testings.

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

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.

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.

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).

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.

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.

counted (auf einer Zählachse) oder not-counted (außerhalb jeder Zählung).

fuehrend (trägt die Designation) oder segment (ausführende Einrichtung, keine eigene Designation).

eLoT (früh), aLoT (fortgeschritten) oder iLoT (investigational); jede Achse zählt getrennt.

Zahl der New LoTs im Setting.

Zahl der Modified LoTs seit der letzten New LoT.

Gemeinsamer Identifier der Linie; verkettet ausführende Segmente mit der führenden Episode.

Eigenständiges, dem Plan vorausgehendes Behandlungsziel; übergeordnet (strategische Intention) oder als Episodenziel.

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

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.

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.

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).

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.

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.

uebergeordnet (genau ein aktives Ziel der Intentions-Ära) oder episodenziel (optional, einem Behandlungsabschnitt zugeordnet).

Heilung, Lebensverlängerung, Symptomkontrolle, Lebensqualität, Funktionserhalt.

Klartext-Beschreibung des angestrebten Ziels.

Erkrankung, auf die sich das Ziel bezieht (Tumorerkrankung bzw. chronische Grunderkrankung).

Messbarer angestrebter Zielzustand: woran gemessen wird, welcher Wert als erreicht gilt, bis wann.

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

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.

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.

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).

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.

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.

Woran die Zielerreichung gemessen wird — codiert (z. B. LOINC) oder als Text (Scores, PROMs).

Welcher Wert bzw. Wertebereich als erreicht gilt.

Zeitpunkt bzw. Frist, bis zu der das Ziel erreicht sein soll.

Verlaufs-Beobachtungen, die die Zielerreichung evidenzieren; pro Ziel eigen, leer bis zur ersten Beobachtung.

Warum bzw. ob die Zielverfolgung läuft oder endet: proposed, active, completed (nur bei Erfolg), cancelled …

in-progress, achieved, not-achieved, not-attainable (keine Trajektorie-Codes).

Shared-Decision-Kern: Akzeptanz des Ziels durch die Beteiligten — die Akzeptanz wohnt am Ziel, nicht am Plan oder an der Maßnahme.

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

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.

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.

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).

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.

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.

Wessen Akzeptanz abgebildet wird: Patientin/Patient, Behandler:in oder Angehörige.

agree (akzeptiert), disagree (abgelehnt) oder pending (Entscheidung steht aus).

Begründung, warum das Ziel nicht akzeptiert wurde — nur bei abgelehntem Ziel.

Beziehung zu anderen Zielen der Behandlungs-Journey.

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

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.

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.

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).

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.

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.

predecessor/successor (zeitliche Journey nach erfolgreichem Abschluss) oder replacement (Intentions-Pivot).

Das in Beziehung stehende Therapieziel.

Relative Priorität bei mehreren konkurrierenden Zielen.

Wer das Ziel formuliert hat — Behandler:in oder Patient:in. Für die Shared-Decision-Nachvollziehbarkeit wesentlich.

Beginn der Zielverfolgung als Datum oder als codiertes Ereignis (z. B. nach Operation, nach Bestrahlung).

Empfehlungsliste des Tumorboards oder episodenspezifischer Plan tatsächlich erbrachter Versorgung.

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

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.

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.

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).

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.

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.

empfehlung (Tumorboard-Empfehlungsliste) oder behandlung (episodenspezifischer Behandlungsplan).

Lebenszyklus des Plans: entworfen, aktiv, abgeschlossen, verworfen — auch eine nicht umgesetzte Empfehlung ist so ausdrückbar.

Ob der Plan den diagnostischen oder den therapeutischen Abschnitt abbildet. Ersetzt die frühere Unterscheidung über zwei getrennte Profile.

Therapieintention, die der Plan verfolgt.

Die vom Plan adressierte Tumorerkrankung.

Für Pflege und Aktualisierung des Plans verantwortliche Stelle.

Therapieziel(e), die der Plan verfolgt — Verfolgungs-Referenz, kein Besitz; dasselbe Ziel kann von mehreren Plänen verfolgt werden.

Episode, in deren Rahmen der Plan umgesetzt wird.

Ein Behandlungsplan erfüllt eine Empfehlung (Referenz auf den Empfehlungsplan).

Einzelne geplante bzw. empfohlene Maßnahme des Plans.

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

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.

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.

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).

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.

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.

prozedur (Operation, Bestrahlung, Diagnostik) oder medikation (Systemtherapie).

Die zugehörige Anforderung (Prozedur- bzw. Medikations-Request).

Lebenszyklus der einzelnen Empfehlung — der entscheidende Status: vorgeschlagen, aktiv, abgeschlossen, verworfen (z. B. abgelehnte Empfehlung).

Grund des Umsetzungsstatus, z. B. Patientenwunsch, Komorbidität, Progress — versorgungsrelevant für die nächste Tumorboard-Runde.

Vollzugslink auf das durchführende Ereignis (Prozedur, Medikationsgabe, Befund). Kein Ergebnis-Element: klinische Ergebnisse wohnen am Ereignis bzw. zielbezogen im Therapieziel-Ergebnis.

Einordnung einer Therapieänderung nach EnLiST: new (Progression oder fehlendes Ansprechen), modified (nicht-progressionsbedingt) oder same (prospektiv geplant).

Logisches Modell der drei Kernkonzepte des Leitfadens und ihrer Beziehungen:

• Behandlungsepisode — wer behandelt, in welchem Rahmen (Art, Intention, Zeitraum, verantwortliche Organisation),
• Therapieziel — was erreicht werden soll (Zielart, messbarer Zielwert, Erreichungsgrad),
• Versorgungsplan — welche Maßnahmen geplant sind (Tumorboard-Empfehlung bzw. Behandlungsplan mit den geplanten Anforderungen).

Das Ziel geht dem Plan voraus; der Plan verfolgt das Ziel (verfolgtesZiel) und ist seiner Episode zugeordnet (episode). Zwischen Ziel und Episode gibt es keine direkte Referenz — die Zuordnung ergibt sich implizit über den Plan (siehe schematische Darstellung).

Person, auf die sich Episoden, Ziele und Pläne beziehen (subject aller Ressourcen).

Abgegrenzter Versorgungsabschnitt mit eigener Intention: Therapielinie, Diagnostiklinie, Active Surveillance, Watchful Waiting u. a.

Therapielinie (systemisch), lokoregionale Behandlungslinie, Diagnostiklinie, Active Surveillance, Watchful Waiting … (offen/extensible).

Zweck der Episode — das Wozu: kurativ, palliativ, supportiv; bei Diagnostik der Informationsgewinn.

Kontext der Maßnahme im Behandlungsablauf: neoadjuvant, adjuvant, intraoperativ, additiv. Kombinierbar mit der Intention, nicht alternativ zu ihr — eine neoadjuvante Therapie ist in aller Regel kurativ intendiert.

Sequenzielle Phase innerhalb des Konzepts: Induktion, Konsolidierung, Intensivierung, Erhaltung.

Womit behandelt wird: Chemo-, Hormon-, Immuntherapie, Bestrahlung, Operation. Eigenes Merkmal neben der Episodenart; mehrfach belegbar (z. B. Radiochemotherapie).

Beginn und Ende des Versorgungsabschnitts.

Organisation bzw. Team, das die Episode führt (z. B. Tumorzentrum, betreuende Praxis).

Lebenszyklus der Episode: geplant, aktiv, beendet.

Historie der Statuswechsel mit jeweiligem Zeitraum.

Der jeweilige Status.

Zeitraum, in dem dieser Status galt.

Für die Episode fallverantwortliche behandelnde Person.

An der Episode beteiligtes Versorgungsteam, z. B. Tumorboard.

Der Episode zugrunde liegende Tumorerkrankung. Für therapeutische Episodenarten verpflichtend, für die Erstdiagnose-Diagnostiklinie optional.

Die der Episode zugrunde liegende Anforderung — Überweisung, Prozedur- oder Medikationsanforderung.

Zählung der systemischen Therapielinie nach EnLiST. Nur bei Episodenart „systemische Therapielinie"; experimentell bis zum Abschluss des ESMO-Road-Testings.

counted (auf einer Zählachse) oder not-counted (außerhalb jeder Zählung).

fuehrend (trägt die Designation) oder segment (ausführende Einrichtung, keine eigene Designation).

eLoT (früh), aLoT (fortgeschritten) oder iLoT (investigational); jede Achse zählt getrennt.

Zahl der New LoTs im Setting.

Zahl der Modified LoTs seit der letzten New LoT.

Gemeinsamer Identifier der Linie; verkettet ausführende Segmente mit der führenden Episode.

Eigenständiges, dem Plan vorausgehendes Behandlungsziel; übergeordnet (strategische Intention) oder als Episodenziel.

uebergeordnet (genau ein aktives Ziel der Intentions-Ära) oder episodenziel (optional, einem Behandlungsabschnitt zugeordnet).

Heilung, Lebensverlängerung, Symptomkontrolle, Lebensqualität, Funktionserhalt.

Klartext-Beschreibung des angestrebten Ziels.

Erkrankung, auf die sich das Ziel bezieht (Tumorerkrankung bzw. chronische Grunderkrankung).

Messbarer angestrebter Zielzustand: woran gemessen wird, welcher Wert als erreicht gilt, bis wann.

Woran die Zielerreichung gemessen wird — codiert (z. B. LOINC) oder als Text (Scores, PROMs).

Welcher Wert bzw. Wertebereich als erreicht gilt.

Zeitpunkt bzw. Frist, bis zu der das Ziel erreicht sein soll.

Verlaufs-Beobachtungen, die die Zielerreichung evidenzieren; pro Ziel eigen, leer bis zur ersten Beobachtung.

Warum bzw. ob die Zielverfolgung läuft oder endet: proposed, active, completed (nur bei Erfolg), cancelled …

in-progress, achieved, not-achieved, not-attainable (keine Trajektorie-Codes).

Shared-Decision-Kern: Akzeptanz des Ziels durch die Beteiligten — die Akzeptanz wohnt am Ziel, nicht am Plan oder an der Maßnahme.

Wessen Akzeptanz abgebildet wird: Patientin/Patient, Behandler:in oder Angehörige.

agree (akzeptiert), disagree (abgelehnt) oder pending (Entscheidung steht aus).

Begründung, warum das Ziel nicht akzeptiert wurde — nur bei abgelehntem Ziel.

Beziehung zu anderen Zielen der Behandlungs-Journey.

predecessor/successor (zeitliche Journey nach erfolgreichem Abschluss) oder replacement (Intentions-Pivot).

Das in Beziehung stehende Therapieziel.

Relative Priorität bei mehreren konkurrierenden Zielen.

Wer das Ziel formuliert hat — Behandler:in oder Patient:in. Für die Shared-Decision-Nachvollziehbarkeit wesentlich.

Beginn der Zielverfolgung als Datum oder als codiertes Ereignis (z. B. nach Operation, nach Bestrahlung).

Empfehlungsliste des Tumorboards oder episodenspezifischer Plan tatsächlich erbrachter Versorgung.

empfehlung (Tumorboard-Empfehlungsliste) oder behandlung (episodenspezifischer Behandlungsplan).

Lebenszyklus des Plans: entworfen, aktiv, abgeschlossen, verworfen — auch eine nicht umgesetzte Empfehlung ist so ausdrückbar.

Ob der Plan den diagnostischen oder den therapeutischen Abschnitt abbildet. Ersetzt die frühere Unterscheidung über zwei getrennte Profile.

Therapieintention, die der Plan verfolgt.

Die vom Plan adressierte Tumorerkrankung.

Für Pflege und Aktualisierung des Plans verantwortliche Stelle.

Therapieziel(e), die der Plan verfolgt — Verfolgungs-Referenz, kein Besitz; dasselbe Ziel kann von mehreren Plänen verfolgt werden.

Episode, in deren Rahmen der Plan umgesetzt wird.

Ein Behandlungsplan erfüllt eine Empfehlung (Referenz auf den Empfehlungsplan).

Einzelne geplante bzw. empfohlene Maßnahme des Plans.

prozedur (Operation, Bestrahlung, Diagnostik) oder medikation (Systemtherapie).

Die zugehörige Anforderung (Prozedur- bzw. Medikations-Request).

Lebenszyklus der einzelnen Empfehlung — der entscheidende Status: vorgeschlagen, aktiv, abgeschlossen, verworfen (z. B. abgelehnte Empfehlung).

Grund des Umsetzungsstatus, z. B. Patientenwunsch, Komorbidität, Progress — versorgungsrelevant für die nächste Tumorboard-Runde.

Vollzugslink auf das durchführende Ereignis (Prozedur, Medikationsgabe, Befund). Kein Ergebnis-Element: klinische Ergebnisse wohnen am Ereignis bzw. zielbezogen im Therapieziel-Ergebnis.

Einordnung einer Therapieänderung nach EnLiST: new (Progression oder fehlendes Ansprechen), modified (nicht-progressionsbedingt) oder same (prospektiv geplant).

Logisches Modell der drei Kernkonzepte des Leitfadens und ihrer Beziehungen:

• Behandlungsepisode — wer behandelt, in welchem Rahmen (Art, Intention, Zeitraum, verantwortliche Organisation),
• Therapieziel — was erreicht werden soll (Zielart, messbarer Zielwert, Erreichungsgrad),
• Versorgungsplan — welche Maßnahmen geplant sind (Tumorboard-Empfehlung bzw. Behandlungsplan mit den geplanten Anforderungen).

Das Ziel geht dem Plan voraus; der Plan verfolgt das Ziel (verfolgtesZiel) und ist seiner Episode zugeordnet (episode). Zwischen Ziel und Episode gibt es keine direkte Referenz — die Zuordnung ergibt sich implizit über den Plan (siehe schematische Darstellung).

Person, auf die sich Episoden, Ziele und Pläne beziehen (subject aller Ressourcen).

Abgegrenzter Versorgungsabschnitt mit eigener Intention: Therapielinie, Diagnostiklinie, Active Surveillance, Watchful Waiting u. a.

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

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.

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.

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).

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.

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.

Therapielinie (systemisch), lokoregionale Behandlungslinie, Diagnostiklinie, Active Surveillance, Watchful Waiting … (offen/extensible).

Zweck der Episode — das Wozu: kurativ, palliativ, supportiv; bei Diagnostik der Informationsgewinn.

Kontext der Maßnahme im Behandlungsablauf: neoadjuvant, adjuvant, intraoperativ, additiv. Kombinierbar mit der Intention, nicht alternativ zu ihr — eine neoadjuvante Therapie ist in aller Regel kurativ intendiert.

Sequenzielle Phase innerhalb des Konzepts: Induktion, Konsolidierung, Intensivierung, Erhaltung.

Womit behandelt wird: Chemo-, Hormon-, Immuntherapie, Bestrahlung, Operation. Eigenes Merkmal neben der Episodenart; mehrfach belegbar (z. B. Radiochemotherapie).

Beginn und Ende des Versorgungsabschnitts.

Organisation bzw. Team, das die Episode führt (z. B. Tumorzentrum, betreuende Praxis).

Lebenszyklus der Episode: geplant, aktiv, beendet.

Historie der Statuswechsel mit jeweiligem Zeitraum.

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

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.

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.

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).

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.

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.

Der jeweilige Status.

Zeitraum, in dem dieser Status galt.

Für die Episode fallverantwortliche behandelnde Person.

An der Episode beteiligtes Versorgungsteam, z. B. Tumorboard.

Der Episode zugrunde liegende Tumorerkrankung. Für therapeutische Episodenarten verpflichtend, für die Erstdiagnose-Diagnostiklinie optional.

Die der Episode zugrunde liegende Anforderung — Überweisung, Prozedur- oder Medikationsanforderung.

Zählung der systemischen Therapielinie nach EnLiST. Nur bei Episodenart „systemische Therapielinie"; experimentell bis zum Abschluss des ESMO-Road-Testings.

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

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.

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.

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).

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.

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.

counted (auf einer Zählachse) oder not-counted (außerhalb jeder Zählung).

fuehrend (trägt die Designation) oder segment (ausführende Einrichtung, keine eigene Designation).

eLoT (früh), aLoT (fortgeschritten) oder iLoT (investigational); jede Achse zählt getrennt.

Zahl der New LoTs im Setting.

Zahl der Modified LoTs seit der letzten New LoT.

Gemeinsamer Identifier der Linie; verkettet ausführende Segmente mit der führenden Episode.

Eigenständiges, dem Plan vorausgehendes Behandlungsziel; übergeordnet (strategische Intention) oder als Episodenziel.

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

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.

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.

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).

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.

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.

uebergeordnet (genau ein aktives Ziel der Intentions-Ära) oder episodenziel (optional, einem Behandlungsabschnitt zugeordnet).

Heilung, Lebensverlängerung, Symptomkontrolle, Lebensqualität, Funktionserhalt.

Klartext-Beschreibung des angestrebten Ziels.

Erkrankung, auf die sich das Ziel bezieht (Tumorerkrankung bzw. chronische Grunderkrankung).

Messbarer angestrebter Zielzustand: woran gemessen wird, welcher Wert als erreicht gilt, bis wann.

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

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.

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.

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).

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.

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.

Woran die Zielerreichung gemessen wird — codiert (z. B. LOINC) oder als Text (Scores, PROMs).

Welcher Wert bzw. Wertebereich als erreicht gilt.

Zeitpunkt bzw. Frist, bis zu der das Ziel erreicht sein soll.

Verlaufs-Beobachtungen, die die Zielerreichung evidenzieren; pro Ziel eigen, leer bis zur ersten Beobachtung.

Warum bzw. ob die Zielverfolgung läuft oder endet: proposed, active, completed (nur bei Erfolg), cancelled …

in-progress, achieved, not-achieved, not-attainable (keine Trajektorie-Codes).

Shared-Decision-Kern: Akzeptanz des Ziels durch die Beteiligten — die Akzeptanz wohnt am Ziel, nicht am Plan oder an der Maßnahme.

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

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.

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.

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).

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.

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.

Wessen Akzeptanz abgebildet wird: Patientin/Patient, Behandler:in oder Angehörige.

agree (akzeptiert), disagree (abgelehnt) oder pending (Entscheidung steht aus).

Begründung, warum das Ziel nicht akzeptiert wurde — nur bei abgelehntem Ziel.

Beziehung zu anderen Zielen der Behandlungs-Journey.

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

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.

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.

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).

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.

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.

predecessor/successor (zeitliche Journey nach erfolgreichem Abschluss) oder replacement (Intentions-Pivot).

Das in Beziehung stehende Therapieziel.

Relative Priorität bei mehreren konkurrierenden Zielen.

Wer das Ziel formuliert hat — Behandler:in oder Patient:in. Für die Shared-Decision-Nachvollziehbarkeit wesentlich.

Beginn der Zielverfolgung als Datum oder als codiertes Ereignis (z. B. nach Operation, nach Bestrahlung).

Empfehlungsliste des Tumorboards oder episodenspezifischer Plan tatsächlich erbrachter Versorgung.

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

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.

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.

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).

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.

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.

empfehlung (Tumorboard-Empfehlungsliste) oder behandlung (episodenspezifischer Behandlungsplan).

Lebenszyklus des Plans: entworfen, aktiv, abgeschlossen, verworfen — auch eine nicht umgesetzte Empfehlung ist so ausdrückbar.

Ob der Plan den diagnostischen oder den therapeutischen Abschnitt abbildet. Ersetzt die frühere Unterscheidung über zwei getrennte Profile.

Therapieintention, die der Plan verfolgt.

Die vom Plan adressierte Tumorerkrankung.

Für Pflege und Aktualisierung des Plans verantwortliche Stelle.

Therapieziel(e), die der Plan verfolgt — Verfolgungs-Referenz, kein Besitz; dasselbe Ziel kann von mehreren Plänen verfolgt werden.

Episode, in deren Rahmen der Plan umgesetzt wird.

Ein Behandlungsplan erfüllt eine Empfehlung (Referenz auf den Empfehlungsplan).

Einzelne geplante bzw. empfohlene Maßnahme des Plans.

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

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.

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.

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).