Overview

Profile: CancerDiseaseStatus

Base FHIR Resource: Observation
Derived from: Observation
Description: A clinician’s qualitative judgement on the current trend of the cancer.
mCODE-specific Attribute Constraints:
- basedOn reference is restricted to (ServiceRequest | MedicationRequest)
- partOf reference is restricted to (MedicationAdministration | MedicationStatement | Procedure)
- Subject is required, must support and references (Cancer Patient)
- Focus references (Cancer Condition Parent)
- Status is must support
- Code is must support and is fixed to LOINC#88040-1 “Response to cancer treatment”
- Effective[x] is must support and is restricted to dateTime and Period
- Performer reference is restricted to (US Core Practitioner Profile)
- Value[x] is restricted to valueCoedableConcept and is must support
- bodySite, specimen, device, referenceRange, hasMember, and component are zeroed out
mCODE-specific Extensions:
- mcode-evidence-type
mCODE-specific Slices: none
mCODE-specific ValueSets:
- valueCodeableConcept is bound to Condition Status Trend Value Set (required)

This profile is meant to represent the current trend of the cancer as a whole, not the response to a specific treatment
The LOINC code chosen to represent this observation (88040-1) does not precisely match the meaning of the profile; however, it’s the closest available at the present time. The current LOINC code is more granular than the definition of the profile and a new LOINC code has been requested to represent cancer disease status.
The basedOn, partOf, performer, subject, focus, value[x], and effective[x] attributes are restricted so references that would not be logical for this profile are not allowed.
bodySite, specimen, device, referenceRange, hasMember, and component are zeroed out because including a data element for this attributes would not be logical for this profile.
The purpose of mcode-evidence-type is to signify what kind of evidence was used as input to clinical judgement. This is the S and O in SOAP.