INCISIVE Implementation Guide
0.1.1 - draft

INCISIVE Implementation Guide - Local Development build (v0.1.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Breast Cancer Message Support Guidance

Introduction

This guide aims to explain the process to follow in order to read and understand the message “Breast-Cancer-Message-Bundle-Example” based on breast Excel template. More information on FHIR messages can also be found in Simplifier INCISIVE project.

Message description

In this chapter describes the message content in a table containing these columns.

Table Columns description

Column Name Description
Tab Template Tab name included in excel file of Breast Cancer
Variable Variable name included in Excel file
ID resource ID identification inside the assigned resource
FHIR message location Attribute used to inform the variable inside the bundle
Example value Example value used to inform the variable assigned
Required by FHIR specification Inform the variable is mandatory/optional in XML, based on compliance with the FHIR specification
INCISIVE profile URL of profiles created by INCISIVE
Condition Description term condition

Table with Message description

Tab template General Info

Variable ID resource FHIR message location Example Value Required by FHIR specification INCISVE Profile Condition
Patient Number breastpatient01 Patient.identifier.value 004-000001 Optional
Gender breastpatient01 Patient.gender female Optional
Ethnicity breastpatient01 Patient.extension.valueCodeableConcept.coding.code 1 Optional Extension
Patient.extension.valueCodeableConcept.coding.display White Optional
Number of births breastobservation01 Observation.component.valueInteger 2 Optional
Age at diagnosis breastdiagnosticReport01 DiagnosticReport.extension.valueAge.value 56 Mandatory Extension
Pre/post menopause breastobservation01 Observation.component.valueCodeableConcept.coding.code 0 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Pre Optional
Medical History breastcondition01 Condition.code.text N39.8 Optional
Familial Cancer History Father breastobservation01 Observation.component.valueBoolean true Optional
Familial Cancer History Mother breastobservation01 Observation.component.valueBoolean true Optional
Medication general info breastmedication01 Medication.code.text Medication therapy Optional
Symptoms general info breastcondition02 Condition.evidence.code.coding.code 1 Optional CodeSystem If Symptoms general info=null delete all breastcondition02
Condition.evidence.code.coding.display Nothing Optional
CEA breastobservation01 Observation.component.valueQuantity.value 11.9 Optional
CA 15-3 breastobservation01 Observation.component.valueQuantity.value 37 Optional
Current state breastpatient01 Patient.extension.valueCode 0 Optional Extension
Clinical findings general info breastcondition03 Condition.note.text Dysuria Mandatory If Clinical findings general info=null delete all breastcondition03
Notes general info breastobservation01 Observation.note.text Observation note Mandatory
Provider breastorganization01 Organization.identifier.type.coding.code 1 Optional CodeSystem
Organization.identifier.type.coding.display AUTH Optional
Case - MessageHeader.eventCoding.display Malignant neoplasm of breast (disorder) Mandatory
Delivery Time general info - Bundle.timestamp 2023-07-21T12:29:17.239+02:00 Optional

Tab template Baseline

Variable ID resource FHIR message location Example Value Required by FHIR specification INCISVE Profile Condition
Mammography baseline breastobservation02 Observation.component.valueBoolean true Optional
Annotated Mammography baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Positive annotation Optional
Ultrasound baseline breastobservation02 Observation.component.valueBoolean true Optional
Annotated Ultrasound baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Positive annotation Optional
Existence of Laboratory data baseline breastobservation02 Observation.component.valueBoolean true Optional
Computerized axial tomography (CT) baseline breastobservation03 Observation.component.valueBoolean true Optional
Annotated CT baseline breastobservation03 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Positive annotation Optional
Magnetic resonance imaging (MRI) baseline breastobservation03 Observation.component.valueBoolean true Optional
Annotated MRI baseline breastobservation03 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Positive annotation Optional
Positron emission tomography (PET/CT) baseline breastobservation03 Observation.component.valueBoolean true Optional
Annotated PET/CT baseline breastobservation03 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Positive annotation Optional
Histopathology Image baseline breastobservation03 Observation.component.valueBoolean true Optional
Annotated Histopathology Image baseline breastobservation03 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Positive annotation Optional
Xray baseline breastobservation03 Observation.component.valueBoolean true Optional
Annotated Xray baseline breastobservation03 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Positive annotation Optional
Baseline location breastobservation03 Observation.bodySite.coding.code AN Optional CodeSystem
Observation.bodySite.coding.display Nipple and Areola Optional
Max tumor diameter breastobservation02 Observation.component.valueQuantity.value 4.8 Optional
Breast laterality breastobservation02 Observation.component.valueCodeableConcept.coding.code 0 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Right breast Optional
Mass Shape baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Oval Optional
Mass Margin baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code 2 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Angular Optional
Mass orientation baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Parallel Optional
Mass echo pattern baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Anechoic Optional
Posterior features baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code 3 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Shadowing Optional
Calcifications baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display In mass Optional
Associated Features baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Skin thickness Optional
Breast composition baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Fatty Optional
Parenchymal enhancement level baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Minimal Optional
Parenchymal enhancement symmetry baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Symmetric Optional
Presence of foci baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Unifocal Optional
Pathological lymph-nodes baseline breastobservation02 Observation.component.valueBoolean true Optional
Other breast lesions baseline breastobservation02 Observation.component.valueBoolean true Optional
Distant metastasis baseline breastobservation02 Observation.component.valueBoolean true Optional
Distant metastasis location baseline breastobservation02 Observation.bodySite.coding.code 1 Optional CodeSystem
Observation.bodySite.coding.display Bone Optional
Left Breast BIRADS classification baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code BI-RADS 0 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Incomplete need additional imaging evaluation Optional
Right Breast BIRADS classification baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code BI-RADS 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Negative symmetrical and no masses, architectural distortion, or suspicious calcifications Optional
Ti baseline breastobservation02 Observation.component.valueString T0 Optional
Ni baseline breastobservation02 Observation.component.valueString N0 Optional
Mi baseline breastobservation02 Observation.component.valueString M0 Optional

Tab template Timepoints

Variable ID resource FHIR message location Example Value Required by FHIR specification INCISVE Profile Condition
Label timepoints breastobservation04 Observation.code.coding.code 1 Mandatory CodeSystem
Observation.code.coding.display After 1st Treatment Mandatory
Define other if selected timepoints breastobservation04 Observation.category.text Between 1st and 2nd dose of CT Optional
Date timepoints breastobservation04 Observation.valueInteger 2 Optional
Mammography timepoints breastobservation04 Observation.component.valueBoolean true Optional
Annotated Mammography timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Positive annotation Optional
Ultrasound timepoints breastobservation04 Observation.component.valueBoolean true Optional
Annotated Ultrasound timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Positive annotation Optional
Symptoms timepoints breastcondition04 Condition.evidence.code.coding.code 1 Optional CodeSystem If Symptoms timepoints=null delete all breastcondition04
Condition.evidence.code.coding.display Breast pain Optional
Existence of Laboratory data timepoints breastobservation04 Observation.component.valueBoolean true Optional
Computerized axial tomography (CT) timepoints breastobservation04 Observation.component.valueBoolean true Optional
Annotated CT timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Positive annotation Optional
Magnetic resonance imaging (MRI) timepoints breastobservation04 Observation.component.valueBoolean true Optional
Annotated MRI timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Positive annotation Optional
Positron emission tomography (PET/CT) timepoints breastobservation04 Observation.component.valueBoolean true Optional
Annotated PET/CT timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Positive annotation Optional
Histopathology Image timepoints breastobservation04 Observation.component.valueBoolean true Optional
Annotated Histopathology Image timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Positive annotation Optional
Xray timepoints breastobservation04 Observation.component.valueBoolean true Optional
Annotated Xray timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Positive annotation Optional
Clinical findings timepoints breastcondition05 Condition.note.text Dysuria Mandatory If Clinical findings timepoints=null delete all breastcondition05
Tumor size breastobservation04 Observation.component.valueQuantity.value 4.8 Optional
Pathological Lymph-nodes timepoints breastobservation04 Observation.component.valueBoolean true Optional
Other breast lesions timepoints breastobservation04 Observation.component.valueBoolean true Optional
Biopsy after follow-up breastobservation04 Observation.component.valueBoolean true Optional
Surgery after follow-up breastobservation04 Observation.component.valueBoolean true Optional
Changes in tumor profile breastobservation04 Observation.component.valueBoolean true Optional
Mass Shape timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Oval Optional
Mass Margin timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 2 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Angular Optional
Mass orientation timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display parallel Optional
Mass echo pattern timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Anechoic Optional
Posterior features timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 3 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Shadowing Optional
Calcifications timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display In mass Optional
Associated Features timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Skin thickness Optional
Breast composition timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Fatty Optional
Parenchymal enhancement level timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Minimal Optional
Parenchymal enhancement symmetry timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Symmetric Optional
Presence of foci timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Unifocal Optional
Changes in treatment breastobservation04 Observation.component.valueBoolean true Optional
Treatment after follow-up If = true
Type of treatment after follow-up breastprocedure01 Procedure.code.text Surgery Optional If Treatment after follow-up=true, else delete all breastprocedure01
Distant metastasis timepoints breastobservation04 Observation.component.valueBoolean true Optional
Distant metastasis location timepoints breastobservation04 Observation.bodySite.coding.code 1 Optional CodeSystem
Observation.bodySite.coding.display Bone Optional
Response to treatment breastobservation04 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display CR Optional
Ti timeponts breastobservation04 Observation.component.valueString T0 Optional
Ni timepoints breastobservation04 Observation.component.valueString N0 Optional
Mi timepoints breastobservation04 Observation.component.valueString M0 Optional
Left Breast BIRADS classification timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code BI-RADS 0 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Incomplete need additional imaging evaluation Optional
Right Breast BIRADS classification timepoints breastobservation04 Observation.component.valueCodeableConcept.coding.code BI-RADS 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Negative symmetrical and no masses, architectural distortion, or suspicious calcifications Optional
Notes timepoints breastobservation04 Observation.note.text Observation note Mandatory

Tab template Treatment

Variable ID resource FHIR message location Example Value Required by FHIR specification INCISVE Profile Condition
Label treatment breastobservation07 Observation.code.coding.code 1 Mandatory CodeSystem
Observation.code.coding.display After 1st Treatment-1st FollowUp Mandatory
Define other if selected treatment breastobservation07 Observation.category.text Between 1st and 2nd dose of CT Optional
Other treatment details breastobservation07 Observation.valueString Other treatment details Optional
Performance status breastobservation07 Observation.component.valueInteger 5 Optional
Surgery treatment If = true
Type of surgery breastprocedure02 Procedure.category.coding.code 2 Optional CodeSystem If Surgery treatment=true, else delete all breastprocedure02
Procedure.category.coding.display Mastectomy Optional
Date of Surgery breastprocedure02 Procedure.performedString 2 Optional
Lymph-node surgery breastobservation08 Observation.valueCodeableConcept.coding.code 0 Optional CodeSystem If Surgery treatment=true, else delete all breastobservation08
Observation.valueCodeableConcept.coding.display No Optional
Chemotherapy (CTX) If = true
Type of CTX breastprocedure03 Procedure.code.text Capecitabine Optional If CTX=true, else delete all breastprocedure03
Date of CTX breastprocedure03 Procedure.performedString 2 Optional
Chemoradiotherapy (CRT) If = true
Type of CRT breastprocedure04 Procedure.code.text Nitrosoureas Optional If CRT=true, else delete all breastprocedure04
Date of CRT breastprocedure04 Procedure.performedString 2 Optional
Chemoimmunotherapy (CIT) If = true
Type of CIT breastprocedure05 Procedure.code.text Tamoxifen Optional If CIT=true, else delete all breastprocedure05
Date of last CIT breastprocedure05 Procedure.performedString 2 Optional
Radiation therapy (RT) If = true
Type of RT breastprocedure06 Procedure.code.text Tamoxifen Optional If RT=true, else delete all breastprocedure06
Date of RT breastprocedure06 Procedure.performedString 2 Optional
Delivered dose of RT - Whole Breast [Gy] breastmedicationAdministration01 MedicationAdministration.dosage.dose.value 40.4 Optional
Number of fractions of RT - Whole Breast breastmedicationAdministration01 MedicationAdministration.dosage.rateQuantity.value 28 Optional
Boost If Boost = true
Delivered dose - Boost region [Gy] breastmedicationAdministration02 MedicationAdministration.dosage.dose.value 50.4 Optional If boost=true, else delete breastmedicationAdministration02 and partOf reference breastmedicationAdministration02 in breastobservation05 and breastobservation06
Number of fractions - Boost breastmedicationAdministration02 MedicationAdministration.dosage.rateQuantity.value 7 Optional
Hormone therapy (HT) If = true
Type of HT breastprocedure07 Procedure.code.text Tamoxifen Optional If HT=true, else delete all breastprocedure07
Date of HT breastprocedure07 Procedure.performedString 2 Optional
Targeted therapy (TT) If = true
Type of TT breastprocedure08 Procedure.code.text Trastuzumab Optional If TT=true, else delete all breastprocedure08
Date of TT breastprocedure08 Procedure.performedString 3 Optional
Immune therapy (IT) If = true
Type of IT breastprocedure09 Procedure.code.text Pembrolizumab Optional If IT=true, else delete all breastprocedure09
Date of IT breastprocedure09 Procedure.performedString 2 Optional
Adjuvant treatment breastobservation06 Observation.valueBoolean true Optional If Adjuvant treatment=true delete all breastobservation05
Neoadjuvant treatment breastobservation05 Observation.valueBoolean true Optional If Neoadjuvant treatment=true delete all breastobservation06

Tab template Histology - Mutations

Variable ID resource FHIR message location Example Value Required by FHIR specification INCISVE Profile Condition
Biopsy If = true
Biopsy label breastprocedure10 Procedure.statusReason.coding.code 1 Optional CodeSystem If Biopsy=true, else delete all breastprocedure10
Procedure.statusReason.coding.display After 1st Treatment Optional
Type of Biopsy breastprocedure10 Procedure.category.coding.code 1 Optional CodeSystem
Procedure.category.coding.display FNAC Optional
Define other if selected histology-mutations breastprocedure10 Procedure.category.text Between 1st and 2nd dose of CT Optional
Date of Biopsy breastprocedure10 Procedure.performedString 3 Optional
Surgery histology-mutations If = true
Surgery date breastprocedure11 Procedure.performedString 2 Optional If Surgery histology-mutations=true, else delete all breastprocedure11
Breast Cancer Type breastobservation11 Observation.category.coding.code IBC Optional CodeSystem
breastobservation11 Observation.category.coding.display Inflamatory Breast Carcinoma Optional
Molecular Subtype breastobservation11 Observation.category.coding.code 1 Optional CodeSystem
Observation.category.coding.display Luminal A Optional
Breast Cancer Grade breastobservation11 Observation.component.valueInteger 1 Optional
HER2 (c-erB2) breastobservation09 Observation.component.valueBoolean true Optional
ER breastobservation09 Observation.component.valueBoolean true Optional
PR breastobservation09 Observation.component.valueBoolean true Optional
Ki67 breastobservation09 Observation.component.valueQuantity.value 10 Optional
BRCA 1 mutation breastobservation09 Observation.component.valueBoolean true Optional
BRCA 2 mutation breastobservation09 Observation.component.valueBoolean true Optional
VI / LVI breastobservation09 Observation.component.valueBoolean true Optional
Sampling breastobservation10 Observation.component.valueString Light microscopy Optional
Staining/type of assay performed breastobservation10 Observation.component.valueString Hematoxylin Optional
Magnification breastobservation10 Observation.component.valueString x10 Optional
Other sample-related information breastobservation10 Observation.component.valueString example Optional

Tab template Lab Results

Variable ID resource FHIR message location Example Value Required by FHIR specification INCISVE Profile Condition
Exam label breastobservation12 Observation.code.coding.code 1 Mandatory CodeSystem
Observation.code.coding.display After 1st Treatment Mandatory
Define other if selected lab results breastobservation12 Observation.category.text Between 1st and 2nd dose of CT Optional
Date Laboratory breastobservation12 Observation.valueInteger 2 Optional
Leukocytes breastobservation12 Observation.component.valueQuantity.value 15.8 Optional
Hemoglobin (Hb) breastobservation12 Observation.component.valueQuantity.value 16.7 Optional
Hematocrit (HCT) breastobservation12 Observation.component.valueQuantity.value 47.4 Optional
Platelets (PLT) breastobservation12 Observation.component.valueQuantity.value 287 Optional
Blood sugar levels breastobservation12 Observation.component.valueQuantity.value 87 Optional
Insulin breastobservation12 Observation.component.valueQuantity.value 4 Optional
Urea breastobservation12 Observation.component.valueQuantity.value 36 Optional
Creatinine breastobservation12 Observation.component.valueQuantity.value 0.72 Optional
Uric acid breastobservation12 Observation.component.valueQuantity.value 3.5 Optional
Potassium breastobservation12 Observation.component.valueQuantity.value 4.8 Optional
Sodium breastobservation12 Observation.component.valueQuantity.value 142 Optional
Calcium breastobservation12 Observation.component.valueQuantity.value 9.31 Optional
Cholesterol breastobservation12 Observation.component.valueQuantity.value 197 Optional
Triglycerides breastobservation12 Observation.component.valueQuantity.value 59 Optional
HDL breastobservation12 Observation.component.valueQuantity.value 60 Optional
Low density lipoprotein (LDL) breastobservation12 Observation.component.valueQuantity.value 120 Optional
SGOT breastobservation12 Observation.component.valueQuantity.value 19 Optional
SGPT breastobservation12 Observation.component.valueQuantity.value 33 Optional
y-GT breastobservation12 Observation.component.valueQuantity.value 14 Optional
ALP breastobservation12 Observation.component.valueQuantity.value 227 Optional
LDH breastobservation12 Observation.component.valueQuantity.value 270 Optional
TSH breastobservation12 Observation.component.valueQuantity.value 0.73 Optional
Cortisol breastobservation12 Observation.component.valueQuantity.value 22 Optional
CRP breastobservation12 Observation.component.valueQuantity.value 0.5 Optional
BNP breastobservation12 Observation.component.valueQuantity.value 120 Optional
HbA1c breastobservation12 Observation.component.valueQuantity.value 5.1 Optional
Total protein in urine breastobservation12 Observation.component.valueQuantity.value 80 Optional
Creatinine urine breastobservation12 Observation.component.valueQuantity.value 100 Optional

In order to build the message for each patient, and to report the variables in the table above, the following steps must be followed:

  1. Search inside the message text with the same word that appears in the “Variable” column.
  2. Check that the resource to which it redirects us has the same id as in the “ID resource” column.
  3. Enter the desired value in the double quoted space of the attribute indicated in the “Fhirmessage location” column.
  4. Do not delete any part of the message, the whole structure must be the same, just change the example value, for the value you want to report. Do not change the order.
  5. If you don’t have the information of the element, you can delete the node, but validate XML to ensure the structure of the XML FHIR is still correct and has no errors (you can omit the warnings in the validation). The entire message structure is static except for the values given for the attributes in the “Fhir message location” column and the timestamp which is the current datatime.

Description mandatory/optional of term

There will be mandatory/optional for different scenarios, according to different scenarios corresponding to different rules. These scenarios are described separately below.

  • If the attribute is mandatory, all attribute structure information for this column must be reported. It cannot be deleted.
Variable ID resource FHIR message location Example Value Required by FHIR specification INCISVE Profile Condition
Notes general info breastobservation01 Observation.note.text Observation note Mandatory
  • If the attribute is mandatory with a comment reporting the condition of this variable, all attribute structure information for this column must be reported, unless the variable has not value for report, all resources must be deleted.
Variable ID resource FHIR message location Example Value Required by FHIR specification INCISVE Profile Condition
Clinical findings general info breastcondition03 Condition.note.text Dysuria Mandatory If Clinical findings general info=null delete all breastcondition03
  • If an optional attribute needs to be deleted, all attribute structures except for the primary resource (e.g., observation, procedure, condition, etc.) must be deleted if that primary resource has another variable. For example, for the variable Gender, you can delete the attribute gender from the resource Patient, while other attributes such as identifier have values and do not have to be deleted.
Variable ID resource FHIR message location Example Value Required by FHIR specification INCISVE Profile Condition
Gender breastpatient01 Patient.gender female Optional
  • If the attribute is optional, this happens in observation.component because Observation.component has two parts inside, Observation.component.code and Observation.component.value (this value can be valueCodeableConcept, ValueBoolean, ValueSrting, valueInteger, valueQuantity, etc.). If the variable has a value that needs to be informed, then code is mandatory, that code is mostly the SNOMED CT code or LOINC code for that variable. This means that if you need to delete variable, then you need to delete all Observation.component and cannot delete the whole Observation resource, unless there are no other elements in the same Observation, then you can delete the whole Observation resource.
Variable ID resource FHIR message location Example Value Required by FHIR specification INCISVE Profile Condition
Annotated Mammography baseline breastobservation02 Observation.component.valueCodeableConcept.coding.code 1 Optional CodeSystem
Observation.component.valueCodeableConcept.coding.display Positive annotation Optional
  • If the attribute is optional with a comment reporting the condition of this variable, you can delete all resource if the variable has not value for report.
Variable ID resource FHIR message location Example Value Required by FHIR specification INCISVE Profile Condition
Symptoms general info breastcondition02 Condition.evidence.code.coding.code 1 Optional CodeSystem If Symptoms general info=null delete all breastcondition02

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