Nictiz FHIR NL STU3 Zib2017 - Local Development build (v1.3.15) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: HCIM SNAQScore

A Observation resource as defined by the Dutch HCIM SNAQScore-v3.1(2017EN). The Short Nutritional Assessment Questionnaire (SNAQ) is a (validated) measuring tool for determining the extent of a patient’s malnutrition. The tool comprises three questions, each of which is assigned a score. The total score determines the extent of malnutrition. The SNAQ helps to recognize and treat malnutrition at an early stage. Three varieties of the measuring tool were developed for different care settings: hospitals, nursing and retirement homes and independently living seniors. This concept describes the tool intended for the hospital setting.

#Purpose The SNAQ score is used to determine the extent of malnutrition or the risk of malnutrition. To treat malnutrition quickly and effectively, it is important to identify the malnutrition at an early stage.

#Rationale HL7 uses observations for defining scores like APGAR, to stay consistent, Nictiz chose to the Observation resource too.

Usage:

• Examples for this Resource Profile: Observation/zib-snaqscore-01

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from nl-core-observation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	nl-core-observation	SNAQ Score Zib-SNAQScore-1: If one of the component codes is present, all SHALL be present.
code
Slices for coding		1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:SNAQScoreCode		1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8881000146104
display		0..1	string	Representation defined by the system
effectiveDateTime:effectiveDateTime		1..1	dateTime	SNAQScoreDateTime
value[x]:valueQuantity		0..1	Quantity	TotalScore
value		0..1	decimal	Numerical value (with implicit precision)
comment		0..1	string	Comments about result
Slices for component		0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code
component:WeightLossScore		0..1	BackboneElement	Component results
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.3
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	WeightLossScore Binding: SNAQGewichtsverliesScoreCodelijst (extensible): SNAQGewichtsverliesScoreCodelijst Example Example of WeightLossScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.1","code":"G2","display":"Meer dan 6 kg in de laatste 6 maanden"}]}
component:AppetiteScore		0..1	BackboneElement	Component results
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.4
coding
display		0..1	string	Representation defined by the system
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	AppetiteScore Binding: EetlustScoreCodelijst (extensible): EetlustScoreCodelijst Example Example of AppetiteScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.2","code":"B1","display":"Verminderde eetlust de afgelopen maand"}]}
component:NutritionScore		0..1	BackboneElement	Component results
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.5
coding
display		0..1	string	Representation defined by the system
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	NutritionScore Binding: VoedingsScoreCodelijst (extensible): VoedingsScoreCodelijst Example Example of NutritionScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.3","code":"Z0","display":"GeenVoeding"}]}
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.component:WeightLossScore.valueCodeableConcept:valueCodeableConcept	extensible	SNAQGewichtsverliesScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.1--20171231000000 from this IG
Observation.component:AppetiteScore.valueCodeableConcept:valueCodeableConcept	extensible	EetlustScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.2--20171231000000 from this IG
Observation.component:NutritionScore.valueCodeableConcept:valueCodeableConcept	extensible	VoedingsScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.3--20171231000000 from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
Zib-SNAQScore-1	error	Observation	If one of the component codes is present, all SHALL be present. : ( component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.5').empty() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.4').empty() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.3').empty() ) or ( component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.5').exists() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.4').exists() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.3').exists() )

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	nl-core-observation	SNAQ Score obs-7: If code is the same as a component code then the value element associated with the code SHALL NOT be present obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present Zib-SNAQScore-1: If one of the component codes is present, all SHALL be present.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:SNAQScoreCode	Σ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8881000146104
display	Σ	0..1	string	Representation defined by the system
subject	Σ	1..1	Reference(Group | Device | nl-core-location | nl-core-patient)	Who and/or what this is about
Slices for effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveDateTime	Σ	1..1	dateTime	SNAQScoreDateTime
value[x]:valueQuantity	ΣC	0..1	Quantity	TotalScore
value	Σ	0..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
comment		0..1	string	Comments about result
Slices for component	Σ	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code
component:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
component:WeightLossScore	Σ	0..1	BackboneElement	Component results
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.3
value[x]:valueCodeableConcept	Σ	0..1	CodeableConcept	WeightLossScore Binding: SNAQGewichtsverliesScoreCodelijst (extensible): SNAQGewichtsverliesScoreCodelijst Example Example of WeightLossScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.1","code":"G2","display":"Meer dan 6 kg in de laatste 6 maanden"}]}
component:AppetiteScore	Σ	0..1	BackboneElement	Component results
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.4
value[x]:valueCodeableConcept	Σ	0..1	CodeableConcept	AppetiteScore Binding: EetlustScoreCodelijst (extensible): EetlustScoreCodelijst Example Example of AppetiteScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.2","code":"B1","display":"Verminderde eetlust de afgelopen maand"}]}
component:NutritionScore	Σ	0..1	BackboneElement	Component results
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.5
value[x]:valueCodeableConcept	Σ	0..1	CodeableConcept	NutritionScore Binding: VoedingsScoreCodelijst (extensible): VoedingsScoreCodelijst Example Example of NutritionScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.3","code":"Z0","display":"GeenVoeding"}]}
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status from the FHIR Standard
Observation.code	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator from the FHIR Standard
Observation.component.code	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:WeightLossScore.code	example	Pattern: 4.6.3 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:WeightLossScore.value[x]:valueCodeableConcept	extensible	SNAQGewichtsverliesScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.1--20171231000000 from this IG
Observation.component:AppetiteScore.code	example	Pattern: 4.6.4 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:AppetiteScore.value[x]:valueCodeableConcept	extensible	EetlustScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.2--20171231000000 from this IG
Observation.component:NutritionScore.code	example	Pattern: 4.6.5 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:NutritionScore.value[x]:valueCodeableConcept	extensible	VoedingsScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.3--20171231000000 from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
Zib-SNAQScore-1	error	Observation	If one of the component codes is present, all SHALL be present. : ( component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.5').empty() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.4').empty() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.3').empty() ) or ( component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.5').exists() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.4').exists() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.3').exists() )
dom-1	error	Observation	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Observation	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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If code is the same as a component code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	nl-core-observation	SNAQ Score obs-7: If code is the same as a component code then the value element associated with the code SHALL NOT be present obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present Zib-SNAQScore-1: If one of the component codes is present, all SHALL be present.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)	Fulfills plan, proposal or order
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: Observation Category Codes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:SNAQScoreCode	Σ	1..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8881000146104
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(Group | Device | nl-core-location | nl-core-patient)	Who and/or what this is about
context		0..1	Reference(nl-core-episodeofcare | HCIM Encounter | gp-Encounter)	Healthcare event during which this observation is made
Slices for effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveDateTime	Σ	1..1	dateTime	SNAQScoreDateTime
issued	Σ	0..1	instant	Date/Time this was made available
performer	Σ	0..*	Reference(nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who is responsible for the observation
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
value[x]:valueQuantity	ΣC	0..1	Quantity	TotalScore
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
comment		0..1	string	Comments about result
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: Observation Methods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: Observation Reference Range Meaning Codes (extensible): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: Observation Reference Range Applies To Codes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
related	Σ	0..*	BackboneElement	Resource related to this observation
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type		0..1	code	has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.
target		1..1	Reference(Observation | QuestionnaireResponse | Sequence)	Resource that is related to this one
Slices for component	Σ	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code
component:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueAttachment			Attachment
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:WeightLossScore	Σ	0..1	BackboneElement	Component results
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.3
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]:valueCodeableConcept	Σ	0..1	CodeableConcept	WeightLossScore Binding: SNAQGewichtsverliesScoreCodelijst (extensible): SNAQGewichtsverliesScoreCodelijst Example Example of WeightLossScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.1","code":"G2","display":"Meer dan 6 kg in de laatste 6 maanden"}]}
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:AppetiteScore	Σ	0..1	BackboneElement	Component results
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value[x]:valueCodeableConcept	Σ	0..1	CodeableConcept	AppetiteScore Binding: EetlustScoreCodelijst (extensible): EetlustScoreCodelijst Example Example of AppetiteScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.2","code":"B1","display":"Verminderde eetlust de afgelopen maand"}]}
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:NutritionScore	Σ	0..1	BackboneElement	Component results
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.5
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value[x]:valueCodeableConcept	Σ	0..1	CodeableConcept	NutritionScore Binding: VoedingsScoreCodelijst (extensible): VoedingsScoreCodelijst Example Example of NutritionScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.3","code":"Z0","display":"GeenVoeding"}]}
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status from the FHIR Standard
Observation.category	preferred	Observation Category Codes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator from the FHIR Standard
Observation.dataAbsentReason	extensible	Observation Value Absent Reason http://hl7.org/fhir/ValueSet/observation-valueabsentreason from the FHIR Standard
Observation.interpretation	extensible	Observation Interpretation Codes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMED CT Body Structures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	Observation Methods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	extensible	Observation Reference Range Meaning Codes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	Observation Reference Range Applies To Codes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.related.type	required	ObservationRelationshipType http://hl7.org/fhir/ValueSet/observation-relationshiptypes from the FHIR Standard
Observation.component.code	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	Observation Value Absent Reason http://hl7.org/fhir/ValueSet/observation-valueabsentreason from the FHIR Standard
Observation.component.interpretation	extensible	Observation Interpretation Codes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:WeightLossScore.code	example	Pattern: 4.6.3 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:WeightLossScore.value[x]:valueCodeableConcept	extensible	SNAQGewichtsverliesScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.1--20171231000000 from this IG
Observation.component:WeightLossScore.dataAbsentReason	extensible	Observation Value Absent Reason http://hl7.org/fhir/ValueSet/observation-valueabsentreason from the FHIR Standard
Observation.component:WeightLossScore.interpretation	extensible	Observation Interpretation Codes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:AppetiteScore.code	example	Pattern: 4.6.4 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:AppetiteScore.value[x]:valueCodeableConcept	extensible	EetlustScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.2--20171231000000 from this IG
Observation.component:AppetiteScore.dataAbsentReason	extensible	Observation Value Absent Reason http://hl7.org/fhir/ValueSet/observation-valueabsentreason from the FHIR Standard
Observation.component:AppetiteScore.interpretation	extensible	Observation Interpretation Codes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:NutritionScore.code	example	Pattern: 4.6.5 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:NutritionScore.value[x]:valueCodeableConcept	extensible	VoedingsScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.3--20171231000000 from this IG
Observation.component:NutritionScore.dataAbsentReason	extensible	Observation Value Absent Reason http://hl7.org/fhir/ValueSet/observation-valueabsentreason from the FHIR Standard
Observation.component:NutritionScore.interpretation	extensible	Observation Interpretation Codes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
Zib-SNAQScore-1	error	Observation	If one of the component codes is present, all SHALL be present. : ( component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.5').empty() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.4').empty() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.3').empty() ) or ( component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.5').exists() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.4').exists() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.3').exists() )
dom-1	error	Observation	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Observation	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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If code is the same as a component code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

This structure is derived from nl-core-observation

Summary

Mandatory: 5 elements
Fixed: 2 elements

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.code.coding
• The element 1 is sliced based on the value of Observation.component

Differential View

This structure is derived from nl-core-observation

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	nl-core-observation	SNAQ Score Zib-SNAQScore-1: If one of the component codes is present, all SHALL be present.
code
Slices for coding		1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:SNAQScoreCode		1..1	Coding	Code defined by a terminology system
system		1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 8881000146104
display		0..1	string	Representation defined by the system
effectiveDateTime:effectiveDateTime		1..1	dateTime	SNAQScoreDateTime
value[x]:valueQuantity		0..1	Quantity	TotalScore
value		0..1	decimal	Numerical value (with implicit precision)
comment		0..1	string	Comments about result
Slices for component		0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code
component:WeightLossScore		0..1	BackboneElement	Component results
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.3
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	WeightLossScore Binding: SNAQGewichtsverliesScoreCodelijst (extensible): SNAQGewichtsverliesScoreCodelijst Example Example of WeightLossScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.1","code":"G2","display":"Meer dan 6 kg in de laatste 6 maanden"}]}
component:AppetiteScore		0..1	BackboneElement	Component results
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.4
coding
display		0..1	string	Representation defined by the system
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	AppetiteScore Binding: EetlustScoreCodelijst (extensible): EetlustScoreCodelijst Example Example of AppetiteScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.2","code":"B1","display":"Verminderde eetlust de afgelopen maand"}]}
component:NutritionScore		0..1	BackboneElement	Component results
code		1..1	CodeableConcept	Type of component observation (code / type) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.5
coding
display		0..1	string	Representation defined by the system
valueCodeableConcept:valueCodeableConcept		0..1	CodeableConcept	NutritionScore Binding: VoedingsScoreCodelijst (extensible): VoedingsScoreCodelijst Example Example of NutritionScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.3","code":"Z0","display":"GeenVoeding"}]}
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.component:WeightLossScore.valueCodeableConcept:valueCodeableConcept	extensible	SNAQGewichtsverliesScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.1--20171231000000 from this IG
Observation.component:AppetiteScore.valueCodeableConcept:valueCodeableConcept	extensible	EetlustScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.2--20171231000000 from this IG
Observation.component:NutritionScore.valueCodeableConcept:valueCodeableConcept	extensible	VoedingsScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.3--20171231000000 from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
Zib-SNAQScore-1	error	Observation	If one of the component codes is present, all SHALL be present. : ( component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.5').empty() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.4').empty() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.3').empty() ) or ( component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.5').exists() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.4').exists() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.3').exists() )

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	nl-core-observation	SNAQ Score obs-7: If code is the same as a component code then the value element associated with the code SHALL NOT be present obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present Zib-SNAQScore-1: If one of the component codes is present, all SHALL be present.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:SNAQScoreCode	Σ	1..1	Coding	Code defined by a terminology system
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8881000146104
display	Σ	0..1	string	Representation defined by the system
subject	Σ	1..1	Reference(Group | Device | nl-core-location | nl-core-patient)	Who and/or what this is about
Slices for effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveDateTime	Σ	1..1	dateTime	SNAQScoreDateTime
value[x]:valueQuantity	ΣC	0..1	Quantity	TotalScore
value	Σ	0..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
comment		0..1	string	Comments about result
Slices for component	Σ	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code
component:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
component:WeightLossScore	Σ	0..1	BackboneElement	Component results
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.3
value[x]:valueCodeableConcept	Σ	0..1	CodeableConcept	WeightLossScore Binding: SNAQGewichtsverliesScoreCodelijst (extensible): SNAQGewichtsverliesScoreCodelijst Example Example of WeightLossScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.1","code":"G2","display":"Meer dan 6 kg in de laatste 6 maanden"}]}
component:AppetiteScore	Σ	0..1	BackboneElement	Component results
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.4
value[x]:valueCodeableConcept	Σ	0..1	CodeableConcept	AppetiteScore Binding: EetlustScoreCodelijst (extensible): EetlustScoreCodelijst Example Example of AppetiteScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.2","code":"B1","display":"Verminderde eetlust de afgelopen maand"}]}
component:NutritionScore	Σ	0..1	BackboneElement	Component results
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations. Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.5
value[x]:valueCodeableConcept	Σ	0..1	CodeableConcept	NutritionScore Binding: VoedingsScoreCodelijst (extensible): VoedingsScoreCodelijst Example Example of NutritionScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.3","code":"Z0","display":"GeenVoeding"}]}
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status from the FHIR Standard
Observation.code	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator from the FHIR Standard
Observation.component.code	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:WeightLossScore.code	example	Pattern: 4.6.3 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:WeightLossScore.value[x]:valueCodeableConcept	extensible	SNAQGewichtsverliesScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.1--20171231000000 from this IG
Observation.component:AppetiteScore.code	example	Pattern: 4.6.4 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:AppetiteScore.value[x]:valueCodeableConcept	extensible	EetlustScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.2--20171231000000 from this IG
Observation.component:NutritionScore.code	example	Pattern: 4.6.5 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:NutritionScore.value[x]:valueCodeableConcept	extensible	VoedingsScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.3--20171231000000 from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
Zib-SNAQScore-1	error	Observation	If one of the component codes is present, all SHALL be present. : ( component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.5').empty() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.4').empty() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.3').empty() ) or ( component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.5').exists() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.4').exists() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.3').exists() )
dom-1	error	Observation	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Observation	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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If code is the same as a component code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	nl-core-observation	SNAQ Score obs-7: If code is the same as a component code then the value element associated with the code SHALL NOT be present obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present Zib-SNAQScore-1: If one of the component codes is present, all SHALL be present.
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: Common Languages (extensible): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ProcedureRequest | ReferralRequest)	Fulfills plan, proposal or order
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		0..*	CodeableConcept	Classification of type of observation Binding: Observation Category Codes (preferred): Codes for high level observation categories.
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
Slices for coding	Σ	1..*	Coding	Code defined by a terminology system Slice: Unordered, Open by value:code
coding:SNAQScoreCode	Σ	1..1	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Fixed Value: http://snomed.info/sct
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: 8881000146104
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
subject	Σ	1..1	Reference(Group | Device | nl-core-location | nl-core-patient)	Who and/or what this is about
context		0..1	Reference(nl-core-episodeofcare | HCIM Encounter | gp-Encounter)	Healthcare event during which this observation is made
Slices for effective[x]	Σ	1..1	dateTime	Clinically relevant time/time-period for observation Slice: Unordered, Closed by type:$this
effective[x]:effectiveDateTime	Σ	1..1	dateTime	SNAQScoreDateTime
issued	Σ	0..1	instant	Date/Time this was made available
performer	Σ	0..*	Reference(nl-core-organization | nl-core-patient | nl-core-practitioner | nl-core-relatedperson)	Who is responsible for the observation
id		0..1	string	xml:id (or equivalent in JSON)
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
practitionerRole		0..1	Reference(nl-core-practitionerrole)	Optional Extensions Element URL: http://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
value[x]:valueQuantity	ΣC	0..1	Quantity	TotalScore
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
comment		0..1	string	Comments about result
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMED CT Body Structures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: Observation Methods (example): Methods for simple observations.
specimen		0..1	Reference(Specimen)	Specimen used for this observation
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
low	C	0..1	SimpleQuantity	Low Range, if relevant
high	C	0..1	SimpleQuantity	High Range, if relevant
type		0..1	CodeableConcept	Reference range qualifier Binding: Observation Reference Range Meaning Codes (extensible): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: Observation Reference Range Applies To Codes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
related	Σ	0..*	BackboneElement	Resource related to this observation
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
type		0..1	code	has-member | derived-from | sequel-to | replaces | qualified-by | interfered-by Binding: ObservationRelationshipType (required): Codes specifying how two observations are related.
target		1..1	Reference(Observation | QuestionnaireResponse | Sequence)	Resource that is related to this one
Slices for component	Σ	0..*	BackboneElement	Component results Slice: Unordered, Open by pattern:code
component:All Slices				Content/Rules for all slices
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueAttachment			Attachment
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:WeightLossScore	Σ	0..1	BackboneElement	Component results
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.3
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]:valueCodeableConcept	Σ	0..1	CodeableConcept	WeightLossScore Binding: SNAQGewichtsverliesScoreCodelijst (extensible): SNAQGewichtsverliesScoreCodelijst Example Example of WeightLossScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.1","code":"G2","display":"Meer dan 6 kg in de laatste 6 maanden"}]}
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:AppetiteScore	Σ	0..1	BackboneElement	Component results
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.4
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value[x]:valueCodeableConcept	Σ	0..1	CodeableConcept	AppetiteScore Binding: EetlustScoreCodelijst (extensible): EetlustScoreCodelijst Example Example of AppetiteScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.2","code":"B1","display":"Verminderde eetlust de afgelopen maand"}]}
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
component:NutritionScore	Σ	0..1	BackboneElement	Component results
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored
code	Σ	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINC Codes (example): Codes identifying names of simple observations. Required Pattern: At least the following
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 4.6.5
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	0..*	Coding	Code defined by a terminology system
id		0..1	string	xml:id (or equivalent in JSON)
extension		0..*	Extension	Additional Content defined by implementations Slice: Unordered, Open by value:url
system	Σ	0..1	uri	Identity of the terminology system
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	0..1	code	Symbol in syntax defined by the system
display	Σ	0..1	string	Representation defined by the system
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value[x]:valueCodeableConcept	Σ	0..1	CodeableConcept	NutritionScore Binding: VoedingsScoreCodelijst (extensible): VoedingsScoreCodelijst Example Example of NutritionScore: {"coding":[{"system":"urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.5.3","code":"Z0","display":"GeenVoeding"}]}
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: Observation Value Absent Reason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..1	CodeableConcept	High, low, normal, etc. Binding: Observation Interpretation Codes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Observation.language	extensible	Common Languages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status from the FHIR Standard
Observation.category	preferred	Observation Category Codes http://hl7.org/fhir/ValueSet/observation-category from the FHIR Standard
Observation.code	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator from the FHIR Standard
Observation.dataAbsentReason	extensible	Observation Value Absent Reason http://hl7.org/fhir/ValueSet/observation-valueabsentreason from the FHIR Standard
Observation.interpretation	extensible	Observation Interpretation Codes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMED CT Body Structures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	Observation Methods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	extensible	Observation Reference Range Meaning Codes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	Observation Reference Range Applies To Codes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.related.type	required	ObservationRelationshipType http://hl7.org/fhir/ValueSet/observation-relationshiptypes from the FHIR Standard
Observation.component.code	example	LOINC Codes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	Observation Value Absent Reason http://hl7.org/fhir/ValueSet/observation-valueabsentreason from the FHIR Standard
Observation.component.interpretation	extensible	Observation Interpretation Codes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:WeightLossScore.code	example	Pattern: 4.6.3 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:WeightLossScore.value[x]:valueCodeableConcept	extensible	SNAQGewichtsverliesScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.1--20171231000000 from this IG
Observation.component:WeightLossScore.dataAbsentReason	extensible	Observation Value Absent Reason http://hl7.org/fhir/ValueSet/observation-valueabsentreason from the FHIR Standard
Observation.component:WeightLossScore.interpretation	extensible	Observation Interpretation Codes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:AppetiteScore.code	example	Pattern: 4.6.4 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:AppetiteScore.value[x]:valueCodeableConcept	extensible	EetlustScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.2--20171231000000 from this IG
Observation.component:AppetiteScore.dataAbsentReason	extensible	Observation Value Absent Reason http://hl7.org/fhir/ValueSet/observation-valueabsentreason from the FHIR Standard
Observation.component:AppetiteScore.interpretation	extensible	Observation Interpretation Codes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.component:NutritionScore.code	example	Pattern: 4.6.5 http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component:NutritionScore.value[x]:valueCodeableConcept	extensible	VoedingsScoreCodelijst http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.4.6.3--20171231000000 from this IG
Observation.component:NutritionScore.dataAbsentReason	extensible	Observation Value Absent Reason http://hl7.org/fhir/ValueSet/observation-valueabsentreason from the FHIR Standard
Observation.component:NutritionScore.interpretation	extensible	Observation Interpretation Codes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
Zib-SNAQScore-1	error	Observation	If one of the component codes is present, all SHALL be present. : ( component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.5').empty() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.4').empty() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.3').empty() ) or ( component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.5').exists() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.4').exists() and component.code.coding.where(system='urn:oid:2.16.840.1.113883.2.4.3.11.60.40.4.0').where(code='4.6.3').exists() )
dom-1	error	Observation	If the resource is contained in another resource, it SHALL NOT contain any narrative : contained.text.empty()
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource : contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4	error	Observation	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()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() | (children().count() > id.count())
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If code is the same as a component code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where( (coding.code = %resource.code.coding.code) and (coding.system = %resource.code.coding.system)).empty()

This structure is derived from nl-core-observation

Summary

Mandatory: 5 elements
Fixed: 2 elements

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.code.coding
• The element 1 is sliced based on the value of Observation.component