ID

40049

Descripción

The form corresponds to an incomplete version of FHIR Resource Observation, v4.0.1. It contains all data elements that query a medical issue. The file was created for analysis purposes. https://www.hl7.org/fhir/resourcelist.html 02.01.2020

Link

https://www.hl7.org/fhir/resourcelist.html

Palabras clave

Versiones (2)
  1. 10/3/20 10/3/20 -
  2. 10/3/20 10/3/20 -
Titular de derechos de autor

HL7 FHIR

Subido en

10 de marzo de 2020

DOI

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Licencia

Creative Commons BY-NC 4.0
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FHIR v4.0.1

Inglés

Resource Observation (N)

1 formularios  
Observation
Descripción

Observation

Alias
UMLS CUI-1
C1554188
Observation basis
Descripción

A plan, proposal or order that is fulfilled in whole or in part by this event. For example, a MedicationRequest may require a patient to have laboratory test performed before it is dispensed.

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1554188
UMLS CUI [1,2]
C1527178
If observation is part of a larger event, please fill in
Descripción

A larger event of which this particular Observation is a component or step. For example, an observation as part of a procedure.

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1554188
UMLS CUI [1,2]
C0441471
UMLS CUI [1,3]
C1705248
Observation status
Descripción

The status of the result value. The corresponding value set can be found at https://www.hl7.org/fhir/valueset-observation-status.html

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1554188
UMLS CUI [1,2]
C0449438
Observation category
Descripción

A code that classifies the general type of observation being made. The corresponding value set can be found at https://www.hl7.org/fhir/valueset-observation-category.html

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1554188
UMLS CUI [1,2]
C0683312
Observation code
Descripción

Describes what was observed. Sometimes this is called the observation "name". The corresponding value set can be found at https://www.hl7.org/fhir/valueset-observation-codes.html.

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1554188
UMLS CUI [1,2]
C0805701
Focus of observation
Descripción

The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record. The focus of an observation could also be an existing condition, an intervention, the subject's diet, another observation of the subject, or a body structure such as tumor or implanted device. An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1554188
UMLS CUI [1,2]
C1521840
The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.
Descripción

Observation.encounter

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1947978
UMLS CUI [1,2]
C1554188
Relevant time of an observed value
Descripción

The time or time-period the observed value is asserted as being true. For biological subjects - e.g. human patients - this is usually called the "physiologically relevant time". This is usually either the time of the procedure or of specimen collection, but very often the source of the date/time is not known, only the date/time itself.

Tipo de datos

datetime

Alias
UMLS CUI [1,1]
C0302523
UMLS CUI [1,2]
C2347946
UMLS CUI [1,3]
C0040223
Value of observation
Descripción

The information determined as a result of making the observation, if the information has a simple value. An observation may have; 1) a single value here, 2) both a value and a set of related or component values, or 3) only a set of related or component values. If a value is present, the datatype for this element should be determined by Observation.code. A CodeableConcept with just a text would be used instead of a string if the field was usually coded, or if the type associated with the Observation.code defines a coded value. For additional guidance, see the Notes section below.

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1554188
UMLS CUI [1,2]
C1301772
Reason for absent data during observation
Descripción

Provides a reason why the expected value in the element Observation.value[x] is missing.

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0332197
UMLS CUI [1,2]
C1554188
UMLS CUI [1,3]
C1511726
A categorical assessment of an observation value. For example, high, low, normal.
Descripción

Historically used for laboratory results (known as 'abnormal flag' ), its use extends to other use cases where coded interpretations are relevant. Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaning/normalcy status of the result. The corresponding value set can be found at https://www.hl7.org/fhir/valueset-observation-interpretation.html

Tipo de datos

text

Alias
UMLS CUI [1,1]
C2711437
UMLS CUI [1,2]
C1554188
Comments about the observation or the results
Descripción

Comments about the observation or the results. May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation. The corresponding value set can be found at https://www.hl7.org/fhir/valueset-observation-interpretation.html

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1317574
UMLS CUI [1,2]
C1554188
UMLS CUI [2,1]
C1317574
UMLS CUI [2,2]
C1274040
Site on the subject's body where observation was made
Descripción

Indicates the site on the subject's body where the observation was made (i.e. the target site). Only used if not implicit in code found in Observation.code. In many systems, this may be represented as a related observation instead of an inline component. The corresponding value set can be found at https://www.hl7.org/fhir/valueset-body-site.html

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1515974
UMLS CUI [1,2]
C0700325
Method of observation
Descripción

Indicates the mechanism used to perform the observation. Only used if not implicit in code for Observation.code. The corresponding value set can be found at https://www.hl7.org/fhir/valueset-observation-methods.html

Tipo de datos

text

Alias
UMLS CUI [1,1]
C2911685
UMLS CUI [1,2]
C1554188
Specimen
Descripción

The specimen that was used when this observation was made. Should only be used if not implicit in code found in Observation.code

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0370003
UMLS CUI [1,2]
C1554188
Observation device
Descripción

The device used to generate the observation data.

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0302523
UMLS CUI [1,2]
C0699733
Low reference range
Descripción

The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3).

Tipo de datos

text

Alias
UMLS CUI [1]
C2346904
High reference range
Descripción

The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3).

Tipo de datos

text

Alias
UMLS CUI [1]
C2348973
Reference range type
Descripción

Codes to indicate the what part of the targeted reference population it applies to. For example, the normal or therapeutic range. This SHOULD be populated if there is more than one range. If this element is not present then the normal range is assumed. https://www.hl7.org/fhir/valueset-referencerange-meaning.html

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0883335
UMLS CUI [1,2]
C0332307
Target population of the reference range
Descripción

Codes to indicate the target population this reference range applies to. For example, a reference range may be based on the normal population or a particular sex or race. Multiple appliesTo are interpreted as an "AND" of the target populations. For example, to represent a target population of African American females, both a code of female and a code for African American would be used. The corresponding value set can be found at https://www.hl7.org/fhir/valueset-referencerange-appliesto.html

Tipo de datos

text

Alias
UMLS CUI [1,1]
C0883335
UMLS CUI [1,2]
C0039309
Age at which this reference range is applicable
Descripción

The age at which this reference range is applicable. This is a neonatal age (e.g. number of weeks at term) if the meaning says so.

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1706839
UMLS CUI [1,2]
C0001779
UMLS CUI [1,3]
C0883335
Reference range text
Descripción

Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals".

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1527021
UMLS CUI [1,2]
C0883335
Target resource from which this observation value is derived
Descripción

The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1521840
UMLS CUI [1,2]
C0035201
UMLS CUI [1,3]
C1554188
Component code
Descripción

Describes what was observed. Sometimes this is called the observation "code". The corresponding value set can be found at https://www.hl7.org/fhir/valueset-observation-codes.html

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1705248
UMLS CUI [1,2]
C0805701
Component value
Descripción

The information determined as a result of making the observation, if the information has a simple value.

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1705248
UMLS CUI [1,2]
C0042294
Reason for missing value in Component value
Descripción

Provides a reason why the expected value in the element Observation.component.value[x] is missing. The corresponding value set can be found at https://www.hl7.org/fhir/valueset-data-absent-reason.html

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1705248
UMLS CUI [1,2]
C0042294
UMLS CUI [1,3]
C1709044
Interpretations of the presence and level of reactivity of the specified component
Descripción

Interpretations of the presence and level of reactivity of the specified component / analyte with the reagent in the performed laboratory test. The corresponding value set can be found at https://www.hl7.org/fhir/valueset-observation-interpretation.html

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1705248
UMLS CUI [1,2]
C1511790
UMLS CUI [1,3]
C2711437
UMLS CUI [1,4]
C1554188
Component reference range
Descripción

Guidance on how to interpret the value by comparison to a normal or recommended range.

Tipo de datos

text

Alias
UMLS CUI [1,1]
C1705248
UMLS CUI [1,2]
C0883335
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Similar models

Resource Observation (N)

1 formularios
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Observation
C1554188 (UMLS CUI-1)
Observation.basedOn
Item
Observation basis
text
C1554188 (UMLS CUI [1,1])
C1527178 (UMLS CUI [1,2])
Observation.partOf
Item
If observation is part of a larger event, please fill in
text
C1554188 (UMLS CUI [1,1])
C0441471 (UMLS CUI [1,2])
C1705248 (UMLS CUI [1,3])
Item
Observation status
text
C1554188 (UMLS CUI [1,1])
C0449438 (UMLS CUI [1,2])
Observation status
Code List
Observation status
CL Item
registered (registered)
The existence of the observation is registered, but there is no result yet available. (Comment:en)
CL Item
preliminary  (preliminary)
This is an initial or interim observation: data may be incomplete or unverified. (Comment:en)
CL Item
final  (final)
The observation is complete and there are no further actions needed. Additional information such "released", "signed", etc would be represented using [Provenance](provenance.html) which provides not only the act but also the actors and dates and other related data. These act states would be associated with an observation status of `preliminary` until they are all completed and then a status of `final` would be applied. (Comment:en)
CL Item
amended (amended)
Subsequent to being Final, the observation has been modified subsequent. This includes updates/new information and corrections. (Comment:en)
CL Item
corrected  (corrected)
Subsequent to being Final, the observation has been modified to correct an error in the test result. (Comment:en)
CL Item
cancelled  (cancelled)
The observation is unavailable because the measurement was not started or not completed (also sometimes called "aborted"). (Comment:en)
CL Item
entered-in-error (entered-in-error)
The observation has been withdrawn following previous final release. This electronic record should never have existed, though it is possible that real-world decisions were based on it. (If real-world activity has occurred, the status should be "cancelled" rather than "entered-in-error".). (Comment:en)
CL Item
unknown (unknown)
The authoring/source system does not know which of the status values currently applies for this observation. Note: This concept is not to be used for "other" - one of the listed statuses is presumed to apply, but the authoring/source system does not know which. (Comment:en)
Item
Observation category
text
C1554188 (UMLS CUI [1,1])
C0683312 (UMLS CUI [1,2])
Observation category
Code List
Observation category
CL Item
social-history (social-history)
Social History Observations define the patient's occupational, personal (e.g., lifestyle), social, familial, and environmental history and health risk factors that may impact the patient's health. (Comment:en)
CL Item
vital-signs (vital-signs)
Clinical observations measure the body's basic functions such as blood pressure, heart rate, respiratory rate, height, weight, body mass index, head circumference, pulse oximetry, temperature, and body surface area. (Comment:en)
CL Item
imaging (imaging)
Observations generated by imaging. The scope includes observations regarding plain x-ray, ultrasound, CT, MRI, angiography, echocardiography, and nuclear medicine. (Comment:en)
CL Item
laboratory (laboratory)
The results of observations generated by laboratories. Laboratory results are typically generated by laboratories providing analytic services in areas such as chemistry, hematology, serology, histology, cytology, anatomic pathology (including digital pathology), microbiology, and/or virology. These observations are based on analysis of specimens obtained from the patient and submitted to the laboratory. (Comment:en)
CL Item
procedure  (procedure)
Observations generated by other procedures. This category includes observations resulting from interventional and non-interventional procedures excluding laboratory and imaging (e.g., cardiology catheterization, endoscopy, electrodiagnostics, etc.). Procedure results are typically generated by a clinician to provide more granular information about component observations made during a procedure. An example would be when a gastroenterologist reports the size of a polyp observed during a colonoscopy. (Comment:en)
CL Item
survey (survey)
Assessment tool/survey instrument observations (e.g., Apgar Scores, Montreal Cognitive Assessment (MoCA)). (Comment:en)
CL Item
exam  (exam)
Observations generated by physical exam findings including direct observations made by a clinician and use of simple instruments and the result of simple maneuvers performed directly on the patient's body. (Comment:en)
CL Item
therapy (therapy)
Observations generated by non-interventional treatment protocols (e.g. occupational, physical, radiation, nutritional and medication therapy) (Comment:en)
CL Item
activity (activity)
Observations that measure or record any bodily activity that enhances or maintains physical fitness and overall health and wellness. Not under direct supervision of practitioner such as a physical therapist. (e.g., laps swum, steps, sleep data) (Comment:en)
Observation.code
Item
Observation code
text
C1554188 (UMLS CUI [1,1])
C0805701 (UMLS CUI [1,2])
Observation.focus
Item
Focus of observation
text
C1554188 (UMLS CUI [1,1])
C1521840 (UMLS CUI [1,2])
Observation.encounter
Item
The healthcare event (e.g. a patient and healthcare provider interaction) during which this observation is made.
text
C1947978 (UMLS CUI [1,1])
C1554188 (UMLS CUI [1,2])
Observation.effective[x]
Item
Relevant time of an observed value
datetime
C0302523 (UMLS CUI [1,1])
C2347946 (UMLS CUI [1,2])
C0040223 (UMLS CUI [1,3])
Observation.value[x]
Item
Value of observation
text
C1554188 (UMLS CUI [1,1])
C1301772 (UMLS CUI [1,2])
Item
Reason for absent data during observation
text
C0332197 (UMLS CUI [1,1])
C1554188 (UMLS CUI [1,2])
C1511726 (UMLS CUI [1,3])
Absent Data
Code List
Reason for absent data during observation
CL Item
Unknown  (unknown)
The value is expected to exist but is not known. (Comment:en)
CL Item
Asked But Unknown  (asked-unknown)
The source was asked but does not know the value. (Comment:en)
CL Item
Temporarily Unknown  (temp-unknown)
There is reason to expect (from the workflow) that the value may become known. (Comment:en)
CL Item
Not Asked  (not-asked)
The workflow didn't lead to this value being known. (Comment:en)
CL Item
Asked But Declined  (asked-declined)
The source was asked but declined to answer. (Comment:en)
CL Item
Masked (masked)
The information is not available due to security, privacy or related reasons. (Comment:en)
CL Item
Not Applicable  (not-applicable)
There is no proper value for this element (e.g. last menstrual period for a male). (Comment:en)
CL Item
Unsupported (unsupported)
The source system wasn't capable of supporting this element. (Comment:en)
CL Item
As Text  (as-text)
The content of the data is represented in the resource narrative. (Comment:en)
CL Item
Error (error)
Some system or workflow process error means that the information is not available. (Comment:en)
CL Item
Not a Number (NaN)  (not-a-number)
The numeric value is undefined or unrepresentable due to a floating point processing error. (Comment:en)
CL Item
Negative Infinity (NINF)  (negative-infinity)
The numeric value is excessively low and unrepresentable due to a floating point processing error. (Comment:en)
CL Item
Positive Infinity (PINF)  (positive-infinity)
The numeric value is excessively high and unrepresentable due to a floating point processing error. (Comment:en)
CL Item
Not Performed  (not-perfomed)
The value is not available because the observation procedure (test, etc.) was not performed. (Comment:en)
CL Item
Not Permitted  (not-permitted)
The value is not permitted in this context (e.g. due to profiles, or the base data types). (Comment:en)
Observation.interpretation
Item
A categorical assessment of an observation value. For example, high, low, normal.
text
C2711437 (UMLS CUI [1,1])
C1554188 (UMLS CUI [1,2])
Observation.note
Item
Comments about the observation or the results
text
C1317574 (UMLS CUI [1,1])
C1554188 (UMLS CUI [1,2])
C1317574 (UMLS CUI [2,1])
C1274040 (UMLS CUI [2,2])
Observation.bodySite
Item
Site on the subject's body where observation was made
text
C1515974 (UMLS CUI [1,1])
C0700325 (UMLS CUI [1,2])
Observation.method
Item
Method of observation
text
C2911685 (UMLS CUI [1,1])
C1554188 (UMLS CUI [1,2])
Observation.specimen
Item
Specimen
text
C0370003 (UMLS CUI [1,1])
C1554188 (UMLS CUI [1,2])
Observation.device
Item
Observation device
text
C0302523 (UMLS CUI [1,1])
C0699733 (UMLS CUI [1,2])
Observation.referenceRange.low
Item
Low reference range
text
C2346904 (UMLS CUI [1])
Observation.referenceRange.high
Item
High reference range
text
C2348973 (UMLS CUI [1])
Item
Reference range type
text
C0883335 (UMLS CUI [1,1])
C0332307 (UMLS CUI [1,2])
Reference range type
Code List
Reference range type
CL Item
Normal Range  (normal)
Values expected for a normal member of the relevant control population being measured. Typically each results producer such as a laboratory has specific normal ranges and they are usually defined as within two standard deviations from the mean and account for 95.45% of this population. (Comment:en)
CL Item
Recommended Range (recommended)
The range that is recommended by a relevant professional body. (Comment:en)
CL Item
Treatment Range  (treatment)
The range at which treatment would/should be considered. (Comment:en)
CL Item
Therapeutic Desired Level  (therapeutic)
The optimal range for best therapeutic outcomes. (Comment:en)
CL Item
Pre Therapeutic Desired Level  (pre)
The optimal range for best therapeutic outcomes for a specimen taken immediately before administration. (Comment:en)
CL Item
Therapeutic Desired Level- Post Therapeutic Desired Level  (post)
The optimal range for best therapeutic outcomes for a specimen taken immediately after administration. (Comment:en)
CL Item
Pre-Puberty  (pre-puberty)
An expected range in an individual prior to puberty. (Comment:en)
CL Item
Follicular Stage  (follicular)
An expected range in an individual during the follicular stage of the cycle. (Comment:en)
CL Item
MidCycle  (midcycle)
An expected range in an individual during the midcycle stage of the cycle. (Comment:en)
CL Item
Luteal (luteal)
An expected range in an individual during the luteal stage of the cycle. (Comment:en)
CL Item
Post-Menopause (postmenopausal)
An expected range in an individual post-menopause. (Comment:en)
Observation.referenceRange.appliesTo
Item
Target population of the reference range
text
C0883335 (UMLS CUI [1,1])
C0039309 (UMLS CUI [1,2])
Observation.referenceRange.age
Item
Age at which this reference range is applicable
text
C1706839 (UMLS CUI [1,1])
C0001779 (UMLS CUI [1,2])
C0883335 (UMLS CUI [1,3])
Observation.referenceRange.text
Item
Reference range text
text
C1527021 (UMLS CUI [1,1])
C0883335 (UMLS CUI [1,2])
Observation.derivedFrom
Item
Target resource from which this observation value is derived
text
C1521840 (UMLS CUI [1,1])
C0035201 (UMLS CUI [1,2])
C1554188 (UMLS CUI [1,3])
Observation.component.code
Item
Component code
text
C1705248 (UMLS CUI [1,1])
C0805701 (UMLS CUI [1,2])
Observation.component.value[x]
Item
Component value
text
C1705248 (UMLS CUI [1,1])
C0042294 (UMLS CUI [1,2])
Item
Reason for missing value in Component value
text
C1705248 (UMLS CUI [1,1])
C0042294 (UMLS CUI [1,2])
C1709044 (UMLS CUI [1,3])
Component Data - Absent reason
Code List
Reason for missing value in Component value
CL Item
Unknown (unknown)
The value is expected to exist but is not known. (Comment:en)
CL Item
Asked But Unknown  (asked-unknown)
The source was asked but does not know the value. (Comment:en)
CL Item
Temporarily Unknown  (temp-unknown)
There is reason to expect (from the workflow) that the value may become known. (Comment:en)
CL Item
Not Asked  (not-asked)
The workflow didn't lead to this value being known. (Comment:en)
CL Item
Asked But Declined  (asked-declined)
The source was asked but declined to answer. (Comment:en)
CL Item
Masked (masked)
The information is not available due to security, privacy or related reasons. (Comment:en)
CL Item
Not Applicable  (not-applicable)
There is no proper value for this element (e.g. last menstrual period for a male). (Comment:en)
CL Item
Unsupported  (unsupported)
The source system wasn't capable of supporting this element. (Comment:en)
CL Item
As Text  (as-text)
The content of the data is represented in the resource narrative. (Comment:en)
CL Item
Error  (error)
Some system or workflow process error means that the information is not available. (Comment:en)
CL Item
Not a Number (NaN)  (not-a-number)
The numeric value is undefined or unrepresentable due to a floating point processing error. (Comment:en)
CL Item
Negative Infinity (NINF)  (negative-infinity)
The numeric value is excessively low and unrepresentable due to a floating point processing error. (Comment:en)
CL Item
Positive Infinity (PINF)  (positive-infinity)
The numeric value is excessively high and unrepresentable due to a floating point processing error. (Comment:en)
CL Item
Not Performed  (not-performed)
The value is not available because the observation procedure (test, etc.) was not performed. (Comment:en)
CL Item
Not Permitted  (not-permitted)
The value is not permitted in this context (e.g. due to profiles, or the base data types). (Comment:en)
Item
Interpretations of the presence and level of reactivity of the specified component
text
C1705248 (UMLS CUI [1,1])
C1511790 (UMLS CUI [1,2])
C2711437 (UMLS CUI [1,3])
C1554188 (UMLS CUI [1,4])
Interpretation
Code List
Interpretations of the presence and level of reactivity of the specified component
CL Item
Non-reactive  (NR)
An absence finding used to indicate that the specified component / analyte did not react measurably with the reagent. (Comment:en)
CL Item
Reactive (RR)
A presence finding used to indicate that the specified component / analyte reacted with the reagent above the reliably measurable limit of the performed test. (Comment:en)
CL Item
Weakly reactive (WR)
A weighted presence finding used to indicate that the specified component / analyte reacted with the reagent, but below the reliably measurable limit of the performed test. (Comment:en)
Observation.component.referenceRange
Item
Component reference range
text
C1705248 (UMLS CUI [1,1])
C0883335 (UMLS CUI [1,2])
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