Generated Narrative: StructureDefinition sm-condition Name Flags Card. Type Description & Constraints Condition 0..* Condition 有关病情、问题或诊断的详细信息 id 0..1 id 不重复的ID用以识别储存在特定FHIR Server中的Condition纪录，通常又称为逻辑性ID。 extension 0..* Extension 扩展字段 identifier 0..* Identifier 此病情、问题或诊断的外部识别码 clinicalStatus S 1..1 CodeableConcept active | recurrence | relapse | inactive | remission | resolved ，病情、问题或诊断的临床状态。 Binding: ConditionClinicalStatusCodes (required) verificationStatus S 0..1 CodeableConcept unconfirmed | provisional | differential | confirmed | refuted | entered-in-error ，支持或拒绝病情、问题或诊断的临床状态的验证状态。 Binding: ConditionVerificationStatus (required) category 0..* CodeableConcept problem-list-item | encounter-diagnosis ，指定病情、问题或诊断的类别。 severity S 0..1 CodeableConcept 病情、问题或诊断的主观严重程度 Binding: Condition/DiagnosisSeverity (extensible) code S 0..1 CodeableConcept 病情、问题或诊断的识别 Binding: Condition/Problem/DiagnosisCodes (example) Slices for coding 0..* Coding 由专门术语系统（terminology system）定义的代码。此资料项目为可扩充绑定预设国际标准值集，但实作者可视实务专案需求只绑定以下slices中的任一值集。目前未只限定绑定预设值集是因为尚无slice值集与预设国际标准值集的代码对应表，待后续有相对的代码对应表后将建议采用国际标准值集作为唯一绑定值集并针对该值集进行扩充与管理，以利进行跨国与跨系统之资料交换。 Slice: Unordered, Open by pattern:$this coding:absentOrUnknownProblem S 0..1 Coding 不存在的问题或未知问题的代码 Binding: Absent or Unknown Problems - IPS (required): 应填入所绑定值集中的其中一个代码。 coding:sct S 0..1 Coding 此为SNOMED CT诊断代码，若机构已有购买相关授权，亦可使用。 Binding: ValueSet-SNOMED CT诊断代码值集 (required) bodySite S 0..* CodeableConcept 如果相关请填写解剖位置 Binding: SNOMEDCTBodyStructures (extensible) subject S 1..1 Reference(SmPatient | Group) 谁有此病情、问题或诊断？ encounter 0..1 Reference(Encounter) 作为病情、问题或诊断纪录的一部分的就医（Encounter）纪录 onset[x] S 0..1 dateTime, Age, Period, Range, string 估计的或实际的日期、日期—时间或年龄。医师认为此病情、问题或诊断之推估或实际发生时间或日期时间等 abatement[x] S 0..1 dateTime, Age, Period, Range, string 何时解决/缓解 recorder 0..1 Reference(SmPractitioner | SmPractitionerRole | SmPatient | RelatedPerson) 谁记录此病情、问题或诊断 asserter S 0..1 Reference(SmPractitioner | SmPractitionerRole | SmPatient | RelatedPerson) 声称有此病情、问题或诊断的人 stage 0..* BackboneElement 分期（stage）／分级（grade），通常是正式的评估。 summary 0..1 CodeableConcept 简单的摘要（特定疾病）。 Binding: ConditionStage (extensible): 描述病情、问题或诊断分期的代码（例如：癌症分期）。应填入所绑定值集中适合的代码，确定无适合的代码才可以使用其他值集的代码来表示。 assessment 0..* Reference(ClinicalImpression | DiagnosticReport | Observation) 正式的评估记录 type 0..1 CodeableConcept 分期的种类 Binding: ConditionStageType (extensible): 病情、问题或诊断分期种类的代码（如临床或病理）；应填入所绑定值集中适合的代码，确定无适合的代码才可以使用其他值集的代码来表示。 evidence 0..* BackboneElement 支持的证据 code 0..* CodeableConcept 表现／症状 Binding: ManifestationAndSymptomCodes (extensible): 病情、问题或诊断的表现或症状之代码；应填入所绑定值集中适合的代码，确定无适合的代码才可以使用其他值集的代码来表示。 detail 0..* Reference(Resource) 在其他地方找到的支持信息 note S 0..* Annotation 关于此Condition的附加信息 Documentation for this format
一个临床病情、问题、诊断或其他事件、情况、或临床概念，已上升到需要关注的程度。
Most systems will expect a clinicalStatus to be valued for problem-list-items that are managed over time, but might not need a clinicalStatus for point in time encounter-diagnosis.
Condition.clinicalStatus SHALL be present if verificationStatus is not entered-in-error and category is problem-list-item
clinicalStatus.exists() or verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code = 'entered-in-error').exists() or category.select($this='problem-list-item').empty()
exists(f:clinicalStatus) or exists(f:verificationStatus/f:coding/f:code/@value='entered-in-error') or not(exists(category[@value='problem-list-item']))
If condition is abated, then clinicalStatus must be either inactive, resolved, or remission
abatement.empty() or clinicalStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-clinical' and (code='resolved' or code='remission' or code='inactive')).exists()
not(exists(*[starts-with(local-name(.), 'abatement')])) or exists(f:clinicalStatus/f:coding[f:system/@value='http://terminology.hl7.org/CodeSystem/condition-clinical' and f:code/@value=('resolved', 'remission', 'inactive')])
Condition.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
verificationStatus.coding.where(system='http://terminology.hl7.org/CodeSystem/condition-ver-status' and code='entered-in-error').empty() or clinicalStatus.empty()
not(exists(f:verificationStatus/f:coding[f:system/@value='http://terminology.hl7.org/CodeSystem/condition-ver-status' and f:code/@value='entered-in-error'])) or not(exists(f:clinicalStatus))
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
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()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
< 243796009 |Situation with explicit context| : 246090004 |Associated finding| = ( ( < 404684003 |Clinical finding| MINUS ( << 420134006 |Propensity to adverse reactions| OR << 473010000 |Hypersensitivity condition| OR << 79899007 |Drug interaction| OR << 69449002 |Drug action| OR << 441742003 |Evaluation finding| OR << 307824009 |Administrative status| OR << 385356007 |Tumor stage finding|)) OR < 272379006 |Event|)
Observation[classCode=OBS, moodCode=EVN, code=ASSERTION, value<Diagnosis]
不重复的ID用以识别储存在特定FHIR Server中的Condition纪录，通常又称为逻辑性ID。
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
一个resource使用新增操作（create operation）提交给服务器时，此resource没有id，它的id在resource被创建后由服务器分配/指定。
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
The base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
Text summary of the resource, for human interpretation
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
由执行者或其他系统指定给此病情、问题或诊断的业务用识别码，即使此resource作更新及在服务器之间的传递，此识别码仍保持不变。
这是一个业务识别码，不是一个resource识别码（详见讨论）。最好的做法是该识别码只出现在单个resource实例上，但是业务实务有可能会规定可以在多个resource实例中具有相同识别码—甚至可能具有不同的resource型例。例如：多个 「Patient（病人）」和 「Person（个人）」resource实例可能共用同一个社会保险号码。
Allows identification of the condition as it is known by various participating systems and in a way that remains consistent across servers.
active | recurrence | relapse | inactive | remission | resolved ，病情、问题或诊断的临床状态。
The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.
This element is labeled as a modifier because the status contains codes that mark the condition as no longer active.
Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value
unconfirmed | provisional | differential | confirmed | refuted | entered-in-error ，支持或拒绝病情、问题或诊断的临床状态的验证状态。
The verification status to support the clinical status of the condition.
verificationStatus不是必须的。例如：当病人在急诊室出现腹痛时，不可能出现验证状态。资料类型是CodeableConcept，因为verificationStatus涉及到一些临床判断，因此可能需要比所需的FHIR值集更多的特殊性。例如：SNOMED编码可能允许更多的特殊性。
This element is labeled as a modifier because the status contains the code refuted and entered-in-error that mark the Condition as not currently valid.
Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value
problem-list-item | encounter-diagnosis ，指定病情、问题或诊断的类别。
The categorization is often highly contextual and may appear poorly differentiated or not very useful in other contexts.
'problem' if from PRB-3. 'diagnosis' if from DG1 segment in PV1 message
A subjective assessment of the severity of the condition as evaluated by the clinician.
Coding of the severity with a terminology is preferred, where possible.
Can be pre/post-coordinated into value. Or ./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="severity"].value
Identification of the condition, problem or diagnosis.
0..1 to account for primarily narrative only resources.
code 246090004 |Associated finding| (< 404684003 |Clinical finding| MINUS << 420134006 |Propensity to adverse reactions| MINUS << 473010000 |Hypersensitivity condition| MINUS << 79899007 |Drug interaction| MINUS << 69449002 |Drug action| MINUS << 441742003 |Evaluation finding| MINUS << 307824009 |Administrative status| MINUS << 385356007 |Tumor stage finding|) OR < 413350009 |Finding with explicit context| OR < 272379006 |Event|
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
由专门术语系统（terminology system）定义的代码。此资料项目为可扩充绑定预设国际标准值集，但实作者可视实务专案需求只绑定以下slices中的任一值集。目前未只限定绑定预设值集是因为尚无slice值集与预设国际标准值集的代码对应表，待后续有相对的代码对应表后将建议采用国际标准值集作为唯一绑定值集并针对该值集进行扩充与管理，以利进行跨国与跨系统之资料交换。
A reference to a code defined by a terminology system.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Allows for alternative encodings within a code system, and translations to other code systems.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
表示「absent problem」或「problems unknown」的代码
代码可以在列举清单（enumerations）或代码清单（code lists）中非常随意地定义，直至有非常正式的定义，如SNOMED CT—更多信息见HL7 v3核心原则（Core Principles）。编码的排序是未定义的因而 **必须没有（SHALL NOT）** 被用来推断意义。一般来说，最多只有一个编码值（coding values）会被标记为UserSelected = true。
允许使用者在不知道识别码系统的情况下利用识别码
应填入所绑定值集中的其中一个代码。
此为SNOMED CT诊断代码，若机构已有购买相关授权，亦可使用。
Plain text representation of the concept
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Very often the text is the same as a displayName of one of the codings.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
The anatomical location where this condition manifests itself.
只有在Condition.code中找到的代码未隐含此资料项目概念时才使用。如果使用案例（use-case）要求将BodySite作为一个单独的resource来处理（例如：识别和追踪），那么就使用标准的资料项目扩充方式来扩充bodySite。可以是一个摘要代码，也可以是对一个非常精确位置定义的参照，或者两者都是。
< 442083009 |Anatomical or acquired body structure|
Indicates the patient or group who the condition record is associated with.
Group is typically used for veterinary or public health use cases.
作为病情、问题或诊断纪录的一部分的就医（Encounter）纪录
The Encounter during which this Condition was created or to which the creation of this record is tightly associated.
This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter. This record indicates the encounter this particular record is associated with. In the case of a "new" diagnosis reflecting ongoing/revised information about the condition, this might be distinct from the first encounter in which the underlying condition was first "known".
.inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]
估计的或实际的日期、日期—时间或年龄。医师认为此病情、问题或诊断之推估或实际发生时间或日期时间等
Estimated or actual date or date-time the condition began, in the opinion of the clinician.
Age is generally used when the patient reports an age at which the Condition began to occur.
.effectiveTime.low or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at onset"].value
病情、问题或诊断缓解或开始缓解的日期或估计日期。因为与「缓解（remissio）」或 「解决（resolution）」相关的许多过多含义—病情、问题或诊断不会真正解决，但它们可以缓解，所以称为「缓解 （abatement）」，
There is no explicit distinction between resolution and remission because in many cases the distinction is not clear. Age is generally used when the patient reports an age at which the Condition abated. If there is no abatement element, it is unknown whether the condition has resolved or entered remission; applications and users should generally assume that the condition is still valid. When abatementString exists, it implies the condition is abated.
.effectiveTime.high or .inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="age at remission"].value or .inboundRelationship[typeCode=SUBJ]source[classCode=CONC, moodCode=EVN].status=completed
The recordedDate represents when this particular Condition record was created in the system, which is often a system-generated date.
Individual who recorded the record and takes responsibility for its content.
Individual who is making the condition statement.
病情、问题或诊断的临床分期或分级，可能包括正式的严重程度评估。
exists(f:summary) or exists(f:assessment)
./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage/grade"]
Extensions that cannot be ignored even if unrecognized
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
对分期的简单摘要，如「第3期」。针对特定疾病的分期测定。
描述病情、问题或诊断分期的代码（例如：癌症分期）。应填入所绑定值集中适合的代码，确定无适合的代码才可以使用其他值集的代码来表示。
分期评估所依据的证据之正式记录
分期的种类，如病理分期或临床分期。
病情、问题或诊断分期种类的代码（如临床或病理）；应填入所绑定值集中适合的代码，确定无适合的代码才可以使用其他值集的代码来表示。
./inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="stage type"]
作为病情、问题或诊断验证状态基础的支持证据／临床表现，如证实或反驳病情、问题或诊断的证据。
证据可以是一个简单的编码症状／临床表现的清单，或参考检验检查或者正式评估，或者两者都是。
.outboundRelationship[typeCode=SPRT].target[classCode=OBS, moodCode=EVN]
导致记录此病情、问题或诊断的表现或症状
病情、问题或诊断的表现或症状之代码；应填入所绑定值集中适合的代码，确定无适合的代码才可以使用其他值集的代码来表示。
其他相关信息的连接，包括病理报告。
关于此Condition的附加信息。这是一个一般的注释／意见纪录，用于描述病情、问题或诊断、其诊断和预后。
.inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code="annotation"].value