Release 4 R5 Final QA

This page is part of the FHIR Specification (v4.0.1: R4 (v5.0.0-draft-final: Final QA Preview for R5 - Mixed Normative and STU see ballot notes ) in it's permanent home (it will always be available at this URL). ). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4 Content Examples Detailed Descriptions Mappings R4B Profiles & Extensions R4 11.24 R3 Resource SubstanceNucleicAcid - Content R2

Example ValueSet/procedure-category (JSON)

Biomedical Research and Regulation Terminology Infrastructure Work Group Maturity Level : 0   Trial Use N/A Security Category Standards Status : Anonymous Informative Compartments : Not linked to any defined compartments
Nucleic acids are defined by three distinct elements: the base, sugar and linkage. Individual substance/moiety IDs will be created for each of these elements. The nucleotide sequence will be always entered in the 5’-3’ direction. 11.24.1 Scope and Usage This resource is referenced by SubstanceSpecification 11.24.2 Resource Content Structure Name Flags Card. Type Description & Constraints SubstanceNucleicAcid Σ TU DomainResource Nucleic acids are defined by three distinct elements: the base, sugar and linkage. Individual substance/moiety IDs will be created for each of these elements. The nucleotide sequence will be always entered in the 5’-3’ direction Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension sequenceType Σ 0..1 CodeableConcept The type of the sequence shall be specified based on a controlled vocabulary numberOfSubunits Σ 0..1 integer The number of linear sequences of nucleotides linked through phosphodiester bonds shall be described. Subunits would be strands of nucleic acids that are tightly associated typically through Watson-Crick base pairing. NOTE: If not specified in the reference source, the assumption is that there is 1 subunit areaOfHybridisation Σ 0..1 string The area of hybridisation shall be described if applicable for double stranded RNA or DNA. The number associated with the subunit followed by the number associated to the residue shall be specified in increasing order. The underscore “” shall be used as separator as follows: “Subunitnumber Residue” oligoNucleotideType Σ 0..1 CodeableConcept (TBC) subunit Σ 0..* BackboneElement Subunits are listed in order of decreasing length; sequences of the same length will be ordered by molecular weight; subunits that have identical sequences will be repeated multiple times subunit Σ 0..1 integer Index of linear sequences of nucleic acids in order of decreasing length. Sequences of the same length will be ordered by molecular weight. Subunits that have identical sequences will be repeated and have sequential subscripts sequence Σ 0..1 string Actual nucleotide sequence notation from 5' to 3' end using standard single letter codes. In addition to the base sequence, sugar and type of phosphate or non-phosphate linkage should also be captured length Σ 0..1 integer The length of the sequence shall be captured sequenceAttachment Σ 0..1 Attachment (TBC) fivePrime Σ 0..1 CodeableConcept The nucleotide present at the 5’ terminal shall be specified based on a controlled vocabulary. Since the sequence is represented from the 5' to the 3' end, the 5’ prime nucleotide is the letter at the first position in the sequence. A separate representation would be redundant threePrime Σ 0..1 CodeableConcept The nucleotide present at the 3’ terminal shall be specified based on a controlled vocabulary. Since the sequence is represented from the 5' to the 3' end, the 5’ prime nucleotide is the letter at the last position in the sequence. A separate representation would be redundant linkage Σ 0..* BackboneElement The linkages between sugar residues will also be captured connectivity Σ 0..1 string The entity that links the sugar residues together should also be captured for nearly all naturally occurring nucleic acid the linkage is a phosphate group. For many synthetic oligonucleotides phosphorothioate linkages are often seen. Linkage connectivity is assumed to be 3’-5’. If the linkage is either 3’-3’ or 5’-5’ this should be specified identifier Σ 0..1 Identifier Each linkage will be registered as a fragment and have an ID name Σ 0..1 string Each linkage will be registered as a fragment and have at least one name. A single name shall be assigned to each linkage residueSite Σ 0..1 string Residues shall be captured as described in 5.3.6.8.3 sugar Σ 0..* BackboneElement 5.3.6.8.1 Sugar ID (Mandatory) identifier Σ 0..1 Identifier The Substance ID of the sugar or sugar-like component that make up the nucleotide name Σ 0..1 string The name of the sugar or sugar-like component that make up the nucleotide residueSite Σ 0..1 string The residues that contain a given sugar will be captured. The order of given residues will be captured in the 5‘-3‘direction consistent with the base sequences listed above Documentation for this format

UML Diagram ( Legend Raw JSON ) SubstanceNucleicAcid ( DomainResource ) The type of the sequence shall be specified based on a controlled vocabulary sequenceType : CodeableConcept [0..1] The number of linear sequences of nucleotides linked through phosphodiester bonds shall be described. Subunits would be strands of nucleic acids that are tightly associated typically through Watson-Crick base pairing. NOTE: If not specified in the reference source, the assumption is that there is 1 subunit numberOfSubunits : integer [0..1] The area of hybridisation shall be described if applicable for double stranded RNA or DNA. The number associated with the subunit followed by the number associated to the residue shall be specified in increasing order. The underscore “” shall be used as separator as follows: “Subunitnumber Residue” areaOfHybridisation : string [0..1] (TBC) oligoNucleotideType : CodeableConcept [0..1] Subunit Index of linear sequences of nucleic acids in order of decreasing length. Sequences of the same length will be ordered by molecular weight. Subunits that have identical sequences will be repeated and have sequential subscripts subunit : integer [0..1] Actual nucleotide sequence notation from 5' to 3' end using standard single letter codes. In addition to the base sequence, sugar and type of phosphate or non-phosphate linkage should also be captured sequence : string [0..1] The length of the sequence shall be captured length : integer [0..1] (TBC) sequenceAttachment : Attachment [0..1] The nucleotide present at the 5’ terminal shall be specified based on a controlled vocabulary. Since the sequence is represented from the 5' to the 3' end, the 5’ prime nucleotide is the letter at the first position in the sequence. A separate representation would be redundant fivePrime : CodeableConcept [0..1] The nucleotide present at the 3’ terminal shall be specified based on a controlled vocabulary. Since the sequence is represented from the 5' to the 3' end, the 5’ prime nucleotide is the letter at the last position in the sequence. A separate representation would be redundant threePrime : CodeableConcept [0..1] Linkage The entity that links the sugar residues together should also be captured for nearly all naturally occurring nucleic acid the linkage is a phosphate group. For many synthetic oligonucleotides phosphorothioate linkages are often seen. Linkage connectivity is assumed to be 3’-5’. If the linkage is either 3’-3’ or 5’-5’ this should be specified connectivity : string [0..1] Each linkage will be registered as a fragment and have an ID identifier : Identifier [0..1] Each linkage will be registered as a fragment and have at least one name. A single name shall be assigned to each linkage name : string [0..1] Residues shall be captured as described in 5.3.6.8.3 residueSite : string [0..1] Sugar The Substance ID of the sugar or sugar-like component that make up the nucleotide identifier : Identifier [0..1] The name of the sugar or sugar-like component that make up the nucleotide name : string [0..1] The residues that contain a given sugar will be captured. The order of given residues will be captured in the 5‘-3‘direction consistent with the base sequences listed above residueSite : string canonical form [0..1] The linkages between sugar residues will + also be captured linkage [0..*] 5.3.6.8.1 Sugar ID (Mandatory) sugar [0..*] Subunits are listed in order of decreasing length; sequences of the same length will be ordered by molecular weight; subunits that have identical sequences will be repeated multiple times subunit see JSON Format Specification [0..*] XML Template )

< <!-- from --> <!-- from --> <</sequenceType> < < <</oligoNucleotideType> < < < < <</sequenceAttachment> <</fivePrime> <</threePrime> < < <</identifier> < < </linkage> < <</identifier> < < </sugar> </subunit> </SubstanceNucleicAcid>

JSON Template Definition for Value SetProcedure Category Codes (SNOMED CT)

{ "resourceType" : "", // from // from " " " " " " " " " " " " " " " " }], " " " "
{
  "resourceType" : "ValueSet",
  "id" : "procedure-category",
  "meta" : {
    "lastUpdated" : "2023-03-01T23:03:57.298+11:00",
    "profile" : ["http://hl7.org/fhir/StructureDefinition/shareablevalueset"]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><ul><li>Include these codes as defined in <a href=\"http://www.snomed.org/\"><code>http://snomed.info/sct</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href=\"http://snomed.info/id/24642003\">24642003</a></td><td>Psychiatry procedure or service</td></tr><tr><td><a href=\"http://snomed.info/id/409063005\">409063005</a></td><td>Counseling</td></tr><tr><td><a href=\"http://snomed.info/id/409073007\">409073007</a></td><td>Education</td></tr><tr><td><a href=\"http://snomed.info/id/387713003\">387713003</a></td><td>Surgical procedure (procedure)</td></tr><tr><td><a href=\"http://snomed.info/id/103693007\">103693007</a></td><td>Diagnostic procedure</td></tr><tr><td><a href=\"http://snomed.info/id/46947000\">46947000</a></td><td>Chiropractic manipulation</td></tr><tr><td><a href=\"http://snomed.info/id/410606002\">410606002</a></td><td>Social service procedure (procedure)</td></tr></table></li></ul></div>"
  },
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "pc"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "draft"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 1
  }],
  "url" : "http://hl7.org/fhir/ValueSet/procedure-category",
  "identifier" : [{
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.3.430"
  },
  {
    "use" : "old",
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.3.421"
  },
  {
    "use" : "old",
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.2.241"
  }],
  "version" : "5.0.0-draft-final",
  "name" : "ProcedureCategoryCodesSNOMEDCT",
  "title" : "Procedure Category Codes (SNOMED CT)",
  "status" : "draft",
  "experimental" : true,
  "publisher" : "FHIR Project team",
  "contact" : [{
    "telecom" : [{
      "system" : "url",
      "value" : "http://hl7.org/fhir"

    }]
  }]

  }],
  "description" : "Procedure Category code: A selection of relevant SNOMED CT codes.",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "code" : "001",
      "display" : "World"
    }]
  }],
  "copyright" : "This resource includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyright of the International Health Terminology Standards Development Organisation (IHTSDO). Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org",
  "compose" : {
    "include" : [{
      "system" : "http://snomed.info/sct",
      "concept" : [{
        "code" : "24642003"
      },
      {
        "code" : "409063005"
      },
      {
        "code" : "409073007"
      },
      {
        "code" : "387713003"
      },
      {
        "code" : "103693007"
      },
      {
        "code" : "46947000"
      },
      {
        "code" : "410606002"
      }]
    }]
  }

}
Turtle Template @prefix fhir: <http://hl7.org/fhir/> . [ a fhir:; fhir:nodeRole fhir:treeRoot; # if this is the parser root # from # from fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: ], ...; fhir: fhir: fhir: fhir: ], ...; ], ...; ] Changes since R3 This resource did not exist in Release 2 This analysis is available as XML or JSON .

Structure Name Flags Card. Type Description & Constraints SubstanceNucleicAcid Σ TU DomainResource Nucleic acids are defined by three distinct elements: the base, sugar and linkage. Individual substance/moiety IDs will be created for each of these elements. The nucleotide sequence will be always entered in the 5’-3’ direction Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension sequenceType Σ 0..1 CodeableConcept The type of the sequence shall be specified based on a controlled vocabulary numberOfSubunits Σ 0..1 integer The number of linear sequences of nucleotides linked through phosphodiester bonds shall be described. Subunits would be strands of nucleic acids that are tightly associated typically through Watson-Crick base pairing. NOTE: If not specified in the reference source, the assumption is that there is 1 subunit areaOfHybridisation Σ 0..1 string The area of hybridisation shall be described if applicable for double stranded RNA or DNA. The number associated with the subunit followed by the number associated to the residue shall be specified in increasing order. The underscore “” shall be used as separator as follows: “Subunitnumber Residue” oligoNucleotideType Σ 0..1 CodeableConcept (TBC) subunit Σ 0..* BackboneElement Subunits are listed in order of decreasing length; sequences of the same length will be ordered by molecular weight; subunits that have identical sequences will be repeated multiple times subunit Σ 0..1 integer Index of linear sequences of nucleic acids in order of decreasing length. Sequences of the same length will be ordered by molecular weight. Subunits that have identical sequences will be repeated and have sequential subscripts sequence Σ 0..1 string Actual nucleotide sequence notation from 5' to 3' end using standard single letter codes. In addition to the base sequence, sugar and type of phosphate or non-phosphate linkage should also be captured length Σ 0..1 integer The length of the sequence shall be captured sequenceAttachment Σ 0..1 Attachment (TBC) fivePrime Σ 0..1 CodeableConcept The nucleotide present at the 5’ terminal shall be specified based on a controlled vocabulary. Since the sequence is represented from the 5' to the 3' end, the 5’ prime nucleotide is the letter at the first position in the sequence. A separate representation would be redundant threePrime Σ 0..1 CodeableConcept The nucleotide present at the 3’ terminal shall be specified based on a controlled vocabulary. Since the sequence is represented from the 5' Usage note: every effort has been made to the 3' end, the 5’ prime nucleotide is the letter at the last position in the sequence. A separate representation would be redundant linkage Σ 0..* BackboneElement The linkages between sugar residues will also be captured connectivity Σ 0..1 string The entity ensure that links the sugar residues together should also be captured for nearly all naturally occurring nucleic acid the linkage is a phosphate group. For many synthetic oligonucleotides phosphorothioate linkages examples are often seen. Linkage connectivity is assumed to be 3’-5’. If the linkage is either 3’-3’ or 5’-5’ this should be specified identifier Σ 0..1 Identifier Each linkage will be registered as a fragment and have an ID name Σ 0..1 string Each linkage will be registered as a fragment correct and have at least one name. A single name shall be assigned to each linkage residueSite Σ 0..1 string Residues shall be captured as described in 5.3.6.8.3 sugar Σ 0..* BackboneElement 5.3.6.8.1 Sugar ID (Mandatory) identifier Σ 0..1 Identifier The Substance ID of the sugar or sugar-like component that make up the nucleotide name Σ 0..1 string The name of the sugar or sugar-like component that make up the nucleotide residueSite Σ 0..1 string The residues that contain a given sugar will be captured. The order of given residues will be captured in the 5‘-3‘direction consistent with the base sequences listed above Documentation for this format UML Diagram ( Legend ) SubstanceNucleicAcid ( DomainResource ) The type of the sequence shall be specified based on a controlled vocabulary sequenceType : CodeableConcept [0..1] The number of linear sequences of nucleotides linked through phosphodiester bonds shall be described. Subunits would be strands of nucleic acids that useful, but they are tightly associated typically through Watson-Crick base pairing. NOTE: If not specified in the reference source, the assumption is that there is 1 subunit numberOfSubunits : integer [0..1] The area of hybridisation shall be described if applicable for double stranded RNA or DNA. The number associated with the subunit followed by the number associated to the residue shall be specified in increasing order. The underscore “” shall be used as separator as follows: “Subunitnumber Residue” areaOfHybridisation : string [0..1] (TBC) oligoNucleotideType : CodeableConcept [0..1] Subunit Index of linear sequences of nucleic acids in order of decreasing length. Sequences of the same length will be ordered by molecular weight. Subunits that have identical sequences will be repeated and have sequential subscripts subunit : integer [0..1] Actual nucleotide sequence notation from 5' to 3' end using standard single letter codes. In addition to the base sequence, sugar and type of phosphate or non-phosphate linkage should also be captured sequence : string [0..1] The length of the sequence shall be captured length : integer [0..1] (TBC) sequenceAttachment : Attachment [0..1] The nucleotide present at the 5’ terminal shall be specified based on a controlled vocabulary. Since the sequence is represented from the 5' to the 3' end, the 5’ prime nucleotide is the letter at the first position in the sequence. A separate representation would be redundant fivePrime : CodeableConcept [0..1] The nucleotide present at the 3’ terminal shall be specified based on a controlled vocabulary. Since the sequence is represented from the 5' to the 3' end, the 5’ prime nucleotide is the letter at the last position in the sequence. A separate representation would be redundant threePrime : CodeableConcept [0..1] Linkage The entity that links the sugar residues together should also be captured for nearly all naturally occurring nucleic acid the linkage is a phosphate group. For many synthetic oligonucleotides phosphorothioate linkages are often seen. Linkage connectivity is assumed to be 3’-5’. If the linkage is either 3’-3’ or 5’-5’ this should be specified connectivity : string [0..1] Each linkage will be registered as a fragment and have an ID identifier : Identifier [0..1] Each linkage will be registered as a fragment and have at least one name. A single name shall be assigned to each linkage name : string [0..1] Residues shall be captured as described in 5.3.6.8.3 residueSite : string [0..1] Sugar The Substance ID of the sugar or sugar-like component that make up the nucleotide identifier : Identifier [0..1] The name of the sugar or sugar-like component that make up the nucleotide name : string [0..1] The residues that contain a given sugar will be captured. The order of given residues will be captured in the 5‘-3‘direction consistent with the base sequences listed above residueSite : string [0..1] The linkages between sugar residues will also be captured linkage [0..*] 5.3.6.8.1 Sugar ID (Mandatory) sugar [0..*] Subunits are listed in order of decreasing length; sequences normative part of the same length will be ordered by molecular weight; subunits that have identical sequences will be repeated multiple times subunit [0..*] XML Template < <!-- from --> <!-- from --> <</sequenceType> < < <</oligoNucleotideType> < < < < <</sequenceAttachment> <</fivePrime> <</threePrime> < < <</identifier> < < </linkage> < <</identifier> < < </sugar> </subunit> </SubstanceNucleicAcid> JSON Template { "resourceType" : "", // from // from " " " " " " " " " " " " " " " " }], " " " " }] }] } Turtle Template @prefix fhir: <http://hl7.org/fhir/> . [ a fhir:; fhir:nodeRole fhir:treeRoot; # if this is the parser root # from # from fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: fhir: ], ...; fhir: fhir: fhir: fhir: ], ...; ], ...; ] Changes since Release 3 This resource did not exist in Release 2 This analysis is available as XML or JSON . specification.

  See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions & the dependency analysis