# Observation: Comorbidities - HL7 Europe Common Cancer Model v1.0.0-ballot

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **Observation: Comorbidities**

## Resource Profile: Observation: Comorbidities 

| | | |
| :--- | :--- | :--- |
| *Official URL*:http://hl7.eu/fhir/cancer-common/StructureDefinition/observation-comorbidity-eu-ccm | *Version*:1.0.0-ballot | |
| * Standards status: *[Informative](http://hl7.org/fhir/R4/versions.html#std-process) | [Maturity Level](http://hl7.org/fhir/versions.html#maturity): 0 | *Computable Name*:ObservationComorbiditiesEuCcm |
| **Copyright/Legal**: HL7 Europe Copyright. Licensed under Common Creative License (CC0 1.0). Details at [Copyright](copyright.md). | | |

 
This informative profile constrains the Observation resource to represent Comorbidities for the purpose of the ECCDM. It is provided as future implementation-oriented content in this publication and is expected to evolve in subsequent iterations of this guide. This profiles is adapted from the mCode FHIR Implementation Guide 

**Future implementation content**This generated FHIR profile is provided as informative implementation-oriented content in this publication and is expected to evolve in subsequent iterations of this guide.

**Usages:**

* Examples for this Profile: [Observation/ComorbidityObservation1-Example](Observation-ComorbidityObservation1-Example.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/resource/hl7.fhir.eu.cancer-common|current/StructureDefinition/StructureDefinition-observation-comorbidity-eu-ccm.json)

### Formal Views of Profile Content

 [Description of Profiles, Differentials, Snapshots and how the different presentations work](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](StructureDefinition-observation-comorbidity-eu-ccm.csv), [Excel](StructureDefinition-observation-comorbidity-eu-ccm.xlsx), [Schematron](StructureDefinition-observation-comorbidity-eu-ccm.sch) 



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "observation-comorbidity-eu-ccm",
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 0
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "informative"
  }],
  "url" : "http://hl7.eu/fhir/cancer-common/StructureDefinition/observation-comorbidity-eu-ccm",
  "version" : "1.0.0-ballot",
  "name" : "ObservationComorbiditiesEuCcm",
  "title" : "Observation: Comorbidities",
  "status" : "active",
  "date" : "2026-06-14T12:51:40+02:00",
  "publisher" : "HL7 Europe",
  "contact" : [{
    "name" : "HL7 Europe",
    "telecom" : [{
      "system" : "url",
      "value" : "http://hl7.eu"
    }]
  }],
  "description" : "This informative profile constrains the Observation resource to represent Comorbidities for the purpose of the ECCDM. It is provided as future implementation-oriented content in this publication and is expected to evolve in subsequent iterations of this guide.\nThis profiles is adapted from the mCode FHIR Implementation Guide",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
      "code" : "150",
      "display" : "Europe"
    }]
  }],
  "copyright" : "HL7 Europe Copyright. Licensed under Common Creative License (CC0 1.0). Details at [Copyright](copyright.html).",
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "workflow",
    "uri" : "http://hl7.org/fhir/workflow",
    "name" : "Workflow Pattern"
  },
  {
    "identity" : "sct-concept",
    "uri" : "http://snomed.info/conceptdomain",
    "name" : "SNOMED CT Concept Domain Binding"
  },
  {
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern Mapping"
  },
  {
    "identity" : "sct-attr",
    "uri" : "http://snomed.org/attributebinding",
    "name" : "SNOMED CT Attribute Binding"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "Observation",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Observation",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "Observation",
      "path" : "Observation"
    },
    {
      "id" : "Observation.extension",
      "path" : "Observation.extension",
      "slicing" : {
        "discriminator" : [{
          "type" : "value",
          "path" : "url"
        }],
        "ordered" : false,
        "rules" : "open"
      }
    },
    {
      "id" : "Observation.extension:comorbidConditionPresent",
      "path" : "Observation.extension",
      "sliceName" : "comorbidConditionPresent",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition"]
      }]
    },
    {
      "id" : "Observation.extension:comorbidConditionPresent.value[x]",
      "path" : "Observation.extension.value[x]",
      "slicing" : {
        "discriminator" : [{
          "type" : "type",
          "path" : "$this"
        }],
        "ordered" : false,
        "rules" : "open"
      }
    },
    {
      "id" : "Observation.extension:comorbidConditionPresent.value[x]:valueCodeableConcept",
      "path" : "Observation.extension.value[x]",
      "sliceName" : "valueCodeableConcept",
      "min" : 1,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }]
    },
    {
      "id" : "Observation.extension:comorbidConditionAbsent",
      "path" : "Observation.extension",
      "sliceName" : "comorbidConditionAbsent",
      "min" : 0,
      "max" : "*",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-related-condition-absent"]
      }]
    },
    {
      "id" : "Observation.code",
      "path" : "Observation.code",
      "patternCodeableConcept" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "75618-9",
          "display" : "Comorbid condition"
        }]
      }
    },
    {
      "id" : "Observation.subject",
      "path" : "Observation.subject",
      "definition" : "The patient whose comorbidities are recorded.",
      "min" : 1,
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://hl7.eu/fhir/cancer-common/StructureDefinition/patient-eu-ccm"]
      }]
    },
    {
      "id" : "Observation.value[x]",
      "path" : "Observation.value[x]",
      "short" : "Comorbidity score or risk index",
      "definition" : "Comorbidity score or risk index",
      "type" : [{
        "code" : "Quantity"
      },
      {
        "code" : "integer"
      }]
    },
    {
      "id" : "Observation.bodySite",
      "path" : "Observation.bodySite",
      "max" : "0"
    },
    {
      "id" : "Observation.method",
      "path" : "Observation.method",
      "short" : "Comorbidity framework used.",
      "definition" : "The formal methodology used, such as Charlson, NCI, Elixhauser, or ACE-27. The method must be specified if a comorbidity index is specified, otherwise the index cannot be correctly interpreted."
    },
    {
      "id" : "Observation.specimen",
      "path" : "Observation.specimen",
      "max" : "0"
    },
    {
      "id" : "Observation.device",
      "path" : "Observation.device",
      "max" : "0"
    },
    {
      "id" : "Observation.hasMember",
      "path" : "Observation.hasMember",
      "max" : "0"
    },
    {
      "id" : "Observation.component",
      "path" : "Observation.component",
      "max" : "0"
    }]
  }
}

```
