PanCareSurPass Project HL7 FHIR Implementation Guide
0.1.0 - trial-use 150

This page is part of the PanCareSurPass Project HL7 FHIR Implementation Guide (v0.1.0: QA Preview) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Logical Model: Radiotherapy - Detailed Descriptions

Active as of 2023-01-26

Definitions for the Radiotherapy logical model.

Guidance on how to interpret the contents of this table can be found here.

1. Radiotherapy
Definition

Radiotherapy Maturity Level: 2 - Ready for Review

Control0..?
2. Radiotherapy.relatedDiagnosis
Definition

Identifier of the diagnosis for which this radiotherapy is performed

Control0..1
TypeIdentifier
3. Radiotherapy.relatedRelapse
Definition

Identifier of the relapse/progression (after FLT) for which this radiotherapy is performed

Control0..1
TypeIdentifier
4. Radiotherapy.identifier
Definition

Progressive number of radotherapy episode. An EPISODE might be a single or several courses of pre-planned treatment within a consecutive time period to different sites. For example, if a patient had radiotherapy to a limb and also to the lungs for a Ewing?s sarcoma these should be entered in one episode of treatment but as separate radiotherapy courses with their respective site, total dose, and number of fractions. They will both be within one episode

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
5. Radiotherapy.istitutionOfTreatment
Definition

Please indicate the institution in which the radiotherapeutic treatment was given

Control0..1
TypeBackboneElement
6. Radiotherapy.istitutionOfTreatment.description
Definition

Please provide name, city and countryof the institution

Control0..1
Typestring
7. Radiotherapy.istitutionOfTreatment.name
Definition

Institution name

Control0..1
Typestring
8. Radiotherapy.istitutionOfTreatment.address
Definition

Institution address

Control0..1
TypeBackboneElement
9. Radiotherapy.istitutionOfTreatment.address.name
Definition

Institution city

Control0..1
Typestring
10. Radiotherapy.istitutionOfTreatment.address.country
Definition

Institution country

Control0..1
Typestring
11. Radiotherapy.startDate
Definition

Enter the date on which the first treatment (fraction) of radiotherapy was given, in a DD/MM/YYYY format. If the date is unkown or partially missed insert the year at the best of your knowledge.

Control1..1
TypedateTime
12. Radiotherapy.enddate
Definition

Enter the full date on which the last treatment (fraction) of radiotherapy was given in a DD/MM/YYYY format.
When only a single radiation treatment/fraction was given, the start and end dates will be the same. If the date is unkown or partially missed insert the year at the best of your knowledge.

Control0..1
TypedateTime
13. Radiotherapy.type
Definition

External Beam Radiation: The radiation is produced by a large machine, and the type of the machine needs to be recorded in the subsequent field. Brachytherapy: a material that is radioactive (often a fine wire or a tiny ?seed?) is placed on or in the body to give a very localized high dose of radiation. Details will be asked in the next field Metabolic or radionuclide treatment/therapy: a liquid substance is injected into the blood stream and carries radiation throughout the body with the aim of reaching tumour tissue. Also in this case, details will be asked in the subsequent field. 1 => External beam 2 => Brachytherapy 3 => Metabolic/radionuclide therapy

Control1..1
TypeCodeableConcept
14. Radiotherapy.deviceType
Definition

A detailed description of the type of machine can be found in the user's manual. If you have the name of a machine but cannot find it in this list, please select Other and add the name in free text. If you know the treatment was with external beam but not which machine or energy, select 'Unknown'. 1 =>Orthovoltage / kilovoltage usually 200 - 300kv X rays/photons 2 =>Linac (Linear Accelerator) megavoltage MV X Rays/photons 3 =>Linac (Linear Accelerator) electrons 4 => Cobalt - MV gamma rays / photons 5 => Proton Beam 6 => Other, if other specify the name -9922 => Unknown

Control0..1
TypeCodeableConcept
15. Radiotherapy.brachytherapyType
Definition

? Surface brachytherapy - a radiation source (radioactive material) is positioned on a superficial tumour ? Interstitial brachytherapy ? a radiation source is implanted into a tumour ? Intracavitary or intraluminal brachytherapy - a radiation source is introduced in special applicators into a body cavity or lumen

1 => Surface brachytherapy 2 => Interstitial brachytherapy 3 => Intracavitary or intraluminal brachytherapy -9922=> Unknown

Control0..1
TypeCodeableConcept
16. Radiotherapy.isotopes
Definition

Specify the radioactive material (isotopes) used: If not listed, select 'Other then specify' 1 => Iridium (Ir) 2 => Gold (Au) 3 => Iodine (I) 4 => Caesium (Cs) 5 => Other -9922 => Unknown

Control0..1
TypeCodeableConcept
17. Radiotherapy.radionuclides
Definition

A detailed description of the radionuclides can be found in the user's manual. If you have the name of a radionuclide but cannot find it in this list, please select Other and add the name in free text. If you know the treatment was with external beam but not which machine or energy, select 'Unknown'. 1 => Iodine-131 2 => MIBG 3 =>Yttrium 90 4 => Other -9922 => Unknown

Control0..1
TypeCodeableConcept
18. Radiotherapy.numberOfCourses
Definition

For Metabolic/radionuclide therapy

Control0..1
Typeinteger
19. Radiotherapy.target
Definition

Site' refers to the radiation therapy treatment field, i.e. the part of the body that received the radiation dose in order to treat the tumour. Required if Type of radiotherapy = 1 or 2 (External Beam, Brachytherapy)� If more than one body site was treated with radiotherapy, you can add anther site and describe; upto 5 sites are allowed by the system

Control0..5
TypeBackboneElement
20. Radiotherapy.target.site
Definition

RT sites are coded with a 3 tier level (see list). The first is ?Tier 1?. The first digit/s of the code, describes the large topographical body areas e.g. brain, chest, abdomen, limb. Since radiation fields often involve more than one topographical area we have added ?cervico-thoracic?, ?thoraco abdominal? and ?abdomino pelvic? areas to Tier 1. The second (Tier 2) includes subcategories of Tier 1 sites e.g. brain stem, heart, liver, upper limb. Where the information is available a third (Tier 3) of further subdivisions includes more detailed areas. When using the SurPass platform, as you start typing the name of the site, a drop down list with related terms will appear (special sites like Inverted Y are included). If the RT site listed in the medical record cannot reasonably be matched to one of the sites listed in the computer, choose ??Other' (.98 in tier 2) and then add in free text the name of this RT site.

Control1..1
TypeCodeableConcept
21. Radiotherapy.target.site.notes
Definition

Record any available details on the shielded tissue/organ (or size of shielded area).

Control0..1
Typestring
22. Radiotherapy.target.laterality
Definition

Report laterality of the radiation. R = right, L = left, B = bilateral

Control0..1
TypeCodeableConcept
23. Radiotherapy.target.details
Definition

If needed it is possible to add details

Control0..1
Typestring
24. Radiotherapy.target.from
Definition

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the starting point using the vertebrae to identify the upper limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Thoracic / dorsal vertebra 10)

Control0..1
Typestring
25. Radiotherapy.target.to
Definition

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the ending point using the vertebrae to identify the lower limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Lumbar vertebra 3)

Control0..1
Typestring
26. Radiotherapy.target.position
Definition

Specify whether the radiation was anterior or posterior. 1 => Anterior 2 => Posterior -9922 = NK

Control0..1
TypeCodeableConcept
27. Radiotherapy.target.totalDose
Definition

Specify the total dose given to the primary radiation therapy site. If the dose is not known, write NK.

Control0..1
TypeBackboneElement
28. Radiotherapy.target.totalDose.completionStatus
Definition

Check in case of incomplete doses

Control0..1
TypeCodeableConcept
29. Radiotherapy.target.totalDose.statusReason
Definition

Specify reasons of incomplete estimated doses

Control0..1
TypeCodeableConcept
30. Radiotherapy.target.totalDose.notKnown
Definition

Not known dose

Control0..1
Typestring
31. Radiotherapy.target.totalDose.dose
Definition

Specify the total dose given to the primary radiation therapy site.

Control0..1
Typedecimal
32. Radiotherapy.target.totalDose.unit
Definition

External Beam Radiation Therapy (EBRT) and Brachytherapy doses are in Gy. If doses are reported in cGY, roughly two zeroes need to be deleted (e.g. 100 cGy = 1 Gy). specify if dose is recorded in bequerels (MBq or GBq) or curies (Ci) or Unkwnon

Control0..1
TypeCodeableConcept
33. Radiotherapy.target.totalDose.fractions
Definition

A FRACTION of radiation treatment is a single attendance for treatment; if 'not known' insert NK

Control0..1
Typeinteger
34. Radiotherapy.target.boost
Definition

A boost is an extra dose of radiotherapy directed to a smaller area inside the primary radiation field. (only if type is External Beam)

Control0..5
TypeBackboneElement
35. Radiotherapy.target.boost.type
Definition

Specify radiation type of the boost. 1 => External Beam 2 => Brachytherapy -9922 => NK �

Control1..1
TypeCodeableConcept
36. Radiotherapy.target.boost.given
Definition

Flag indicating if a boost was given, not given or unknown

Control0..1
TypeCodeableConcept
37. Radiotherapy.target.boost.site
Definition

Site' refers to the radiation therapy treatment field. As you start typing the name of the site, a drop down list with related terms will appear (special sites like Inverted Y are included). If the RT site listed in the medical record cannot reasonably be matched to one of the sites listed in the computer, choose: ??Other' and then add in free text the name of this RT site. required if given

Control0..1
TypeCodeableConcept
38. Radiotherapy.target.boost.laterality
Definition

Report laterality of the radiation. R = right, L = left, B = bilateral

Control0..1
TypeCodeableConcept
39. Radiotherapy.target.boost.details
Definition

If needed it is possible to add details

Control0..1
Typestring
40. Radiotherapy.target.boost.from
Definition

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the starting point using the vertebrae to identify the upper limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Thoracic / dorsal vertebra 10)

Control0..1
Typestring
41. Radiotherapy.target.boost.to
Definition

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the ending point using the vertebrae to identify the lower limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Lumbar vertebra 3)

Control0..1
Typestring
42. Radiotherapy.target.boost.position
Definition

Specify whether the radiation was anterior or posterior. 1 => Anterior 2 => Posterior -9922 = NK

Control0..1
TypeCodeableConcept
43. Radiotherapy.target.boost.totalDose
Definition

Specify the total dose given to the boost site.

Control1..1
TypeBackboneElement
44. Radiotherapy.target.boost.totalDose.completionStatus
Definition

Check in case of incomplete doses

Control0..1
TypeCodeableConcept
45. Radiotherapy.target.boost.totalDose.statusReason
Definition

Specify reasons of incomplete estimated doses

Control0..1
TypeCodeableConcept
46. Radiotherapy.target.boost.totalDose.notKnown
Definition

Not known dose

Control0..1
TypeCodeableConcept
47. Radiotherapy.target.boost.totalDose.dose
Definition

Specify the total dose given to the boost site.

Control0..1
Typedecimal
48. Radiotherapy.target.boost.totalDose.unit
Definition

Specify the unit of the boost in case of external beam radiotherapy as Gy. specify if dose is recorded in bequerels (MBq or GBq) or curies (Ci) or Unkwnon

Control0..1
TypeCodeableConcept
49. Radiotherapy.target.boost.totalDose.fractions
Definition

A fraction of radiation treatment is a single attendance for treatment. Please specify the number of fractions given as included in the boost. If not known, insert NK.

Control0..1
Typeinteger
50. Radiotherapy.target.shielding
Definition

Shielding, in some records this is called ?blocking? or ?blocks?.

Control0..1
TypeBackboneElement
51. Radiotherapy.target.shielding.status
Definition

Specify if shielding was used or not. Yes; No; NK �

Control0..1
TypeCodeableConcept
52. Radiotherapy.target.shielding.position
Definition

Describe the positioning of shielding

Control0..1
Typestring
53. Radiotherapy.organAtRisk
Definition

Organs at Risk

Control0..1
TypeBackboneElement
54. Radiotherapy.organAtRisk.dosimetry
Definition

Specify if there is available information on Dosimetry of Organs at Risk [Yes/No]

Control0..1
TypeCodeableConcept
55. Radiotherapy.organAtRisk.dosimetryDocument
Definition

If Dosimetry on Organ at Risk is available, upload here the electronic / scanned version(s) of any relevant document(s)

Control0..2
TypeBinary
56. Radiotherapy.files
Definition

Radiotherapy file(s) can be uploaded here

Control0..2
TypeBinary
57. Radiotherapy.notes
Definition

Notes

Control0..1
Typestring

Guidance on how to interpret the contents of this table can be found here.

1. Radiotherapy
Definition

Radiotherapy Maturity Level: 2 - Ready for Review

Control0..*
2. Radiotherapy.relatedDiagnosis
Definition

Identifier of the diagnosis for which this radiotherapy is performed

Control0..1
TypeIdentifier
3. Radiotherapy.relatedRelapse
Definition

Identifier of the relapse/progression (after FLT) for which this radiotherapy is performed

Control0..1
TypeIdentifier
4. Radiotherapy.identifier
Definition

Progressive number of radotherapy episode. An EPISODE might be a single or several courses of pre-planned treatment within a consecutive time period to different sites. For example, if a patient had radiotherapy to a limb and also to the lungs for a Ewing?s sarcoma these should be entered in one episode of treatment but as separate radiotherapy courses with their respective site, total dose, and number of fractions. They will both be within one episode

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
5. Radiotherapy.istitutionOfTreatment
Definition

Please indicate the institution in which the radiotherapeutic treatment was given

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. Radiotherapy.istitutionOfTreatment.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
7. Radiotherapy.istitutionOfTreatment.description
Definition

Please provide name, city and countryof the institution

Control0..1
Typestring
8. Radiotherapy.istitutionOfTreatment.name
Definition

Institution name

Control0..1
Typestring
9. Radiotherapy.istitutionOfTreatment.address
Definition

Institution address

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
10. Radiotherapy.istitutionOfTreatment.address.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
11. Radiotherapy.istitutionOfTreatment.address.name
Definition

Institution city

Control0..1
Typestring
12. Radiotherapy.istitutionOfTreatment.address.country
Definition

Institution country

Control0..1
Typestring
13. Radiotherapy.startDate
Definition

Enter the date on which the first treatment (fraction) of radiotherapy was given, in a DD/MM/YYYY format. If the date is unkown or partially missed insert the year at the best of your knowledge.

Control1..1
TypedateTime
14. Radiotherapy.enddate
Definition

Enter the full date on which the last treatment (fraction) of radiotherapy was given in a DD/MM/YYYY format.
When only a single radiation treatment/fraction was given, the start and end dates will be the same. If the date is unkown or partially missed insert the year at the best of your knowledge.

Control0..1
TypedateTime
15. Radiotherapy.type
Definition

External Beam Radiation: The radiation is produced by a large machine, and the type of the machine needs to be recorded in the subsequent field. Brachytherapy: a material that is radioactive (often a fine wire or a tiny ?seed?) is placed on or in the body to give a very localized high dose of radiation. Details will be asked in the next field Metabolic or radionuclide treatment/therapy: a liquid substance is injected into the blood stream and carries radiation throughout the body with the aim of reaching tumour tissue. Also in this case, details will be asked in the subsequent field. 1 => External beam 2 => Brachytherapy 3 => Metabolic/radionuclide therapy

Control1..1
TypeCodeableConcept
16. Radiotherapy.deviceType
Definition

A detailed description of the type of machine can be found in the user's manual. If you have the name of a machine but cannot find it in this list, please select Other and add the name in free text. If you know the treatment was with external beam but not which machine or energy, select 'Unknown'. 1 =>Orthovoltage / kilovoltage usually 200 - 300kv X rays/photons 2 =>Linac (Linear Accelerator) megavoltage MV X Rays/photons 3 =>Linac (Linear Accelerator) electrons 4 => Cobalt - MV gamma rays / photons 5 => Proton Beam 6 => Other, if other specify the name -9922 => Unknown

Control0..1
TypeCodeableConcept
17. Radiotherapy.brachytherapyType
Definition

? Surface brachytherapy - a radiation source (radioactive material) is positioned on a superficial tumour ? Interstitial brachytherapy ? a radiation source is implanted into a tumour ? Intracavitary or intraluminal brachytherapy - a radiation source is introduced in special applicators into a body cavity or lumen

1 => Surface brachytherapy 2 => Interstitial brachytherapy 3 => Intracavitary or intraluminal brachytherapy -9922=> Unknown

Control0..1
TypeCodeableConcept
18. Radiotherapy.isotopes
Definition

Specify the radioactive material (isotopes) used: If not listed, select 'Other then specify' 1 => Iridium (Ir) 2 => Gold (Au) 3 => Iodine (I) 4 => Caesium (Cs) 5 => Other -9922 => Unknown

Control0..1
TypeCodeableConcept
19. Radiotherapy.radionuclides
Definition

A detailed description of the radionuclides can be found in the user's manual. If you have the name of a radionuclide but cannot find it in this list, please select Other and add the name in free text. If you know the treatment was with external beam but not which machine or energy, select 'Unknown'. 1 => Iodine-131 2 => MIBG 3 =>Yttrium 90 4 => Other -9922 => Unknown

Control0..1
TypeCodeableConcept
20. Radiotherapy.numberOfCourses
Definition

For Metabolic/radionuclide therapy

Control0..1
Typeinteger
21. Radiotherapy.target
Definition

Site' refers to the radiation therapy treatment field, i.e. the part of the body that received the radiation dose in order to treat the tumour. Required if Type of radiotherapy = 1 or 2 (External Beam, Brachytherapy)� If more than one body site was treated with radiotherapy, you can add anther site and describe; upto 5 sites are allowed by the system

Control0..5
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. Radiotherapy.target.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
23. Radiotherapy.target.site
Definition

RT sites are coded with a 3 tier level (see list). The first is ?Tier 1?. The first digit/s of the code, describes the large topographical body areas e.g. brain, chest, abdomen, limb. Since radiation fields often involve more than one topographical area we have added ?cervico-thoracic?, ?thoraco abdominal? and ?abdomino pelvic? areas to Tier 1. The second (Tier 2) includes subcategories of Tier 1 sites e.g. brain stem, heart, liver, upper limb. Where the information is available a third (Tier 3) of further subdivisions includes more detailed areas. When using the SurPass platform, as you start typing the name of the site, a drop down list with related terms will appear (special sites like Inverted Y are included). If the RT site listed in the medical record cannot reasonably be matched to one of the sites listed in the computer, choose ??Other' (.98 in tier 2) and then add in free text the name of this RT site.

Control1..1
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
24. Radiotherapy.target.site.notes
Definition

Record any available details on the shielded tissue/organ (or size of shielded area).

Control0..1
Typestring
25. Radiotherapy.target.laterality
Definition

Report laterality of the radiation. R = right, L = left, B = bilateral

Control0..1
TypeCodeableConcept
26. Radiotherapy.target.details
Definition

If needed it is possible to add details

Control0..1
Typestring
27. Radiotherapy.target.from
Definition

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the starting point using the vertebrae to identify the upper limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Thoracic / dorsal vertebra 10)

Control0..1
Typestring
28. Radiotherapy.target.to
Definition

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the ending point using the vertebrae to identify the lower limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Lumbar vertebra 3)

Control0..1
Typestring
29. Radiotherapy.target.position
Definition

Specify whether the radiation was anterior or posterior. 1 => Anterior 2 => Posterior -9922 = NK

Control0..1
TypeCodeableConcept
30. Radiotherapy.target.totalDose
Definition

Specify the total dose given to the primary radiation therapy site. If the dose is not known, write NK.

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
31. Radiotherapy.target.totalDose.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
32. Radiotherapy.target.totalDose.completionStatus
Definition

Check in case of incomplete doses

Control0..1
TypeCodeableConcept
33. Radiotherapy.target.totalDose.statusReason
Definition

Specify reasons of incomplete estimated doses

Control0..1
TypeCodeableConcept
34. Radiotherapy.target.totalDose.notKnown
Definition

Not known dose

Control0..1
Typestring
35. Radiotherapy.target.totalDose.dose
Definition

Specify the total dose given to the primary radiation therapy site.

Control0..1
Typedecimal
36. Radiotherapy.target.totalDose.unit
Definition

External Beam Radiation Therapy (EBRT) and Brachytherapy doses are in Gy. If doses are reported in cGY, roughly two zeroes need to be deleted (e.g. 100 cGy = 1 Gy). specify if dose is recorded in bequerels (MBq or GBq) or curies (Ci) or Unkwnon

Control0..1
TypeCodeableConcept
37. Radiotherapy.target.totalDose.fractions
Definition

A FRACTION of radiation treatment is a single attendance for treatment; if 'not known' insert NK

Control0..1
Typeinteger
38. Radiotherapy.target.boost
Definition

A boost is an extra dose of radiotherapy directed to a smaller area inside the primary radiation field. (only if type is External Beam)

Control0..5
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
39. Radiotherapy.target.boost.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
40. Radiotherapy.target.boost.type
Definition

Specify radiation type of the boost. 1 => External Beam 2 => Brachytherapy -9922 => NK �

Control1..1
TypeCodeableConcept
41. Radiotherapy.target.boost.given
Definition

Flag indicating if a boost was given, not given or unknown

Control0..1
TypeCodeableConcept
42. Radiotherapy.target.boost.site
Definition

Site' refers to the radiation therapy treatment field. As you start typing the name of the site, a drop down list with related terms will appear (special sites like Inverted Y are included). If the RT site listed in the medical record cannot reasonably be matched to one of the sites listed in the computer, choose: ??Other' and then add in free text the name of this RT site. required if given

Control0..1
TypeCodeableConcept
43. Radiotherapy.target.boost.laterality
Definition

Report laterality of the radiation. R = right, L = left, B = bilateral

Control0..1
TypeCodeableConcept
44. Radiotherapy.target.boost.details
Definition

If needed it is possible to add details

Control0..1
Typestring
45. Radiotherapy.target.boost.from
Definition

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the starting point using the vertebrae to identify the upper limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Thoracic / dorsal vertebra 10)

Control0..1
Typestring
46. Radiotherapy.target.boost.to
Definition

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the ending point using the vertebrae to identify the lower limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Lumbar vertebra 3)

Control0..1
Typestring
47. Radiotherapy.target.boost.position
Definition

Specify whether the radiation was anterior or posterior. 1 => Anterior 2 => Posterior -9922 = NK

Control0..1
TypeCodeableConcept
48. Radiotherapy.target.boost.totalDose
Definition

Specify the total dose given to the boost site.

Control1..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
49. Radiotherapy.target.boost.totalDose.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
50. Radiotherapy.target.boost.totalDose.completionStatus
Definition

Check in case of incomplete doses

Control0..1
TypeCodeableConcept
51. Radiotherapy.target.boost.totalDose.statusReason
Definition

Specify reasons of incomplete estimated doses

Control0..1
TypeCodeableConcept
52. Radiotherapy.target.boost.totalDose.notKnown
Definition

Not known dose

Control0..1
TypeCodeableConcept
53. Radiotherapy.target.boost.totalDose.dose
Definition

Specify the total dose given to the boost site.

Control0..1
Typedecimal
54. Radiotherapy.target.boost.totalDose.unit
Definition

Specify the unit of the boost in case of external beam radiotherapy as Gy. specify if dose is recorded in bequerels (MBq or GBq) or curies (Ci) or Unkwnon

Control0..1
TypeCodeableConcept
55. Radiotherapy.target.boost.totalDose.fractions
Definition

A fraction of radiation treatment is a single attendance for treatment. Please specify the number of fractions given as included in the boost. If not known, insert NK.

Control0..1
Typeinteger
56. Radiotherapy.target.shielding
Definition

Shielding, in some records this is called ?blocking? or ?blocks?.

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
57. Radiotherapy.target.shielding.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
58. Radiotherapy.target.shielding.status
Definition

Specify if shielding was used or not. Yes; No; NK �

Control0..1
TypeCodeableConcept
59. Radiotherapy.target.shielding.position
Definition

Describe the positioning of shielding

Control0..1
Typestring
60. Radiotherapy.organAtRisk
Definition

Organs at Risk

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
61. Radiotherapy.organAtRisk.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
62. Radiotherapy.organAtRisk.dosimetry
Definition

Specify if there is available information on Dosimetry of Organs at Risk [Yes/No]

Control0..1
TypeCodeableConcept
63. Radiotherapy.organAtRisk.dosimetryDocument
Definition

If Dosimetry on Organ at Risk is available, upload here the electronic / scanned version(s) of any relevant document(s)

Control0..2
TypeBinary
64. Radiotherapy.files
Definition

Radiotherapy file(s) can be uploaded here

Control0..2
TypeBinary
65. Radiotherapy.notes
Definition

Notes

Control0..1
Typestring

Guidance on how to interpret the contents of this table can be found here.

1. Radiotherapy
Definition

Radiotherapy Maturity Level: 2 - Ready for Review

Control0..*
2. Radiotherapy.relatedDiagnosis
Definition

Identifier of the diagnosis for which this radiotherapy is performed

Control0..1
TypeIdentifier
3. Radiotherapy.relatedRelapse
Definition

Identifier of the relapse/progression (after FLT) for which this radiotherapy is performed

Control0..1
TypeIdentifier
4. Radiotherapy.identifier
Definition

Progressive number of radotherapy episode. An EPISODE might be a single or several courses of pre-planned treatment within a consecutive time period to different sites. For example, if a patient had radiotherapy to a limb and also to the lungs for a Ewing?s sarcoma these should be entered in one episode of treatment but as separate radiotherapy courses with their respective site, total dose, and number of fractions. They will both be within one episode

NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
5. Radiotherapy.istitutionOfTreatment
Definition

Please indicate the institution in which the radiotherapeutic treatment was given

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
6. Radiotherapy.istitutionOfTreatment.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
7. Radiotherapy.istitutionOfTreatment.extension
Definition

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.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Radiotherapy.istitutionOfTreatment.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
8. Radiotherapy.istitutionOfTreatment.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
9. Radiotherapy.istitutionOfTreatment.description
Definition

Please provide name, city and countryof the institution

Control0..1
Typestring
10. Radiotherapy.istitutionOfTreatment.name
Definition

Institution name

Control0..1
Typestring
11. Radiotherapy.istitutionOfTreatment.address
Definition

Institution address

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
12. Radiotherapy.istitutionOfTreatment.address.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
13. Radiotherapy.istitutionOfTreatment.address.extension
Definition

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.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Radiotherapy.istitutionOfTreatment.address.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
14. Radiotherapy.istitutionOfTreatment.address.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
15. Radiotherapy.istitutionOfTreatment.address.name
Definition

Institution city

Control0..1
Typestring
16. Radiotherapy.istitutionOfTreatment.address.country
Definition

Institution country

Control0..1
Typestring
17. Radiotherapy.startDate
Definition

Enter the date on which the first treatment (fraction) of radiotherapy was given, in a DD/MM/YYYY format. If the date is unkown or partially missed insert the year at the best of your knowledge.

Control1..1
TypedateTime
18. Radiotherapy.enddate
Definition

Enter the full date on which the last treatment (fraction) of radiotherapy was given in a DD/MM/YYYY format.
When only a single radiation treatment/fraction was given, the start and end dates will be the same. If the date is unkown or partially missed insert the year at the best of your knowledge.

Control0..1
TypedateTime
19. Radiotherapy.type
Definition

External Beam Radiation: The radiation is produced by a large machine, and the type of the machine needs to be recorded in the subsequent field. Brachytherapy: a material that is radioactive (often a fine wire or a tiny ?seed?) is placed on or in the body to give a very localized high dose of radiation. Details will be asked in the next field Metabolic or radionuclide treatment/therapy: a liquid substance is injected into the blood stream and carries radiation throughout the body with the aim of reaching tumour tissue. Also in this case, details will be asked in the subsequent field. 1 => External beam 2 => Brachytherapy 3 => Metabolic/radionuclide therapy

Control1..1
TypeCodeableConcept
20. Radiotherapy.deviceType
Definition

A detailed description of the type of machine can be found in the user's manual. If you have the name of a machine but cannot find it in this list, please select Other and add the name in free text. If you know the treatment was with external beam but not which machine or energy, select 'Unknown'. 1 =>Orthovoltage / kilovoltage usually 200 - 300kv X rays/photons 2 =>Linac (Linear Accelerator) megavoltage MV X Rays/photons 3 =>Linac (Linear Accelerator) electrons 4 => Cobalt - MV gamma rays / photons 5 => Proton Beam 6 => Other, if other specify the name -9922 => Unknown

Control0..1
TypeCodeableConcept
21. Radiotherapy.brachytherapyType
Definition

? Surface brachytherapy - a radiation source (radioactive material) is positioned on a superficial tumour ? Interstitial brachytherapy ? a radiation source is implanted into a tumour ? Intracavitary or intraluminal brachytherapy - a radiation source is introduced in special applicators into a body cavity or lumen

1 => Surface brachytherapy 2 => Interstitial brachytherapy 3 => Intracavitary or intraluminal brachytherapy -9922=> Unknown

Control0..1
TypeCodeableConcept
22. Radiotherapy.isotopes
Definition

Specify the radioactive material (isotopes) used: If not listed, select 'Other then specify' 1 => Iridium (Ir) 2 => Gold (Au) 3 => Iodine (I) 4 => Caesium (Cs) 5 => Other -9922 => Unknown

Control0..1
TypeCodeableConcept
23. Radiotherapy.radionuclides
Definition

A detailed description of the radionuclides can be found in the user's manual. If you have the name of a radionuclide but cannot find it in this list, please select Other and add the name in free text. If you know the treatment was with external beam but not which machine or energy, select 'Unknown'. 1 => Iodine-131 2 => MIBG 3 =>Yttrium 90 4 => Other -9922 => Unknown

Control0..1
TypeCodeableConcept
24. Radiotherapy.numberOfCourses
Definition

For Metabolic/radionuclide therapy

Control0..1
Typeinteger
25. Radiotherapy.target
Definition

Site' refers to the radiation therapy treatment field, i.e. the part of the body that received the radiation dose in order to treat the tumour. Required if Type of radiotherapy = 1 or 2 (External Beam, Brachytherapy)� If more than one body site was treated with radiotherapy, you can add anther site and describe; upto 5 sites are allowed by the system

Control0..5
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
26. Radiotherapy.target.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
27. Radiotherapy.target.extension
Definition

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.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Radiotherapy.target.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
28. Radiotherapy.target.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
29. Radiotherapy.target.site
Definition

RT sites are coded with a 3 tier level (see list). The first is ?Tier 1?. The first digit/s of the code, describes the large topographical body areas e.g. brain, chest, abdomen, limb. Since radiation fields often involve more than one topographical area we have added ?cervico-thoracic?, ?thoraco abdominal? and ?abdomino pelvic? areas to Tier 1. The second (Tier 2) includes subcategories of Tier 1 sites e.g. brain stem, heart, liver, upper limb. Where the information is available a third (Tier 3) of further subdivisions includes more detailed areas. When using the SurPass platform, as you start typing the name of the site, a drop down list with related terms will appear (special sites like Inverted Y are included). If the RT site listed in the medical record cannot reasonably be matched to one of the sites listed in the computer, choose ??Other' (.98 in tier 2) and then add in free text the name of this RT site.

Control1..1
TypeCodeableConcept
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
30. Radiotherapy.target.site.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
31. Radiotherapy.target.site.extension
Definition

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.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Radiotherapy.target.site.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
32. Radiotherapy.target.site.coding
Definition

A reference to a code defined by a terminology system.

Control0..*
TypeCoding
Summarytrue
Requirements

Allows for alternative encodings within a code system, and translations to other code systems.

Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
33. Radiotherapy.target.site.text
Definition

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.

Control0..1
Typestring
Summarytrue
Requirements

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.

Comments

Very often the text is the same as a displayName of one of the codings.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
34. Radiotherapy.target.site.notes
Definition

Record any available details on the shielded tissue/organ (or size of shielded area).

Control0..1
Typestring
35. Radiotherapy.target.laterality
Definition

Report laterality of the radiation. R = right, L = left, B = bilateral

Control0..1
TypeCodeableConcept
36. Radiotherapy.target.details
Definition

If needed it is possible to add details

Control0..1
Typestring
37. Radiotherapy.target.from
Definition

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the starting point using the vertebrae to identify the upper limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Thoracic / dorsal vertebra 10)

Control0..1
Typestring
38. Radiotherapy.target.to
Definition

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the ending point using the vertebrae to identify the lower limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Lumbar vertebra 3)

Control0..1
Typestring
39. Radiotherapy.target.position
Definition

Specify whether the radiation was anterior or posterior. 1 => Anterior 2 => Posterior -9922 = NK

Control0..1
TypeCodeableConcept
40. Radiotherapy.target.totalDose
Definition

Specify the total dose given to the primary radiation therapy site. If the dose is not known, write NK.

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
41. Radiotherapy.target.totalDose.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
42. Radiotherapy.target.totalDose.extension
Definition

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.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Radiotherapy.target.totalDose.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
43. Radiotherapy.target.totalDose.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
44. Radiotherapy.target.totalDose.completionStatus
Definition

Check in case of incomplete doses

Control0..1
TypeCodeableConcept
45. Radiotherapy.target.totalDose.statusReason
Definition

Specify reasons of incomplete estimated doses

Control0..1
TypeCodeableConcept
46. Radiotherapy.target.totalDose.notKnown
Definition

Not known dose

Control0..1
Typestring
47. Radiotherapy.target.totalDose.dose
Definition

Specify the total dose given to the primary radiation therapy site.

Control0..1
Typedecimal
48. Radiotherapy.target.totalDose.unit
Definition

External Beam Radiation Therapy (EBRT) and Brachytherapy doses are in Gy. If doses are reported in cGY, roughly two zeroes need to be deleted (e.g. 100 cGy = 1 Gy). specify if dose is recorded in bequerels (MBq or GBq) or curies (Ci) or Unkwnon

Control0..1
TypeCodeableConcept
49. Radiotherapy.target.totalDose.fractions
Definition

A FRACTION of radiation treatment is a single attendance for treatment; if 'not known' insert NK

Control0..1
Typeinteger
50. Radiotherapy.target.boost
Definition

A boost is an extra dose of radiotherapy directed to a smaller area inside the primary radiation field. (only if type is External Beam)

Control0..5
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
51. Radiotherapy.target.boost.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
52. Radiotherapy.target.boost.extension
Definition

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.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Radiotherapy.target.boost.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
53. Radiotherapy.target.boost.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
54. Radiotherapy.target.boost.type
Definition

Specify radiation type of the boost. 1 => External Beam 2 => Brachytherapy -9922 => NK �

Control1..1
TypeCodeableConcept
55. Radiotherapy.target.boost.given
Definition

Flag indicating if a boost was given, not given or unknown

Control0..1
TypeCodeableConcept
56. Radiotherapy.target.boost.site
Definition

Site' refers to the radiation therapy treatment field. As you start typing the name of the site, a drop down list with related terms will appear (special sites like Inverted Y are included). If the RT site listed in the medical record cannot reasonably be matched to one of the sites listed in the computer, choose: ??Other' and then add in free text the name of this RT site. required if given

Control0..1
TypeCodeableConcept
57. Radiotherapy.target.boost.laterality
Definition

Report laterality of the radiation. R = right, L = left, B = bilateral

Control0..1
TypeCodeableConcept
58. Radiotherapy.target.boost.details
Definition

If needed it is possible to add details

Control0..1
Typestring
59. Radiotherapy.target.boost.from
Definition

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the starting point using the vertebrae to identify the upper limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Thoracic / dorsal vertebra 10)

Control0..1
Typestring
60. Radiotherapy.target.boost.to
Definition

When the radiation involves more than one site, eventually covering different body areas (e.g. torax and abdomen), select the ending point using the vertebrae to identify the lower limit (e.g.: Thoraco-Abdominal (area): Paraspinal - Lumbar vertebra 3)

Control0..1
Typestring
61. Radiotherapy.target.boost.position
Definition

Specify whether the radiation was anterior or posterior. 1 => Anterior 2 => Posterior -9922 = NK

Control0..1
TypeCodeableConcept
62. Radiotherapy.target.boost.totalDose
Definition

Specify the total dose given to the boost site.

Control1..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
63. Radiotherapy.target.boost.totalDose.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
64. Radiotherapy.target.boost.totalDose.extension
Definition

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.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Radiotherapy.target.boost.totalDose.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
65. Radiotherapy.target.boost.totalDose.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
66. Radiotherapy.target.boost.totalDose.completionStatus
Definition

Check in case of incomplete doses

Control0..1
TypeCodeableConcept
67. Radiotherapy.target.boost.totalDose.statusReason
Definition

Specify reasons of incomplete estimated doses

Control0..1
TypeCodeableConcept
68. Radiotherapy.target.boost.totalDose.notKnown
Definition

Not known dose

Control0..1
TypeCodeableConcept
69. Radiotherapy.target.boost.totalDose.dose
Definition

Specify the total dose given to the boost site.

Control0..1
Typedecimal
70. Radiotherapy.target.boost.totalDose.unit
Definition

Specify the unit of the boost in case of external beam radiotherapy as Gy. specify if dose is recorded in bequerels (MBq or GBq) or curies (Ci) or Unkwnon

Control0..1
TypeCodeableConcept
71. Radiotherapy.target.boost.totalDose.fractions
Definition

A fraction of radiation treatment is a single attendance for treatment. Please specify the number of fractions given as included in the boost. If not known, insert NK.

Control0..1
Typeinteger
72. Radiotherapy.target.shielding
Definition

Shielding, in some records this is called ?blocking? or ?blocks?.

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
73. Radiotherapy.target.shielding.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
74. Radiotherapy.target.shielding.extension
Definition

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.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Radiotherapy.target.shielding.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
75. Radiotherapy.target.shielding.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
76. Radiotherapy.target.shielding.status
Definition

Specify if shielding was used or not. Yes; No; NK �

Control0..1
TypeCodeableConcept
77. Radiotherapy.target.shielding.position
Definition

Describe the positioning of shielding

Control0..1
Typestring
78. Radiotherapy.organAtRisk
Definition

Organs at Risk

Control0..1
TypeBackboneElement
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
79. Radiotherapy.organAtRisk.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
XML RepresentationIn the XML format, this property is represented as an attribute.
Summaryfalse
80. Radiotherapy.organAtRisk.extension
Definition

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.

Control0..*
TypeExtension
Summaryfalse
Alternate Namesextensions, user content
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Radiotherapy.organAtRisk.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
81. Radiotherapy.organAtRisk.modifierExtension
Definition

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).

Control0..*
TypeExtension
Is Modifiertrue
Summarytrue
Requirements

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.

Alternate Namesextensions, user content, modifiers
Comments

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.

InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
82. Radiotherapy.organAtRisk.dosimetry
Definition

Specify if there is available information on Dosimetry of Organs at Risk [Yes/No]

Control0..1
TypeCodeableConcept
83. Radiotherapy.organAtRisk.dosimetryDocument
Definition

If Dosimetry on Organ at Risk is available, upload here the electronic / scanned version(s) of any relevant document(s)

Control0..2
TypeBinary
84. Radiotherapy.files
Definition

Radiotherapy file(s) can be uploaded here

Control0..2
TypeBinary
85. Radiotherapy.notes
Definition

Notes

Control0..1
Typestring