MII IG Molekulares Tumorboard DE v2025

Kombinationstherapie-Empfehlung: RequestGroup

Inhalt

Dieses Profil beschreibt ein Therapieempfehlung zur systemischen Therapie mit einer Kombination mehrerer Medikamente.

Statusangabe

Die Statusangabe einer Kombinationstherapie-Empfehlung bezieht sich auf deren Umsetzungsstand. Es wird empfohlen folgende Statusangaben für die beschriebenen Situationen zu verwenden:

Belegung `status`	Beschreibung
`draft`	Nicht umgesetzt
`active`	In Umsetzung
`completed`	Abgeschlossen oder abgebrochen (Patient verstorben)

Hinweis: Die Statusangabe sollte mit der des beschlossenen Therapieplans (siehe Therapieplan: CarePlan) semantisch abgestimmt sein.

Zeitliche Zuordnung im Verlauf

Name	Status	Version	Canonical	Basis
MII_PR_MTB_Therapieempfehlung_Kombination	draft	2024.0.0-ballot	https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieempfehlung-kombination	http://hl7.org/fhir/StructureDefinition/RequestGroup

Inhalt

MII_PR_MTB_Therapieempfehlung_Kombination (RequestGroup)	I		RequestGroup	There are no (further) constraints on this element Element id RequestGroup Short description A group of related requests Definition A group of related requests that can be used to capture intended activities that have inter-dependencies such as "give this medication after that one". Data type RequestGroup Constraints dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources `contained.contained.empty()` dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource `contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()` dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()` dom-5: If a resource is contained in another resource, it SHALL NOT have a security label `contained.meta.security.empty()` dom-6: A resource should have narrative for robust management text.`div`.exists() Mappings rim: Entity. Role, or Act workflow: Request
id	Σ	0..1	string	There are no (further) constraints on this element Element id RequestGroup.id Short description Logical id of this artifact Definition The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. Comments The only time that a resource does not have an id is when it is being submitted to the server using a create operation. Data type string
meta	S Σ	0..1	Meta	There are no (further) constraints on this element Element id RequestGroup.meta Short description Metadata about the resource Definition The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. Data type Meta Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id RequestGroup.meta.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id RequestGroup.meta.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints 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()` Mappings rim: n/a
versionId	Σ	0..1	id	There are no (further) constraints on this element Element id RequestGroup.meta.versionId Short description Version specific identifier Definition The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. Comments The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
lastUpdated	Σ	0..1	instant	There are no (further) constraints on this element Element id RequestGroup.meta.lastUpdated Short description When the resource version last changed Definition When the resource last changed - e.g. when the version changed. Comments This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction. Data type instant Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
source	Σ	0..1	uri	There are no (further) constraints on this element Element id RequestGroup.meta.source Short description Identifies where the resource comes from Definition A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. Comments In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
profile	S Σ	0..*	canonical(StructureDefinition)	There are no (further) constraints on this element Element id RequestGroup.meta.profile Short description Profiles this resource claims to conform to Definition A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. Comments It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. Data type canonical(StructureDefinition) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
security	Σ	0..*	CodingBinding	There are no (further) constraints on this element Element id RequestGroup.meta.security Short description Security Labels applied to this resource Definition Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. Comments The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Security Labels from the Healthcare Privacy and Security Classification System. All Security Labels (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
tag	Σ	0..*	Coding	There are no (further) constraints on this element Element id RequestGroup.meta.tag Short description Tags applied to this resource Definition Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. Comments The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. Data type Coding Binding Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". CommonTags (example) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
implicitRules	Σ ?!	0..1	uri	There are no (further) constraints on this element Element id RequestGroup.implicitRules Short description A set of rules under which this content was created Definition A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Comments Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
language		0..1	codeBinding	There are no (further) constraints on this element Element id RequestGroup.language Short description Language of the resource content Definition The base language in which the resource is written. Comments Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). Data type code Binding A human language. CommonLanguages (preferred) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
text		0..1	Narrative	There are no (further) constraints on this element Element id RequestGroup.text Short description Text summary of the resource, for human interpretation Alternate names narrative, html, xhtml, display Definition A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Comments Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. Data type Narrative Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: Act.text?
contained		0..*	Resource	There are no (further) constraints on this element Element id RequestGroup.contained Short description Contained, inline Resources Alternate names inline resources, anonymous resources, contained resources Definition These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. Comments This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. Data type Resource Mappings rim: N/A
extension	I	0..*	Extension	Element id RequestGroup.extension Short description Additional content defined by implementations Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource. 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. 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. Data type Extension Sliced: Unordered, Open, by url(Value) Constraints 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()` Mappings rim: N/A
Prioritaet	S I	0..1	Extension(decimal positiveInt)	Element id RequestGroup.extension:Prioritaet Short description MII EX MTB Empfehlung Priorität Alternate names extensions, user content Definition Priorität der (einzelnen) Empfehlung 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. Data type Extension(decimal positiveInt) Extension URL https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-empfehlung-prioritaet Constraints 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()` Mappings rim: N/A rim: n/a
Evidenzgraduierung	S I	0..1	Extension(CodeableConcept)	Element id RequestGroup.extension:Evidenzgraduierung Short description MII EX MTB Empfehlung Evidenzgraduierung Alternate names extensions, user content Definition Evidenzgraduierung der (einzelnen) Empfehlung 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. Data type Extension(CodeableConcept) Extension URL https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-empfehlung-evidenzgraduierung Constraints 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()` Mappings rim: N/A rim: n/a
Publikation	S I	0..*	Extension(string Identifier)	Element id RequestGroup.extension:Publikation Short description MII EX MTB Empfehlung Publikation Alternate names extensions, user content Definition Verweis auf Publikation der (einzelnen) Empfehlung 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. Data type Extension(string Identifier) Extension URL https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-empfehlung-publikation Constraints 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()` Mappings rim: N/A rim: n/a
modifierExtension	?! I	0..*	Extension	There are no (further) constraints on this element Element id RequestGroup.modifierExtension Short description Extensions that cannot be ignored Alternate names extensions, user content Definition May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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. 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. Data type Extension Constraints 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()` Mappings rim: N/A
identifier	S Σ	0..*	Identifier	There are no (further) constraints on this element Element id RequestGroup.identifier Short description Business identifier Definition Allows a service to provide a unique, business identifier for the request. Requirements Allows identification of the request as it is known by various participating systems and in a way that remains consistent across servers. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.identifier w5: FiveWs.identifier
instantiatesCanonical	Σ	0..*	canonical()	There are no (further) constraints on this element Element id RequestGroup.instantiatesCanonical Short description Instantiates FHIR protocol or definition Definition A canonical URL referencing a FHIR-defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this request. Data type canonical() Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.instantiatesCanonical
instantiatesUri	Σ	0..*	uri	There are no (further) constraints on this element Element id RequestGroup.instantiatesUri Short description Instantiates external protocol or definition Definition A URL referencing an externally defined protocol, guideline, orderset or other definition that is adhered to in whole or in part by this request. Data type uri Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.instantiatesUri
basedOn		0..*	Reference(Resource)	There are no (further) constraints on this element Element id RequestGroup.basedOn Short description Fulfills plan, proposal, or order Alternate names fulfills Definition A plan, proposal or order that is fulfilled in whole or in part by this request. Requirements Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.basedOn
replaces		0..*	Reference(Resource)	There are no (further) constraints on this element Element id RequestGroup.replaces Short description Request(s) replaced by this request Alternate names supersedes, prior, renewed order Definition Completed or terminated request(s) whose function is taken by this new request. Requirements Allows tracing the continuation of a therapy or administrative process instantiated through multiple requests. Comments The replacement could be because the initial request was immediately rejected (due to an issue) or because the previous request was completed, but the need for the action described by the request remains ongoing. Data type Reference(Resource) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.replaces
groupIdentifier	Σ	0..1	Identifier	There are no (further) constraints on this element Element id RequestGroup.groupIdentifier Short description Composite request this is part of Alternate names grouperid, requisition Definition A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form. Requirements Some business processes need to know if multiple items were ordered as part of the same "prescription" or "requisition" for billing or other purposes. Comments Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation. Data type Identifier Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.groupIdentifier
status	Σ ?!	1..1	codeBinding	Element id RequestGroup.status Short description draft \| active \| on-hold \| revoked \| completed \| entered-in-error \| unknown Definition Status der Umsetzung der Therapieempfehlung Comments draft: Nicht umgesetzt, active: In Umsetzung, completed: Abgeschlossen oder abgebrochen (Patient verstorben) Data type code Binding Codes identifying the lifecycle stage of a request. RequestStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.status w5: FiveWs.status
intent	S Σ ?!	1..1	codeBinding	Element id RequestGroup.intent Short description proposal \| option Alternate names category Definition Da das MTB nur Empfehlungen abgibt, wird hier typischerweise 'proposal' stehen. Es sei denn, diese Therapieempfehlung ist selbst nochmal Teil einer RequestGroup. In dem Fall muss hier 'option' stehen. Requirements Proposals/recommendations, plans and orders all use the same structure and can exist in the same fulfillment chain. Data type code Binding Codes indicating the degree of authority/intentionality associated with a request. RequestIntent (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.intent w5: FiveWs.class
priority	Σ	0..1	codeBinding	There are no (further) constraints on this element Element id RequestGroup.priority Short description routine \| urgent \| asap \| stat Definition Indicates how quickly the request should be addressed with respect to other requests. Meaning when missing If missing, this request should be performed with normal priority Data type code Binding Identifies the level of importance to be assigned to actioning the request. RequestPriority (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.priority w5: FiveWs.grade
code	Σ	0..1	CodeableConcept	There are no (further) constraints on this element Element id RequestGroup.code Short description What's being requested/ordered Definition A code that identifies what the overall request group is. Comments This element can be used to provide a code that captures the meaning of the request group as a whole, as opposed to the code of the action element, which captures the meaning of the individual actions within the request group. Data type CodeableConcept Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.code w5: FiveWs.what[x]
subject	S	0..1	Reference(Patient)	Element id RequestGroup.subject Short description Who the request group is about Definition The subject for which the request group was created. Data type Reference(Patient) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.subject w5: FiveWs.subject[x] w5: FiveWs.subject
encounter		0..1	Reference(Encounter)	There are no (further) constraints on this element Element id RequestGroup.encounter Short description Created as part of Definition Describes the context of the request group, if any. Data type Reference(Encounter) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.encounter w5: FiveWs.context
authoredOn		0..1	dateTime	There are no (further) constraints on this element Element id RequestGroup.authoredOn Short description When the request group was authored Definition Indicates when the request group was created. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.authoredOn w5: FiveWs.recorded
author		0..1	Reference(Practitioner \| PractitionerRole)	Element id RequestGroup.author Short description Device or practitioner that authored the request group Definition Provides a reference to the author of the request group. Data type Reference(Practitioner \| PractitionerRole) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.requester w5: FiveWs.author
reasonCode		0..*	CodeableConcept	There are no (further) constraints on this element Element id RequestGroup.reasonCode Short description Why the request group is needed Definition Describes the reason for the request group in coded or textual form. Data type CodeableConcept Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.reasonCode w5: FiveWs.why[x]
reasonReference		0..*	Reference(Condition \| Observation \| DiagnosticReport \| DocumentReference)	There are no (further) constraints on this element Element id RequestGroup.reasonReference Short description Why the request group is needed Definition Indicates another resource whose existence justifies this request group. Data type Reference(Condition \| Observation \| DiagnosticReport \| DocumentReference) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.reasonReference w5: FiveWs.why[x]
note		0..*	Annotation	There are no (further) constraints on this element Element id RequestGroup.note Short description Additional notes about the response Definition Provides a mechanism to communicate additional information about the response. Data type Annotation Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.note
action	S I	1..*	BackboneElement	There are no (further) constraints on this element Element id RequestGroup.action Short description Proposed actions, if any Definition The actions, if any, produced by the evaluation of the artifact. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` rqg-1: Must have resource or action but not both `resource.exists() != action.exists()`
id		0..1	string	There are no (further) constraints on this element Element id RequestGroup.action.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id RequestGroup.action.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Constraints 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()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id RequestGroup.action.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. 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. Data type Extension Constraints 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()` Mappings rim: N/A
prefix		0..1	string	There are no (further) constraints on this element Element id RequestGroup.action.prefix Short description User-visible prefix for the action (e.g. 1. or A.) Definition A user-visible prefix for the action. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
title		0..1	string	There are no (further) constraints on this element Element id RequestGroup.action.title Short description User-visible title Definition The title of the action displayed to a user. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
description	Σ	0..1	string	There are no (further) constraints on this element Element id RequestGroup.action.description Short description Short description of the action Definition A short description of the action used to provide a summary to display to the user. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
textEquivalent	Σ	0..1	string	There are no (further) constraints on this element Element id RequestGroup.action.textEquivalent Short description Static text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system Definition A text equivalent of the action to be performed. This provides a human-interpretable description of the action when the definition is consumed by a system that might not be capable of interpreting it dynamically. Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
priority		0..1	codeBinding	There are no (further) constraints on this element Element id RequestGroup.action.priority Short description routine \| urgent \| asap \| stat Definition Indicates how quickly the action should be addressed with respect to other actions. Data type code Binding Identifies the level of importance to be assigned to actioning the request. RequestPriority (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.priority
code		0..*	CodeableConcept	There are no (further) constraints on this element Element id RequestGroup.action.code Short description Code representing the meaning of the action or sub-actions Definition A code that provides meaning for the action or action group. For example, a section may have a LOINC code for a section of a documentation template. Data type CodeableConcept Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.code
documentation		0..*	RelatedArtifact	There are no (further) constraints on this element Element id RequestGroup.action.documentation Short description Supporting documentation for the intended performer of the action Definition Didactic or other informational resources associated with the action that can be provided to the CDS recipient. Information resources can include inline text commentary and links to web resources. Data type RelatedArtifact Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.supportingInfo
condition		0..*	BackboneElement	There are no (further) constraints on this element Element id RequestGroup.action.condition Short description Whether or not the action is applicable Definition An expression that describes applicability criteria, or start/stop conditions for the action. Comments When multiple conditions of the same kind are present, the effects are combined using AND semantics, so the overall condition is true only if all of the conditions are true. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id RequestGroup.action.condition.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id RequestGroup.action.condition.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Constraints 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()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id RequestGroup.action.condition.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. 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. Data type Extension Constraints 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()` Mappings rim: N/A
kind		1..1	codeBinding	There are no (further) constraints on this element Element id RequestGroup.action.condition.kind Short description applicability \| start \| stop Definition The kind of condition. Comments Applicability criteria are used to determine immediate applicability when a plan definition is applied to a given context. Start and stop criteria are carried through application and used to describe enter/exit criteria for an action. Data type code Binding The kind of condition for the action. ActionConditionKind (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
expression		0..1	Expression	There are no (further) constraints on this element Element id RequestGroup.action.condition.expression Short description Boolean-valued expression Definition An expression that returns true or false, indicating whether or not the condition is satisfied. Comments The expression may be inlined, or may be a reference to a named expression within a logic library referenced by the library element. Data type Expression Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
relatedAction		0..*	BackboneElement	There are no (further) constraints on this element Element id RequestGroup.action.relatedAction Short description Relationship to another action Definition A relationship to another action such as "before" or "30-60 minutes after start of". Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
id		0..1	string	There are no (further) constraints on this element Element id RequestGroup.action.relatedAction.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id RequestGroup.action.relatedAction.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. 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. Data type Extension Constraints 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()` Mappings rim: n/a
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id RequestGroup.action.relatedAction.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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). 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. 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. Data type Extension Constraints 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()` Mappings rim: N/A
actionId		1..1	id	There are no (further) constraints on this element Element id RequestGroup.action.relatedAction.actionId Short description What action this is related to Definition The element id of the action this is related to. Data type id Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
relationship		1..1	codeBinding	There are no (further) constraints on this element Element id RequestGroup.action.relatedAction.relationship Short description before-start \| before \| before-end \| concurrent-with-start \| concurrent \| concurrent-with-end \| after-start \| after \| after-end Definition The relationship of this action to the related action. Data type code Binding Defines the types of relationships between actions. ActionRelationshipType (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
offset[x]		0..1		There are no (further) constraints on this element Element id RequestGroup.action.relatedAction.offset[x] Short description Time offset for the relationship Definition A duration or range of durations to apply to the relationship. For example, 30-60 minutes before. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
offsetDuration			Duration	There are no (further) constraints on this element Data type Duration
offsetRange			Range	There are no (further) constraints on this element Data type Range
timing[x]		0..1		There are no (further) constraints on this element Element id RequestGroup.action.timing[x] Short description When the action should take place Definition An optional value describing when the action should be performed. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.occurrence[x]
timingDateTime			dateTime	There are no (further) constraints on this element Data type dateTime
timingAge			Age	There are no (further) constraints on this element Data type Age
timingPeriod			Period	There are no (further) constraints on this element Data type Period
timingDuration			Duration	There are no (further) constraints on this element Data type Duration
timingRange			Range	There are no (further) constraints on this element Data type Range
timingTiming			Timing	There are no (further) constraints on this element Data type Timing
participant		0..*	Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Device)	There are no (further) constraints on this element Element id RequestGroup.action.participant Short description Who should perform the action Definition The participant that should perform or be responsible for this action. Data type Reference(Patient \| Practitioner \| PractitionerRole \| RelatedPerson \| Device) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings workflow: Request.performer w5: FiveWs.actor
type		0..1	CodeableConceptBinding	There are no (further) constraints on this element Element id RequestGroup.action.type Short description create \| update \| remove \| fire-event Definition The type of action to perform (create, update, remove). Data type CodeableConcept Binding The type of action to be performed. ActionType (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
groupingBehavior		0..1	codeBinding	There are no (further) constraints on this element Element id RequestGroup.action.groupingBehavior Short description visual-group \| logical-group \| sentence-group Definition Defines the grouping behavior for the action and its children. Data type code Binding Defines organization behavior of a group. ActionGroupingBehavior (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
selectionBehavior		0..1	codeBinding	There are no (further) constraints on this element Element id RequestGroup.action.selectionBehavior Short description any \| all \| all-or-none \| exactly-one \| at-most-one \| one-or-more Definition Defines the selection behavior for the action and its children. Data type code Binding Defines selection behavior of a group. ActionSelectionBehavior (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
requiredBehavior		0..1	codeBinding	There are no (further) constraints on this element Element id RequestGroup.action.requiredBehavior Short description must \| could \| must-unless-documented Definition Defines expectations around whether an action is required. Data type code Binding Defines expectations around whether an action or action group is required. ActionRequiredBehavior (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
precheckBehavior		0..1	codeBinding	There are no (further) constraints on this element Element id RequestGroup.action.precheckBehavior Short description yes \| no Definition Defines whether the action should usually be preselected. Data type code Binding Defines selection frequency behavior for an action or group. ActionPrecheckBehavior (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
cardinalityBehavior		0..1	codeBinding	There are no (further) constraints on this element Element id RequestGroup.action.cardinalityBehavior Short description single \| multiple Definition Defines whether the action can be selected multiple times. Data type code Binding Defines behavior for an action or a group for how many times that item may be repeated. ActionCardinalityBehavior (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
resource	S I	1..1	Reference(MII_PR_MTB_Therapieempfehlung \| MedicationRequest)	Element id RequestGroup.action.resource Short description The target of the action Definition The resource that is the target of the action (e.g. CommunicationRequest). Comments The target resource SHALL be a Request resource with a Request.intent set to "option". Data type Reference(MII_PR_MTB_Therapieempfehlung \| MedicationRequest) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
action	I	0..0	see (action)	There are no (further) constraints on this element Element id RequestGroup.action.action Short description Sub action Definition Sub actions. Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`

Therapieempfehlung für eine medikamentöse Kombinationstherapie

Feldname	Kurzbeschreibung
RequestGroup.meta
RequestGroup.meta.profile
RequestGroup.extension:Prioritaet
RequestGroup.extension:Evidenzgraduierung
RequestGroup.extension:Publikation
RequestGroup.identifier
RequestGroup.intent	proposal \| option
RequestGroup.subject
RequestGroup.action
RequestGroup.action.resource

<StructureDefinition xmlns="http://hl7.org/fhir">
    <id value="mii-pr-mtb-therapieempfehlung-kombination" />
    <url value="https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieempfehlung-kombination" />
    <version value="2024.0.0-ballot" />
    <name value="MII_PR_MTB_Therapieempfehlung_Kombination" />
    <title value="MII PR MTB Therapieempfehlung Kombinationstherapie" />
    <status value="draft" />
    <publisher value="Medizininformatik Initiative" />
    <contact>
        <telecom>
            <system value="url" />
            <value value="https://www.medizininformatik-initiative.de" />
        </telecom>
    </contact>
    <description value="Therapieempfehlung f&#252;r eine medikament&#246;se Kombinationstherapie" />
    <fhirVersion value="4.0.1" />
    <kind value="resource" />
    <abstract value="false" />
    <type value="RequestGroup" />
    <baseDefinition value="http://hl7.org/fhir/StructureDefinition/RequestGroup" />
    <derivation value="constraint" />
    <differential>
        <element id="RequestGroup.meta">
            <path value="RequestGroup.meta" />
            <mustSupport value="true" />
        </element>
        <element id="RequestGroup.meta.profile">
            <path value="RequestGroup.meta.profile" />
            <mustSupport value="true" />
        </element>
        <element id="RequestGroup.extension:Prioritaet">
            <path value="RequestGroup.extension" />
            <sliceName value="Prioritaet" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-empfehlung-prioritaet" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="RequestGroup.extension:Evidenzgraduierung">
            <path value="RequestGroup.extension" />
            <sliceName value="Evidenzgraduierung" />
            <min value="0" />
            <max value="1" />
            <type>
                <code value="Extension" />
                <profile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-empfehlung-evidenzgraduierung" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="RequestGroup.extension:Publikation">
            <path value="RequestGroup.extension" />
            <sliceName value="Publikation" />
            <min value="0" />
            <max value="*" />
            <type>
                <code value="Extension" />
                <profile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-empfehlung-publikation" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="RequestGroup.identifier">
            <path value="RequestGroup.identifier" />
            <mustSupport value="true" />
        </element>
        <element id="RequestGroup.status">
            <path value="RequestGroup.status" />
            <definition value="Status der Umsetzung der Therapieempfehlung" />
            <comment value="draft: Nicht umgesetzt, \n    active: In Umsetzung, \n    completed: Abgeschlossen oder abgebrochen (Patient verstorben)" />
        </element>
        <element id="RequestGroup.intent">
            <path value="RequestGroup.intent" />
            <short value="proposal | option" />
            <definition value="Da das MTB nur Empfehlungen abgibt, wird hier typischerweise &#39;proposal&#39; stehen. Es sei denn,\ndiese Therapieempfehlung ist selbst nochmal Teil einer RequestGroup. In dem Fall muss hier &#39;option&#39; stehen." />
            <mustSupport value="true" />
        </element>
        <element id="RequestGroup.subject">
            <path value="RequestGroup.subject" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Patient" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="RequestGroup.author">
            <path value="RequestGroup.author" />
            <type>
                <code value="Reference" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/Practitioner" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/PractitionerRole" />
            </type>
        </element>
        <element id="RequestGroup.action">
            <path value="RequestGroup.action" />
            <min value="1" />
            <mustSupport value="true" />
        </element>
        <element id="RequestGroup.action.resource">
            <path value="RequestGroup.action.resource" />
            <min value="1" />
            <type>
                <code value="Reference" />
                <targetProfile value="https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieempfehlung" />
                <targetProfile value="http://hl7.org/fhir/StructureDefinition/MedicationRequest" />
            </type>
            <mustSupport value="true" />
        </element>
        <element id="RequestGroup.action.action">
            <path value="RequestGroup.action.action" />
            <max value="0" />
        </element>
    </differential>
</StructureDefinition>

{
    "resourceType": "StructureDefinition",
    "id": "mii-pr-mtb-therapieempfehlung-kombination",
    "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieempfehlung-kombination",
    "version": "2024.0.0-ballot",
    "name": "MII_PR_MTB_Therapieempfehlung_Kombination",
    "title": "MII PR MTB Therapieempfehlung Kombinationstherapie",
    "status": "draft",
    "publisher": "Medizininformatik Initiative",
    "contact":  [
        {
            "telecom":  [
                {
                    "system": "url",
                    "value": "https://www.medizininformatik-initiative.de"
                }
            ]
        }
    ],
    "description": "Therapieempfehlung für eine medikamentöse Kombinationstherapie",
    "fhirVersion": "4.0.1",
    "kind": "resource",
    "abstract": false,
    "type": "RequestGroup",
    "baseDefinition": "http://hl7.org/fhir/StructureDefinition/RequestGroup",
    "derivation": "constraint",
    "differential": {
        "element":  [
            {
                "id": "RequestGroup.meta",
                "path": "RequestGroup.meta",
                "mustSupport": true
            },
            {
                "id": "RequestGroup.meta.profile",
                "path": "RequestGroup.meta.profile",
                "mustSupport": true
            },
            {
                "id": "RequestGroup.extension:Prioritaet",
                "path": "RequestGroup.extension",
                "sliceName": "Prioritaet",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-empfehlung-prioritaet"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "RequestGroup.extension:Evidenzgraduierung",
                "path": "RequestGroup.extension",
                "sliceName": "Evidenzgraduierung",
                "min": 0,
                "max": "1",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-empfehlung-evidenzgraduierung"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "RequestGroup.extension:Publikation",
                "path": "RequestGroup.extension",
                "sliceName": "Publikation",
                "min": 0,
                "max": "*",
                "type":  [
                    {
                        "code": "Extension",
                        "profile":  [
                            "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-empfehlung-publikation"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "RequestGroup.identifier",
                "path": "RequestGroup.identifier",
                "mustSupport": true
            },
            {
                "id": "RequestGroup.status",
                "path": "RequestGroup.status",
                "definition": "Status der Umsetzung der Therapieempfehlung",
                "comment": "\n    draft: Nicht umgesetzt, \n    active: In Umsetzung, \n    completed: Abgeschlossen oder abgebrochen (Patient verstorben)"
            },
            {
                "id": "RequestGroup.intent",
                "path": "RequestGroup.intent",
                "short": "proposal | option",
                "definition": "Da das MTB nur Empfehlungen abgibt, wird hier typischerweise 'proposal' stehen. Es sei denn,\ndiese Therapieempfehlung ist selbst nochmal Teil einer RequestGroup. In dem Fall muss hier 'option' stehen.",
                "mustSupport": true
            },
            {
                "id": "RequestGroup.subject",
                "path": "RequestGroup.subject",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Patient"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "RequestGroup.author",
                "path": "RequestGroup.author",
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "http://hl7.org/fhir/StructureDefinition/Practitioner",
                            "http://hl7.org/fhir/StructureDefinition/PractitionerRole"
                        ]
                    }
                ]
            },
            {
                "id": "RequestGroup.action",
                "path": "RequestGroup.action",
                "min": 1,
                "mustSupport": true
            },
            {
                "id": "RequestGroup.action.resource",
                "path": "RequestGroup.action.resource",
                "min": 1,
                "type":  [
                    {
                        "code": "Reference",
                        "targetProfile":  [
                            "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieempfehlung",
                            "http://hl7.org/fhir/StructureDefinition/MedicationRequest"
                        ]
                    }
                ],
                "mustSupport": true
            },
            {
                "id": "RequestGroup.action.action",
                "path": "RequestGroup.action.action",
                "max": "0"
            }
        ]
    }
}

MII PR MTB Therapieempfehlung Kombinationstherapie

Mapping Datensatz zu FHIR

TODO: FHIR LM für Kombinationstherapie

Suchparameter

Folgende Suchparameter sind für dieses Modul relevant, auch in Kombination:

Der Suchparameter "_id" MUSS unterstützt werden:

Beispiele:

GET [base]/RequestGroup?_id=12345

Anwendungshinweise: Weitere Informationen zur Suche nach "_id" finden sich in der FHIR-Basisspezifikation - Abschnitt "Parameters for all resources".
Der Suchparameter "_profile" MUSS unterstützt werden:

Beispiele:

GET [base]/RequestGroup?_profile=https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieempfehlung

Anwendungshinweise: Weitere Informationen zur Suche nach "_profile" finden sich in der FHIR-Basisspezifikation - Abschnitt "token".
Der Suchparameter "identifier" MUSS unterstützt werden:

Beispiele:

GET [base]/RequestGroup?identifier=urn:fdc:medizininformatik-initiative.de:mtb-medications|0001

Anwendungshinweise: Weitere Informationen zur Suche nach "identifier" finden sich in der FHIR-Basisspezifikation - Abschnitt "token".
Der Suchparameter "intent" MUSS unterstützt werden:

Beispiele:

GET [base]/RequestGroup?intent=final

Anwendungshinweise: Weitere Informationen zur Suche nach "intent" finden sich in der FHIR-Basisspezifikation - Abschnitt "token".
Der Suchparameter "subject" MUSS unterstützt werden:

Beispiele:

GET [base]/RequestGroup?subject=Patient/example

Anwendungshinweise: Weitere Informationen zur Suche nach "subject" finden sich in der FHIR-Basisspezifikation - Abschnitt "reference".
Der Suchparameter "action-resource" MUSS unterstützt werden:

Beispiele:

GET [base]/RequestGroup?action-resource=MedicationRequest/example

Anwendungshinweise: Weitere Informationen zur Suche nach "action-resource" finden sich in der FHIR-Basisspezifikation - Abschnitt "reference".

Beispiele

Beispiel: Empfehlung einer Kombinationstherapie bestehend aus Dabrafenib und Trametinib für Kim Musterperson vom 28.03.2023 (siehe Beschreibung von Szenarien fuer die Anwendung der Module)

Tabelle
JSON

RequestGroup.id[0]	mii-exa-mtb-therapieempfehlung-kombinationstherapie
RequestGroup.meta[0].profile[0]	https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieempfehlung-kombination
RequestGroup.extension[0].url[0]	https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-empfehlung-prioritaet
RequestGroup.extension[0].value[0]	1
RequestGroup.extension[1].url[0]	https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-empfehlung-publikation
RequestGroup.extension[1].value[0].system[0]	https://doi.org
RequestGroup.extension[1].value[0].value[0]	10.1002/gcc.23222
RequestGroup.extension[2].url[0]	https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-empfehlung-evidenzgraduierung
RequestGroup.extension[2].value[0].coding[0].system[0]	https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-empfehlung-evidenzgrad
RequestGroup.extension[2].value[0].coding[0].code[0]	m1C
RequestGroup.status[0]	active
RequestGroup.intent[0]	proposal
RequestGroup.subject[0].reference[0]	Patient/mii-exa-mtb-patient
RequestGroup.action[0].title[0]	Therapieempfehlung für Dabrafenib
RequestGroup.action[0].resource[0].reference[0]	MedicationRequest/mii-exa-mtb-therapieempfehlung-dabrafenib
RequestGroup.action[1].title[0]	Therapieempfehlung für Trametinib
RequestGroup.action[1].resource[0].reference[0]	MedicationRequest/mii-exa-mtb-therapieempfehlung-trametinib

{
    "resourceType": "RequestGroup",
    "id": "mii-exa-mtb-therapieempfehlung-kombinationstherapie",
    "meta": {
        "profile":  [
            "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieempfehlung-kombination"
        ]
    },
    "action":  [
        {
            "title": "Therapieempfehlung für Dabrafenib",
            "resource": {
                "reference": "MedicationRequest/mii-exa-mtb-therapieempfehlung-dabrafenib"
            }
        },
        {
            "title": "Therapieempfehlung für Trametinib",
            "resource": {
                "reference": "MedicationRequest/mii-exa-mtb-therapieempfehlung-trametinib"
            }
        }
    ],
    "extension":  [
        {
            "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-empfehlung-prioritaet",
            "valuePositiveInt": 1
        },
        {
            "valueIdentifier": {
                "system": "https://doi.org",
                "value": "10.1002/gcc.23222"
            },
            "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-empfehlung-publikation"
        },
        {
            "valueCodeableConcept": {
                "coding":  [
                    {
                        "system": "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/CodeSystem/mii-cs-mtb-empfehlung-evidenzgrad",
                        "code": "m1C"
                    }
                ]
            },
            "url": "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-ex-mtb-empfehlung-evidenzgraduierung"
        }
    ],
    "status": "active",
    "intent": "proposal",
    "subject": {
        "reference": "Patient/mii-exa-mtb-patient"
    }
}

Dazu die jeweiligen MedicationRequests:

MedicationRequest.id[0]	mii-exa-mtb-therapieempfehlung-dabrafenib
MedicationRequest.meta[0].profile[0]	https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieempfehlung
MedicationRequest.status[0]	active
MedicationRequest.intent[0]	option
MedicationRequest.medication[0].reference[0]	Medication/mii-exa-mtb-medikation-dabrafenib
MedicationRequest.subject[0].reference[0]	Patient/mii-exa-mtb-patient
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]	1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].when[0]	MORN
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].when[1]	EVE
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].value[0]	2
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].unit[0]	Tablet
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].system[0]	http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].code[0]	{Tablet}

{
    "resourceType": "MedicationRequest",
    "id": "mii-exa-mtb-therapieempfehlung-dabrafenib",
    "meta": {
        "profile":  [
            "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieempfehlung"
        ]
    },
    "dosageInstruction":  [
        {
            "timing": {
                "repeat": {
                    "when":  [
                        "MORN",
                        "EVE"
                    ],
                    "frequency": 1
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 2,
                        "system": "http://unitsofmeasure.org",
                        "code": "{Tablet}",
                        "unit": "Tablet"
                    }
                }
            ]
        }
    ],
    "status": "active",
    "intent": "option",
    "subject": {
        "reference": "Patient/mii-exa-mtb-patient"
    },
    "medicationReference": {
        "reference": "Medication/mii-exa-mtb-medikation-dabrafenib"
    }
}

MedicationRequest.id[0]	mii-exa-mtb-therapieempfehlung-trametinib
MedicationRequest.meta[0].profile[0]	https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieempfehlung
MedicationRequest.status[0]	active
MedicationRequest.intent[0]	option
MedicationRequest.medication[0].reference[0]	Medication/mii-exa-mtb-medikation-trametinib
MedicationRequest.subject[0].reference[0]	Patient/mii-exa-mtb-patient
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0]	1
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].when[0]	MORN
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].value[0]	1
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].unit[0]	Tablet
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].system[0]	http://unitsofmeasure.org
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].code[0]	{Tablet}

{
    "resourceType": "MedicationRequest",
    "id": "mii-exa-mtb-therapieempfehlung-trametinib",
    "meta": {
        "profile":  [
            "https://www.medizininformatik-initiative.de/fhir/ext/modul-mtb/StructureDefinition/mii-pr-mtb-therapieempfehlung"
        ]
    },
    "dosageInstruction":  [
        {
            "timing": {
                "repeat": {
                    "when":  [
                        "MORN"
                    ],
                    "frequency": 1
                }
            },
            "doseAndRate":  [
                {
                    "doseQuantity": {
                        "value": 1,
                        "system": "http://unitsofmeasure.org",
                        "code": "{Tablet}",
                        "unit": "Tablet"
                    }
                }
            ]
        }
    ],
    "status": "active",
    "intent": "option",
    "subject": {
        "reference": "Patient/mii-exa-mtb-patient"
    },
    "medicationReference": {
        "reference": "Medication/mii-exa-mtb-medikation-trametinib"
    }
}

Und die Medications:

Medication.id[0]	mii-exa-mtb-medikation-dabrafenib
Medication.meta[0].profile[0]	https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/Medication
Medication.code[0].coding[0].system[0]	http://fhir.de/CodeSystem/bfarm/atc
Medication.code[0].coding[0].version[0]	2023
Medication.code[0].coding[0].code[0]	L01EC02
Medication.code[0].coding[0].display[0]	Dabrafenib 0,3 g O
Medication.form[0].coding[0].system[0]	http://standardterms.edqm.eu
Medication.form[0].coding[0].code[0]	10219000
Medication.form[0].coding[0].display[0]	Tablette
Medication.ingredient[0].extension[0].url[0]	https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/wirkstofftyp
Medication.ingredient[0].extension[0].value[0].system[0]	https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/CodeSystem/wirkstofftyp
Medication.ingredient[0].extension[0].value[0].code[0]	MIN
Medication.ingredient[0].item[0].coding[0].system[0]	http://snomed.info/sct
Medication.ingredient[0].item[0].coding[0].code[0]	703648007
Medication.ingredient[0].item[0].coding[0].display[0]	Dabrafenib (as dabrafenib mesilate) 75 mg oral capsule
Medication.ingredient[0].strength[0].numerator[0].value[0]	75
Medication.ingredient[0].strength[0].numerator[0].system[0]	http://unitsofmeasure.org
Medication.ingredient[0].strength[0].numerator[0].code[0]	mg
Medication.ingredient[0].strength[0].denominator[0].value[0]	1
Medication.ingredient[0].strength[0].denominator[0].system[0]	http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm
Medication.ingredient[0].strength[0].denominator[0].code[0]	TAB

{
    "resourceType": "Medication",
    "id": "mii-exa-mtb-medikation-dabrafenib",
    "meta": {
        "profile":  [
            "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/Medication"
        ]
    },
    "code": {
        "coding":  [
            {
                "code": "L01EC02",
                "system": "http://fhir.de/CodeSystem/bfarm/atc",
                "display": "Dabrafenib 0,3 g O",
                "version": "2023"
            }
        ]
    },
    "form": {
        "coding":  [
            {
                "code": "10219000",
                "system": "http://standardterms.edqm.eu",
                "display": "Tablette"
            }
        ]
    },
    "ingredient":  [
        {
            "itemCodeableConcept": {
                "coding":  [
                    {
                        "code": "703648007",
                        "system": "http://snomed.info/sct",
                        "display": "Dabrafenib (as dabrafenib mesilate) 75 mg oral capsule"
                    }
                ]
            },
            "strength": {
                "numerator": {
                    "system": "http://unitsofmeasure.org",
                    "value": 75,
                    "code": "mg"
                },
                "denominator": {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
                    "value": 1,
                    "code": "TAB"
                }
            },
            "extension":  [
                {
                    "url": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/wirkstofftyp",
                    "valueCoding": {
                        "system": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/CodeSystem/wirkstofftyp",
                        "code": "MIN"
                    }
                }
            ]
        }
    ]
}

Medication.id[0]	mii-exa-mtb-medikation-trametinib
Medication.meta[0].profile[0]	https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/Medication
Medication.code[0].coding[0].system[0]	http://fhir.de/CodeSystem/bfarm/atc
Medication.code[0].coding[0].version[0]	2023
Medication.code[0].coding[0].code[0]	L01EE01
Medication.code[0].coding[0].display[0]	Trametinib 2 mg O
Medication.form[0].coding[0].system[0]	http://standardterms.edqm.eu
Medication.form[0].coding[0].code[0]	10219000
Medication.form[0].coding[0].display[0]	Tablette
Medication.ingredient[0].extension[0].url[0]	https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/wirkstofftyp
Medication.ingredient[0].extension[0].value[0].system[0]	https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/CodeSystem/wirkstofftyp
Medication.ingredient[0].extension[0].value[0].code[0]	MIN
Medication.ingredient[0].item[0].coding[0].system[0]	http://snomed.info/sct
Medication.ingredient[0].item[0].coding[0].code[0]	895671007
Medication.ingredient[0].item[0].coding[0].display[0]	Trametinib (as trametinib dimethyl sulfoxide) 2 mg oral tablet
Medication.ingredient[0].strength[0].numerator[0].value[0]	2
Medication.ingredient[0].strength[0].numerator[0].system[0]	http://unitsofmeasure.org
Medication.ingredient[0].strength[0].numerator[0].code[0]	mg
Medication.ingredient[0].strength[0].denominator[0].value[0]	1
Medication.ingredient[0].strength[0].denominator[0].system[0]	http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm
Medication.ingredient[0].strength[0].denominator[0].code[0]	TAB

{
    "resourceType": "Medication",
    "id": "mii-exa-mtb-medikation-trametinib",
    "meta": {
        "profile":  [
            "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/Medication"
        ]
    },
    "code": {
        "coding":  [
            {
                "code": "L01EE01",
                "system": "http://fhir.de/CodeSystem/bfarm/atc",
                "display": "Trametinib 2 mg O",
                "version": "2023"
            }
        ]
    },
    "form": {
        "coding":  [
            {
                "code": "10219000",
                "system": "http://standardterms.edqm.eu",
                "display": "Tablette"
            }
        ]
    },
    "ingredient":  [
        {
            "itemCodeableConcept": {
                "coding":  [
                    {
                        "code": "895671007",
                        "system": "http://snomed.info/sct",
                        "display": "Trametinib (as trametinib dimethyl sulfoxide) 2 mg oral tablet"
                    }
                ]
            },
            "strength": {
                "numerator": {
                    "system": "http://unitsofmeasure.org",
                    "value": 2,
                    "code": "mg"
                },
                "denominator": {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
                    "value": 1,
                    "code": "TAB"
                }
            },
            "extension":  [
                {
                    "url": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/StructureDefinition/wirkstofftyp",
                    "valueCoding": {
                        "system": "https://www.medizininformatik-initiative.de/fhir/core/modul-medikation/CodeSystem/wirkstofftyp",
                        "code": "MIN"
                    }
                }
            ]
        }
    ]
}