Manifest-based Access to DICOM Objects (MADO)
1.0.0 - trial-use

Manifest-based Access to DICOM Objects (MADO) - Downloaded Version 1.0.0 See the Directory of published versions

## Resource Profile: MADO Composition

Official URL: https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoComposition | Version: 1.0.0
Standards status: Trial-use | Maturity Level: 1 | Computable Name: MadoComposition

A FHIR Composition profile for MADO manifests is needed as FHIR Bundles of type `document` require a `Composition` resource as the first entry. Instances of this profile can be rendered in normal document based system without the need for the Client to understand the MADO-specific profiles, while still allowing to represent the essential information of the manifest such as patient, modality, and anatomical region.

The `Composition.text` field includes a description of the study level info which includes the following information:

- SHALL include subject (identifiers and name)
- SHALL include author (identifiers and name) of device as well as organization
- SHALL include `StudyInstanceUID`
- SHALL include manifest creation date
- SHALL include type and categories
- SHALL include study date and time
- SHALL include `StudyDescription` (if present)
- SHALL include modalities in the study
- SHALL include anatomical regions
- SHALL include accession number(s)
- SHALL include the number of series in the study
- SHOULD include a link to the webviewer endpoint for the study (if present and reachable)

Optionally, each section in the Composition may provide information on each series.

Besides the author information, all information in the `Composition` is a derivative of the information in the manifest and should not be used as the definitive source of information.

Usages:

- Use this Profile: MADO FHIR Imaging Study Manifest Bundle

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition |  | 0..* | Composition | A set of resources composed into a single coherent clinical statement with clinical attestation
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
text | S | 1..1 | Narrative | A human readable narrative that contains information about the manifest. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
status |  | 1..1 | code | generated | extensions | additional | empty Binding: ValueSet: Non-empty Narrative status codes (required)
div | C | 1..1 | xhtml | Limited xhtml content Constraints: txt-1, txt-2
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..1 | Identifier | An OID according for a FHIR-Based formatted Imaging Study Manifest. The OID is structured according to the DICOM UI value representation. In the case that a DICOM KOS manifest is present, this field will hold the same value as the SOP Instance UID of the corresponding translated DICOM KOS manifest.
status | ?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type | S Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible), see section 6.X.6 of volume 3. Binding: FHIRDocumentTypeCodes (preferred): Type of a composition.
category | S Σ | 0..* | CodeableConcept | Categorization of document, see section 6.X.6 of volume 3. Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
subject | S Σ | 1..1 | Reference(MADO Patient) | Who and/or what the composition is about
date | S Σ | 1..1 | dateTime | When the manifest was created.
Slices for author | Σ | 2..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the document (i.e. manifest) Slice: Unordered, Open by profile:$this.resolve()
author:source-organization | Σ | 1..1 | Reference(MADO Creator Organization) | The organization that generated the manifest.
author:source-device | Σ | 1..1 | Reference(MADO Creator) | The device that generated the manifest.
title | S Σ | 1..1 | string | Human readable title to display for the manifest.
custodian | Σ | 0..1 | Reference(Organization) | The organization that is the custodian of the manifest.
Slices for event | Σ | 1..* | BackboneElement | The clinical service(s) being documented Slice: Unordered, Open by profile:detail.resolve()
event:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
event:imaging-study | S Σ | 1..1 | BackboneElement | The clinical service(s) being documented
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
detail | Σ | 0..* | Reference(MADO Imaging Study) | Reference to the ImagingStudy that contains the details of the study that is being described in the manifest.
section | S C | 0..* | BackboneElement | Optionally, one or more sections. Each section provides information on a series in the study. Constraints: cmp-1, cmp-2
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S C | 1..1 | Narrative | A human readable narrative that contains the information about the section. This narrative could contain information like: the series instance UID, the series description, the number of instances in the series, and/or the modality. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
status |  | 1..1 | code | generated | extensions | additional | empty Binding: ValueSet: Non-empty Narrative status codes (required)
div | C | 1..1 | xhtml | Limited xhtml content Constraints: txt-1, txt-2
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Composition.text.status | Base | required | ValueSet: Non-empty Narrative status codes | 📦1.0.0 | This IG
Composition.status | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
Composition.type | Base | preferred | FHIR Document Type Codes | 📍4.0.1 | FHIR Std.
Composition.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
Composition.section.​text.status | Base | required | ValueSet: Non-empty Narrative status codes | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
cmp-1 | error | Composition.section | A section must contain at least one of text, entries, or sub-sections | `text.exists() or entry.exists() or section.exists()`
cmp-2 | error | Composition.section | A section can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Composition | 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 | error | Composition | 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 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Composition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
txt-1 | error | Composition.text.div, Composition.section.text.div | The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes | `htmlChecks()`
txt-2 | error | Composition.text.div, Composition.section.text.div | The narrative SHALL have some non-whitespace content | `htmlChecks()`

This structure is derived from Composition

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition |  | 0..* | Composition | A set of resources composed into a single coherent clinical statement with clinical attestation
text | S | 1..1 | Narrative | A human readable narrative that contains information about the manifest.
status |  | 1..1 | code | generated | extensions | additional | empty Binding: ValueSet: Non-empty Narrative status codes (required)
identifier | S | 1..1 | Identifier | An OID according for a FHIR-Based formatted Imaging Study Manifest. The OID is structured according to the DICOM UI value representation. In the case that a DICOM KOS manifest is present, this field will hold the same value as the SOP Instance UID of the corresponding translated DICOM KOS manifest.
type | S | 1..1 | CodeableConcept | Kind of document (LOINC if possible), see section 6.X.6 of volume 3.
category | S | 0..* | CodeableConcept | Categorization of document, see section 6.X.6 of volume 3.
subject | S | 1..1 | Reference(MADO Patient) | Who and/or what the composition is about
date | S | 1..1 | dateTime | When the manifest was created.
Slices for author |  | 2..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the document (i.e. manifest) Slice: Unordered, Open by profile:$this.resolve()
author:source-organization |  | 1..1 | Reference(MADO Creator Organization) | The organization that generated the manifest.
author:source-device |  | 1..1 | Reference(MADO Creator) | The device that generated the manifest.
title | S | 1..1 | string | Human readable title to display for the manifest.
custodian |  | 0..1 | Reference(Organization) | The organization that is the custodian of the manifest.
Slices for event |  | 1..* | BackboneElement | The clinical service(s) being documented Slice: Unordered, Open by profile:detail.resolve()
event:imaging-study | S | 1..1 | BackboneElement | The clinical service(s) being documented
detail |  | 0..* | Reference(MADO Imaging Study) | Reference to the ImagingStudy that contains the details of the study that is being described in the manifest.
section | S | 0..* | BackboneElement | Optionally, one or more sections. Each section provides information on a series in the study.
text | S | 1..1 | Narrative | A human readable narrative that contains the information about the section. This narrative could contain information like: the series instance UID, the series description, the number of instances in the series, and/or the modality.
status |  | 1..1 | code | generated | extensions | additional | empty Binding: ValueSet: Non-empty Narrative status codes (required)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Composition.text.status | Base | required | ValueSet: Non-empty Narrative status codes | 📦1.0.0 | This IG
Composition.section.​text.status | Base | required | ValueSet: Non-empty Narrative status codes | 📦1.0.0 | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition |  | 0..* | Composition | A set of resources composed into a single coherent clinical statement with clinical attestation
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text | S | 1..1 | Narrative | A human readable narrative that contains information about the manifest. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
status |  | 1..1 | code | generated | extensions | additional | empty Binding: ValueSet: Non-empty Narrative status codes (required)
div | C | 1..1 | xhtml | Limited xhtml content Constraints: txt-1, txt-2
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..1 | Identifier | An OID according for a FHIR-Based formatted Imaging Study Manifest. The OID is structured according to the DICOM UI value representation. In the case that a DICOM KOS manifest is present, this field will hold the same value as the SOP Instance UID of the corresponding translated DICOM KOS manifest.
status | ?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type | S Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible), see section 6.X.6 of volume 3. Binding: FHIRDocumentTypeCodes (preferred): Type of a composition.
category | S Σ | 0..* | CodeableConcept | Categorization of document, see section 6.X.6 of volume 3. Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
subject | S Σ | 1..1 | Reference(MADO Patient) | Who and/or what the composition is about
encounter | Σ | 0..1 | Reference(Encounter) | Context of the Composition
date | S Σ | 1..1 | dateTime | When the manifest was created.
Slices for author | Σ | 2..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the document (i.e. manifest) Slice: Unordered, Open by profile:$this.resolve()
author:source-organization | Σ | 1..1 | Reference(MADO Creator Organization) | The organization that generated the manifest.
author:source-device | Σ | 1..1 | Reference(MADO Creator) | The device that generated the manifest.
title | S Σ | 1..1 | string | Human readable title to display for the manifest.
confidentiality | Σ | 0..1 | code | As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
attester |  | 0..* | BackboneElement | Attests to accuracy of composition
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time |  | 0..1 | dateTime | When the composition was attested
party |  | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) | Who attested the composition
custodian | Σ | 0..1 | Reference(Organization) | The organization that is the custodian of the manifest.
relatesTo |  | 0..* | BackboneElement | Relationships to other compositions/documents
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x] |  | 1..1 |  | Target of the relationship
targetIdentifier |  |  | Identifier |
targetReference |  |  | Reference(Composition) |
Slices for event | Σ | 1..* | BackboneElement | The clinical service(s) being documented Slice: Unordered, Open by profile:detail.resolve()
event:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 0..* | CodeableConcept | Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period | Σ | 0..1 | Period | The period covered by the documentation
detail | Σ | 0..* | Reference(Resource) | The event(s) being documented
event:imaging-study | S Σ | 1..1 | BackboneElement | The clinical service(s) being documented
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 0..* | CodeableConcept | Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period | Σ | 0..1 | Period | The period covered by the documentation
detail | Σ | 0..* | Reference(MADO Imaging Study) | Reference to the ImagingStudy that contains the details of the study that is being described in the manifest.
section | S C | 0..* | BackboneElement | Optionally, one or more sections. Each section provides information on a series in the study. Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 0..1 | string | Label for section (e.g. for ToC)
code |  | 0..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | A human readable narrative that contains the information about the section. This narrative could contain information like: the series instance UID, the series description, the number of instances in the series, and/or the modality. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
status |  | 1..1 | code | generated | extensions | additional | empty Binding: ValueSet: Non-empty Narrative status codes (required)
div | C | 1..1 | xhtml | Limited xhtml content Constraints: txt-1, txt-2
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(Resource) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Composition.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Composition.text.status | Base | required | ValueSet: Non-empty Narrative status codes | 📦1.0.0 | This IG
Composition.status | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
Composition.type | Base | preferred | FHIR Document Type Codes | 📍4.0.1 | FHIR Std.
Composition.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
Composition.confidentiality | Base | required | V3 Value SetConfidentialityClassification | 📍2014-03-26 | FHIR Std.
Composition.attester.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
Composition.event.code | Base | example | v3 Code System ActCode | 📦3.0.0 | THO v7.3
Composition.event:imaging-study.​code | Base | example | v3 Code System ActCode | 📦3.0.0 | THO v7.3
Composition.section.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section.​text.status | Base | required | ValueSet: Non-empty Narrative status codes | 📦1.0.0 | This IG
Composition.section.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
cmp-1 | error | Composition.section | A section must contain at least one of text, entries, or sub-sections | `text.exists() or entry.exists() or section.exists()`
cmp-2 | error | Composition.section | A section can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Composition | 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 | error | Composition | 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 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Composition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
txt-1 | error | Composition.text.div, Composition.section.text.div | The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes | `htmlChecks()`
txt-2 | error | Composition.text.div, Composition.section.text.div | The narrative SHALL have some non-whitespace content | `htmlChecks()`

This structure is derived from Composition

Summary

Mandatory: 7 elements(1 nested mandatory element)
Must-Support: 10 elements

Structures

This structure refers to these other structures:

- MADO Patient (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoPatient)
- MADO Creator Organization (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoCreatorOrganization)
- MADO Creator (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoCreator)
- MADO Imaging Study (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoImagingStudy)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Composition.author
- The element 1 is sliced based on the value of Composition.event

Maturity: 1

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition |  | 0..* | Composition | A set of resources composed into a single coherent clinical statement with clinical attestation
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
text | S | 1..1 | Narrative | A human readable narrative that contains information about the manifest. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
status |  | 1..1 | code | generated | extensions | additional | empty Binding: ValueSet: Non-empty Narrative status codes (required)
div | C | 1..1 | xhtml | Limited xhtml content Constraints: txt-1, txt-2
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..1 | Identifier | An OID according for a FHIR-Based formatted Imaging Study Manifest. The OID is structured according to the DICOM UI value representation. In the case that a DICOM KOS manifest is present, this field will hold the same value as the SOP Instance UID of the corresponding translated DICOM KOS manifest.
status | ?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type | S Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible), see section 6.X.6 of volume 3. Binding: FHIRDocumentTypeCodes (preferred): Type of a composition.
category | S Σ | 0..* | CodeableConcept | Categorization of document, see section 6.X.6 of volume 3. Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
subject | S Σ | 1..1 | Reference(MADO Patient) | Who and/or what the composition is about
date | S Σ | 1..1 | dateTime | When the manifest was created.
Slices for author | Σ | 2..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the document (i.e. manifest) Slice: Unordered, Open by profile:$this.resolve()
author:source-organization | Σ | 1..1 | Reference(MADO Creator Organization) | The organization that generated the manifest.
author:source-device | Σ | 1..1 | Reference(MADO Creator) | The device that generated the manifest.
title | S Σ | 1..1 | string | Human readable title to display for the manifest.
custodian | Σ | 0..1 | Reference(Organization) | The organization that is the custodian of the manifest.
Slices for event | Σ | 1..* | BackboneElement | The clinical service(s) being documented Slice: Unordered, Open by profile:detail.resolve()
event:All Slices |  |  |  | Content/Rules for all slices
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
event:imaging-study | S Σ | 1..1 | BackboneElement | The clinical service(s) being documented
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
detail | Σ | 0..* | Reference(MADO Imaging Study) | Reference to the ImagingStudy that contains the details of the study that is being described in the manifest.
section | S C | 0..* | BackboneElement | Optionally, one or more sections. Each section provides information on a series in the study. Constraints: cmp-1, cmp-2
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S C | 1..1 | Narrative | A human readable narrative that contains the information about the section. This narrative could contain information like: the series instance UID, the series description, the number of instances in the series, and/or the modality. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
status |  | 1..1 | code | generated | extensions | additional | empty Binding: ValueSet: Non-empty Narrative status codes (required)
div | C | 1..1 | xhtml | Limited xhtml content Constraints: txt-1, txt-2
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Composition.text.status | Base | required | ValueSet: Non-empty Narrative status codes | 📦1.0.0 | This IG
Composition.status | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
Composition.type | Base | preferred | FHIR Document Type Codes | 📍4.0.1 | FHIR Std.
Composition.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
Composition.section.​text.status | Base | required | ValueSet: Non-empty Narrative status codes | 📦1.0.0 | This IG

#### Constraints

Id | Grade | Path(s) | Description | Expression
cmp-1 | error | Composition.section | A section must contain at least one of text, entries, or sub-sections | `text.exists() or entry.exists() or section.exists()`
cmp-2 | error | Composition.section | A section can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Composition | 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 | error | Composition | 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 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Composition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
txt-1 | error | Composition.text.div, Composition.section.text.div | The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes | `htmlChecks()`
txt-2 | error | Composition.text.div, Composition.section.text.div | The narrative SHALL have some non-whitespace content | `htmlChecks()`

Differential View

This structure is derived from Composition

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition |  | 0..* | Composition | A set of resources composed into a single coherent clinical statement with clinical attestation
text | S | 1..1 | Narrative | A human readable narrative that contains information about the manifest.
status |  | 1..1 | code | generated | extensions | additional | empty Binding: ValueSet: Non-empty Narrative status codes (required)
identifier | S | 1..1 | Identifier | An OID according for a FHIR-Based formatted Imaging Study Manifest. The OID is structured according to the DICOM UI value representation. In the case that a DICOM KOS manifest is present, this field will hold the same value as the SOP Instance UID of the corresponding translated DICOM KOS manifest.
type | S | 1..1 | CodeableConcept | Kind of document (LOINC if possible), see section 6.X.6 of volume 3.
category | S | 0..* | CodeableConcept | Categorization of document, see section 6.X.6 of volume 3.
subject | S | 1..1 | Reference(MADO Patient) | Who and/or what the composition is about
date | S | 1..1 | dateTime | When the manifest was created.
Slices for author |  | 2..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the document (i.e. manifest) Slice: Unordered, Open by profile:$this.resolve()
author:source-organization |  | 1..1 | Reference(MADO Creator Organization) | The organization that generated the manifest.
author:source-device |  | 1..1 | Reference(MADO Creator) | The device that generated the manifest.
title | S | 1..1 | string | Human readable title to display for the manifest.
custodian |  | 0..1 | Reference(Organization) | The organization that is the custodian of the manifest.
Slices for event |  | 1..* | BackboneElement | The clinical service(s) being documented Slice: Unordered, Open by profile:detail.resolve()
event:imaging-study | S | 1..1 | BackboneElement | The clinical service(s) being documented
detail |  | 0..* | Reference(MADO Imaging Study) | Reference to the ImagingStudy that contains the details of the study that is being described in the manifest.
section | S | 0..* | BackboneElement | Optionally, one or more sections. Each section provides information on a series in the study.
text | S | 1..1 | Narrative | A human readable narrative that contains the information about the section. This narrative could contain information like: the series instance UID, the series description, the number of instances in the series, and/or the modality.
status |  | 1..1 | code | generated | extensions | additional | empty Binding: ValueSet: Non-empty Narrative status codes (required)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
Composition.text.status | Base | required | ValueSet: Non-empty Narrative status codes | 📦1.0.0 | This IG
Composition.section.​text.status | Base | required | ValueSet: Non-empty Narrative status codes | 📦1.0.0 | This IG

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Composition |  | 0..* | Composition | A set of resources composed into a single coherent clinical statement with clinical attestation
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text | S | 1..1 | Narrative | A human readable narrative that contains information about the manifest. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
status |  | 1..1 | code | generated | extensions | additional | empty Binding: ValueSet: Non-empty Narrative status codes (required)
div | C | 1..1 | xhtml | Limited xhtml content Constraints: txt-1, txt-2
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S Σ | 1..1 | Identifier | An OID according for a FHIR-Based formatted Imaging Study Manifest. The OID is structured according to the DICOM UI value representation. In the case that a DICOM KOS manifest is present, this field will hold the same value as the SOP Instance UID of the corresponding translated DICOM KOS manifest.
status | ?!Σ | 1..1 | code | preliminary | final | amended | entered-in-error Binding: CompositionStatus (required): The workflow/clinical status of the composition.
type | S Σ | 1..1 | CodeableConcept | Kind of document (LOINC if possible), see section 6.X.6 of volume 3. Binding: FHIRDocumentTypeCodes (preferred): Type of a composition.
category | S Σ | 0..* | CodeableConcept | Categorization of document, see section 6.X.6 of volume 3. Binding: DocumentClassValueSet (example): High-level kind of a clinical document at a macro level.
subject | S Σ | 1..1 | Reference(MADO Patient) | Who and/or what the composition is about
encounter | Σ | 0..1 | Reference(Encounter) | Context of the Composition
date | S Σ | 1..1 | dateTime | When the manifest was created.
Slices for author | Σ | 2..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the document (i.e. manifest) Slice: Unordered, Open by profile:$this.resolve()
author:source-organization | Σ | 1..1 | Reference(MADO Creator Organization) | The organization that generated the manifest.
author:source-device | Σ | 1..1 | Reference(MADO Creator) | The device that generated the manifest.
title | S Σ | 1..1 | string | Human readable title to display for the manifest.
confidentiality | Σ | 0..1 | code | As defined by affinity domain Binding: v3.ConfidentialityClassification (2014-03-26) (required): Codes specifying the level of confidentiality of the composition.
attester |  | 0..* | BackboneElement | Attests to accuracy of composition
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
mode |  | 1..1 | code | personal | professional | legal | official Binding: CompositionAttestationMode (required): The way in which a person authenticated a composition.
time |  | 0..1 | dateTime | When the composition was attested
party |  | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole | Organization) | Who attested the composition
custodian | Σ | 0..1 | Reference(Organization) | The organization that is the custodian of the manifest.
relatesTo |  | 0..* | BackboneElement | Relationships to other compositions/documents
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code |  | 1..1 | code | replaces | transforms | signs | appends Binding: DocumentRelationshipType (required): The type of relationship between documents.
target[x] |  | 1..1 |  | Target of the relationship
targetIdentifier |  |  | Identifier |
targetReference |  |  | Reference(Composition) |
Slices for event | Σ | 1..* | BackboneElement | The clinical service(s) being documented Slice: Unordered, Open by profile:detail.resolve()
event:All Slices |  |  |  | Content/Rules for all slices
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 0..* | CodeableConcept | Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period | Σ | 0..1 | Period | The period covered by the documentation
detail | Σ | 0..* | Reference(Resource) | The event(s) being documented
event:imaging-study | S Σ | 1..1 | BackboneElement | The clinical service(s) being documented
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
code | Σ | 0..* | CodeableConcept | Code(s) that apply to the event being documented Binding: v3 Code System ActCode (example): This list of codes represents the main clinical acts being documented.
period | Σ | 0..1 | Period | The period covered by the documentation
detail | Σ | 0..* | Reference(MADO Imaging Study) | Reference to the ImagingStudy that contains the details of the study that is being described in the manifest.
section | S C | 0..* | BackboneElement | Optionally, one or more sections. Each section provides information on a series in the study. Constraints: cmp-1, cmp-2
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
title |  | 0..1 | string | Label for section (e.g. for ToC)
code |  | 0..1 | CodeableConcept | Classification of section (recommended) Binding: DocumentSectionCodes (example): Classification of a section of a composition/document.
author |  | 0..* | Reference(Practitioner | PractitionerRole | Device | Patient | RelatedPerson | Organization) | Who and/or what authored the section
focus |  | 0..1 | Reference(Resource) | Who/what the section is about, when it is not about the subject of composition
text | S C | 1..1 | Narrative | A human readable narrative that contains the information about the section. This narrative could contain information like: the series instance UID, the series description, the number of instances in the series, and/or the modality. This profile does not constrain the narrative in regard to content, language, or traceability to data elements
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
status |  | 1..1 | code | generated | extensions | additional | empty Binding: ValueSet: Non-empty Narrative status codes (required)
div | C | 1..1 | xhtml | Limited xhtml content Constraints: txt-1, txt-2
mode |  | 0..1 | code | working | snapshot | changes Binding: ListMode (required): The processing mode that applies to this section.
orderedBy |  | 0..1 | CodeableConcept | Order of section entries Binding: ListOrderCodes (preferred): What order applies to the items in the entry.
entry | C | 0..* | Reference(Resource) | A reference to data that supports this section
emptyReason | C | 0..1 | CodeableConcept | Why the section is empty Binding: ListEmptyReasons (preferred): If a section is empty, why it is empty.
section | C | 0..* | See section (Composition) | Nested Section
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
Composition.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
Composition.text.status | Base | required | ValueSet: Non-empty Narrative status codes | 📦1.0.0 | This IG
Composition.status | Base | required | CompositionStatus | 📍4.0.1 | FHIR Std.
Composition.type | Base | preferred | FHIR Document Type Codes | 📍4.0.1 | FHIR Std.
Composition.category | Base | example | Document Class Value Set | 📍4.0.1 | FHIR Std.
Composition.confidentiality | Base | required | V3 Value SetConfidentialityClassification | 📍2014-03-26 | FHIR Std.
Composition.attester.​mode | Base | required | CompositionAttestationMode | 📍4.0.1 | FHIR Std.
Composition.relatesTo.​code | Base | required | DocumentRelationshipType | 📍4.0.1 | FHIR Std.
Composition.event.code | Base | example | v3 Code System ActCode | 📦3.0.0 | THO v7.3
Composition.event:imaging-study.​code | Base | example | v3 Code System ActCode | 📦3.0.0 | THO v7.3
Composition.section.​code | Base | example | Document Section Codes | 📍4.0.1 | FHIR Std.
Composition.section.​text.status | Base | required | ValueSet: Non-empty Narrative status codes | 📦1.0.0 | This IG
Composition.section.​mode | Base | required | ListMode | 📍4.0.1 | FHIR Std.
Composition.section.​orderedBy | Base | preferred | List Order Codes | 📍4.0.1 | FHIR Std.
Composition.section.​emptyReason | Base | preferred | List Empty Reasons | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
cmp-1 | error | Composition.section | A section must contain at least one of text, entries, or sub-sections | `text.exists() or entry.exists() or section.exists()`
cmp-2 | error | Composition.section | A section can only have an emptyReason if it is empty | `emptyReason.empty() or entry.empty()`
dom-2 | error | Composition | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | Composition | 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 | error | Composition | 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 | error | Composition | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | Composition | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
txt-1 | error | Composition.text.div, Composition.section.text.div | The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained style attributes | `htmlChecks()`
txt-2 | error | Composition.text.div, Composition.section.text.div | The narrative SHALL have some non-whitespace content | `htmlChecks()`

This structure is derived from Composition

Summary

Mandatory: 7 elements(1 nested mandatory element)
Must-Support: 10 elements

Structures

This structure refers to these other structures:

- MADO Patient (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoPatient)
- MADO Creator Organization (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoCreatorOrganization)
- MADO Creator (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoCreator)
- MADO Imaging Study (https://profiles.ihe.net/RAD/MADO/StructureDefinition/MadoImagingStudy)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of Composition.author
- The element 1 is sliced based on the value of Composition.event

Maturity: 1

Other representations of profile: CSV, Excel, Schematron