Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions RN03-Exame: Se a terminologia utilizada para representar o exame for Tabela SUS, TUSS ou CBHPM, esse elemento torna-se obrigatório. O exame realizado deve utilizar as terminologias (Tabela SUS, TUSS ou CBHPM) para representar o método analítico utilizado para determinação do resultado do analito. RN04-Exame: Se o resultado for quantitativo, é obrigatório enviar os valores de referência, sejam eles estruturados ou não estruturados. O laudo deve conter os valores de referência claras sobre o resultado quantitativo sendo eles estruturados ou não estruturados.
basedOn		0..*	Reference(Suspeita Diagnóstica Investigada)	Fulfills plan, proposal or order
category		1..1	CodeableConcept	Classification of type of observation Binding: Categoria do Exame (required)
code		1..1	CodeableConcept	Type of observation (code / type) Binding: Exame (required)
subject		1..1	Reference(Indivíduo)	Who and/or what the observation is about
identifier	C	1..1	Identifier	Logical reference, when literal reference is not known CPFouCNS: O sistema de identificação do indivíduo deve ser ou CPF ou CNS
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
issued		1..1	instant	Date/Time this version was made available
Slices for performer		3..4	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Closed by value:$this.id
performer:All Slices				Content/Rules for all slices
identifier		1..1	Identifier	Logical reference, when literal reference is not known
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
performer:laboratorio		1..1	Reference(Estabelecimento de Saúde)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: laboratorio
performer:responsavelTecnico		1..1	Reference(Profissional)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: responsavelTecnico
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
conselhoProfissional		1..1	(Complex)	Conselho Profissional URL: https://fhir.saude.go.gov.br/r4/core/StructureDefinition/conselho-profissional
performer:responsavelResultado		1..1	Reference(Profissional)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: responsavelResultado
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
conselhoProfissional		1..1	(Complex)	Conselho Profissional URL: https://fhir.saude.go.gov.br/r4/core/StructureDefinition/conselho-profissional
performer:laboratorioApoio		0..1	Reference(Estabelecimento de Saúde)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: laboratorioApoio
Slices for value[x]		1..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result Slice: Unordered, Open by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	Actual result Binding: Resultado Qualitativo Exame (required)
value[x]:valueQuantity		0..1	Quantity	Actual result
system		0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
specimen	C	1..1	Reference(Amostra)	Specimen used for this observation ReferenceContained: Referência deve ser um recurso contido
referenceRange
low
system		0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
high
system		0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.category	required	CategoriaExame https://fhir.saude.go.gov.br/r4/core/ValueSet/categoria-exame from this IG
Observation.code	required	Exame https://fhir.saude.go.gov.br/r4/core/ValueSet/exame from this IG
Observation.value[x]:valueCodeableConcept	required	ResultadoQualitativoExame https://fhir.saude.go.gov.br/r4/core/ValueSet/resultado-qualitativo-exame from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
CPFouCNS	error	Observation.subject.identifier	O sistema de identificação do indivíduo deve ser ou CPF ou CNS : system = 'https://fhir.saude.go.gov.br/sid/cpf' or system = 'https://fhir.saude.go.gov.br/sid/cns'
RN03-Exame	warning	Observation	Se a terminologia utilizada para representar o exame for Tabela SUS, TUSS ou CBHPM, esse elemento torna-se obrigatório. O exame realizado deve utilizar as terminologias (Tabela SUS, TUSS ou CBHPM) para representar o método analítico utilizado para determinação do resultado do analito. : code.coding.where(system = 'http://www.saude.gov.br/fhir/r4/CodeSystem/BRTabelaSUS' or system = 'http://www.saude.gov.br/fhir/r4/CodeSystem/BRCBHPMTUSS') implies method.exists()
RN04-Exame	warning	Observation	Se o resultado for quantitativo, é obrigatório enviar os valores de referência, sejam eles estruturados ou não estruturados. O laudo deve conter os valores de referência claras sobre o resultado quantitativo sendo eles estruturados ou não estruturados. : (value is Quantity) implies referenceRange.exists()
ReferenceContained	error	Observation.specimen	Referência deve ser um recurso contido : reference.startsWith('#')

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present RN03-Exame: Se a terminologia utilizada para representar o exame for Tabela SUS, TUSS ou CBHPM, esse elemento torna-se obrigatório. O exame realizado deve utilizar as terminologias (Tabela SUS, TUSS ou CBHPM) para representar o método analítico utilizado para determinação do resultado do analito. RN04-Exame: Se o resultado for quantitativo, é obrigatório enviar os valores de referência, sejam eles estruturados ou não estruturados. O laudo deve conter os valores de referência claras sobre o resultado quantitativo sendo eles estruturados ou não estruturados.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
basedOn	Σ	0..*	Reference(Suspeita Diagnóstica Investigada)	Fulfills plan, proposal or order
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		1..1	CodeableConcept	Classification of type of observation Binding: Categoria do Exame (required)
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: Exame (required)
subject	Σ	1..1	Reference(Indivíduo)	Who and/or what the observation is about
identifier	ΣC	1..1	Identifier	Logical reference, when literal reference is not known CPFouCNS: O sistema de identificação do indivíduo deve ser ou CPF ou CNS
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
issued	Σ	1..1	instant	Date/Time this version was made available
Slices for performer	Σ	3..4	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Closed by value:$this.id
performer:All Slices				Content/Rules for all slices
identifier	Σ	1..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
performer:laboratorio	Σ	1..1	Reference(Estabelecimento de Saúde)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: laboratorio
performer:responsavelTecnico	Σ	1..1	Reference(Profissional)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: responsavelTecnico
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
conselhoProfissional		1..1	(Complex)	Conselho Profissional URL: https://fhir.saude.go.gov.br/r4/core/StructureDefinition/conselho-profissional
performer:responsavelResultado	Σ	1..1	Reference(Profissional)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: responsavelResultado
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
conselhoProfissional		1..1	(Complex)	Conselho Profissional URL: https://fhir.saude.go.gov.br/r4/core/StructureDefinition/conselho-profissional
performer:laboratorioApoio	Σ	0..1	Reference(Estabelecimento de Saúde)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: laboratorioApoio
Slices for value[x]	ΣC	1..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result Binding: Resultado Qualitativo Exame (required)
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
specimen	C	1..1	Reference(Amostra)	Specimen used for this observation ReferenceContained: Referência deve ser um recurso contido
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	required	CategoriaExame https://fhir.saude.go.gov.br/r4/core/ValueSet/categoria-exame from this IG
Observation.code	required	Exame https://fhir.saude.go.gov.br/r4/core/ValueSet/exame from this IG
Observation.subject.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.performer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.value[x]:valueCodeableConcept	required	ResultadoQualitativoExame https://fhir.saude.go.gov.br/r4/core/ValueSet/resultado-qualitativo-exame from this IG
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
CPFouCNS	error	Observation.subject.identifier	O sistema de identificação do indivíduo deve ser ou CPF ou CNS : system = 'https://fhir.saude.go.gov.br/sid/cpf' or system = 'https://fhir.saude.go.gov.br/sid/cns'
RN03-Exame	warning	Observation	Se a terminologia utilizada para representar o exame for Tabela SUS, TUSS ou CBHPM, esse elemento torna-se obrigatório. O exame realizado deve utilizar as terminologias (Tabela SUS, TUSS ou CBHPM) para representar o método analítico utilizado para determinação do resultado do analito. : code.coding.where(system = 'http://www.saude.gov.br/fhir/r4/CodeSystem/BRTabelaSUS' or system = 'http://www.saude.gov.br/fhir/r4/CodeSystem/BRCBHPMTUSS') implies method.exists()
RN04-Exame	warning	Observation	Se o resultado for quantitativo, é obrigatório enviar os valores de referência, sejam eles estruturados ou não estruturados. O laudo deve conter os valores de referência claras sobre o resultado quantitativo sendo eles estruturados ou não estruturados. : (value is Quantity) implies referenceRange.exists()
ReferenceContained	error	Observation.specimen	Referência deve ser um recurso contido : reference.startsWith('#')
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	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	Observation	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	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	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()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present RN03-Exame: Se a terminologia utilizada para representar o exame for Tabela SUS, TUSS ou CBHPM, esse elemento torna-se obrigatório. O exame realizado deve utilizar as terminologias (Tabela SUS, TUSS ou CBHPM) para representar o método analítico utilizado para determinação do resultado do analito. RN04-Exame: Se o resultado for quantitativo, é obrigatório enviar os valores de referência, sejam eles estruturados ou não estruturados. O laudo deve conter os valores de referência claras sobre o resultado quantitativo sendo eles estruturados ou não estruturados.
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		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(Suspeita Diagnóstica Investigada)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		1..1	CodeableConcept	Classification of type of observation Binding: Categoria do Exame (required)
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: Exame (required)
subject	Σ	1..1	Reference(Indivíduo)	Who and/or what the observation is about
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	1..1	Identifier	Logical reference, when literal reference is not known CPFouCNS: O sistema de identificação do indivíduo deve ser ou CPF ou CNS
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	1..1	instant	Date/Time this version was made available
Slices for performer	Σ	3..4	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Closed by value:$this.id
performer: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 Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	1..1	Identifier	Logical reference, when literal reference is not known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
performer:laboratorio	Σ	1..1	Reference(Estabelecimento de Saúde)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: laboratorio
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
performer:responsavelTecnico	Σ	1..1	Reference(Profissional)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: responsavelTecnico
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
conselhoProfissional		1..1	(Complex)	Conselho Profissional URL: https://fhir.saude.go.gov.br/r4/core/StructureDefinition/conselho-profissional
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
performer:responsavelResultado	Σ	1..1	Reference(Profissional)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: responsavelResultado
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
conselhoProfissional		1..1	(Complex)	Conselho Profissional URL: https://fhir.saude.go.gov.br/r4/core/StructureDefinition/conselho-profissional
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
performer:laboratorioApoio	Σ	0..1	Reference(Estabelecimento de Saúde)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: laboratorioApoio
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
Slices for value[x]	ΣC	1..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result Binding: Resultado Qualitativo Exame (required)
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	Σ	0..1	code	Coded form of the unit
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen	C	1..1	Reference(Amostra)	Specimen used for this observation ReferenceContained: Referência deve ser um recurso contido
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
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
low	C	0..1	SimpleQuantity	Low Range, if relevant
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	Σ	0..1	code	Coded form of the unit
high	C	0..1	SimpleQuantity	High Range, if relevant
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	Σ	0..1	code	Coded form of the unit
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	Σ	0..*	BackboneElement	Component results
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	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	required	CategoriaExame https://fhir.saude.go.gov.br/r4/core/ValueSet/categoria-exame from this IG
Observation.code	required	Exame https://fhir.saude.go.gov.br/r4/core/ValueSet/exame from this IG
Observation.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.subject.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.subject.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Observation.performer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.performer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.performer.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Observation.performer:laboratorio.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.performer:responsavelTecnico.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.performer:responsavelResultado.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.performer:laboratorioApoio.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.value[x]:valueCodeableConcept	required	ResultadoQualitativoExame https://fhir.saude.go.gov.br/r4/core/ValueSet/resultado-qualitativo-exame from this IG
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
CPFouCNS	error	Observation.subject.identifier	O sistema de identificação do indivíduo deve ser ou CPF ou CNS : system = 'https://fhir.saude.go.gov.br/sid/cpf' or system = 'https://fhir.saude.go.gov.br/sid/cns'
RN03-Exame	warning	Observation	Se a terminologia utilizada para representar o exame for Tabela SUS, TUSS ou CBHPM, esse elemento torna-se obrigatório. O exame realizado deve utilizar as terminologias (Tabela SUS, TUSS ou CBHPM) para representar o método analítico utilizado para determinação do resultado do analito. : code.coding.where(system = 'http://www.saude.gov.br/fhir/r4/CodeSystem/BRTabelaSUS' or system = 'http://www.saude.gov.br/fhir/r4/CodeSystem/BRCBHPMTUSS') implies method.exists()
RN04-Exame	warning	Observation	Se o resultado for quantitativo, é obrigatório enviar os valores de referência, sejam eles estruturados ou não estruturados. O laudo deve conter os valores de referência claras sobre o resultado quantitativo sendo eles estruturados ou não estruturados. : (value is Quantity) implies referenceRange.exists()
ReferenceContained	error	Observation.specimen	Referência deve ser um recurso contido : reference.startsWith('#')
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	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	Observation	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	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	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()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Summary

Mandatory: 18 elements

Structures

This structure refers to these other structures:

• Suspeita Diagnóstica Investigada (https://fhir.saude.go.gov.br/r4/core/StructureDefinition/suspeita-diagnostica-investigada)
• Indivíduo (https://fhir.saude.go.gov.br/r4/core/StructureDefinition/individuo)
• Estabelecimento de Saúde (https://fhir.saude.go.gov.br/r4/core/StructureDefinition/estabelecimento-saude)
• Profissional (https://fhir.saude.go.gov.br/r4/core/StructureDefinition/profissional)
• Amostra (https://fhir.saude.go.gov.br/r4/core/StructureDefinition/amostra)

Extensions

This structure refers to these extensions:

• https://fhir.saude.go.gov.br/r4/core/StructureDefinition/conselho-profissional

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Observation.performer (Closed)
• The element 1 is sliced based on the value of Observation.value[x]

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions RN03-Exame: Se a terminologia utilizada para representar o exame for Tabela SUS, TUSS ou CBHPM, esse elemento torna-se obrigatório. O exame realizado deve utilizar as terminologias (Tabela SUS, TUSS ou CBHPM) para representar o método analítico utilizado para determinação do resultado do analito. RN04-Exame: Se o resultado for quantitativo, é obrigatório enviar os valores de referência, sejam eles estruturados ou não estruturados. O laudo deve conter os valores de referência claras sobre o resultado quantitativo sendo eles estruturados ou não estruturados.
basedOn		0..*	Reference(Suspeita Diagnóstica Investigada)	Fulfills plan, proposal or order
category		1..1	CodeableConcept	Classification of type of observation Binding: Categoria do Exame (required)
code		1..1	CodeableConcept	Type of observation (code / type) Binding: Exame (required)
subject		1..1	Reference(Indivíduo)	Who and/or what the observation is about
identifier	C	1..1	Identifier	Logical reference, when literal reference is not known CPFouCNS: O sistema de identificação do indivíduo deve ser ou CPF ou CNS
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
issued		1..1	instant	Date/Time this version was made available
Slices for performer		3..4	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Closed by value:$this.id
performer:All Slices				Content/Rules for all slices
identifier		1..1	Identifier	Logical reference, when literal reference is not known
system		1..1	uri	The namespace for the identifier value
value		1..1	string	The value that is unique
performer:laboratorio		1..1	Reference(Estabelecimento de Saúde)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: laboratorio
performer:responsavelTecnico		1..1	Reference(Profissional)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: responsavelTecnico
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
conselhoProfissional		1..1	(Complex)	Conselho Profissional URL: https://fhir.saude.go.gov.br/r4/core/StructureDefinition/conselho-profissional
performer:responsavelResultado		1..1	Reference(Profissional)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: responsavelResultado
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
conselhoProfissional		1..1	(Complex)	Conselho Profissional URL: https://fhir.saude.go.gov.br/r4/core/StructureDefinition/conselho-profissional
performer:laboratorioApoio		0..1	Reference(Estabelecimento de Saúde)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: laboratorioApoio
Slices for value[x]		1..1	Quantity, CodeableConcept, string, boolean, integer, Range, Ratio, SampledData, time, dateTime, Period	Actual result Slice: Unordered, Open by type:$this
value[x]:valueCodeableConcept		0..1	CodeableConcept	Actual result Binding: Resultado Qualitativo Exame (required)
value[x]:valueQuantity		0..1	Quantity	Actual result
system		0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
specimen	C	1..1	Reference(Amostra)	Specimen used for this observation ReferenceContained: Referência deve ser um recurso contido
referenceRange
low
system		0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
high
system		0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Observation.category	required	CategoriaExame https://fhir.saude.go.gov.br/r4/core/ValueSet/categoria-exame from this IG
Observation.code	required	Exame https://fhir.saude.go.gov.br/r4/core/ValueSet/exame from this IG
Observation.value[x]:valueCodeableConcept	required	ResultadoQualitativoExame https://fhir.saude.go.gov.br/r4/core/ValueSet/resultado-qualitativo-exame from this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
CPFouCNS	error	Observation.subject.identifier	O sistema de identificação do indivíduo deve ser ou CPF ou CNS : system = 'https://fhir.saude.go.gov.br/sid/cpf' or system = 'https://fhir.saude.go.gov.br/sid/cns'
RN03-Exame	warning	Observation	Se a terminologia utilizada para representar o exame for Tabela SUS, TUSS ou CBHPM, esse elemento torna-se obrigatório. O exame realizado deve utilizar as terminologias (Tabela SUS, TUSS ou CBHPM) para representar o método analítico utilizado para determinação do resultado do analito. : code.coding.where(system = 'http://www.saude.gov.br/fhir/r4/CodeSystem/BRTabelaSUS' or system = 'http://www.saude.gov.br/fhir/r4/CodeSystem/BRCBHPMTUSS') implies method.exists()
RN04-Exame	warning	Observation	Se o resultado for quantitativo, é obrigatório enviar os valores de referência, sejam eles estruturados ou não estruturados. O laudo deve conter os valores de referência claras sobre o resultado quantitativo sendo eles estruturados ou não estruturados. : (value is Quantity) implies referenceRange.exists()
ReferenceContained	error	Observation.specimen	Referência deve ser um recurso contido : reference.startsWith('#')

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present RN03-Exame: Se a terminologia utilizada para representar o exame for Tabela SUS, TUSS ou CBHPM, esse elemento torna-se obrigatório. O exame realizado deve utilizar as terminologias (Tabela SUS, TUSS ou CBHPM) para representar o método analítico utilizado para determinação do resultado do analito. RN04-Exame: Se o resultado for quantitativo, é obrigatório enviar os valores de referência, sejam eles estruturados ou não estruturados. O laudo deve conter os valores de referência claras sobre o resultado quantitativo sendo eles estruturados ou não estruturados.
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
basedOn	Σ	0..*	Reference(Suspeita Diagnóstica Investigada)	Fulfills plan, proposal or order
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		1..1	CodeableConcept	Classification of type of observation Binding: Categoria do Exame (required)
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: Exame (required)
subject	Σ	1..1	Reference(Indivíduo)	Who and/or what the observation is about
identifier	ΣC	1..1	Identifier	Logical reference, when literal reference is not known CPFouCNS: O sistema de identificação do indivíduo deve ser ou CPF ou CNS
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
issued	Σ	1..1	instant	Date/Time this version was made available
Slices for performer	Σ	3..4	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Closed by value:$this.id
performer:All Slices				Content/Rules for all slices
identifier	Σ	1..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
performer:laboratorio	Σ	1..1	Reference(Estabelecimento de Saúde)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: laboratorio
performer:responsavelTecnico	Σ	1..1	Reference(Profissional)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: responsavelTecnico
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
conselhoProfissional		1..1	(Complex)	Conselho Profissional URL: https://fhir.saude.go.gov.br/r4/core/StructureDefinition/conselho-profissional
performer:responsavelResultado	Σ	1..1	Reference(Profissional)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: responsavelResultado
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
conselhoProfissional		1..1	(Complex)	Conselho Profissional URL: https://fhir.saude.go.gov.br/r4/core/StructureDefinition/conselho-profissional
performer:laboratorioApoio	Σ	0..1	Reference(Estabelecimento de Saúde)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: laboratorioApoio
Slices for value[x]	ΣC	1..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result Binding: Resultado Qualitativo Exame (required)
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
specimen	C	1..1	Reference(Amostra)	Specimen used for this observation ReferenceContained: Referência deve ser um recurso contido
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	required	CategoriaExame https://fhir.saude.go.gov.br/r4/core/ValueSet/categoria-exame from this IG
Observation.code	required	Exame https://fhir.saude.go.gov.br/r4/core/ValueSet/exame from this IG
Observation.subject.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.performer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.value[x]:valueCodeableConcept	required	ResultadoQualitativoExame https://fhir.saude.go.gov.br/r4/core/ValueSet/resultado-qualitativo-exame from this IG
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
CPFouCNS	error	Observation.subject.identifier	O sistema de identificação do indivíduo deve ser ou CPF ou CNS : system = 'https://fhir.saude.go.gov.br/sid/cpf' or system = 'https://fhir.saude.go.gov.br/sid/cns'
RN03-Exame	warning	Observation	Se a terminologia utilizada para representar o exame for Tabela SUS, TUSS ou CBHPM, esse elemento torna-se obrigatório. O exame realizado deve utilizar as terminologias (Tabela SUS, TUSS ou CBHPM) para representar o método analítico utilizado para determinação do resultado do analito. : code.coding.where(system = 'http://www.saude.gov.br/fhir/r4/CodeSystem/BRTabelaSUS' or system = 'http://www.saude.gov.br/fhir/r4/CodeSystem/BRCBHPMTUSS') implies method.exists()
RN04-Exame	warning	Observation	Se o resultado for quantitativo, é obrigatório enviar os valores de referência, sejam eles estruturados ou não estruturados. O laudo deve conter os valores de referência claras sobre o resultado quantitativo sendo eles estruturados ou não estruturados. : (value is Quantity) implies referenceRange.exists()
ReferenceContained	error	Observation.specimen	Referência deve ser um recurso contido : reference.startsWith('#')
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	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	Observation	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	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	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()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()

Name	Flags	Card.	Type	Description & Constraints
Observation	C	0..*	Observation	Measurements and simple assertions obs-6: dataAbsentReason SHALL only be present if Observation.value[x] is not present obs-7: If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present RN03-Exame: Se a terminologia utilizada para representar o exame for Tabela SUS, TUSS ou CBHPM, esse elemento torna-se obrigatório. O exame realizado deve utilizar as terminologias (Tabela SUS, TUSS ou CBHPM) para representar o método analítico utilizado para determinação do resultado do analito. RN04-Exame: Se o resultado for quantitativo, é obrigatório enviar os valores de referência, sejam eles estruturados ou não estruturados. O laudo deve conter os valores de referência claras sobre o resultado quantitativo sendo eles estruturados ou não estruturados.
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		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for observation
basedOn	Σ	0..*	Reference(Suspeita Diagnóstica Investigada)	Fulfills plan, proposal or order
partOf	Σ	0..*	Reference(MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy)	Part of referenced event
status	?!Σ	1..1	code	registered | preliminary | final | amended + Binding: ObservationStatus (required): Codes providing the status of an observation.
category		1..1	CodeableConcept	Classification of type of observation Binding: Categoria do Exame (required)
code	Σ	1..1	CodeableConcept	Type of observation (code / type) Binding: Exame (required)
subject	Σ	1..1	Reference(Indivíduo)	Who and/or what the observation is about
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	ΣC	1..1	Identifier	Logical reference, when literal reference is not known CPFouCNS: O sistema de identificação do indivíduo deve ser ou CPF ou CNS
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
focus	Σ	0..*	Reference(Resource)	What the observation is about, when it is not about the subject of record
encounter	Σ	0..1	Reference(Encounter)	Healthcare event during which this observation is made
effective[x]	Σ	0..1		Clinically relevant time/time-period for observation
effectiveDateTime			dateTime
effectivePeriod			Period
effectiveTiming			Timing
effectiveInstant			instant
issued	Σ	1..1	instant	Date/Time this version was made available
Slices for performer	Σ	3..4	Reference(Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson)	Who is responsible for the observation Slice: Unordered, Closed by value:$this.id
performer: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 Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	1..1	Identifier	Logical reference, when literal reference is not known
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.
system	Σ	1..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
display	Σ	0..1	string	Text alternative for the resource
performer:laboratorio	Σ	1..1	Reference(Estabelecimento de Saúde)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: laboratorio
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
performer:responsavelTecnico	Σ	1..1	Reference(Profissional)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: responsavelTecnico
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
conselhoProfissional		1..1	(Complex)	Conselho Profissional URL: https://fhir.saude.go.gov.br/r4/core/StructureDefinition/conselho-profissional
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
performer:responsavelResultado	Σ	1..1	Reference(Profissional)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: responsavelResultado
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
conselhoProfissional		1..1	(Complex)	Conselho Profissional URL: https://fhir.saude.go.gov.br/r4/core/StructureDefinition/conselho-profissional
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
performer:laboratorioApoio	Σ	0..1	Reference(Estabelecimento de Saúde)	Who is responsible for the observation
id		0..1	string	Unique id for inter-element referencing Required Pattern: laboratorioApoio
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
reference	ΣC	0..1	string	Literal reference, Relative, internal or absolute URL
type	Σ	0..1	uri	Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model).
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
display	Σ	0..1	string	Text alternative for the resource
Slices for value[x]	ΣC	1..1		Actual result Slice: Unordered, Open by type:$this
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
value[x]:valueCodeableConcept	ΣC	0..1	CodeableConcept	Actual result Binding: Resultado Qualitativo Exame (required)
value[x]:valueQuantity	ΣC	0..1	Quantity	Actual result
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< | <= | >= | > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	Σ	0..1	code	Coded form of the unit
dataAbsentReason	C	0..1	CodeableConcept	Why the result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
note		0..*	Annotation	Comments about the observation
bodySite		0..1	CodeableConcept	Observed body part Binding: SNOMEDCTBodyStructures (example): Codes describing anatomical locations. May include laterality.
method		0..1	CodeableConcept	How it was done Binding: ObservationMethods (example): Methods for simple observations.
specimen	C	1..1	Reference(Amostra)	Specimen used for this observation ReferenceContained: Referência deve ser um recurso contido
device		0..1	Reference(Device | DeviceMetric)	(Measurement) Device
referenceRange	C	0..*	BackboneElement	Provides guide for interpretation obs-3: Must have at least a low or a high or text
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
low	C	0..1	SimpleQuantity	Low Range, if relevant
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	Σ	0..1	code	Coded form of the unit
high	C	0..1	SimpleQuantity	High Range, if relevant
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	Σ	0..1	code	Coded form of the unit
type		0..1	CodeableConcept	Reference range qualifier Binding: ObservationReferenceRangeMeaningCodes (preferred): Code for the meaning of a reference range.
appliesTo		0..*	CodeableConcept	Reference range population Binding: ObservationReferenceRangeAppliesToCodes (example): Codes identifying the population the reference range applies to.
age		0..1	Range	Applicable age range, if relevant
text		0..1	string	Text based reference range in an observation
hasMember	Σ	0..*	Reference(Observation | QuestionnaireResponse | MolecularSequence)	Related resource that belongs to the Observation group
derivedFrom	Σ	0..*	Reference(DocumentReference | ImagingStudy | Media | QuestionnaireResponse | Observation | MolecularSequence)	Related measurements the observation is made from
component	Σ	0..*	BackboneElement	Component results
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	1..1	CodeableConcept	Type of component observation (code / type) Binding: LOINCCodes (example): Codes identifying names of simple observations.
value[x]	Σ	0..1		Actual component result
valueQuantity			Quantity
valueCodeableConcept			CodeableConcept
valueString			string
valueBoolean			boolean
valueInteger			integer
valueRange			Range
valueRatio			Ratio
valueSampledData			SampledData
valueTime			time
valueDateTime			dateTime
valuePeriod			Period
dataAbsentReason	C	0..1	CodeableConcept	Why the component result is missing Binding: DataAbsentReason (extensible): Codes specifying why the result (Observation.value[x]) is missing.
interpretation		0..*	CodeableConcept	High, low, normal, etc. Binding: ObservationInterpretationCodes (extensible): Codes identifying interpretations of observations.
referenceRange		0..*	See referenceRange (Observation)	Provides guide for interpretation of component result
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Observation.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
Observation.status	required	ObservationStatus http://hl7.org/fhir/ValueSet/observation-status|4.0.1 from the FHIR Standard
Observation.category	required	CategoriaExame https://fhir.saude.go.gov.br/r4/core/ValueSet/categoria-exame from this IG
Observation.code	required	Exame https://fhir.saude.go.gov.br/r4/core/ValueSet/exame from this IG
Observation.subject.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.subject.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.subject.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Observation.performer.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.performer.identifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Observation.performer.identifier.type	extensible	Identifier Type Codes http://hl7.org/fhir/ValueSet/identifier-type from the FHIR Standard
Observation.performer:laboratorio.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.performer:responsavelTecnico.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.performer:responsavelResultado.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.performer:laboratorioApoio.type	extensible	ResourceType http://hl7.org/fhir/ValueSet/resource-types from the FHIR Standard
Observation.value[x]:valueCodeableConcept	required	ResultadoQualitativoExame https://fhir.saude.go.gov.br/r4/core/ValueSet/resultado-qualitativo-exame from this IG
Observation.value[x]:valueQuantity.comparator	required	QuantityComparator http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 from the FHIR Standard
Observation.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard
Observation.bodySite	example	SNOMEDCTBodyStructures http://hl7.org/fhir/ValueSet/body-site from the FHIR Standard
Observation.method	example	ObservationMethods http://hl7.org/fhir/ValueSet/observation-methods from the FHIR Standard
Observation.referenceRange.type	preferred	ObservationReferenceRangeMeaningCodes http://hl7.org/fhir/ValueSet/referencerange-meaning from the FHIR Standard
Observation.referenceRange.appliesTo	example	ObservationReferenceRangeAppliesToCodes http://hl7.org/fhir/ValueSet/referencerange-appliesto from the FHIR Standard
Observation.component.code	example	LOINCCodes (a valid code from LOINC) http://hl7.org/fhir/ValueSet/observation-codes from the FHIR Standard
Observation.component.dataAbsentReason	extensible	DataAbsentReason http://hl7.org/fhir/ValueSet/data-absent-reason from the FHIR Standard
Observation.component.interpretation	extensible	ObservationInterpretationCodes http://hl7.org/fhir/ValueSet/observation-interpretation from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
CPFouCNS	error	Observation.subject.identifier	O sistema de identificação do indivíduo deve ser ou CPF ou CNS : system = 'https://fhir.saude.go.gov.br/sid/cpf' or system = 'https://fhir.saude.go.gov.br/sid/cns'
RN03-Exame	warning	Observation	Se a terminologia utilizada para representar o exame for Tabela SUS, TUSS ou CBHPM, esse elemento torna-se obrigatório. O exame realizado deve utilizar as terminologias (Tabela SUS, TUSS ou CBHPM) para representar o método analítico utilizado para determinação do resultado do analito. : code.coding.where(system = 'http://www.saude.gov.br/fhir/r4/CodeSystem/BRTabelaSUS' or system = 'http://www.saude.gov.br/fhir/r4/CodeSystem/BRCBHPMTUSS') implies method.exists()
RN04-Exame	warning	Observation	Se o resultado for quantitativo, é obrigatório enviar os valores de referência, sejam eles estruturados ou não estruturados. O laudo deve conter os valores de referência claras sobre o resultado quantitativo sendo eles estruturados ou não estruturados. : (value is Quantity) implies referenceRange.exists()
ReferenceContained	error	Observation.specimen	Referência deve ser um recurso contido : reference.startsWith('#')
dom-2	error	Observation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Observation	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	Observation	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	Observation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Observation	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()
obs-3	error	Observation.referenceRange	Must have at least a low or a high or text : low.exists() or high.exists() or text.exists()
obs-6	error	Observation	dataAbsentReason SHALL only be present if Observation.value[x] is not present : dataAbsentReason.empty() or value.empty()
obs-7	error	Observation	If Observation.code is the same as an Observation.component.code then the value element associated with the code SHALL NOT be present : value.empty() or component.code.where(coding.intersect(%resource.code.coding).exists()).empty()