ICD10-GM 代码验证未能用于标本诊断

Question

我在尝试验证样本配置文件中的 ICD10（德语版）代码时收到这些错误消息。 我使用 HAPI FHIR 库进行验证，并根据 bbmri.de implementation guide sample profile进行验证。

Bundle.entry[6].resource.ofType(Specimen).extension[2].value.ofType(CodeableConcept).coding[0] slicing-1: 'When slice no-icd is present, the other slices must not be present' Rule 'When slice no-icd is present, the other slices must not be present' Failed
Bundle.entry[7].resource.ofType(Specimen).extension[2].value.ofType(CodeableConcept).coding[0] Validation failed for 'http://fhir.de/CodeSystem/dimdi/icd-10-gm#C34.9'
Bundle.entry[7].resource.ofType(Specimen).extension[2].value.ofType(CodeableConcept).coding[0] slicing-1: 'When slice no-icd is present, the other slices must not be present' Rule 'When slice no-icd is present, the other slices must not be present' Failed
Bundle.entry[9].resource.ofType(Specimen).extension[2].value.ofType(CodeableConcept).coding[0] Validation failed for 'http://fhir.de/CodeSystem/dimdi/icd-10-gm#C78.0'

这是我要验证的 json 文件中的一个样本资源：

"resource": {
        "resourceType": "Specimen",
        "id": "pat0-specimen0",
        "meta": {
          "profile": [
            "https://fhir.bbmri.de/StructureDefinition/Specimen"
          ]
        },
        "extension": [
          {
            "url": "https://fhir.bbmri.de/StructureDefinition/Custodian",
            "valueReference": {
              "reference": "Organization/Tumor"
            }
          },
          {
            "url": "https://fhir.bbmri.de/StructureDefinition/StorageTemperature",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "https://fhir.bbmri.de/CodeSystem/StorageTemperature",
                  "code": "temperatureLN",
                  "display": "Liquid nitrogen"
                }
              ]
            }
          },
          {
            "url": "https://fhir.bbmri.de/StructureDefinition/SampleDiagnosis",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "http://fhir.de/CodeSystem/dimdi/icd-10-gm",
                  "code": "C50",
                  "display": "Bösartige Neubildung der Brustdrüse [Mamma]"
                }
              ]
            }
          }
        ],
        "status": "available",
        "type": {
          "coding": [
            {
              "system": "https://fhir.bbmri.de/CodeSystem/SampleMaterialType",
              "code": "tissue-ffpe",
              "display": "Tissue FFPE"
            }
          ]
        },
        "subject": {
          "reference": "Patient/pat0"
        },
        "collection": {
          "collectedDateTime": "2021-11-19T13:44:13+01:00",
          "fastingStatusCodeableConcept": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/v2-0916",
                "code": "NG",
                "display": "Not Given - Patient was not asked at the time of the procedure."
              }
            ]
          }
        }
      }
}

有人可以告诉我我做错了什么还是配置文件定义有问题？ bbmri IG 的其他资源运行良好。

Answer 1

这个约束：“no-icd.exists().not() or (icd-10-who.exists() or icd-10-gm.exists() or icd-9.exists()).not()”被打破。

资源中没有（也不可能）任何名称为“no-icd”或“icd-10-who”等的元素。约束不能与切片名称相关联，只能与实例中的实际数据相关联。 你不得不说这样的话：

code.coding.where(system="123" and version="456").exists()

此外，在查看您的个人资料时，我没有看到为系统或版本声明的固定值，这是您的鉴别器。 （通过 $this 来区分一种编码也是没有意义的。）