import { Annotation } from './Annotation.js';
import { Attachment } from './Attachment.js';
import { BiologicallyDerivedProduct } from './BiologicallyDerivedProduct.js';
import { BodyStructure } from './BodyStructure.js';
import { CarePlan } from './CarePlan.js';
import { CareTeam } from './CareTeam.js';
import { CodeableConcept } from './CodeableConcept.js';
import { Device } from './Device.js';
import { DeviceMetric } from './DeviceMetric.js';
import { DeviceRequest } from './DeviceRequest.js';
import { DocumentReference } from './DocumentReference.js';
import { Encounter } from './Encounter.js';
import { Extension } from './Extension.js';
import { FhirPrimitive } from './FhirPrimitive.js';
import { GenomicStudy } from './GenomicStudy.js';
import { Group } from './Group.js';
import { Identifier } from './Identifier.js';
import { ImagingSelection } from './ImagingSelection.js';
import { ImagingStudy } from './ImagingStudy.js';
import { Immunization } from './Immunization.js';
import { ImmunizationRecommendation } from './ImmunizationRecommendation.js';
import { Location } from './Location.js';
import { Medication } from './Medication.js';
import { MedicationAdministration } from './MedicationAdministration.js';
import { MedicationDispense } from './MedicationDispense.js';
import { MedicationRequest } from './MedicationRequest.js';
import { MedicationStatement } from './MedicationStatement.js';
import { Meta } from './Meta.js';
import { MolecularSequence } from './MolecularSequence.js';
import { Narrative } from './Narrative.js';
import { NutritionOrder } from './NutritionOrder.js';
import { NutritionProduct } from './NutritionProduct.js';
import { Observation_Component } from './Observation_Component.js';
import { Observation_ReferenceRange } from './Observation_ReferenceRange.js';
import { Observation_TriggeredBy } from './Observation_TriggeredBy.js';
import { Organization } from './Organization.js';
import { Patient } from './Patient.js';
import { Period } from './Period.js';
import { Practitioner } from './Practitioner.js';
import { PractitionerRole } from './PractitionerRole.js';
import { Procedure } from './Procedure.js';
import { Quantity } from './Quantity.js';
import { QuestionnaireResponse } from './QuestionnaireResponse.js';
import { Range } from './Range.js';
import { Ratio } from './Ratio.js';
import { Reference } from './Reference.js';
import { RelatedPerson } from './RelatedPerson.js';
import { Resource } from './Resource.js';
import { SampledData } from './SampledData.js';
import { ServiceRequest } from './ServiceRequest.js';
import { Specimen } from './Specimen.js';
import { Substance } from './Substance.js';
import { Timing } from './Timing.js';
export interface Observation {
    /**
     * @description The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
     * @comment Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.
     * @short Logical id of this artifact
     */
    id?: string;
    /**
     * @description The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
     * @short Metadata about the resource
     */
    meta?: Meta;
    /**
     * @description A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
     * @comment Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers andor specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.
     * @short A set of rules under which this content was created
     */
    implicitRules?: FhirPrimitive<string>;
    /**
     * @description The base language in which the resource is written.
     * @comment Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies  to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
     * @short Language of the resource content
     */
    language?: FhirPrimitive<string>;
    /**
     * @description A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
     * @comment Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied).  This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
     * @short Text summary of the resource, for human interpretation
     */
    text?: Narrative;
    /**
     * @description These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides contextmeaning.
     * @comment This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.
     * @short Contained, inline Resources
     */
    contained?: Resource[];
    /**
     * @description May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
     * @comment There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
     * @short Additional content defined by implementations
     */
    extension?: Extension[];
    /**
     * @description May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it andor the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
  
  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
     * @comment There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
     * @short Extensions that cannot be ignored
     */
    modifierExtension?: Extension[];
    /**
     * @description A unique identifier assigned to this observation.
     * @short Business Identifier for observation
     */
    identifier?: Identifier[];
    /**
     * @choice This is part of the instantiates[x] choice.
     * @oneOf instantiatesCanonical, instantiatesReference
     */
    instantiatesCanonical?: FhirPrimitive<string>;
    /**
     * @choice This is part of the instantiates[x] choice.
     * @oneOf instantiatesCanonical, instantiatesReference
     */
    instantiatesReference?: Reference;
    /**
     * @description A plan, proposal or order that is fulfilled in whole or in part by this event.  For example, a MedicationRequest may require a patient to have laboratory test performed before  it is dispensed.
     * @short Fulfills plan, proposal or order
     */
    basedOn?: Reference<CarePlan | DeviceRequest | ImmunizationRecommendation | MedicationRequest | NutritionOrder | ServiceRequest>[];
    /**
     * @backbone Nested BackboneElement: triggeredBy [0..*]
     */
    triggeredBy?: Observation_TriggeredBy[];
    /**
     * @description A larger event of which this particular Observation is a component or step.  For example,  an observation as part of a procedure.
     * @comment To link an Observation to an Encounter use `encounter`.  See the  [Notes](observation.html#obsgrouping) below for guidance on referencing another Observation.
     * @short Part of referenced event
     */
    partOf?: Reference<MedicationAdministration | MedicationDispense | MedicationStatement | Procedure | Immunization | ImagingStudy | GenomicStudy>[];
    /**
     * @description The status of the result value.
     * @comment This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
     * @short registered | preliminary | final | amended +
     */
    status: FhirPrimitive<string>;
    /**
     * @description A code that classifies the general type of observation being made.
     * @comment In addition to the required category valueset, this element allows various categorization schemes based on the owner’s definition of the category and effectively multiple categories can be used at once.  The level of granularity is defined by the category concepts in the value set.
     * @short Classification of  type of observation
     */
    category?: CodeableConcept[];
    /**
     * @description Describes what was observed. Sometimes this is called the observation "name".
     * @comment All code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation.
     * @short Type of observation (code  type)
     */
    code: CodeableConcept;
    /**
     * @description The patient, or group of patients, location, device, organization, procedure or practitioner this observation is about and into whose or what record the observation is placed. If the actual focus of the observation is different from the subject (or a sample of, part, or region of the subject), the `focus` element or the `code` itself specifies the actual focus of the observation.
     * @comment One would expect this element to be a cardinality of 1..1. The only circumstance in which the subject can be missing is when the observation is made by a device that does not know the patient. In this case, the observation SHALL be matched to a patient through some contextchannel matching technique, and at this point, the observation should be updated. The subject of an Observation may in some cases be a procedure.  This supports the regulatory inspection use case where observations are captured during inspections of a procedure that is being performed (independent of any particular patient or whether patient related at all).
     * @short Who andor what the observation is about
     */
    subject?: Reference<Patient | Group | Device | Location | Organization | Procedure | Practitioner | Medication | Substance | BiologicallyDerivedProduct | NutritionProduct>;
    /**
     * @description The actual focus of an observation when it is not the patient of record representing something or someone associated with the patient such as a spouse, parent, fetus, or donor. For example, fetus observations in a mother's record.  The focus of an observation could also be an existing condition,  an intervention, the subject's diet,  another observation of the subject,  or a body structure such as tumor or implanted device.   An example use case would be using the Observation resource to capture whether the mother is trained to change her child's tracheostomy tube. In this example, the child is the patient of record and the mother is the focus.
     * @comment Typically, an observation is made about the subject - a patient, or group of patients, location, or device - and the distinction between the subject and what is directly measured for an observation is specified in the observation code itself ( e.g., "Blood Glucose") and does not need to be represented separately using this element.  Use `specimen` if a reference to a specimen is required.  If a code is required instead of a resource use either  `bodysite` for bodysites or the standard extension [http:hl7.orgfhirStructureDefinitionobservation-focusCode](http:hl7.orgfhirextensionsStructureDefinition-observation-focusCode.html).
     * @short What the observation is about, when it is not about the subject of record
     */
    focus?: Reference<Resource>[];
    /**
     * @description The healthcare event  (e.g. a patient and healthcare provider interaction) during which this observation is made.
     * @comment This will typically be the encounter the event occurred within, but some events may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission laboratory tests).
     * @short Healthcare event during which this observation is made
     */
    encounter?: Reference<Encounter>;
    /**
     * @choice This is part of the effective[x] choice.
     * @oneOf effectiveDateTime, effectivePeriod, effectiveTiming, effectiveInstant
     */
    effectiveDateTime?: FhirPrimitive<string>;
    /**
     * @choice This is part of the effective[x] choice.
     * @oneOf effectiveDateTime, effectivePeriod, effectiveTiming, effectiveInstant
     */
    effectivePeriod?: Period;
    /**
     * @choice This is part of the effective[x] choice.
     * @oneOf effectiveDateTime, effectivePeriod, effectiveTiming, effectiveInstant
     */
    effectiveTiming?: Timing;
    /**
     * @choice This is part of the effective[x] choice.
     * @oneOf effectiveDateTime, effectivePeriod, effectiveTiming, effectiveInstant
     */
    effectiveInstant?: FhirPrimitive<string>;
    /**
     * @description The date and time this version of the observation was made available to providers, typically after the results have been reviewed and verified.
     * @comment For Observations that don't require review and verification, it may be the same as the [`lastUpdated` ](resource-definitions.html#Meta.lastUpdated) time of the resource itself.  For Observations that do require review and verification for certain updates, it might not be the same as the `lastUpdated` time of the resource itself due to a non-clinically significant update that doesn't require the new version to be reviewed and verified again.
     * @short DateTime this version was made available
     */
    issued?: FhirPrimitive<string>;
    /**
     * @description Who was responsible for asserting the observed value as "true".
     * @short Who is responsible for the observation
     */
    performer?: Reference<Practitioner | PractitionerRole | Organization | CareTeam | Patient | RelatedPerson>[];
    /**
     * @choice This is part of the value[x] choice.
     * @oneOf valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueInteger, valueRange, valueRatio, valueSampledData, valueTime, valueDateTime, valuePeriod, valueAttachment, valueReference
     */
    valueQuantity?: Quantity;
    /**
     * @choice This is part of the value[x] choice.
     * @oneOf valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueInteger, valueRange, valueRatio, valueSampledData, valueTime, valueDateTime, valuePeriod, valueAttachment, valueReference
     */
    valueCodeableConcept?: CodeableConcept;
    /**
     * @choice This is part of the value[x] choice.
     * @oneOf valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueInteger, valueRange, valueRatio, valueSampledData, valueTime, valueDateTime, valuePeriod, valueAttachment, valueReference
     */
    valueString?: FhirPrimitive<string>;
    /**
     * @choice This is part of the value[x] choice.
     * @oneOf valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueInteger, valueRange, valueRatio, valueSampledData, valueTime, valueDateTime, valuePeriod, valueAttachment, valueReference
     */
    valueBoolean?: FhirPrimitive<boolean>;
    /**
     * @choice This is part of the value[x] choice.
     * @oneOf valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueInteger, valueRange, valueRatio, valueSampledData, valueTime, valueDateTime, valuePeriod, valueAttachment, valueReference
     */
    valueInteger?: FhirPrimitive<number>;
    /**
     * @choice This is part of the value[x] choice.
     * @oneOf valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueInteger, valueRange, valueRatio, valueSampledData, valueTime, valueDateTime, valuePeriod, valueAttachment, valueReference
     */
    valueRange?: Range;
    /**
     * @choice This is part of the value[x] choice.
     * @oneOf valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueInteger, valueRange, valueRatio, valueSampledData, valueTime, valueDateTime, valuePeriod, valueAttachment, valueReference
     */
    valueRatio?: Ratio;
    /**
     * @choice This is part of the value[x] choice.
     * @oneOf valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueInteger, valueRange, valueRatio, valueSampledData, valueTime, valueDateTime, valuePeriod, valueAttachment, valueReference
     */
    valueSampledData?: SampledData;
    /**
     * @choice This is part of the value[x] choice.
     * @oneOf valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueInteger, valueRange, valueRatio, valueSampledData, valueTime, valueDateTime, valuePeriod, valueAttachment, valueReference
     */
    valueTime?: FhirPrimitive<string>;
    /**
     * @choice This is part of the value[x] choice.
     * @oneOf valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueInteger, valueRange, valueRatio, valueSampledData, valueTime, valueDateTime, valuePeriod, valueAttachment, valueReference
     */
    valueDateTime?: FhirPrimitive<string>;
    /**
     * @choice This is part of the value[x] choice.
     * @oneOf valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueInteger, valueRange, valueRatio, valueSampledData, valueTime, valueDateTime, valuePeriod, valueAttachment, valueReference
     */
    valuePeriod?: Period;
    /**
     * @choice This is part of the value[x] choice.
     * @oneOf valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueInteger, valueRange, valueRatio, valueSampledData, valueTime, valueDateTime, valuePeriod, valueAttachment, valueReference
     */
    valueAttachment?: Attachment;
    /**
     * @choice This is part of the value[x] choice.
     * @oneOf valueQuantity, valueCodeableConcept, valueString, valueBoolean, valueInteger, valueRange, valueRatio, valueSampledData, valueTime, valueDateTime, valuePeriod, valueAttachment, valueReference
     */
    valueReference?: Reference;
    /**
     * @description Provides a reason why the expected value in the element Observation.value[x] is missing.
     * @comment Null or exceptional values can be represented two ways in FHIR Observations.  One way is to simply include them in the value set and represent the exceptions in the value.  For example, measurement values for a serology test could be  "detected", "not detected", "inconclusive", or  "specimen unsatisfactory".
  
  The alternate way is to use the value element for actual observations and use the explicit dataAbsentReason element to record exceptional values.  For example, the dataAbsentReason code "error" could be used when the measurement was not completed. Note that an observation may only be reported if there are values to report. For example differential cell counts values may be reported only when > 0.  Because of these options, use-case agreements are required to interpret general observations for null or exceptional values.
     * @short Why the result is missing
     */
    dataAbsentReason?: CodeableConcept;
    /**
     * @description A categorical assessment of an observation value.  For example, high, low, normal.
     * @comment Historically used for laboratory results (known as 'abnormal flag' ),  its use extends to other use cases where coded interpretations  are relevant.  Often reported as one or more simple compact codes this element is often placed adjacent to the result value in reports and flow sheets to signal the meaningnormalcy status of the result.
     * @short High, low, normal, etc
     */
    interpretation?: CodeableConcept[];
    /**
     * @description Comments about the observation or the results.
     * @comment May include general statements about the observation, or statements about significant, unexpected or unreliable results values, or information about its source when relevant to its interpretation.
     * @short Comments about the observation
     */
    note?: Annotation[];
    /**
     * @description Indicates the site on the subject's body where the observation was made (i.e. the target site).
     * @comment Only used if not implicit in code found in Observation.code.  In many systems, this may be represented as a related observation instead of an inline component.
     * @short Observed body part
     */
    bodySite?: CodeableConcept;
    /**
     * @description Indicates the body structure on the subject's body where the observation was made (i.e. the target site).
     * @comment Only used if not implicit in code found in Observation.code or bodySite is used. In many systems, this may be represented as a related observation instead of an inline component.
     * @short Observed body structure
     */
    bodyStructure?: Reference<BodyStructure>;
    /**
     * @description Indicates the mechanism used to perform the observation.
     * @comment Only used if not implicit in code for Observation.code.
     * @short How it was done
     */
    method?: CodeableConcept;
    /**
     * @description The specimen that was used when this observation was made.
     * @comment Should only be used if not implicit in code found in `Observation.code`.  Observations are not made on specimens themselves; they are made on a subject, but in many cases by the means of a specimen. Note that although specimens are often involved, they are not always tracked and reported explicitly. Also note that observation resources may be used in contexts that track the specimen explicitly (e.g. Diagnostic Report).
     * @short Specimen used for this observation
     */
    specimen?: Reference<Specimen | Group>;
    /**
     * @description A reference to the device that generates the measurements or the device settings for the device.
     * @comment Note that this is not meant to represent a device involved in the transmission of the result, e.g., a gateway.  Such devices may be documented using the Provenance resource where relevant.
     * @short A reference to the device that generates the measurements or the device settings for the device
     */
    device?: Reference<Device | DeviceMetric>;
    /**
     * @backbone Nested BackboneElement: referenceRange [0..*]
     */
    referenceRange?: Observation_ReferenceRange[];
    /**
     * @description This observation is a group observation (e.g. a battery, a panel of tests, a set of vital sign measurements) that includes the target as a member of the group.
     * @comment When using this element, an observation will typically have either a value or a set of related resources, although both may be present in some cases.  For a discussion on the ways Observations can assembled in groups together, see [Notes](observation.html#obsgrouping) below.  Note that a system may calculate results from [QuestionnaireResponse](questionnaireresponse.html)  into a final score and represent the score as an Observation.
     * @short Related resource that belongs to the Observation group
     */
    hasMember?: Reference<Observation | QuestionnaireResponse | MolecularSequence>[];
    /**
     * @description The target resource that represents a measurement from which this observation value is derived. For example, a calculated anion gap or a fetal measurement based on an ultrasound image.
     * @comment All the reference choices that are listed in this element can represent clinical observations and other measurements that may be the source for a derived value.  The most common reference will be another Observation.  For a discussion on the ways Observations can assembled in groups together, see [Notes](observation.html#obsgrouping) below.
     * @short Related resource from which the observation is made
     */
    derivedFrom?: Reference<DocumentReference | ImagingStudy | ImagingSelection | QuestionnaireResponse | Observation | MolecularSequence | GenomicStudy>[];
    /**
     * @backbone Nested BackboneElement: component [0..*]
     */
    component?: Observation_Component[];
    /**
     * @const Auto-injected fixed value: Observation
     */
    resourceType: "Observation";
}
//# sourceMappingURL=Observation.d.ts.map