Background: DiagnosticReport.effective and DiagnosticReport.issued were made conditionally mandatory for this ballot based on  FHIR-34330  . Which resulted in the invariant referenced by the commenter: for example: Constraints Id Grade Path Details Requirements us-core-10 error DiagnosticReport effective [x] SHALL be present if the status is 'partial', 'preliminary', 'final', 'amended', 'corrected' or 'appended' : (status='partial' or status='preliminary' or status='final' or status='amended' or status='corrected' or status='appended' ) implies effective.exists() The targets of these constraints currently have a minimum cardinality of 1, because the tracker was only partially applied: for example:   Reasoning: We agree with the commenter. This is an editorial error. The minimum cardinality for the elements targeted by the invariant should be 0.   Proposed Changes: Will change the minimum cardinality for the following elements from 1 to 0 : US Core DiagnosticReport Profile for Report and Note exchange DiagnosticReport.effective[x] US Core DiagnosticReport Profile for Laboratory Results Reporting DiagnosticReport.effective[x] DiagnosticReport.issued