Genomics Reporting Implementation Guide
3.0.0 - release International flag

Genomics Reporting Implementation Guide, published by HL7 International / Clinical Genomics. This guide is not an authorized publication; it is the continuous build for version 3.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/genomics-reporting/ and changes regularly. See the Directory of published versions

: bundle-oncologyexamples-r4 - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="bundle-oncologyexamples-r4"/>
  <type value="transaction"/>
  <entry>
    <fullUrl value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
    <resource>
      <Patient>
        <id value="Inline-Instance-for-oncologyexamples-r4-1"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Patient_Inline-Instance-for-oncologyexamples-r4-1"> </a><p class="res-header-id"><b>Generated Narrative: Patient Inline-Instance-for-oncologyexamples-r4-1</b></p><a name="Inline-Instance-for-oncologyexamples-r4-1"> </a><a name="hcInline-Instance-for-oncologyexamples-r4-1"> </a><a name="Inline-Instance-for-oncologyexamples-r4-1-en-US"> </a><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Carrot John Mr  Male, DoB: 1962-12-31 ( 1007)</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Patient Links">Links:</td><td colspan="3"><ul><li>General Practitioner: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef">Bundle: type = transaction</a></li></ul></td></tr></table></div>
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          <given value="Carrot"/>
          <given value="John"/>
          <given value="Mr"/>
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        <gender value="male"/>
        <birthDate value="1962-12-31"/>
        <generalPractitioner>
          <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
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    <resource>
      <Practitioner>
        <id value="Inline-Instance-for-oncologyexamples-r4-2"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Practitioner_Inline-Instance-for-oncologyexamples-r4-2"> </a><p class="res-header-id"><b>Generated Narrative: Practitioner Inline-Instance-for-oncologyexamples-r4-2</b></p><a name="Inline-Instance-for-oncologyexamples-r4-2"> </a><a name="hcInline-Instance-for-oncologyexamples-r4-2"> </a><a name="Inline-Instance-for-oncologyexamples-r4-2-en-US"> </a><p><b>identifier</b>: 4654765876</p><p><b>name</b>: Akerman Philip Prof </p><p><b>address</b>: Castro Valley CA </p></div>
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        <name>
          <given value="Akerman"/>
          <given value="Philip"/>
          <given value="Prof"/>
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        <address>
          <city value="Castro Valley"/>
          <state value="CA"/>
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      <method value="POST"/>
      <url value="Practitioner"/>
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    <resource>
      <Specimen>
        <id value="Inline-Instance-for-oncologyexamples-r4-3"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Specimen_Inline-Instance-for-oncologyexamples-r4-3"> </a><p class="res-header-id"><b>Generated Narrative: Specimen Inline-Instance-for-oncologyexamples-r4-3</b></p><a name="Inline-Instance-for-oncologyexamples-r4-3"> </a><a name="hcInline-Instance-for-oncologyexamples-r4-3"> </a><a name="Inline-Instance-for-oncologyexamples-r4-3-en-US"> </a><p><b>identifier</b>: 076e1948-2217-11e9-94d8-12e241dc1f66</p><p><b>status</b>: Available</p><p><b>subject</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-d0b4affa-91d6-46d1-af01-b30d9f16ef6d">Bundle: type = transaction</a></p><h3>Collections</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Collector</b></td></tr><tr><td style="display: none">*</td><td><a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef">Bundle: type = transaction</a></td></tr></table></div>
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      <url value="Specimen"/>
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  <entry>
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    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-4"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/molecular-biomarker"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_Inline-Instance-for-oncologyexamples-r4-4"> </a><p class="res-header-id"><b>Generated Narrative: Observation Inline-Instance-for-oncologyexamples-r4-4</b></p><a name="Inline-Instance-for-oncologyexamples-r4-4"> </a><a name="hcInline-Instance-for-oncologyexamples-r4-4"> </a><a name="Inline-Instance-for-oncologyexamples-r4-4-en-US"> </a><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs biomarker-category}">A characterization of a given biomarker observation.</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://loinc.org 94076-7}">Mutations/Megabase [# Ratio] in Tumor</span></p><p><b>subject</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-d0b4affa-91d6-46d1-af01-b30d9f16ef6d">Bundle: type = transaction</a></p><p><b>effective</b>: 2023-04-05</p><p><b>performer</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef">Bundle: type = transaction</a></p><p><b>value</b>: 25 somatic variants per megabase of sequenced DNA<span style="background: LightGoldenRodYellow"> (Details: UCUM  code1/1000000 = '1/1000000')</span></p><p><b>specimen</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a5d6a6a9-4859-480e-85b2-56974fef3b9d">Bundle: type = transaction</a></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs biomarker-category}">A characterization of a given biomarker observation.</span></td><td><span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/molecular-biomarker-ontology-cs molgen}">molecular sequence adjacent category</span></td></tr></table></div>
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        <category>
          <coding>
            <system
                    value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
            <code value="biomarker-category"/>
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        <category>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
            <code value="GE"/>
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        <code>
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            <system value="http://loinc.org"/>
            <code value="94076-7"/>
            <display value="Mutations/Megabase [# Ratio] in Tumor"/>
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        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
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        <effectiveDateTime value="2023-04-05"/>
        <performer>
          <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
        </performer>
        <valueQuantity>
          <value value="25"/>
          <unit value="somatic variants per megabase of sequenced DNA"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="1/1000000"/>
        </valueQuantity>
        <specimen>
          <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
        </specimen>
        <component>
          <code>
            <coding>
              <system
                      value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
              <code value="biomarker-category"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/molecular-biomarker-ontology-cs"/>
              <code value="molgen"/>
              <display value="molecular sequence adjacent category"/>
            </coding>
          </valueCodeableConcept>
        </component>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:64b91716-6431-41bd-8fd4-7ac99bebdee9"/>
    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-5"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/molecular-biomarker"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_Inline-Instance-for-oncologyexamples-r4-5"> </a><p class="res-header-id"><b>Generated Narrative: Observation Inline-Instance-for-oncologyexamples-r4-5</b></p><a name="Inline-Instance-for-oncologyexamples-r4-5"> </a><a name="hcInline-Instance-for-oncologyexamples-r4-5"> </a><a name="Inline-Instance-for-oncologyexamples-r4-5-en-US"> </a><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs biomarker-category}">A characterization of a given biomarker observation.</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81695-9}">Microsatellite instability [Interpretation] in Cancer specimen Qualitative</span></p><p><b>subject</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-d0b4affa-91d6-46d1-af01-b30d9f16ef6d">Bundle: type = transaction</a></p><p><b>effective</b>: 2023-04-05</p><p><b>performer</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef">Bundle: type = transaction</a></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA14122-8}">Stable</span></p><p><b>specimen</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a5d6a6a9-4859-480e-85b2-56974fef3b9d">Bundle: type = transaction</a></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs biomarker-category}">A characterization of a given biomarker observation.</span></td><td><span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/molecular-biomarker-ontology-cs molgen}">molecular sequence adjacent category</span></td></tr></table></div>
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        <category>
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            <code value="laboratory"/>
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        <category>
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            <system
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            <code value="biomarker-category"/>
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        <category>
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            <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
            <code value="GE"/>
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        <code>
          <coding>
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            <code value="81695-9"/>
            <display
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        <subject>
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          <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
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          <code>
            <coding>
              <system
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              <code value="biomarker-category"/>
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          <valueCodeableConcept>
            <coding>
              <system
                      value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/molecular-biomarker-ontology-cs"/>
              <code value="molgen"/>
              <display value="molecular sequence adjacent category"/>
            </coding>
          </valueCodeableConcept>
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    <request>
      <method value="POST"/>
      <url value="Observation"/>
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  </entry>
  <entry>
    <fullUrl value="urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d"/>
    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-6"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/variant"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_Inline-Instance-for-oncologyexamples-r4-6"> </a><p class="res-header-id"><b>Generated Narrative: Observation Inline-Instance-for-oncologyexamples-r4-6</b></p><a name="Inline-Instance-for-oncologyexamples-r4-6"> </a><a name="hcInline-Instance-for-oncologyexamples-r4-6"> </a><a name="Inline-Instance-for-oncologyexamples-r4-6-en-US"> </a><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://loinc.org 69548-6}">Genetic variant assessment</span></p><p><b>subject</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-d0b4affa-91d6-46d1-af01-b30d9f16ef6d">Bundle: type = transaction</a></p><p><b>effective</b>: 2023-04-05</p><p><b>performer</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef">Bundle: type = transaction</a></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA9633-4}">Present</span></p><p><b>method</b>: <span title="Codes:{http://loinc.org LA26398-0}">Sequencing</span></p><p><b>specimen</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a5d6a6a9-4859-480e-85b2-56974fef3b9d">Bundle: type = transaction</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81290-9}">Genomic DNA change (gHGVS)</span></p><p><b>value</b>: <span title="Codes:{http://varnomen.hgvs.org NC_000009.12:g.5073770G&gt;T}">NC_000009.12:g.5073770G&gt;T</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48005-3}">Amino acid change (pHGVS)</span></p><p><b>value</b>: <span title="Codes:{http://varnomen.hgvs.org NP_004963.1:p.Val617Phe}">NP_004963.1:p.Val617Phe</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48002-0}">Genomic source class</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA6683-2}">Germline</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48018-6}">Gene studied ID</span></p><p><b>value</b>: <span title="Codes:">JAK2</span></p></blockquote></div>
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        <status value="final"/>
        <category>
          <coding>
            <system
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            <code value="laboratory"/>
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            <code value="GE"/>
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        <code>
          <coding>
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            <code value="69548-6"/>
            <display value="Genetic variant assessment"/>
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            <code value="LA9633-4"/>
            <display value="Present"/>
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        <method>
          <coding>
            <system value="http://loinc.org"/>
            <code value="LA26398-0"/>
            <display value="Sequencing"/>
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        </method>
        <specimen>
          <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
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          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="81290-9"/>
              <display value="Genomic DNA change (gHGVS)"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://varnomen.hgvs.org"/>
              <code value="NC_000009.12:g.5073770G&gt;T"/>
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          </valueCodeableConcept>
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        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="48005-3"/>
              <display value="Amino acid change (pHGVS)"/>
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          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://varnomen.hgvs.org"/>
              <code value="NP_004963.1:p.Val617Phe"/>
              <display value="NP_004963.1:p.Val617Phe"/>
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          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="48002-0"/>
              <display value="Genomic source class"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA6683-2"/>
              <display value="Germline"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="48018-6"/>
              <display value="Gene studied ID"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://www.genenames.org"/>
              <display value="JAK2"/>
            </coding>
          </valueCodeableConcept>
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      </Observation>
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    <request>
      <method value="POST"/>
      <url value="Observation"/>
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  </entry>
  <entry>
    <fullUrl value="urn:uuid:772de7d7-e1bd-4183-bdb5-cea8eda317cd"/>
    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-7"/>
        <meta>
          <profile
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        </meta>
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          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA30200-2"/>
              <display value="Very strong evidence pathogenic"/>
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        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="81259-4"/>
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          </code>
          <valueCodeableConcept>
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        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="51963-7"/>
              <display value="Medication assessed"/>
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          <valueCodeableConcept>
            <text value="AT9283"/>
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    <request>
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    <resource>
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        <meta>
          <profile
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        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_Inline-Instance-for-oncologyexamples-r4-11"> </a><p class="res-header-id"><b>Generated Narrative: Observation Inline-Instance-for-oncologyexamples-r4-11</b></p><a name="Inline-Instance-for-oncologyexamples-r4-11"> </a><a name="hcInline-Instance-for-oncologyexamples-r4-11"> </a><a name="Inline-Instance-for-oncologyexamples-r4-11-en-US"> </a><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs therapeutic-implication}">Therapeutic Implication</span></p><p><b>subject</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-d0b4affa-91d6-46d1-af01-b30d9f16ef6d">Bundle: type = transaction</a></p><p><b>effective</b>: 2023-04-05</p><p><b>performer</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef">Bundle: type = transaction</a></p><p><b>method</b>: <span title="Codes:{http://loinc.org LA26811-2}">Computational analysis</span></p><p><b>specimen</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a5d6a6a9-4859-480e-85b2-56974fef3b9d">Bundle: type = transaction</a></p><p><b>derivedFrom</b>: <a href="Bundle-bundle-complexVariant-nonHGVS.html#urn-uuid-16fdd5fc-e665-48af-99e4-48d603f3e12d">Bundle: type = transaction</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs therapeutic-implication}">Therapeutic Implication</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA6677-4}">Responsive</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 93044-6}">Level of Evidence</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA30200-2}">Very strong evidence pathogenic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81259-4}">Associated phenotype</span></p><p><b>value</b>: <span title="Codes:">Polycythemia vera (PV)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 51963-7}">Medication assessed</span></p><p><b>value</b>: <span title="Codes:">SNX-5422</span></p></blockquote></div>
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        <status value="final"/>
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            <system
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            <code value="laboratory"/>
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            <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
            <code value="GE"/>
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          <coding>
            <system
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            <code value="therapeutic-implication"/>
            <display value="Therapeutic Implication"/>
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        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
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        <effectiveDateTime value="2023-04-05"/>
        <performer>
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        <method>
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            <system value="http://loinc.org"/>
            <code value="LA26811-2"/>
            <display value="Computational analysis"/>
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          <reference value="urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d"/>
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        <component>
          <code>
            <coding>
              <system
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              <code value="therapeutic-implication"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA6677-4"/>
              <display value="Responsive"/>
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          </valueCodeableConcept>
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        <component>
          <code>
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              <system value="http://loinc.org"/>
              <code value="93044-6"/>
              <display value="Level of Evidence"/>
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          <valueCodeableConcept>
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              <system value="http://loinc.org"/>
              <code value="LA30200-2"/>
              <display value="Very strong evidence pathogenic"/>
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        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="81259-4"/>
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          </code>
          <valueCodeableConcept>
            <text value="Polycythemia vera (PV)"/>
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        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="51963-7"/>
              <display value="Medication assessed"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <text value="SNX-5422"/>
          </valueCodeableConcept>
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      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:294f1401-e2eb-4df1-b6d2-09e1b7a6eca4"/>
    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-12"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/therapeutic-implication"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_Inline-Instance-for-oncologyexamples-r4-12"> </a><p class="res-header-id"><b>Generated Narrative: Observation Inline-Instance-for-oncologyexamples-r4-12</b></p><a name="Inline-Instance-for-oncologyexamples-r4-12"> </a><a name="hcInline-Instance-for-oncologyexamples-r4-12"> </a><a name="Inline-Instance-for-oncologyexamples-r4-12-en-US"> </a><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs therapeutic-implication}">Therapeutic Implication</span></p><p><b>subject</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-d0b4affa-91d6-46d1-af01-b30d9f16ef6d">Bundle: type = transaction</a></p><p><b>effective</b>: 2023-04-05</p><p><b>performer</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef">Bundle: type = transaction</a></p><p><b>method</b>: <span title="Codes:{http://loinc.org LA26811-2}">Computational analysis</span></p><p><b>specimen</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a5d6a6a9-4859-480e-85b2-56974fef3b9d">Bundle: type = transaction</a></p><p><b>derivedFrom</b>: <a href="Bundle-bundle-complexVariant-nonHGVS.html#urn-uuid-16fdd5fc-e665-48af-99e4-48d603f3e12d">Bundle: type = transaction</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs therapeutic-implication}">Therapeutic Implication</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA6677-4}">Responsive</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 93044-6}">Level of Evidence</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA30200-2}">Very strong evidence pathogenic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81259-4}">Associated phenotype</span></p><p><b>value</b>: <span title="Codes:">Polycythemia vera (PV)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 51963-7}">Medication assessed</span></p><p><b>value</b>: <span title="Codes:">TG02</span></p></blockquote></div>
        </text>
        <status value="final"/>
        <category>
          <coding>
            <system
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            <code value="laboratory"/>
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        <category>
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            <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
            <code value="GE"/>
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        <code>
          <coding>
            <system
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            <code value="therapeutic-implication"/>
            <display value="Therapeutic Implication"/>
          </coding>
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        <subject>
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            <system value="http://loinc.org"/>
            <code value="LA26811-2"/>
            <display value="Computational analysis"/>
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        <specimen>
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        <derivedFrom>
          <reference value="urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d"/>
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          <code>
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              <system
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              <code value="therapeutic-implication"/>
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          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA6677-4"/>
              <display value="Responsive"/>
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              <system value="http://loinc.org"/>
              <code value="93044-6"/>
              <display value="Level of Evidence"/>
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          <valueCodeableConcept>
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              <system value="http://loinc.org"/>
              <code value="LA30200-2"/>
              <display value="Very strong evidence pathogenic"/>
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              <system value="http://loinc.org"/>
              <code value="81259-4"/>
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          <valueCodeableConcept>
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              <code value="51963-7"/>
              <display value="Medication assessed"/>
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          </code>
          <valueCodeableConcept>
            <text value="TG02"/>
          </valueCodeableConcept>
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      </Observation>
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    <request>
      <method value="POST"/>
      <url value="Observation"/>
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  </entry>
  <entry>
    <fullUrl value="urn:uuid:294f1401-e2eb-4df1-b6d2-09e1b7a6ecb6"/>
    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-14"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/therapeutic-implication"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_Inline-Instance-for-oncologyexamples-r4-14"> </a><p class="res-header-id"><b>Generated Narrative: Observation Inline-Instance-for-oncologyexamples-r4-14</b></p><a name="Inline-Instance-for-oncologyexamples-r4-14"> </a><a name="hcInline-Instance-for-oncologyexamples-r4-14"> </a><a name="Inline-Instance-for-oncologyexamples-r4-14-en-US"> </a><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs therapeutic-implication}">Therapeutic Implication</span></p><p><b>subject</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-d0b4affa-91d6-46d1-af01-b30d9f16ef6d">Bundle: type = transaction</a></p><p><b>effective</b>: 2023-04-05</p><p><b>performer</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef">Bundle: type = transaction</a></p><p><b>derivedFrom</b>: <a href="Bundle-bundle-complexVariant-nonHGVS.html#urn-uuid-16fdd5fc-e665-48af-99e4-48d603f3e12d">Bundle: type = transaction</a></p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Extension</b></td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td/><td><span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs associated-therapy}">Associated Therapy</span></td><td><span title="Codes:">Ruxolitinib</span></td></tr></table><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: PlanDefinition  #PlanDefRuxolitinib</b></p><a name="Inline-Instance-for-oncologyexamples-r4-14/PlanDefRuxolitinib"> </a><a name="hcInline-Instance-for-oncologyexamples-r4-14/PlanDefRuxolitinib"> </a><a name="Inline-Instance-for-oncologyexamples-r4-14/PlanDefRuxolitinib-en-US"> </a><p><b>name</b>: RuxolitinibPlan</p><p><b>status</b>: Draft</p><p><b>description</b>: </p><div><p>This is not a fully defined resource, just here as a place holder to show how a PlanDefinition could be packaged.</p>
</div></blockquote></div>
        </text>
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          <PlanDefinition>
            <id value="PlanDefRuxolitinib"/>
            <name value="RuxolitinibPlan"/>
            <status value="draft"/>
            <description
                         value="This is not a fully defined resource, just here as a place holder to show how a PlanDefinition could be packaged."/>
          </PlanDefinition>
        </contained>
        <status value="final"/>
        <category>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/observation-category"/>
            <code value="laboratory"/>
          </coding>
        </category>
        <category>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
            <code value="GE"/>
          </coding>
        </category>
        <code>
          <coding>
            <system
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            <code value="therapeutic-implication"/>
            <display value="Therapeutic Implication"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
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        <effectiveDateTime value="2023-04-05"/>
        <performer>
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        <derivedFrom>
          <reference value="urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d"/>
        </derivedFrom>
        <component>
          <extension
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            <valueReference>
              <reference value="#PlanDefRuxolitinib"/>
            </valueReference>
          </extension>
          <code>
            <coding>
              <system
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              <code value="associated-therapy"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <text value="Ruxolitinib"/>
          </valueCodeableConcept>
        </component>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
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    <resource>
      <DiagnosticReport>
        <id value="Inline-Instance-for-oncologyexamples-r4-13"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="DiagnosticReport_Inline-Instance-for-oncologyexamples-r4-13"> </a><p class="res-header-id"><b>Generated Narrative: DiagnosticReport Inline-Instance-for-oncologyexamples-r4-13</b></p><a name="Inline-Instance-for-oncologyexamples-r4-13"> </a><a name="hcInline-Instance-for-oncologyexamples-r4-13"> </a><a name="Inline-Instance-for-oncologyexamples-r4-13-en-US"> </a><h2><span title="Codes:{http://loinc.org 51969-4}">Genetic analysis report</span> (<span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span>) </h2><table class="grid"><tr><td>Subject</td><td>Not done yet</td></tr><tr><td>Performer</td><td> <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef">Bundle: type = transaction</a></td></tr></table><p><b>Report Details</b></p><table class="grid"><tr><td><b>Code</b></td><td><b>Value</b></td></tr><tr><td/><td/></tr><tr><td/><td/></tr><tr><td/><td/></tr><tr><td/><td/></tr><tr><td/><td/></tr><tr><td/><td/></tr><tr><td/><td/></tr><tr><td/><td/></tr><tr><td/><td/></tr></table></div>
        </text>
        <status value="final"/>
        <category>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
            <code value="GE"/>
          </coding>
        </category>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="51969-4"/>
          </coding>
          <text value="Genetic analysis report"/>
        </code>
        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
        </subject>
        <performer>
          <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
        </performer>
        <specimen>
          <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
        </specimen>
        <result>
          <reference value="urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d"/>
          <display value="SNV analysis for JAK2 variant"/>
        </result>
        <result>
          <reference value="urn:uuid:772de7d7-e1bd-4183-bdb5-cea8eda317cd"/>
          <display value="SNV analysis for KDR variant"/>
        </result>
        <result>
          <reference value="urn:uuid:b33eb7ec-d83e-49d2-b0f3-729d024ebe01"/>
          <display value="SNV analysis for ERBB4 variant"/>
        </result>
        <result>
          <reference value="urn:uuid:40e85eda-4d31-4bd2-a5a0-c39d63f9824f"/>
          <display value="TMB value analysis"/>
        </result>
        <result>
          <reference value="urn:uuid:64b91716-6431-41bd-8fd4-7ac99bebdee9"/>
          <display value="MSI status analysis"/>
        </result>
        <result>
          <reference value="urn:uuid:1bf9642d-fd1c-4819-8c5d-44fae4bad524"/>
          <display value="Therapy match result 1"/>
        </result>
        <result>
          <reference value="urn:uuid:1301943b-55db-4adf-8355-3635f7268a1b"/>
          <display value="Therapy match result 2"/>
        </result>
        <result>
          <reference value="urn:uuid:05713d1c-0df5-46d5-a5a9-2085eef56c20"/>
          <display value="Therapy match result 3"/>
        </result>
        <result>
          <reference value="urn:uuid:294f1401-e2eb-4df1-b6d2-09e1b7a6eca4"/>
          <display value="Therapy match result 4"/>
        </result>
      </DiagnosticReport>
    </resource>
    <request>
      <method value="POST"/>
      <url value="DiagnosticReport"/>
    </request>
  </entry>
</Bundle>