Genomics Reporting Implementation Guide
4.0.0-cibuild - CI Build

Genomics Reporting Implementation Guide, published by HL7 International / Clinical Genomics. This guide is not an authorized publication; it is the continuous build for version 4.0.0-cibuild 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-oncology-diagnostic - XML Representation

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    <Bundle xmlns="http://hl7.org/fhir">
      <id value="bundle-oncology-diagnostic"/>
      <type value="transaction"/>
      <entry>
        <fullUrl value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
        <resource>
          <Patient>
            <id value="Inline-Instance-for-oncology-diagnostic-1"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Patient_Inline-Instance-for-oncology-diagnostic-1"> </a><p class="res-header-id"><b>Generated Narrative: Patient Inline-Instance-for-oncology-diagnostic-1</b></p><a name="Inline-Instance-for-oncology-diagnostic-1"> </a><a name="hcInline-Instance-for-oncology-diagnostic-1"> </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">Practitioner Akerman Philip Prof </a></li></ul></td></tr></table></div>
            </text>
            <identifier>
              <value value="1007"/>
            </identifier>
            <name>
              <given value="Carrot"/>
              <given value="John"/>
              <given value="Mr"/>
            </name>
            <gender value="male"/>
            <birthDate value="1962-12-31"/>
            <generalPractitioner>
              <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
            </generalPractitioner>
          </Patient>
        </resource>
        <request>
          <method value="POST"/>
          <url value="Patient"/>
        </request>
      </entry>
      <entry>
        <fullUrl value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
        <resource>
          <Practitioner>
            <id value="Inline-Instance-for-oncology-diagnostic-2"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Practitioner_Inline-Instance-for-oncology-diagnostic-2"> </a><p class="res-header-id"><b>Generated Narrative: Practitioner Inline-Instance-for-oncology-diagnostic-2</b></p><a name="Inline-Instance-for-oncology-diagnostic-2"> </a><a name="hcInline-Instance-for-oncology-diagnostic-2"> </a><p><b>identifier</b>: 4654765876</p><p><b>name</b>: Akerman Philip Prof </p><p><b>address</b>: Castro Valley CA </p></div>
            </text>
            <identifier>
              <value value="4654765876"/>
            </identifier>
            <name>
              <given value="Akerman"/>
              <given value="Philip"/>
              <given value="Prof"/>
            </name>
            <address>
              <city value="Castro Valley"/>
              <state value="CA"/>
            </address>
          </Practitioner>
        </resource>
        <request>
          <method value="POST"/>
          <url value="Practitioner"/>
        </request>
      </entry>
      <entry>
        <fullUrl value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
        <resource>
          <Specimen>
            <id value="Inline-Instance-for-oncology-diagnostic-3"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Specimen_Inline-Instance-for-oncology-diagnostic-3"> </a><p class="res-header-id"><b>Generated Narrative: Specimen Inline-Instance-for-oncology-diagnostic-3</b></p><a name="Inline-Instance-for-oncology-diagnostic-3"> </a><a name="hcInline-Instance-for-oncology-diagnostic-3"> </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">Carrot John Mr  Male, DoB: 1962-12-31 ( 1007)</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">Practitioner Akerman Philip Prof </a></td></tr></table></div>
            </text>
            <identifier>
              <value value="076e1948-2217-11e9-94d8-12e241dc1f66"/>
            </identifier>
            <status value="available"/>
            <subject>
              <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
            </subject>
            <collection>
              <collector>
                <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
              </collector>
            </collection>
          </Specimen>
        </resource>
        <request>
          <method value="POST"/>
          <url value="Specimen"/>
        </request>
      </entry>
      <entry>
        <fullUrl value="urn:uuid:40e85eda-4d31-4bd2-a5a0-c39d63f9824f"/>
        <resource>
          <Observation>
            <id value="Inline-Instance-for-oncology-diagnostic-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-oncology-diagnostic-4"> </a><p class="res-header-id"><b>Generated Narrative: Observation Inline-Instance-for-oncology-diagnostic-4</b></p><a name="Inline-Instance-for-oncology-diagnostic-4"> </a><a name="hcInline-Instance-for-oncology-diagnostic-4"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-molecular-biomarker.html">Molecular Biomarker</a></p></div><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}">Biomarker Category</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">Carrot John Mr  Male, DoB: 1962-12-31 ( 1007)</a></p><p><b>effective</b>: 2019-03-05</p><p><b>performer</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef">Practitioner Akerman Philip Prof </a></p><p><b>value</b>: 25 Mutations/Megabase<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">Specimen: identifier = 076e1948-2217-11e9-94d8-12e241dc1f66; status = available</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}">Biomarker Category</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>
            </text>
            <status value="final"/>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/observation-category"/>
                <code value="laboratory"/>
              </coding>
            </category>
            <category>
              <coding>
                <system
                        value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
                <code value="biomarker-category"/>
              </coding>
            </category>
            <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="94076-7"/>
                <display value="Mutations/Megabase [# Ratio] in Tumor"/>
              </coding>
            </code>
            <subject>
              <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
            </subject>
            <effectiveDateTime value="2019-03-05"/>
            <performer>
              <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
            </performer>
            <valueQuantity>
              <value value="25"/>
              <unit value="Mutations/Megabase"/>
              <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:16fdd5fc-e665-48af-99e4-48d603f3e12d"/>
        <resource>
          <Observation>
            <id value="Inline-Instance-for-oncology-diagnostic-5"/>
            <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-oncology-diagnostic-5"> </a><p class="res-header-id"><b>Generated Narrative: Observation Inline-Instance-for-oncology-diagnostic-5</b></p><a name="Inline-Instance-for-oncology-diagnostic-5"> </a><a name="hcInline-Instance-for-oncology-diagnostic-5"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-variant.html">Variant</a></p></div><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">Carrot John Mr  Male, DoB: 1962-12-31 ( 1007)</a></p><p><b>effective</b>: 2019-03-05</p><p><b>performer</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef">Practitioner Akerman Philip Prof </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">Specimen: identifier = 076e1948-2217-11e9-94d8-12e241dc1f66; status = available</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 62374-4}">Human reference sequence assembly version</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA14029-5}">GRCh37</span></p></blockquote><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_000007.13:g.140453136A&gt;T}">NC_000007.13:g.140453136A&gt;T</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81252-9}">Discrete genetic variant</span></p><p><b>value</b>: <span title="Codes:{http://www.ncbi.nlm.nih.gov/clinvar 13961}">Clinvar ID 13961</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_004324.2:p.Val600Glu}">NP_004324.2:p.Val600Glu</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:{http://www.genenames.org HGNC:1097}">BRAF</span></p></blockquote></div>
            </text>
            <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 value="http://loinc.org"/>
                <code value="69548-6"/>
                <display value="Genetic variant assessment"/>
              </coding>
            </code>
            <subject>
              <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
            </subject>
            <effectiveDateTime value="2019-03-05"/>
            <performer>
              <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
            </performer>
            <valueCodeableConcept>
              <coding>
                <system value="http://loinc.org"/>
                <code value="LA9633-4"/>
                <display value="Present"/>
              </coding>
            </valueCodeableConcept>
            <method>
              <coding>
                <system value="http://loinc.org"/>
                <code value="LA26398-0"/>
                <display value="Sequencing"/>
              </coding>
            </method>
            <specimen>
              <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
            </specimen>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="62374-4"/>
                  <display value="Human reference sequence assembly version"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="LA14029-5"/>
                  <display value="GRCh37"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <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_000007.13:g.140453136A&gt;T"/>
                  <display value="NC_000007.13:g.140453136A&gt;T"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81252-9"/>
                  <display value="Discrete genetic variant"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://www.ncbi.nlm.nih.gov/clinvar"/>
                  <code value="13961"/>
                  <display value="Clinvar ID 13961"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="48005-3"/>
                  <display value="Amino acid change (pHGVS)"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://varnomen.hgvs.org"/>
                  <code value="NP_004324.2:p.Val600Glu"/>
                  <display value="NP_004324.2:p.Val600Glu"/>
                </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"/>
                  <code value="HGNC:1097"/>
                  <display value="BRAF"/>
                </coding>
              </valueCodeableConcept>
            </component>
          </Observation>
        </resource>
        <request>
          <method value="POST"/>
          <url value="Observation"/>
        </request>
      </entry>
      <entry>
        <fullUrl value="urn:uuid:1bf9642d-fd1c-4819-8c5d-44fae4bad524"/>
        <resource>
          <Observation>
            <id value="Inline-Instance-for-oncology-diagnostic-6"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/diagnostic-implication"/>
            </meta>
            <text>
              <status value="extensions"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_Inline-Instance-for-oncology-diagnostic-6"> </a><p class="res-header-id"><b>Generated Narrative: Observation Inline-Instance-for-oncology-diagnostic-6</b></p><a name="Inline-Instance-for-oncology-diagnostic-6"> </a><a name="hcInline-Instance-for-oncology-diagnostic-6"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-diagnostic-implication.html">Diagnostic Implication</a></p></div><p><b>Related artifact</b>: No display for RelatedArtifact  (type: justification; display: https://pmkb.weill.cornell.edu/therapies/103)</p><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 diagnostic-implication}">Diagnostic Implication</span></p><p><b>subject</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-d0b4affa-91d6-46d1-af01-b30d9f16ef6d">Carrot John Mr  Male, DoB: 1962-12-31 ( 1007)</a></p><p><b>effective</b>: 2019-03-05</p><p><b>performer</b>: <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef">Practitioner Akerman Philip Prof </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">Specimen: identifier = 076e1948-2217-11e9-94d8-12e241dc1f66; status = available</a></p><p><b>derivedFrom</b>: <a href="Bundle-bundle-complexVariant-nonHGVS.html#urn-uuid-16fdd5fc-e665-48af-99e4-48d603f3e12d">Observation Genetic variant assessment</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 53037-8}">Genetic variation clinical significance [Imp]</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA6668-3}">Pathogenic</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:">melanoma</span></p></blockquote></div>
            </text>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact">
              <valueRelatedArtifact>
                <type value="justification"/>
                <display value="https://pmkb.weill.cornell.edu/therapies/103"/>
              </valueRelatedArtifact>
            </extension>
            <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
                        value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
                <code value="diagnostic-implication"/>
                <display value="Diagnostic Implication"/>
              </coding>
            </code>
            <subject>
              <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
            </subject>
            <effectiveDateTime value="2019-03-05"/>
            <performer>
              <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
            </performer>
            <method>
              <coding>
                <system value="http://loinc.org"/>
                <code value="LA26811-2"/>
                <display value="Computational analysis"/>
              </coding>
            </method>
            <specimen>
              <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
            </specimen>
            <derivedFrom>
              <reference value="urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d"/>
            </derivedFrom>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="53037-8"/>
                  <display value="Genetic variation clinical significance [Imp]"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="LA6668-3"/>
                  <display value="Pathogenic"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="93044-6"/>
                  <display value="Level of Evidence"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="LA30200-2"/>
                  <display value="Very strong evidence pathogenic"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81259-4"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <text value="melanoma"/>
              </valueCodeableConcept>
            </component>
          </Observation>
        </resource>
        <request>
          <method value="POST"/>
          <url value="Observation"/>
        </request>
      </entry>
      <entry>
        <fullUrl value="urn:uuid:ad7a499b-a43b-4cc8-bf46-cac62d9ecae5"/>
        <resource>
          <DiagnosticReport>
            <id value="Inline-Instance-for-oncology-diagnostic-7"/>
            <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-oncology-diagnostic-7"> </a><p class="res-header-id"><b>Generated Narrative: DiagnosticReport Inline-Instance-for-oncology-diagnostic-7</b></p><a name="Inline-Instance-for-oncology-diagnostic-7"> </a><a name="hcInline-Instance-for-oncology-diagnostic-7"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-genomic-report.html">Genomic Report</a></p></div><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>Carrot John Mr  Male, DoB: 1962-12-31 ( 1007)</td></tr><tr><td>When For</td><td>2019-03-05</td></tr><tr><td>Performer</td><td> <a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-a48256f8-db37-44e0-a0f6-d7af16c7c9ef">Practitioner Akerman Philip Prof </a></td></tr></table><p><b>Report Details</b></p><table class="grid"><tr><td><b>Code</b></td><td><b>Value</b></td><td><b>Flags</b></td><td><b>Reported</b></td></tr><tr><td><a href="Bundle-bundle-complexVariant-nonHGVS.html#urn-uuid-16fdd5fc-e665-48af-99e4-48d603f3e12d"><span title="Codes:{http://loinc.org 69548-6}">Genetic variant assessment</span></a></td><td><span title="Codes:{http://loinc.org LA9633-4}">Present</span></td><td>Final</td><td>2019-03-05 16:04:44+0000</td></tr><tr><td><a href="Bundle-bundle-oncology-diagnostic.html#urn-uuid-1bf9642d-fd1c-4819-8c5d-44fae4bad524"><span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs diagnostic-implication}">Diagnostic Implication</span></a></td><td/><td>Final</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>
            <effectiveDateTime value="2019-03-05"/>
            <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="BRAF V600E mutation observed"/>
            </result>
            <result>
              <reference value="urn:uuid:1bf9642d-fd1c-4819-8c5d-44fae4bad524"/>
              <display value="melanoma implicated"/>
            </result>
          </DiagnosticReport>
        </resource>
        <request>
          <method value="POST"/>
          <url value="DiagnosticReport"/>
        </request>
      </entry>
    </Bundle>