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

## : TxImp05 - XML Representation

Page standards status: Informative

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    <Observation xmlns="http://hl7.org/fhir">
      <id value="TxImp05"/>
      <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">Poor metabolizer of Amitriptyline</div>
      </text>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact">
        <valueRelatedArtifact>
          <type value="citation"/>
          <url
               value="https://cpicpgx.org/guidelines/guideline-for-tricyclic-antidepressants-and-cyp2d6-and-cyp2c19/"/>
        </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="therapeutic-implication"/>
        </coding>
      </code>
      <subject>🔗
        <reference value="Patient/CGPatientExample01"/>
      </subject>
      <effectiveDateTime value="2019-04-01"/>
      <performer>🔗
        <reference value="Organization/ExampleOrg"/>
      </performer>
      <derivedFrom>🔗
        <reference value="Observation/Pgx-geno-1001"/>
      </derivedFrom>
      <component>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="51963-7"/>
          </coding>
        </code>
        <valueCodeableConcept>
          <coding>
            <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
            <code value="704"/>
            <display value="amitriptyline"/>
          </coding>
        </valueCodeableConcept>
      </component>
      <component>
        <code>
          <coding>
            <system
                    value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
            <code value="therapeutic-implication"/>
          </coding>
        </code>
        <valueCodeableConcept>
          <coding>
            <system value="http://loinc.org"/>
            <code value="LA9657-3"/>
            <display value="Poor metabolizer"/>
          </coding>
        </valueCodeableConcept>
      </component>
      <component>
        <code>
          <coding>
            <system
                    value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
            <code value="conclusion-string"/>
          </coding>
        </code>
        <valueString
                     value="For amitriptyline, a 50% reduction in starting dose is recommended with therapeutic drug monitoring to guide dose adjustment. Refer to current guidelines for dosage and recommendations at https://cpicpgx.org/guidelines/guideline-for- tricyclic-antidepressants-and-cyp2d6-and-cyp2c19/. If CYP2D6 genotyping is available, refer to the current guidelines for dosing recommendations."/>
      </component>
    </Observation>