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

## : TxImp01 - XML Representation

Page standards status: Informative

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    <Observation xmlns="http://hl7.org/fhir">
      <id value="TxImp01"/>
      <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 Clopidogrel</div>
      </text>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact">
        <valueRelatedArtifact>
          <type value="citation"/>
          <url
               value="https://cpicpgx.org/guidelines/guideline-for-clopidogrel-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="32968"/>
            <display value="clopidogrel"/>
          </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 clopidogrel, individuals with this diplotype are expected to have significantly reduced platelet inhibition, increased residual platelet aggregation and increased risk for adverse cardiovascular events in response to clopidogrel. Alternative antiplatelet therapy (if no contraindication) is recommended. Refer to current guidelines for dosage and recommendations at https://cpicpgx.org/guidelines/guideline- for-clopidogrel-and-cyp2c19/"/>
      </component>
    </Observation>