Genomics Reporting Implementation Guide
3.0.1-SNAPSHOT - Ballot 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 3.0.1-SNAPSHOT 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 - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "bundle-oncology-diagnostic",
  "type" : "transaction",
  "entry" : [
    {
      "fullUrl" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "Inline-Instance-for-oncology-diagnostic-1",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_Inline-Instance-for-oncology-diagnostic-1\"> </a><p><b>Generated Narrative: Patient</b><a name=\"Inline-Instance-for-oncology-diagnostic-1\"> </a><a name=\"hcInline-Instance-for-oncology-diagnostic-1\"> </a></p><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\">Resource Patient &quot;Inline-Instance-for-oncology-diagnostic-1&quot; </p></div><p><b>identifier</b>: 1007</p><p><b>name</b>: Carrot John Mr </p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1962-12-31</p><p><b>generalPractitioner</b>: See on this page: urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef</p></div>"
        },
        "identifier" : [
          {
            "value" : "1007"
          }
        ],
        "name" : [
          {
            "given" : [
              "Carrot",
              "John",
              "Mr"
            ]
          }
        ],
        "gender" : "male",
        "birthDate" : "1962-12-31",
        "generalPractitioner" : [
          {
            "reference" : "urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "Patient"
      }
    },
    {
      "fullUrl" : "urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef",
      "resource" : {
        "resourceType" : "Practitioner",
        "id" : "Inline-Instance-for-oncology-diagnostic-2",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_Inline-Instance-for-oncology-diagnostic-2\"> </a><p><b>Generated Narrative: Practitioner</b><a name=\"Inline-Instance-for-oncology-diagnostic-2\"> </a><a name=\"hcInline-Instance-for-oncology-diagnostic-2\"> </a></p><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\">Resource Practitioner &quot;Inline-Instance-for-oncology-diagnostic-2&quot; </p></div><p><b>identifier</b>: 4654765876</p><p><b>name</b>: Akerman Philip Prof </p><p><b>address</b>: Castro Valley CA </p></div>"
        },
        "identifier" : [
          {
            "value" : "4654765876"
          }
        ],
        "name" : [
          {
            "given" : [
              "Akerman",
              "Philip",
              "Prof"
            ]
          }
        ],
        "address" : [
          {
            "city" : "Castro Valley",
            "state" : "CA"
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "Practitioner"
      }
    },
    {
      "fullUrl" : "urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d",
      "resource" : {
        "resourceType" : "Specimen",
        "id" : "Inline-Instance-for-oncology-diagnostic-3",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Specimen_Inline-Instance-for-oncology-diagnostic-3\"> </a><p><b>Generated Narrative: Specimen</b><a name=\"Inline-Instance-for-oncology-diagnostic-3\"> </a><a name=\"hcInline-Instance-for-oncology-diagnostic-3\"> </a></p><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\">Resource Specimen &quot;Inline-Instance-for-oncology-diagnostic-3&quot; </p></div><p><b>identifier</b>: 076e1948-2217-11e9-94d8-12e241dc1f66</p><p><b>status</b>: available</p><p><b>subject</b>: See on this page: urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d</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>See on this page: urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef</td></tr></table></div>"
        },
        "identifier" : [
          {
            "value" : "076e1948-2217-11e9-94d8-12e241dc1f66"
          }
        ],
        "status" : "available",
        "subject" : {
          "reference" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"
        },
        "collection" : {
          "collector" : {
            "reference" : "urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"
          }
        }
      },
      "request" : {
        "method" : "POST",
        "url" : "Specimen"
      }
    },
    {
      "fullUrl" : "urn:uuid:40e85eda-4d31-4bd2-a5a0-c39d63f9824f",
      "resource" : {
        "resourceType" : "Observation",
        "id" : "Inline-Instance-for-oncology-diagnostic-4",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/molecular-biomarker"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_Inline-Instance-for-oncology-diagnostic-4\"> </a><p><b>Generated Narrative: Observation</b><a name=\"Inline-Instance-for-oncology-diagnostic-4\"> </a><a name=\"hcInline-Instance-for-oncology-diagnostic-4\"> </a></p><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\">Resource Observation &quot;Inline-Instance-for-oncology-diagnostic-4&quot; </p><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>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span>, A characterization of a given biomarker observation. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tbd-codes-cs.html\">To Be Determined Codes</a>#biomarker-category)</span>, Genetics <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-v2-0074.html\">diagnosticServiceSectionId</a>#GE)</span></p><p><b>code</b>: Mutations/Megabase [# Ratio] in Tumor <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#94076-7)</span></p><p><b>subject</b>: See on this page: urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d</p><p><b>effective</b>: 2019-03-05</p><p><b>performer</b>: See on this page: urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef</p><p><b>value</b>: 25 Mutations/Megabase<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code 1/1000000 = '1/1000000')</span></p><p><b>specimen</b>: See on this page: urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d</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>A characterization of a given biomarker observation. <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tbd-codes-cs.html\">To Be Determined Codes</a>#biomarker-category)</span></td><td>molecular sequence adjacent category <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-molecular-biomarker-ontology-cs.html\">Molecular Biomarker Ontology Codes</a>#molgen)</span></td></tr></table></div>"
        },
        "status" : "final",
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                "code" : "laboratory"
              }
            ]
          },
          {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
                "code" : "biomarker-category"
              }
            ]
          },
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
                "code" : "GE"
              }
            ]
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "94076-7",
              "display" : "Mutations/Megabase [# Ratio] in Tumor"
            }
          ]
        },
        "subject" : {
          "reference" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"
        },
        "effectiveDateTime" : "2019-03-05",
        "performer" : [
          {
            "reference" : "urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"
          }
        ],
        "valueQuantity" : {
          "value" : 25,
          "unit" : "Mutations/Megabase",
          "system" : "http://unitsofmeasure.org",
          "code" : "1/1000000"
        },
        "specimen" : {
          "reference" : "urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"
        },
        "component" : [
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
                  "code" : "biomarker-category"
                }
              ]
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/molecular-biomarker-ontology-cs",
                  "code" : "molgen",
                  "display" : "molecular sequence adjacent category"
                }
              ]
            }
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "Observation"
      }
    },
    {
      "fullUrl" : "urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d",
      "resource" : {
        "resourceType" : "Observation",
        "id" : "Inline-Instance-for-oncology-diagnostic-5",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/variant"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_Inline-Instance-for-oncology-diagnostic-5\"> </a><p><b>Generated Narrative: Observation</b><a name=\"Inline-Instance-for-oncology-diagnostic-5\"> </a><a name=\"hcInline-Instance-for-oncology-diagnostic-5\"> </a></p><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\">Resource Observation &quot;Inline-Instance-for-oncology-diagnostic-5&quot; </p><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>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span>, Genetics <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-v2-0074.html\">diagnosticServiceSectionId</a>#GE)</span></p><p><b>code</b>: Genetic variant assessment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#69548-6)</span></p><p><b>subject</b>: See on this page: urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d</p><p><b>effective</b>: 2019-03-05</p><p><b>performer</b>: See on this page: urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef</p><p><b>value</b>: Present <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA9633-4)</span></p><p><b>method</b>: Sequencing <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA26398-0)</span></p><p><b>specimen</b>: See on this page: urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d</p><blockquote><p><b>component</b></p><p><b>code</b>: Human reference sequence assembly version <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#62374-4)</span></p><p><b>value</b>: GRCh37 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA14029-5)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Genomic DNA change (gHGVS) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#81290-9)</span></p><p><b>value</b>: NC_000007.13:g.140453136A&gt;T <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-v3-hgvs.html\">Human Genome Variation Society nomenclature</a>#NC_000007.13:g.140453136A&gt;T)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Discrete genetic variant <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#81252-9)</span></p><p><b>value</b>: Clinvar ID 13961 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-ClinVarV.html\">ClinVar Variant ID</a>#13961)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Amino acid change (pHGVS) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#48005-3)</span></p><p><b>value</b>: NP_004324.2:p.Val600Glu <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-v3-hgvs.html\">Human Genome Variation Society nomenclature</a>#NP_004324.2:p.Val600Glu)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Gene studied ID <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#48018-6)</span></p><p><b>value</b>: BRAF <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-v3-hgnc.html\">HUGO Gene Nomenclature Committee Genes</a>#HGNC:1097)</span></p></blockquote></div>"
        },
        "status" : "final",
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                "code" : "laboratory"
              }
            ]
          },
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
                "code" : "GE"
              }
            ]
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "69548-6",
              "display" : "Genetic variant assessment"
            }
          ]
        },
        "subject" : {
          "reference" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"
        },
        "effectiveDateTime" : "2019-03-05",
        "performer" : [
          {
            "reference" : "urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"
          }
        ],
        "valueCodeableConcept" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "LA9633-4",
              "display" : "Present"
            }
          ]
        },
        "method" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "LA26398-0",
              "display" : "Sequencing"
            }
          ]
        },
        "specimen" : {
          "reference" : "urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"
        },
        "component" : [
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "62374-4",
                  "display" : "Human reference sequence assembly version"
                }
              ]
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "LA14029-5",
                  "display" : "GRCh37"
                }
              ]
            }
          },
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "81290-9",
                  "display" : "Genomic DNA change (gHGVS)"
                }
              ]
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://varnomen.hgvs.org",
                  "code" : "NC_000007.13:g.140453136A>T",
                  "display" : "NC_000007.13:g.140453136A>T"
                }
              ]
            }
          },
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "81252-9",
                  "display" : "Discrete genetic variant"
                }
              ]
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://www.ncbi.nlm.nih.gov/clinvar",
                  "code" : "13961",
                  "display" : "Clinvar ID 13961"
                }
              ]
            }
          },
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "48005-3",
                  "display" : "Amino acid change (pHGVS)"
                }
              ]
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://varnomen.hgvs.org",
                  "code" : "NP_004324.2:p.Val600Glu",
                  "display" : "NP_004324.2:p.Val600Glu"
                }
              ]
            }
          },
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "48018-6",
                  "display" : "Gene studied ID"
                }
              ]
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://www.genenames.org",
                  "code" : "HGNC:1097",
                  "display" : "BRAF"
                }
              ]
            }
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "Observation"
      }
    },
    {
      "fullUrl" : "urn:uuid:1bf9642d-fd1c-4819-8c5d-44fae4bad524",
      "resource" : {
        "resourceType" : "Observation",
        "id" : "Inline-Instance-for-oncology-diagnostic-6",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/diagnostic-implication"
          ]
        },
        "text" : {
          "status" : "extensions",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_Inline-Instance-for-oncology-diagnostic-6\"> </a><p><b>Generated Narrative: Observation</b><a name=\"Inline-Instance-for-oncology-diagnostic-6\"> </a><a name=\"hcInline-Instance-for-oncology-diagnostic-6\"> </a></p><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\">Resource Observation &quot;Inline-Instance-for-oncology-diagnostic-6&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-diagnostic-implication.html\">Diagnostic Implication</a></p></div><p><b>Related Artifact</b>: </p><p><b>status</b>: final</p><p><b>category</b>: Laboratory <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-observation-category.html\">Observation Category Codes</a>#laboratory)</span>, Genetics <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-v2-0074.html\">diagnosticServiceSectionId</a>#GE)</span></p><p><b>code</b>: Diagnostic Implication <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-tbd-codes-cs.html\">To Be Determined Codes</a>#diagnostic-implication)</span></p><p><b>subject</b>: See on this page: urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d</p><p><b>effective</b>: 2019-03-05</p><p><b>performer</b>: See on this page: urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef</p><p><b>method</b>: Computational analysis <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA26811-2)</span></p><p><b>specimen</b>: See on this page: urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d</p><p><b>derivedFrom</b>: See on this page: urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d</p><blockquote><p><b>component</b></p><p><b>code</b>: Genetic variation clinical significance [Imp] <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#53037-8)</span></p><p><b>value</b>: Pathogenic <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA6668-3)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Level of Evidence <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#93044-6)</span></p><p><b>value</b>: Very strong evidence pathogenic <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#LA30200-2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Prob assoc phenotype <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#81259-4)</span></p><p><b>value</b>: melanoma <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p></blockquote></div>"
        },
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact",
            "valueRelatedArtifact" : {
              "type" : "justification",
              "display" : "https://pmkb.weill.cornell.edu/therapies/103"
            }
          }
        ],
        "status" : "final",
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                "code" : "laboratory"
              }
            ]
          },
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
                "code" : "GE"
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            ]
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
              "code" : "diagnostic-implication",
              "display" : "Diagnostic Implication"
            }
          ]
        },
        "subject" : {
          "reference" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"
        },
        "effectiveDateTime" : "2019-03-05",
        "performer" : [
          {
            "reference" : "urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"
          }
        ],
        "method" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "LA26811-2",
              "display" : "Computational analysis"
            }
          ]
        },
        "specimen" : {
          "reference" : "urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"
        },
        "derivedFrom" : [
          {
            "reference" : "urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d"
          }
        ],
        "component" : [
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "53037-8",
                  "display" : "Genetic variation clinical significance [Imp]"
                }
              ]
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "LA6668-3",
                  "display" : "Pathogenic"
                }
              ]
            }
          },
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "93044-6",
                  "display" : "Level of Evidence"
                }
              ]
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "LA30200-2",
                  "display" : "Very strong evidence pathogenic"
                }
              ]
            }
          },
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "81259-4"
                }
              ]
            },
            "valueCodeableConcept" : {
              "text" : "melanoma"
            }
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "Observation"
      }
    },
    {
      "fullUrl" : "urn:uuid:ad7a499b-a43b-4cc8-bf46-cac62d9ecae5",
      "resource" : {
        "resourceType" : "DiagnosticReport",
        "id" : "Inline-Instance-for-oncology-diagnostic-7",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"DiagnosticReport_Inline-Instance-for-oncology-diagnostic-7\"> </a><p><b>Generated Narrative: DiagnosticReport</b><a name=\"Inline-Instance-for-oncology-diagnostic-7\"> </a><a name=\"hcInline-Instance-for-oncology-diagnostic-7\"> </a></p><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\">Resource DiagnosticReport &quot;Inline-Instance-for-oncology-diagnostic-7&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-genomic-report.html\">Genomic Report</a></p></div><p><b>status</b>: final</p><p><b>category</b>: Genetics <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-v2-0074.html\">diagnosticServiceSectionId</a>#GE)</span></p><p><b>code</b>: Genetic analysis report <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://loinc.org/\">LOINC</a>#51969-4)</span></p><p><b>subject</b>: See on this page: urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d</p><p><b>effective</b>: 2019-03-05</p><p><b>performer</b>: See on this page: urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef</p><p><b>specimen</b>: See on this page: urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d</p><p><b>result</b>: </p><ul><li>See on this page: urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d: BRAF V600E mutation observed</li><li>See on this page: urn:uuid:1bf9642d-fd1c-4819-8c5d-44fae4bad524: melanoma implicated</li></ul></div>"
        },
        "status" : "final",
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
                "code" : "GE"
              }
            ]
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "51969-4"
            }
          ],
          "text" : "Genetic analysis report"
        },
        "subject" : {
          "reference" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"
        },
        "effectiveDateTime" : "2019-03-05",
        "performer" : [
          {
            "reference" : "urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"
          }
        ],
        "specimen" : [
          {
            "reference" : "urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"
          }
        ],
        "result" : [
          {
            "reference" : "urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d",
            "display" : "BRAF V600E mutation observed"
          },
          {
            "reference" : "urn:uuid:1bf9642d-fd1c-4819-8c5d-44fae4bad524",
            "display" : "melanoma implicated"
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "DiagnosticReport"
      }
    }
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}