This page is part of the FHIR Specification (v1.2.0: STU 3 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions
Clinical Genomics Work Group | Maturity Level: 0 | Compartments: Not linked to any defined compartments |
Variation and Sequence data.
The Sequence resource is designed to describe a sequence variant or a sequence without variant information. Complete genetic sequence information, of which specific genetic variations are a part, is reported by reference to the GA4GH repository. Thus, the FHIR Sequence resource avoids large genomic payloads in a manner analogous to how the FHIR ImagingStudy resource references large images maintained in other systems. This resource contextualizes well established standards from the field of clinical genetics into the standards of healthcare (e.g. HGNC - HUGO Gene Nomenclature Committee's international standard for gene names, symbols, and identifiers).
This resource is designed to describe a sequence variation with clinical significance with information such as:
It is strongly encouraged to provide all available information in this resource for any reported variants, because receiving systems (e.g. discovery research, outcomes analysis, and public health reporting) may use this information to normalize variants over time or across sources. However, these data should not be used to dynamically correct/change variant representations for clinical use outside of the laboratory, due to insufficient information.
Implementers should be aware that semantic equivalency of results of genetic variants cannot be guaranteed unless there is an agreed upon standard between sending and receiving systems.
Focus of the resource is to provide data immediately relevant to clinical decision-making. Hence data such as precise read of DNA sequences and sequence alignment are not included; such data are nonetheless accessible through references to GA4GH (Global Alliance for Genomics and Health) API. The Sequence resource will be referenced by Observation to provide variant information. As clinical assessments/diagnosis of a patient are typically captured in the Condition resource or the ClinicalImpression resource, the Sequence resource can be referenced by the Condition resource to provide specific genetic data to support an assertions. This is analogous to how Condition references other resources, such as AllergyIntolerance, Procedure, and Questionnaire resources.
Structure
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Sequence | Σ | DomainResource | A Sequence | |
type | Σ | 1..1 | code | AA | DNA | RNA sequenceType (Example) |
variationID | Σ | 0..* | CodeableConcept | Identifier for variant and ClinVar, dbSNP or COSMIC identifier should be used dbSNP (Example) |
referenceSeq | Σ | 0..1 | CodeableConcept | Reference identifier. It must match the type in the Sequence.type field ENSEMBL (Example) |
quantity | Σ | 0..1 | Quantity | Quantity of the sequence |
coordinate | Σ | 0..* | BackboneElement | The coordinate of the variant |
chromosome | Σ | 0..1 | CodeableConcept | The chromosome containing the genetic finding |
start | Σ | 0..1 | integer | 0-based start position (inclusive) of the sequence |
end | Σ | 0..1 | integer | 0-based end position (exclusive) of the sequence |
genomeBuild | Σ | 0..1 | CodeableConcept | The Genome Build used for reference, following GRCh build versions e.g. 'GRCh 37' |
species | Σ | 0..1 | CodeableConcept | Supporting tests of human, viruses, and bacteria |
observedAllele | Σ | 0..1 | string | Nucleotide(s)/amino acids from start position of sequence to stop position of observed sequence |
referenceAllele | Σ | 0..1 | string | Nucleotide(s)/amino acids from start position of sequence to stop position of reference sequence |
cigar | Σ | 0..1 | string | Extended CIGAR string for aligning the sequence with reference bases |
quality | Σ | 0..* | BackboneElement | Sequence Quality |
start | Σ | 0..1 | integer | 0-based start position (inclusive) of the sequence |
end | Σ | 0..1 | integer | 0-based end position (exclusive) of the sequence |
score | Σ | 0..1 | Quantity | Quality score |
platform | Σ | 0..1 | CodeableConcept | Platform |
allelicState | Σ | 0..1 | CodeableConcept | The level of occurrence of a single DNA Sequence Variation within a set of chromosomes: Heteroplasmic / Homoplasmic / Homozygous / Heterozygous / Hemizygous LOINC 53034-5 answerlist (Example) |
allelicFrequency | Σ | 0..1 | decimal | Allele frequencies |
copyNumberEvent | Σ | 0..1 | CodeableConcept | Copy Number Event: Values: amplificaiton / deletion / LOH |
readCoverage | Σ | 0..1 | integer | Average number of reads representing a given nucleotide in the reconstructed sequence |
chip | Σ | 0..1 | BackboneElement | Information of chip |
chipId | Σ | 0..1 | string | Chip id |
manufacturerId | Σ | 0..1 | string | Chip manufacturer id |
version | Σ | 0..1 | string | Chip version |
repository | Σ | 0..* | BackboneElement | External repository |
url | Σ | 0..1 | uri | URI of the repository |
name | Σ | 0..1 | string | Name of the repository |
structure | Σ | 0..1 | uri | URI of the page containing information about the structure of the repository |
variantId | Σ | 0..1 | string | Id of a GA4GH variant |
readGroupSetId | Σ | 0..1 | string | Id of a GA4GH read group |
Documentation for this format |
UML Diagram
XML Template
<Sequence xmlns="http://hl7.org/fhir"> <!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <type value="[code]"/><!-- 1..1 AA | DNA | RNA --> <variationID><!-- 0..* CodeableConcept Identifier for variant and ClinVar, dbSNP or COSMIC identifier should be used --></variationID> <referenceSeq><!-- 0..1 CodeableConcept Reference identifier. It must match the type in the Sequence.type field --></referenceSeq> <quantity><!-- 0..1 Quantity Quantity of the sequence --></quantity> <coordinate> <!-- 0..* The coordinate of the variant --> <chromosome><!-- 0..1 CodeableConcept The chromosome containing the genetic finding --></chromosome> <start value="[integer]"/><!-- 0..1 0-based start position (inclusive) of the sequence --> <end value="[integer]"/><!-- 0..1 0-based end position (exclusive) of the sequence --> <genomeBuild><!-- 0..1 CodeableConcept The Genome Build used for reference, following GRCh build versions e.g. 'GRCh 37' --></genomeBuild> </coordinate> <species><!-- 0..1 CodeableConcept Supporting tests of human, viruses, and bacteria --></species> <observedAllele value="[string]"/><!-- 0..1 Nucleotide(s)/amino acids from start position of sequence to stop position of observed sequence --> <referenceAllele value="[string]"/><!-- 0..1 Nucleotide(s)/amino acids from start position of sequence to stop position of reference sequence --> <cigar value="[string]"/><!-- 0..1 Extended CIGAR string for aligning the sequence with reference bases --> <quality> <!-- 0..* Sequence Quality --> <start value="[integer]"/><!-- 0..1 0-based start position (inclusive) of the sequence --> <end value="[integer]"/><!-- 0..1 0-based end position (exclusive) of the sequence --> <score><!-- 0..1 Quantity Quality score --></score> <platform><!-- 0..1 CodeableConcept Platform --></platform> </quality> <allelicState><!-- 0..1 CodeableConcept The level of occurrence of a single DNA Sequence Variation within a set of chromosomes: Heteroplasmic / Homoplasmic / Homozygous / Heterozygous / Hemizygous --></allelicState> <allelicFrequency value="[decimal]"/><!-- 0..1 Allele frequencies --> <copyNumberEvent><!-- 0..1 CodeableConcept Copy Number Event: Values: amplificaiton / deletion / LOH --></copyNumberEvent> <readCoverage value="[integer]"/><!-- 0..1 Average number of reads representing a given nucleotide in the reconstructed sequence --> <chip> <!-- 0..1 Information of chip --> <chipId value="[string]"/><!-- 0..1 Chip id --> <manufacturerId value="[string]"/><!-- 0..1 Chip manufacturer id --> <version value="[string]"/><!-- 0..1 Chip version --> </chip> <repository> <!-- 0..* External repository --> <url value="[uri]"/><!-- 0..1 URI of the repository --> <name value="[string]"/><!-- 0..1 Name of the repository --> <structure value="[uri]"/><!-- 0..1 URI of the page containing information about the structure of the repository --> <variantId value="[string]"/><!-- 0..1 Id of a GA4GH variant --> <readGroupSetId value="[string]"/><!-- 0..1 Id of a GA4GH read group --> </repository> </Sequence>
JSON Template
{ "resourceType" : "Sequence", // from Resource: id, meta, implicitRules, and language // from DomainResource: text, contained, extension, and modifierExtension "type" : "<code>", // R! AA | DNA | RNA "variationID" : [{ CodeableConcept }], // Identifier for variant and ClinVar, dbSNP or COSMIC identifier should be used "referenceSeq" : { CodeableConcept }, // Reference identifier. It must match the type in the Sequence.type field "quantity" : { Quantity }, // Quantity of the sequence "coordinate" : [{ // The coordinate of the variant "chromosome" : { CodeableConcept }, // The chromosome containing the genetic finding "start" : <integer>, // 0-based start position (inclusive) of the sequence "end" : <integer>, // 0-based end position (exclusive) of the sequence "genomeBuild" : { CodeableConcept } // The Genome Build used for reference, following GRCh build versions e.g. 'GRCh 37' }], "species" : { CodeableConcept }, // Supporting tests of human, viruses, and bacteria "observedAllele" : "<string>", // Nucleotide(s)/amino acids from start position of sequence to stop position of observed sequence "referenceAllele" : "<string>", // Nucleotide(s)/amino acids from start position of sequence to stop position of reference sequence "cigar" : "<string>", // Extended CIGAR string for aligning the sequence with reference bases "quality" : [{ // Sequence Quality "start" : <integer>, // 0-based start position (inclusive) of the sequence "end" : <integer>, // 0-based end position (exclusive) of the sequence "score" : { Quantity }, // Quality score "platform" : { CodeableConcept } // Platform }], "allelicState" : { CodeableConcept }, // The level of occurrence of a single DNA Sequence Variation within a set of chromosomes: Heteroplasmic / Homoplasmic / Homozygous / Heterozygous / Hemizygous "allelicFrequency" : <decimal>, // Allele frequencies "copyNumberEvent" : { CodeableConcept }, // Copy Number Event: Values: amplificaiton / deletion / LOH "readCoverage" : <integer>, // Average number of reads representing a given nucleotide in the reconstructed sequence "chip" : { // Information of chip "chipId" : "<string>", // Chip id "manufacturerId" : "<string>", // Chip manufacturer id "version" : "<string>" // Chip version }, "repository" : [{ // External repository "url" : "<uri>", // URI of the repository "name" : "<string>", // Name of the repository "structure" : "<uri>", // URI of the page containing information about the structure of the repository "variantId" : "<string>", // Id of a GA4GH variant "readGroupSetId" : "<string>" // Id of a GA4GH read group }] }
Structure
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Sequence | Σ | DomainResource | A Sequence | |
type | Σ | 1..1 | code | AA | DNA | RNA sequenceType (Example) |
variationID | Σ | 0..* | CodeableConcept | Identifier for variant and ClinVar, dbSNP or COSMIC identifier should be used dbSNP (Example) |
referenceSeq | Σ | 0..1 | CodeableConcept | Reference identifier. It must match the type in the Sequence.type field ENSEMBL (Example) |
quantity | Σ | 0..1 | Quantity | Quantity of the sequence |
coordinate | Σ | 0..* | BackboneElement | The coordinate of the variant |
chromosome | Σ | 0..1 | CodeableConcept | The chromosome containing the genetic finding |
start | Σ | 0..1 | integer | 0-based start position (inclusive) of the sequence |
end | Σ | 0..1 | integer | 0-based end position (exclusive) of the sequence |
genomeBuild | Σ | 0..1 | CodeableConcept | The Genome Build used for reference, following GRCh build versions e.g. 'GRCh 37' |
species | Σ | 0..1 | CodeableConcept | Supporting tests of human, viruses, and bacteria |
observedAllele | Σ | 0..1 | string | Nucleotide(s)/amino acids from start position of sequence to stop position of observed sequence |
referenceAllele | Σ | 0..1 | string | Nucleotide(s)/amino acids from start position of sequence to stop position of reference sequence |
cigar | Σ | 0..1 | string | Extended CIGAR string for aligning the sequence with reference bases |
quality | Σ | 0..* | BackboneElement | Sequence Quality |
start | Σ | 0..1 | integer | 0-based start position (inclusive) of the sequence |
end | Σ | 0..1 | integer | 0-based end position (exclusive) of the sequence |
score | Σ | 0..1 | Quantity | Quality score |
platform | Σ | 0..1 | CodeableConcept | Platform |
allelicState | Σ | 0..1 | CodeableConcept | The level of occurrence of a single DNA Sequence Variation within a set of chromosomes: Heteroplasmic / Homoplasmic / Homozygous / Heterozygous / Hemizygous LOINC 53034-5 answerlist (Example) |
allelicFrequency | Σ | 0..1 | decimal | Allele frequencies |
copyNumberEvent | Σ | 0..1 | CodeableConcept | Copy Number Event: Values: amplificaiton / deletion / LOH |
readCoverage | Σ | 0..1 | integer | Average number of reads representing a given nucleotide in the reconstructed sequence |
chip | Σ | 0..1 | BackboneElement | Information of chip |
chipId | Σ | 0..1 | string | Chip id |
manufacturerId | Σ | 0..1 | string | Chip manufacturer id |
version | Σ | 0..1 | string | Chip version |
repository | Σ | 0..* | BackboneElement | External repository |
url | Σ | 0..1 | uri | URI of the repository |
name | Σ | 0..1 | string | Name of the repository |
structure | Σ | 0..1 | uri | URI of the page containing information about the structure of the repository |
variantId | Σ | 0..1 | string | Id of a GA4GH variant |
readGroupSetId | Σ | 0..1 | string | Id of a GA4GH read group |
Documentation for this format |
XML Template
<Sequence xmlns="http://hl7.org/fhir"> <!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <type value="[code]"/><!-- 1..1 AA | DNA | RNA --> <variationID><!-- 0..* CodeableConcept Identifier for variant and ClinVar, dbSNP or COSMIC identifier should be used --></variationID> <referenceSeq><!-- 0..1 CodeableConcept Reference identifier. It must match the type in the Sequence.type field --></referenceSeq> <quantity><!-- 0..1 Quantity Quantity of the sequence --></quantity> <coordinate> <!-- 0..* The coordinate of the variant --> <chromosome><!-- 0..1 CodeableConcept The chromosome containing the genetic finding --></chromosome> <start value="[integer]"/><!-- 0..1 0-based start position (inclusive) of the sequence --> <end value="[integer]"/><!-- 0..1 0-based end position (exclusive) of the sequence --> <genomeBuild><!-- 0..1 CodeableConcept The Genome Build used for reference, following GRCh build versions e.g. 'GRCh 37' --></genomeBuild> </coordinate> <species><!-- 0..1 CodeableConcept Supporting tests of human, viruses, and bacteria --></species> <observedAllele value="[string]"/><!-- 0..1 Nucleotide(s)/amino acids from start position of sequence to stop position of observed sequence --> <referenceAllele value="[string]"/><!-- 0..1 Nucleotide(s)/amino acids from start position of sequence to stop position of reference sequence --> <cigar value="[string]"/><!-- 0..1 Extended CIGAR string for aligning the sequence with reference bases --> <quality> <!-- 0..* Sequence Quality --> <start value="[integer]"/><!-- 0..1 0-based start position (inclusive) of the sequence --> <end value="[integer]"/><!-- 0..1 0-based end position (exclusive) of the sequence --> <score><!-- 0..1 Quantity Quality score --></score> <platform><!-- 0..1 CodeableConcept Platform --></platform> </quality> <allelicState><!-- 0..1 CodeableConcept The level of occurrence of a single DNA Sequence Variation within a set of chromosomes: Heteroplasmic / Homoplasmic / Homozygous / Heterozygous / Hemizygous --></allelicState> <allelicFrequency value="[decimal]"/><!-- 0..1 Allele frequencies --> <copyNumberEvent><!-- 0..1 CodeableConcept Copy Number Event: Values: amplificaiton / deletion / LOH --></copyNumberEvent> <readCoverage value="[integer]"/><!-- 0..1 Average number of reads representing a given nucleotide in the reconstructed sequence --> <chip> <!-- 0..1 Information of chip --> <chipId value="[string]"/><!-- 0..1 Chip id --> <manufacturerId value="[string]"/><!-- 0..1 Chip manufacturer id --> <version value="[string]"/><!-- 0..1 Chip version --> </chip> <repository> <!-- 0..* External repository --> <url value="[uri]"/><!-- 0..1 URI of the repository --> <name value="[string]"/><!-- 0..1 Name of the repository --> <structure value="[uri]"/><!-- 0..1 URI of the page containing information about the structure of the repository --> <variantId value="[string]"/><!-- 0..1 Id of a GA4GH variant --> <readGroupSetId value="[string]"/><!-- 0..1 Id of a GA4GH read group --> </repository> </Sequence>
JSON Template
{ "resourceType" : "Sequence", // from Resource: id, meta, implicitRules, and language // from DomainResource: text, contained, extension, and modifierExtension "type" : "<code>", // R! AA | DNA | RNA "variationID" : [{ CodeableConcept }], // Identifier for variant and ClinVar, dbSNP or COSMIC identifier should be used "referenceSeq" : { CodeableConcept }, // Reference identifier. It must match the type in the Sequence.type field "quantity" : { Quantity }, // Quantity of the sequence "coordinate" : [{ // The coordinate of the variant "chromosome" : { CodeableConcept }, // The chromosome containing the genetic finding "start" : <integer>, // 0-based start position (inclusive) of the sequence "end" : <integer>, // 0-based end position (exclusive) of the sequence "genomeBuild" : { CodeableConcept } // The Genome Build used for reference, following GRCh build versions e.g. 'GRCh 37' }], "species" : { CodeableConcept }, // Supporting tests of human, viruses, and bacteria "observedAllele" : "<string>", // Nucleotide(s)/amino acids from start position of sequence to stop position of observed sequence "referenceAllele" : "<string>", // Nucleotide(s)/amino acids from start position of sequence to stop position of reference sequence "cigar" : "<string>", // Extended CIGAR string for aligning the sequence with reference bases "quality" : [{ // Sequence Quality "start" : <integer>, // 0-based start position (inclusive) of the sequence "end" : <integer>, // 0-based end position (exclusive) of the sequence "score" : { Quantity }, // Quality score "platform" : { CodeableConcept } // Platform }], "allelicState" : { CodeableConcept }, // The level of occurrence of a single DNA Sequence Variation within a set of chromosomes: Heteroplasmic / Homoplasmic / Homozygous / Heterozygous / Hemizygous "allelicFrequency" : <decimal>, // Allele frequencies "copyNumberEvent" : { CodeableConcept }, // Copy Number Event: Values: amplificaiton / deletion / LOH "readCoverage" : <integer>, // Average number of reads representing a given nucleotide in the reconstructed sequence "chip" : { // Information of chip "chipId" : "<string>", // Chip id "manufacturerId" : "<string>", // Chip manufacturer id "version" : "<string>" // Chip version }, "repository" : [{ // External repository "url" : "<uri>", // URI of the repository "name" : "<string>", // Name of the repository "structure" : "<uri>", // URI of the page containing information about the structure of the repository "variantId" : "<string>", // Id of a GA4GH variant "readGroupSetId" : "<string>" // Id of a GA4GH read group }] }
Alternate definitions: Schema/Schematron, Resource Profile (XML, JSON), Questionnaire
Path | Definition | Type | Reference |
---|---|---|---|
Sequence.type | Type if a sequence -- DNA, RNA, or amino acid sequence | Example | sequenceType |
Sequence.variationID | Variant ID | Example | dbSNP |
Sequence.referenceSeq | Reference identifier | Example | ENSEMBL |
Sequence.allelicState | LOINC answer list for AllelicState | Example | LOINC 53034-5 answerlist |
Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.
Name | Type | Description | Paths |
chromosome | token | Chromosome of the sequence | Sequence.coordinate.chromosome |
coordinate | composite | Genomic coordinate of the sequence. For example, a search for sequence in region 1:123-345 can be represented as `coordinate=1$lt345$gt123` | |
end | number | End position (0-based exclusive) of the sequence | Sequence.coordinate.end |
species | token | The organism from which sample of the sequence was extracted. | Sequence.species |
start | number | Start position (0-based inclusive) of the sequence | Sequence.coordinate.start |
type | token | The type of the variant: Amino acid / cDNA transcript / RNA variation. | Sequence.type |
variationid | token | Identifier for variant | Sequence.variationID |