Clinical assessment tool example - GCS with individual score as components (id = "glasgow")

<?xml version="1.0" encoding="UTF-8"?>

<!--   
 This is an example of a Glasgow Coma Score using components to group  the measurements
  source http://www.choa.org/~/media/CHOA/Documents/Services/Concussion/Concussion-glasgow-com
a-scale.pdf
   --><Observation xmlns="http://hl7.org/fhir">
  <id value="glasgow"/> 
  <!--    the mandatory quality flags:    -->
  <status value="final"/> 
  <!--   
    Observations are often coded in multiple code systems.
      - LOINC
    - or SNOMED
      -and/or the source system may provides its own "local" code, which may be
   less or more granular than LOINC.
  In this example there is only LOINC
     -->
  <code> 
    <!--    LOINC - always recommended to have a LOINC code    -->
    <coding> 
      <system value="http://loinc.org"/> 
      <code value="9269-2"/> 
      <display value="Glasgow coma score total"/> 
    </coding> 
    <text value="Glasgow Coma Scale , (GCS)"/> 
  </code> 
  <subject> 
    <reference value="Patient/example"/> 
    <display value="Peter James Chalmers"/> 
  </subject> 
  <effectiveDateTime value="2014-12-11T04:44:16Z"/> 
  <!--    In FHIR, units may be represented twice. Once in the
    agreed human representation, and once in a coded form.
    In this example the UCUM unit is provided but no human representation since
   this is often not displayed
      -->
  <valueQuantity> 
    <value value="13"/> 
    <system value="http://unitsofmeasure.org"/> 
    <code value="{score}"/> 
  </valueQuantity> 
  <referenceRange> 
    <high> 
      <value value="8"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="{score}"/> 
    </high> 
    <!--    meaning as text    -->
    <type> 
      <text value="Severe TBI"/> 
    </type> 
  </referenceRange> 
  <referenceRange> 
    <low> 
      <value value="9"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="{score}"/> 
    </low> 
    <high> 
      <value value="12"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="{score}"/> 
    </high> 
    <!--    meaning as text    -->
    <type> 
      <text value="Moderate TBI"/> 
    </type> 
  </referenceRange> 
  <referenceRange> 
    <low> 
      <value value="13"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="{score}"/> 
    </low> 
    <!--    meaning as text    -->
    <type> 
      <text value="Mild TBI"/> 
    </type> 
  </referenceRange> 
  <!--   Using components since these measurements are typically reported and interpreted
   together   -->
  <!--   GCS motor Component   -->
  <component> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="9268-4"/> 
        <display value="Glasgow coma score motor"/> 
      </coding> 
      <text value="GCS Motor"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://acme.ec/codes"/> 
        <code value="5"/> 
        <display value="Localizes painful stimuli"/> 
      </coding> 
      <coding> 
        <!--     This example has the extension which maps a numeric score to the code this
         may already be known and unecessary in the Observation resource    -->
        <!--    0..1 Value of extension    -->
        <extension url="http://hl7.org/fhir/StructureDefinition/itemWeight">
          <!--    from Element: extension    -->
          <valueDecimal value="5"/> 
        </extension> 
        <system value="http://loinc.org"/> 
        <code value="LA6566-9"/> 
        <display value="Localizing pain"/> 
      </coding> 
      <text value="5 (Localizes painful stimuli)"/> 
    </valueCodeableConcept> 
  </component> 
  <!--   GCS verbal Component   -->
  <component> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="9270-0"/> 
        <display value="Glasgow coma score verbal"/> 
      </coding> 
      <text value="GSC Verbal"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://acme.ec/codes"/> 
        <code value="4"/> 
        <display value="Confused, disoriented"/> 
      </coding> 
      <coding> 
        <!--     This example has the extension which maps a numeric score to the code this
         may already be known and unecessary in the Observation resource    -->
        <!--    0..1 Value of extension    -->
        <extension url="http://hl7.org/fhir/StructureDefinition/itemWeight">
          <!--    from Element: extension    -->
          <valueDecimal value="4"/> 
        </extension> 
        <system value="http://loinc.org"/> 
        <!--   technicallly the code is '5' and the LA is the identifier to do hav e both  would
         require an extention   -->
        <code value="LA6560-2"/> 
        <display value="Confused"/> 
      </coding> 
      <text value="4 (Confused, disoriented)"/> 
    </valueCodeableConcept> 
  </component> 
  <!--   GCS eyes Component   -->
  <component> 
    <code> 
      <coding> 
        <system value="http://loinc.org"/> 
        <code value="9267-6"/> 
        <display value="Glasgow coma score eye opening"/> 
      </coding> 
      <text value="Eyes"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://acme.ec/codes"/> 
        <code value="4"/> 
        <display value="Opens eyes spontaneously"/> 
      </coding> 
      <coding> 
        <!--     This example has the extension which maps a numeric score to the code this
         may already be known and unecessary in the Observation resource    -->
        <!--    0..1 Value of extension    -->
        <extension url="http://hl7.org/fhir/StructureDefinition/itemWeight">
          <!--    from Element: extension    -->
          <valueDecimal value="4"/> 
        </extension> 
        <system value="http://loinc.org"/> 
        <!--   technicallly the code is '4' and the LA is the identifier to do hav e both  would
         require an extention   -->
        <code value="LA6556-0"/> 
        <display value="Eyes open spontaneously"/> 
      </coding> 
      <text value="4 (Opens eyes spontaneously)"/> 
    </valueCodeableConcept> 
  </component> 
</Observation>