Genomics Reporting Implementation Guide
1.1.0 - Ballot

This page is part of the Genetic Reporting Implementation Guide (v1.1.0: STU 2 Ballot 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

: Example - Melanoma implication - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "oncology-diagnostic",
  "type" : "transaction",
  "entry" : [
    {
      "fullUrl" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d",
      "resource" : {
        "resourceType" : "Patient",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 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>: <a href=\"#urnuuida48256f8-db37-44e0-a0f6-d7af16c7c9ef\">See above (Practitioner/null)</a></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",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 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",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/specimen"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 076e1948-2217-11e9-94d8-12e241dc1f66</p><p><b>status</b>: available</p><p><b>subject</b>: <a href=\"#urnuuidd0b4affa-91d6-46d1-af01-b30d9f16ef6d\">See above (Patient/null)</a></p><h3>Collections</h3><table class=\"grid\"><tr><td>-</td><td><b>Collector</b></td></tr><tr><td>*</td><td><a href=\"#urnuuida48256f8-db37-44e0-a0f6-d7af16c7c9ef\">See above (Practitioner/null)</a></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",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title=\"Codes: \">Tumor Mutational Burden</span></p><p><b>subject</b>: <a href=\"#urnuuidd0b4affa-91d6-46d1-af01-b30d9f16ef6d\">See above (Patient/null)</a></p><p><b>performer</b>: <a href=\"#urnuuida48256f8-db37-44e0-a0f6-d7af16c7c9ef\">See above (Practitioner/null)</a></p><p><b>value</b>: 25.0 Mutations/Megabase</p><p><b>specimen</b>: <a href=\"#urnuuida5d6a6a9-4859-480e-85b2-56974fef3b9d\">See above (Specimen/null)</a></p></div>"
        },
        "status" : "final",
        "code" : {
          "text" : "Tumor Mutational Burden"
        },
        "subject" : {
          "reference" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"
        },
        "performer" : [
          {
            "reference" : "urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"
          }
        ],
        "valueQuantity" : {
          "value" : 25.0,
          "unit" : "Mutations/Megabase",
          "system" : "http://unitsofmeasure.org",
          "code" : "1/1000000{Base}"
        },
        "specimen" : {
          "reference" : "urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"
        }
      },
      "request" : {
        "method" : "POST",
        "url" : "Observation"
      }
    },
    {
      "fullUrl" : "urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d",
      "resource" : {
        "resourceType" : "Observation",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/variant"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span></p><p><b>code</b>: <span title=\"Codes: {http://loinc.org 69548-6}\">Genetic variant assessment</span></p><p><b>subject</b>: <a href=\"#urnuuidd0b4affa-91d6-46d1-af01-b30d9f16ef6d\">See above (Patient/null)</a></p><p><b>performer</b>: <a href=\"#urnuuida48256f8-db37-44e0-a0f6-d7af16c7c9ef\">See above (Practitioner/null)</a></p><p><b>value</b>: <span title=\"Codes: {http://loinc.org LA9633-4}\">Present</span></p><p><b>method</b>: <span title=\"Codes: {http://loinc.org LA26398-0}\">Sequencing</span></p><p><b>specimen</b>: <a href=\"#urnuuida5d6a6a9-4859-480e-85b2-56974fef3b9d\">See above (Specimen/null)</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes: {http://loinc.org 62374-4}\">Human reference sequence assembly version</span></p><p><b>value</b>: <span title=\"Codes: {http://loinc.org LA14029-5}\">GRCh37</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes: {http://loinc.org 81290-9}\">Genomic DNA change (gHGVS)</span></p><p><b>value</b>: <span title=\"Codes: {http://varnomen.hgvs.org NC_000007.13:g.140453136A&gt;T}\">NC_000007.13:g.140453136A&gt;T</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes: {http://loinc.org 81252-9}\">Discrete genetic variant</span></p><p><b>value</b>: <span title=\"Codes: {http://www.ncbi.nlm.nih.gov/clinvar 13961}\">Clinvar ID 13961</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes: {http://loinc.org 48005-3}\">Amino acid change (pHGVS)</span></p><p><b>value</b>: <span title=\"Codes: {http://varnomen.hgvs.org p.Val600Glu}\">p.Val600Glu</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes: {http://loinc.org 48006-1}\">Amino acid change type</span></p><p><b>value</b>: <span title=\"Codes: {http://loinc.org LA6698-0}\">Missense</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes: {http://loinc.org 48018-6}\">Gene studied ID</span></p><p><b>value</b>: <span title=\"Codes: {http://www.genenames.org/geneId HGNC:1097}\">BRAF</span></p></blockquote></div>"
        },
        "status" : "final",
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
                "code" : "laboratory"
              }
            ]
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "69548-6",
              "display" : "Genetic variant assessment"
            }
          ]
        },
        "subject" : {
          "reference" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"
        },
        "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" : "p.Val600Glu",
                  "display" : "p.Val600Glu"
                }
              ]
            }
          },
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "48006-1",
                  "display" : "Amino acid change type"
                }
              ]
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "LA6698-0",
                  "display" : "Missense"
                }
              ]
            }
          },
          {
            "code" : {
              "coding" : [
                {
                  "system" : "http://loinc.org",
                  "code" : "48018-6",
                  "display" : "Gene studied ID"
                }
              ]
            },
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://www.genenames.org/geneId",
                  "code" : "HGNC:1097",
                  "display" : "BRAF"
                }
              ]
            }
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "Observation"
      }
    },
    {
      "fullUrl" : "urn:uuid:1bf9642d-fd1c-4819-8c5d-44fae4bad524",
      "resource" : {
        "resourceType" : "Observation",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/diagnostic-implication"
          ]
        },
        "text" : {
          "status" : "extensions",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>Related Artifact</b>: </p><p><b style=\"color: maroon\">Exception generating Narrative: type org.hl7.fhir.r5.model.RelatedArtifact not handled - should not be here</b></p></div>"
        },
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/CGRelatedArtifact",
            "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"
              }
            ]
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/TbdCodes",
              "code" : "diagnostic-implication",
              "display" : "Diagnostic Implication"
            }
          ]
        },
        "subject" : {
          "reference" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"
        },
        "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://hl7.org/fhir/uv/genomics-reporting/CodeSystem/TbdCodes",
                  "code" : "associated-cancer"
                }
              ]
            },
            "valueCodeableConcept" : {
              "text" : "melanoma"
            }
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "Observation"
      }
    },
    {
      "fullUrl" : "urn:uuid:ad7a499b-a43b-4cc8-bf46-cac62d9ecae5",
      "resource" : {
        "resourceType" : "DiagnosticReport",
        "meta" : {
          "profile" : [
            "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomics-report"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>status</b>: final</p><p><b>category</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v2-0074 GE}\">Genetics</span></p><p><b>code</b>: <span title=\"Codes: {http://loinc.org 81247-9}\">Genetic analysis report</span></p><p><b>subject</b>: <a href=\"#urnuuidd0b4affa-91d6-46d1-af01-b30d9f16ef6d\">See above (Patient/null)</a></p><p><b>performer</b>: <a href=\"#urnuuida48256f8-db37-44e0-a0f6-d7af16c7c9ef\">See above (Practitioner/null)</a></p><p><b>specimen</b>: <a href=\"#urnuuida5d6a6a9-4859-480e-85b2-56974fef3b9d\">See above (Specimen/null)</a></p><p><b>result</b>: </p><ul><li><a href=\"#urnuuid16fdd5fc-e665-48af-99e4-48d603f3e12d\">BRAF V600E mutation observed. Generated Summary: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://loinc.org 69548-6}\">Genetic variant assessment</span>; <span title=\"Codes: {http://loinc.org LA9633-4}\">Present</span>; <span title=\"Codes: {http://loinc.org LA26398-0}\">Sequencing</span></a></li><li><a href=\"#urnuuid1bf9642d-fd1c-4819-8c5d-44fae4bad524\">melanoma implicated. Generated Summary: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}\">Laboratory</span>; <span title=\"Codes: {http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/TbdCodes diagnostic-implication}\">Diagnostic Implication</span>; <span title=\"Codes: {http://loinc.org LA26811-2}\">Computational analysis</span></a></li></ul></div>"
        },
        "status" : "final",
        "category" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v2-0074",
                "code" : "GE"
              }
            ]
          }
        ],
        "code" : {
          "coding" : [
            {
              "system" : "http://loinc.org",
              "code" : "81247-9",
              "display" : "Master HL7 genetic variant reporting panel"
            }
          ],
          "text" : "Genetic analysis report"
        },
        "subject" : {
          "reference" : "urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"
        },
        "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"
      }
    }
  ]
}