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 - Observation-TxImp04 - XML Representation

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<Observation xmlns="http://hl7.org/fhir">
  <id value="TxImp04"/>
  <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"><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://hl7.org/fhir/uv/genomics-reporting/CodeSystem/TbdCodes therapeutic-implication}">Therapeutic Implication</span></p><p><b>derivedFrom</b>: <a href="Observation-Pgx-geno-1001.html">Generated Summary: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>; <span title="Codes: {http://loinc.org 84413-4}">Genotype display name</span>; effective: 2020-01-01; <span title="Codes: {http://www.ncbi.nlm.nih.gov/clinvar 638797}">CYP2C19*2/*2</span></a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://loinc.org 51963-7}">Medication assessed [ID]</span></p><p><b>value</b>: <span title="Codes: {http://ncimeta.nci.nih.gov C1099456}">escitalopram</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://loinc.org 53040-2}">Genetic variation's effect on drug metabolism</span></p><p><b>value</b>: <span title="Codes: {http://loinc.org LA9657-3}">Poor metabolizer</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/TbdCodes conclusion-string}">Conclusion text</span></p><p><b>value</b>: For escitalopram, a 50% reduction in starting dose is recommended with therapeutic drug monitoring to guide dose adjustment or select an alternate drug not predominantly metabolized by CYP2C19. Refer to current guidelines for dosage and recommendations at https://cpicpgx.org/guidelines/guideline-for-selective-serotonin-reuptake-inhibitors-and-cyp2d6-and-cyp2c19/. If CYP2D6 genotyping is available, refer to the current guidelines for dosing recommendations.</p></blockquote></div>
  </text>
  <status value="final"/>
  <category>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/observation-category"/>
      <code value="laboratory"/>
    </coding>
  </category>
  <code>
    <coding>
      <system
              value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/TbdCodes"/>
      <code value="therapeutic-implication"/>
    </coding>
  </code>
  <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://ncimeta.nci.nih.gov"/>
        <code value="C1099456"/>
        <display value="escitalopram"/>
      </coding>
    </valueCodeableConcept>
  </component>
  <component>
    <code>
      <coding>
        <system value="http://loinc.org"/>
        <code value="53040-2"/>
      </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/TbdCodes"/>
        <code value="conclusion-string"/>
      </coding>
    </code>
    <valueString
                 value="For escitalopram, a 50% reduction in starting dose is recommended with therapeutic drug monitoring to guide dose adjustment or select an alternate drug not predominantly metabolized by CYP2C19. Refer to current guidelines for dosage and recommendations at https://cpicpgx.org/guidelines/guideline-for-selective-serotonin-reuptake-inhibitors-and-cyp2d6-and-cyp2c19/. If CYP2D6 genotyping is available, refer to the current guidelines for dosing recommendations."/>
  </component>
</Observation>