Genomics Reporting Implementation Guide
2.0.0 - trial-use

This page is part of the Genetic Reporting Implementation Guide (v2.0.0: STU 2) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: bundle-oncologyexamples-r4 - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="bundle-oncologyexamples-r4"/>
  <type value="transaction"/>
  <entry>
    <fullUrl value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
    <resource>
      <Patient>
        <id value="Inline-Instance-for-oncologyexamples-r4-1"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></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 "Inline-Instance-for-oncologyexamples-r4-1" </p></div><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="#Practitioner_Inline-Instance-for-oncologyexamples-r4-2">See above (urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef)</a></p></div>
        </text>
        <identifier>
          <value value="1007"/>
        </identifier>
        <name>
          <given value="Carrot"/>
          <given value="John"/>
          <given value="Mr"/>
        </name>
        <gender value="male"/>
        <birthDate value="1962-12-31"/>
        <generalPractitioner>
          <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
        </generalPractitioner>
      </Patient>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Patient"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
    <resource>
      <Practitioner>
        <id value="Inline-Instance-for-oncologyexamples-r4-2"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></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 "Inline-Instance-for-oncologyexamples-r4-2" </p></div><p><b>identifier</b>: id: 4654765876</p><p><b>name</b>: Akerman Philip Prof </p><p><b>address</b>: Castro Valley CA </p></div>
        </text>
        <identifier>
          <value value="4654765876"/>
        </identifier>
        <name>
          <given value="Akerman"/>
          <given value="Philip"/>
          <given value="Prof"/>
        </name>
        <address>
          <city value="Castro Valley"/>
          <state value="CA"/>
        </address>
      </Practitioner>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Practitioner"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
    <resource>
      <Specimen>
        <id value="Inline-Instance-for-oncologyexamples-r4-3"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></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 "Inline-Instance-for-oncologyexamples-r4-3" </p></div><p><b>identifier</b>: id: 076e1948-2217-11e9-94d8-12e241dc1f66</p><p><b>status</b>: available</p><p><b>subject</b>: <a href="#Patient_Inline-Instance-for-oncologyexamples-r4-1">See above (urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d)</a></p><h3>Collections</h3><table class="grid"><tr><td>-</td><td><b>Collector</b></td></tr><tr><td>*</td><td><a href="#Practitioner_Inline-Instance-for-oncologyexamples-r4-2">See above (urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef)</a></td></tr></table></div>
        </text>
        <identifier>
          <value value="076e1948-2217-11e9-94d8-12e241dc1f66"/>
        </identifier>
        <status value="available"/>
        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
        </subject>
        <collection>
          <collector>
            <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
          </collector>
        </collection>
      </Specimen>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Specimen"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:40e85eda-4d31-4bd2-a5a0-c39d63f9824f"/>
    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-4"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></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 "Inline-Instance-for-oncologyexamples-r4-4" </p></div><p><b>status</b>: final</p><p><b>code</b>: Tumor Mutational Burden <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>subject</b>: <a href="#Patient_Inline-Instance-for-oncologyexamples-r4-1">See above (urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d)</a></p><p><b>performer</b>: <a href="#Practitioner_Inline-Instance-for-oncologyexamples-r4-2">See above (urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef)</a></p><p><b>value</b>: 25 somatic variants per megabase of sequenced DNA<span style="background: LightGoldenRodYellow"> (Details: UCUM code 1/1000000{Base} = '1/1000000{Base}')</span></p><p><b>specimen</b>: <a href="#Specimen_Inline-Instance-for-oncologyexamples-r4-3">See above (urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d)</a></p></div>
        </text>
        <status value="final"/>
        <code>
          <text value="Tumor Mutational Burden"/>
        </code>
        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
        </subject>
        <performer>
          <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
        </performer>
        <valueQuantity>
          <value value="25"/>
          <unit value="somatic variants per megabase of sequenced DNA"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="1/1000000{Base}"/>
        </valueQuantity>
        <specimen>
          <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
        </specimen>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:64b91716-6431-41bd-8fd4-7ac99bebdee9"/>
    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-5"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></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 "Inline-Instance-for-oncologyexamples-r4-5" </p></div><p><b>status</b>: final</p><p><b>code</b>: MSI status <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>subject</b>: <a href="#Patient_Inline-Instance-for-oncologyexamples-r4-1">See above (urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d)</a></p><p><b>performer</b>: <a href="#Practitioner_Inline-Instance-for-oncologyexamples-r4-2">See above (urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef)</a></p><p><b>value</b>: High</p><p><b>specimen</b>: <a href="#Specimen_Inline-Instance-for-oncologyexamples-r4-3">See above (urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d)</a></p></div>
        </text>
        <status value="final"/>
        <code>
          <text value="MSI status"/>
        </code>
        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
        </subject>
        <performer>
          <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
        </performer>
        <valueString value="High"/>
        <specimen>
          <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
        </specimen>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d"/>
    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-6"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/variant"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></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 "Inline-Instance-for-oncologyexamples-r4-6" </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/3.1.0/CodeSystem-observation-category.html">Observation Category Codes</a>#laboratory)</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>: <a href="#Patient_Inline-Instance-for-oncologyexamples-r4-1">See above (urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d)</a></p><p><b>performer</b>: <a href="#Practitioner_Inline-Instance-for-oncologyexamples-r4-2">See above (urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef)</a></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>: <a href="#Specimen_Inline-Instance-for-oncologyexamples-r4-3">See above (urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d)</a></p><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>: 9:g.5073770G&gt;T <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-hgvs.html">Human Genome Variation Society nomenclature</a>#9:g.5073770G&gt;T)</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>: p.Val617Phe <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-hgvs.html">Human Genome Variation Society nomenclature</a>#p.Val617Phe)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Amino acid change type <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#48006-1)</span></p><p><b>value</b>: Missense <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#LA6698-0)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Genomic source class <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#48002-0)</span></p><p><b>value</b>: Germline <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#LA6683-2)</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>: JAK2 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (geneId)</span></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://loinc.org"/>
            <code value="69548-6"/>
            <display value="Genetic variant assessment"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
        </subject>
        <performer>
          <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
        </performer>
        <valueCodeableConcept>
          <coding>
            <system value="http://loinc.org"/>
            <code value="LA9633-4"/>
            <display value="Present"/>
          </coding>
        </valueCodeableConcept>
        <method>
          <coding>
            <system value="http://loinc.org"/>
            <code value="LA26398-0"/>
            <display value="Sequencing"/>
          </coding>
        </method>
        <specimen>
          <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
        </specimen>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="81290-9"/>
              <display value="Genomic DNA change (gHGVS)"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://varnomen.hgvs.org"/>
              <code value="9:g.5073770G&gt;T"/>
              <display value="9:g.5073770G&gt;T"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="48005-3"/>
              <display value="Amino acid change (pHGVS)"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://varnomen.hgvs.org"/>
              <code value="p.Val617Phe"/>
              <display value="p.Val617Phe"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="48006-1"/>
              <display value="Amino acid change type"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA6698-0"/>
              <display value="Missense"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="48002-0"/>
              <display value="Genomic source class"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA6683-2"/>
              <display value="Germline"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="48018-6"/>
              <display value="Gene studied ID"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://www.genenames.org/geneId"/>
              <display value="JAK2"/>
            </coding>
          </valueCodeableConcept>
        </component>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:772de7d7-e1bd-4183-bdb5-cea8eda317cd"/>
    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-7"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/variant"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></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 "Inline-Instance-for-oncologyexamples-r4-7" </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/3.1.0/CodeSystem-observation-category.html">Observation Category Codes</a>#laboratory)</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>: <a href="#Patient_Inline-Instance-for-oncologyexamples-r4-1">See above (urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d)</a></p><p><b>performer</b>: <a href="#Practitioner_Inline-Instance-for-oncologyexamples-r4-2">See above (urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef)</a></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>: <a href="#Specimen_Inline-Instance-for-oncologyexamples-r4-3">See above (urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d)</a></p><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>: 4:g.55972974T&gt;A <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-hgvs.html">Human Genome Variation Society nomenclature</a>#4:g.55972974T&gt;A)</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>: p.Gln472His <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-hgvs.html">Human Genome Variation Society nomenclature</a>#p.Gln472His)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Amino acid change type <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#48006-1)</span></p><p><b>value</b>: Missense <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#LA6698-0)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Genomic source class <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#48002-0)</span></p><p><b>value</b>: Germline <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#LA6683-2)</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>: KDR <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (geneId)</span></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://loinc.org"/>
            <code value="69548-6"/>
            <display value="Genetic variant assessment"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
        </subject>
        <performer>
          <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
        </performer>
        <valueCodeableConcept>
          <coding>
            <system value="http://loinc.org"/>
            <code value="LA9633-4"/>
            <display value="Present"/>
          </coding>
        </valueCodeableConcept>
        <method>
          <coding>
            <system value="http://loinc.org"/>
            <code value="LA26398-0"/>
            <display value="Sequencing"/>
          </coding>
        </method>
        <specimen>
          <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
        </specimen>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="81290-9"/>
              <display value="Genomic DNA change (gHGVS)"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://varnomen.hgvs.org"/>
              <code value="4:g.55972974T&gt;A"/>
              <display value="4:g.55972974T&gt;A"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="48005-3"/>
              <display value="Amino acid change (pHGVS)"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://varnomen.hgvs.org"/>
              <code value="p.Gln472His"/>
              <display value="p.Gln472His"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="48006-1"/>
              <display value="Amino acid change type"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA6698-0"/>
              <display value="Missense"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="48002-0"/>
              <display value="Genomic source class"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA6683-2"/>
              <display value="Germline"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="48018-6"/>
              <display value="Gene studied ID"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://www.genenames.org/geneId"/>
              <display value="KDR"/>
            </coding>
          </valueCodeableConcept>
        </component>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:b33eb7ec-d83e-49d2-b0f3-729d024ebe01"/>
    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-8"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/variant"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></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 "Inline-Instance-for-oncologyexamples-r4-8" </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/3.1.0/CodeSystem-observation-category.html">Observation Category Codes</a>#laboratory)</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>: <a href="#Patient_Inline-Instance-for-oncologyexamples-r4-1">See above (urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d)</a></p><p><b>performer</b>: <a href="#Practitioner_Inline-Instance-for-oncologyexamples-r4-2">See above (urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef)</a></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>: <a href="#Specimen_Inline-Instance-for-oncologyexamples-r4-3">See above (urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d)</a></p><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>: 2:g.212578380del <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/3.1.0/CodeSystem-v3-hgvs.html">Human Genome Variation Society nomenclature</a>#2:g.212578380del)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Amino acid change type <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#48006-1)</span></p><p><b>value</b>: Missense <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#LA6698-0)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Genomic source class <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#48002-0)</span></p><p><b>value</b>: Germline <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#LA6683-2)</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>: ERBB4 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (geneId)</span></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://loinc.org"/>
            <code value="69548-6"/>
            <display value="Genetic variant assessment"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
        </subject>
        <performer>
          <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
        </performer>
        <valueCodeableConcept>
          <coding>
            <system value="http://loinc.org"/>
            <code value="LA9633-4"/>
            <display value="Present"/>
          </coding>
        </valueCodeableConcept>
        <method>
          <coding>
            <system value="http://loinc.org"/>
            <code value="LA26398-0"/>
            <display value="Sequencing"/>
          </coding>
        </method>
        <specimen>
          <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
        </specimen>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="81290-9"/>
              <display value="Genomic DNA change (gHGVS)"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://varnomen.hgvs.org"/>
              <code value="2:g.212578380del"/>
              <display value="2:g.212578380del"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="48006-1"/>
              <display value="Amino acid change type"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA6698-0"/>
              <display value="Missense"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="48002-0"/>
              <display value="Genomic source class"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA6683-2"/>
              <display value="Germline"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="48018-6"/>
              <display value="Gene studied ID"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://www.genenames.org/geneId"/>
              <display value="ERBB4"/>
            </coding>
          </valueCodeableConcept>
        </component>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:1bf9642d-fd1c-4819-8c5d-44fae4bad524"/>
    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-9"/>
        <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><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 "Inline-Instance-for-oncologyexamples-r4-9" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-therapeutic-implication.html">Therapeutic Implication</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/3.1.0/CodeSystem-observation-category.html">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: Therapeutic Implication <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-tbd-codes-cs.html">To Be Determined Codes</a>#therapeutic-implication)</span></p><p><b>subject</b>: <a href="#Patient_Inline-Instance-for-oncologyexamples-r4-1">See above (urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d)</a></p><p><b>performer</b>: <a href="#Practitioner_Inline-Instance-for-oncologyexamples-r4-2">See above (urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef)</a></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>: <a href="#Specimen_Inline-Instance-for-oncologyexamples-r4-3">See above (urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d)</a></p><p><b>derivedFrom</b>: <a href="#Observation_Inline-Instance-for-oncologyexamples-r4-6">See above (urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d)</a></p><blockquote><p><b>component</b></p><p><b>code</b>: Predicted Therapeutic Implication <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-tbd-codes-cs.html">To Be Determined Codes</a>#predicted-therapeutic-implication)</span></p><p><b>value</b>: Responsive <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#LA6677-4)</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>: Associated 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>: Polycythemia vera (PV) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Medication assessed <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#51963-7)</span></p><p><b>value</b>: Ruxolitinib <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></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/tbd-codes-cs"/>
            <code value="therapeutic-implication"/>
            <display value="Therapeutic Implication"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
        </subject>
        <performer>
          <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
        </performer>
        <method>
          <coding>
            <system value="http://loinc.org"/>
            <code value="LA26811-2"/>
            <display value="Computational analysis"/>
          </coding>
        </method>
        <specimen>
          <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
        </specimen>
        <derivedFrom>
          <reference value="urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d"/>
        </derivedFrom>
        <component>
          <code>
            <coding>
              <system
                      value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
              <code value="predicted-therapeutic-implication"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA6677-4"/>
              <display value="Responsive"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="93044-6"/>
              <display value="Level of Evidence"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA30200-2"/>
              <display value="Very strong evidence pathogenic"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="81259-4"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <text value="Polycythemia vera (PV)"/>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="51963-7"/>
              <display value="Medication assessed"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <text value="Ruxolitinib"/>
          </valueCodeableConcept>
        </component>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:1301943b-55db-4adf-8355-3635f7268a1b"/>
    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-10"/>
        <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><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 "Inline-Instance-for-oncologyexamples-r4-10" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-therapeutic-implication.html">Therapeutic Implication</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/3.1.0/CodeSystem-observation-category.html">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: Therapeutic Implication <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-tbd-codes-cs.html">To Be Determined Codes</a>#therapeutic-implication)</span></p><p><b>subject</b>: <a href="#Patient_Inline-Instance-for-oncologyexamples-r4-1">See above (urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d)</a></p><p><b>performer</b>: <a href="#Practitioner_Inline-Instance-for-oncologyexamples-r4-2">See above (urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef)</a></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>: <a href="#Specimen_Inline-Instance-for-oncologyexamples-r4-3">See above (urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d)</a></p><p><b>derivedFrom</b>: <a href="#Observation_Inline-Instance-for-oncologyexamples-r4-6">See above (urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d)</a></p><blockquote><p><b>component</b></p><p><b>code</b>: Predicted Therapeutic Implication <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-tbd-codes-cs.html">To Be Determined Codes</a>#predicted-therapeutic-implication)</span></p><p><b>value</b>: Responsive <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#LA6677-4)</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>: Associated 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>: Polycythemia vera (PV) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Medication assessed <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#51963-7)</span></p><p><b>value</b>: AT9283 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></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/tbd-codes-cs"/>
            <code value="therapeutic-implication"/>
            <display value="Therapeutic Implication"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
        </subject>
        <performer>
          <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
        </performer>
        <method>
          <coding>
            <system value="http://loinc.org"/>
            <code value="LA26811-2"/>
            <display value="Computational analysis"/>
          </coding>
        </method>
        <specimen>
          <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
        </specimen>
        <derivedFrom>
          <reference value="urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d"/>
        </derivedFrom>
        <component>
          <code>
            <coding>
              <system
                      value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
              <code value="predicted-therapeutic-implication"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA6677-4"/>
              <display value="Responsive"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="93044-6"/>
              <display value="Level of Evidence"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA30200-2"/>
              <display value="Very strong evidence pathogenic"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="81259-4"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <text value="Polycythemia vera (PV)"/>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="51963-7"/>
              <display value="Medication assessed"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <text value="AT9283"/>
          </valueCodeableConcept>
        </component>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:05713d1c-0df5-46d5-a5a9-2085eef56c20"/>
    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-11"/>
        <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><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 "Inline-Instance-for-oncologyexamples-r4-11" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-therapeutic-implication.html">Therapeutic Implication</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/3.1.0/CodeSystem-observation-category.html">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: Therapeutic Implication <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-tbd-codes-cs.html">To Be Determined Codes</a>#therapeutic-implication)</span></p><p><b>subject</b>: <a href="#Patient_Inline-Instance-for-oncologyexamples-r4-1">See above (urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d)</a></p><p><b>performer</b>: <a href="#Practitioner_Inline-Instance-for-oncologyexamples-r4-2">See above (urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef)</a></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>: <a href="#Specimen_Inline-Instance-for-oncologyexamples-r4-3">See above (urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d)</a></p><p><b>derivedFrom</b>: <a href="#Observation_Inline-Instance-for-oncologyexamples-r4-6">See above (urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d)</a></p><blockquote><p><b>component</b></p><p><b>code</b>: Predicted Therapeutic Implication <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-tbd-codes-cs.html">To Be Determined Codes</a>#predicted-therapeutic-implication)</span></p><p><b>value</b>: Responsive <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#LA6677-4)</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>: Associated 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>: Polycythemia vera (PV) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Medication assessed <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#51963-7)</span></p><p><b>value</b>: SNX-5422 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></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/tbd-codes-cs"/>
            <code value="therapeutic-implication"/>
            <display value="Therapeutic Implication"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
        </subject>
        <performer>
          <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
        </performer>
        <method>
          <coding>
            <system value="http://loinc.org"/>
            <code value="LA26811-2"/>
            <display value="Computational analysis"/>
          </coding>
        </method>
        <specimen>
          <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
        </specimen>
        <derivedFrom>
          <reference value="urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d"/>
        </derivedFrom>
        <component>
          <code>
            <coding>
              <system
                      value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
              <code value="predicted-therapeutic-implication"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA6677-4"/>
              <display value="Responsive"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="93044-6"/>
              <display value="Level of Evidence"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA30200-2"/>
              <display value="Very strong evidence pathogenic"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="81259-4"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <text value="Polycythemia vera (PV)"/>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="51963-7"/>
              <display value="Medication assessed"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <text value="SNX-5422"/>
          </valueCodeableConcept>
        </component>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:294f1401-e2eb-4df1-b6d2-09e1b7a6eca4"/>
    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-12"/>
        <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><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 "Inline-Instance-for-oncologyexamples-r4-12" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-therapeutic-implication.html">Therapeutic Implication</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/3.1.0/CodeSystem-observation-category.html">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: Therapeutic Implication <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-tbd-codes-cs.html">To Be Determined Codes</a>#therapeutic-implication)</span></p><p><b>subject</b>: <a href="#Patient_Inline-Instance-for-oncologyexamples-r4-1">See above (urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d)</a></p><p><b>performer</b>: <a href="#Practitioner_Inline-Instance-for-oncologyexamples-r4-2">See above (urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef)</a></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>: <a href="#Specimen_Inline-Instance-for-oncologyexamples-r4-3">See above (urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d)</a></p><p><b>derivedFrom</b>: <a href="#Observation_Inline-Instance-for-oncologyexamples-r4-6">See above (urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d)</a></p><blockquote><p><b>component</b></p><p><b>code</b>: Predicted Therapeutic Implication <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-tbd-codes-cs.html">To Be Determined Codes</a>#predicted-therapeutic-implication)</span></p><p><b>value</b>: Responsive <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#LA6677-4)</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>: Associated 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>: Polycythemia vera (PV) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Medication assessed <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#51963-7)</span></p><p><b>value</b>: TG02 <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></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/tbd-codes-cs"/>
            <code value="therapeutic-implication"/>
            <display value="Therapeutic Implication"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
        </subject>
        <performer>
          <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
        </performer>
        <method>
          <coding>
            <system value="http://loinc.org"/>
            <code value="LA26811-2"/>
            <display value="Computational analysis"/>
          </coding>
        </method>
        <specimen>
          <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
        </specimen>
        <derivedFrom>
          <reference value="urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d"/>
        </derivedFrom>
        <component>
          <code>
            <coding>
              <system
                      value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
              <code value="predicted-therapeutic-implication"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA6677-4"/>
              <display value="Responsive"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="93044-6"/>
              <display value="Level of Evidence"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <coding>
              <system value="http://loinc.org"/>
              <code value="LA30200-2"/>
              <display value="Very strong evidence pathogenic"/>
            </coding>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="81259-4"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <text value="Polycythemia vera (PV)"/>
          </valueCodeableConcept>
        </component>
        <component>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="51963-7"/>
              <display value="Medication assessed"/>
            </coding>
          </code>
          <valueCodeableConcept>
            <text value="TG02"/>
          </valueCodeableConcept>
        </component>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:294f1401-e2eb-4df1-b6d2-09e1b7a6ecb6"/>
    <resource>
      <Observation>
        <id value="Inline-Instance-for-oncologyexamples-r4-14"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/therapeutic-implication"/>
        </meta>
        <text>
          <status value="extensions"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></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 "Inline-Instance-for-oncologyexamples-r4-14" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-therapeutic-implication.html">Therapeutic Implication</a></p></div><p><b>Therapy Assessed</b>: <a name="PlanDefRuxolitinib"> </a></p><blockquote><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 "PlanDefRuxolitinib" </p></div><p><b>name</b>: RuxolitinibPlan</p><p><b>status</b>: draft</p><p><b>description</b>: This is not a fully defined resource, just here as a place holder to show how a PlanDefinition could be packaged.</p></blockquote><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/3.1.0/CodeSystem-observation-category.html">Observation Category Codes</a>#laboratory)</span></p><p><b>code</b>: Therapeutic Implication <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-tbd-codes-cs.html">To Be Determined Codes</a>#therapeutic-implication)</span></p><p><b>subject</b>: <a href="#Patient_Inline-Instance-for-oncologyexamples-r4-1">See above (urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d)</a></p><p><b>derivedFrom</b>: <a href="#Observation_Inline-Instance-for-oncologyexamples-r4-6">See above (urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d)</a></p></div>
        </text>
        <contained>
          <PlanDefinition>
            <id value="PlanDefRuxolitinib"/>
            <name value="RuxolitinibPlan"/>
            <status value="draft"/>
            <description
                         value="This is not a fully defined resource, just here as a place holder to show how a PlanDefinition could be packaged."/>
          </PlanDefinition>
        </contained>
        <extension
                   url="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/therapy-assessed">
          <valueReference>
            <reference value="#PlanDefRuxolitinib"/>
          </valueReference>
        </extension>
        <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/tbd-codes-cs"/>
            <code value="therapeutic-implication"/>
            <display value="Therapeutic Implication"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
        </subject>
        <derivedFrom>
          <reference value="urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d"/>
        </derivedFrom>
      </Observation>
    </resource>
    <request>
      <method value="POST"/>
      <url value="Observation"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:ad7a499b-a43b-4cc8-bf46-cac62d9ecae5"/>
    <resource>
      <DiagnosticReport>
        <id value="Inline-Instance-for-oncologyexamples-r4-13"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomics-report"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></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 "Inline-Instance-for-oncologyexamples-r4-13" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-genomics-report.html">Genomics 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/3.1.0/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>#81247-9 "Master HL7 genetic variant reporting panel")</span></p><p><b>subject</b>: <a href="#Patient_Inline-Instance-for-oncologyexamples-r4-1">See above (urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d)</a></p><p><b>performer</b>: <a href="#Practitioner_Inline-Instance-for-oncologyexamples-r4-2">See above (urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef)</a></p><p><b>specimen</b>: <a href="#Specimen_Inline-Instance-for-oncologyexamples-r4-3">See above (urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d)</a></p><p><b>result</b>: </p><ul><li><a href="#Observation_Inline-Instance-for-oncologyexamples-r4-6">See above (urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d: SNV analysis for JAK2 variant)</a></li><li><a href="#Observation_Inline-Instance-for-oncologyexamples-r4-7">See above (urn:uuid:772de7d7-e1bd-4183-bdb5-cea8eda317cd: SNV analysis for KDR variant)</a></li><li><a href="#Observation_Inline-Instance-for-oncologyexamples-r4-8">See above (urn:uuid:b33eb7ec-d83e-49d2-b0f3-729d024ebe01: SNV analysis for ERBB4 variant)</a></li><li><a href="#Observation_Inline-Instance-for-oncologyexamples-r4-4">See above (urn:uuid:40e85eda-4d31-4bd2-a5a0-c39d63f9824f: TMB value analysis)</a></li><li><a href="#Observation_Inline-Instance-for-oncologyexamples-r4-5">See above (urn:uuid:64b91716-6431-41bd-8fd4-7ac99bebdee9: MSI status analysis)</a></li><li><a href="#Observation_Inline-Instance-for-oncologyexamples-r4-9">See above (urn:uuid:1bf9642d-fd1c-4819-8c5d-44fae4bad524: Therapy match result 1)</a></li><li><a href="#Observation_Inline-Instance-for-oncologyexamples-r4-10">See above (urn:uuid:1301943b-55db-4adf-8355-3635f7268a1b: Therapy match result 2)</a></li><li><a href="#Observation_Inline-Instance-for-oncologyexamples-r4-11">See above (urn:uuid:05713d1c-0df5-46d5-a5a9-2085eef56c20: Therapy match result 3)</a></li><li><a href="#Observation_Inline-Instance-for-oncologyexamples-r4-12">See above (urn:uuid:294f1401-e2eb-4df1-b6d2-09e1b7a6eca4: Therapy match result 4)</a></li></ul></div>
        </text>
        <status value="final"/>
        <category>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
            <code value="GE"/>
          </coding>
        </category>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="81247-9"/>
            <display value="Master HL7 genetic variant reporting panel"/>
          </coding>
          <text value="Genetic analysis report"/>
        </code>
        <subject>
          <reference value="urn:uuid:d0b4affa-91d6-46d1-af01-b30d9f16ef6d"/>
        </subject>
        <performer>
          <reference value="urn:uuid:a48256f8-db37-44e0-a0f6-d7af16c7c9ef"/>
        </performer>
        <specimen>
          <reference value="urn:uuid:a5d6a6a9-4859-480e-85b2-56974fef3b9d"/>
        </specimen>
        <result>
          <reference value="urn:uuid:16fdd5fc-e665-48af-99e4-48d603f3e12d"/>
          <display value="SNV analysis for JAK2 variant"/>
        </result>
        <result>
          <reference value="urn:uuid:772de7d7-e1bd-4183-bdb5-cea8eda317cd"/>
          <display value="SNV analysis for KDR variant"/>
        </result>
        <result>
          <reference value="urn:uuid:b33eb7ec-d83e-49d2-b0f3-729d024ebe01"/>
          <display value="SNV analysis for ERBB4 variant"/>
        </result>
        <result>
          <reference value="urn:uuid:40e85eda-4d31-4bd2-a5a0-c39d63f9824f"/>
          <display value="TMB value analysis"/>
        </result>
        <result>
          <reference value="urn:uuid:64b91716-6431-41bd-8fd4-7ac99bebdee9"/>
          <display value="MSI status analysis"/>
        </result>
        <result>
          <reference value="urn:uuid:1bf9642d-fd1c-4819-8c5d-44fae4bad524"/>
          <display value="Therapy match result 1"/>
        </result>
        <result>
          <reference value="urn:uuid:1301943b-55db-4adf-8355-3635f7268a1b"/>
          <display value="Therapy match result 2"/>
        </result>
        <result>
          <reference value="urn:uuid:05713d1c-0df5-46d5-a5a9-2085eef56c20"/>
          <display value="Therapy match result 3"/>
        </result>
        <result>
          <reference value="urn:uuid:294f1401-e2eb-4df1-b6d2-09e1b7a6eca4"/>
          <display value="Therapy match result 4"/>
        </result>
      </DiagnosticReport>
    </resource>
    <request>
      <method value="POST"/>
      <url value="DiagnosticReport"/>
    </request>
  </entry>
</Bundle>