R4 Draft for Comment

This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Observation-example-f205-egfr.xml

Orders and Observations Work GroupMaturity Level: N/ABallot Status: InformativeCompartments: Device, Encounter, Patient, Practitioner, RelatedPerson

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Real-world patient - estimated gfr (id = "f205")

<Observation xmlns="http://hl7.org/fhir">
  <id value="f205"/> 
  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative with Details</b> </p> <p> <b> id</b> : f205</p> <p> <b> identifier</b> : 1304-03720-eGFR</p> <p> <b> status</b> : final</p> <p> <b> code</b> : Glomerular filtration rate/1.73 sq M.predicted [Volume Rate/Area] in Serum or Plasma
         by Creatinine-based formula (MDRD) <span> (Details : {LOINC code '33914-3' = 'Glomerular filtration rate/1.73 sq M.predicted by
           Creatinine-based formula (MDRD)', given as 'Glomerular filtration rate/1.73 sq M.predicted
           [Volume Rate/Area] in Serum or Plasma by Creatinine-based formula (MDRD)'})</span> </p> <p> <b> subject</b> : <a> Roel</a> </p> <p> <b> issued</b> : 04/04/2013 2:34:00 PM</p> <p> <b> performer</b> : <a> Luigi Maas</a> </p> <p> <b> interpretation</b> : interpretation of results should be assigned based upon the level of kindey function
         <span> (Details )</span> </p> <p> <b> comment</b> : GFR estimating equations developed by the Modification of Diet in Renal Disease (MDRD)
         Study Group and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)....</p> <p> <b> method</b> : MDRD <span> (Details : {SNOMED CT code '702668005' = '702668005', given as 'MDRD'})</span> </p> <blockquote> <p> <b> component</b> </p> <p> <b> code</b> : Glomerular filtration rate/1.73 sq M predicted among blacks [Volume Rate/?Area] in Serum
           or Plasma by Creatinine-based formula (MDRD) <span> (Details : {LOINC code '48643-1' = 'Glomerular filtration rate/1.73 sq M predicted among
             blacks by Creatinine-based formula (MDRD)', given as 'Glomerular filtration rate/1.73
             sq M predicted among blacks [Volume Rate/?Area] in Serum or Plasma by Creatinine-based
             formula (MDRD)'})</span> </p> <p> <b> value</b> : &gt;60 mL/min/1.73m2<span>  (Details: UCUM code mL/min/{1.73_m2} = 'mL/min/{1.73_m2}')</span> </p> <h3> ReferenceRanges</h3> <table> <tr> <td> -</td> </tr> <tr> <td> *</td> </tr> </table> </blockquote> <blockquote> <p> <b> component</b> </p> <p> <b> code</b> : Glomerular filtration rate/1.73 sq M predicted among non-blacks [Volume Rate/Area] in
           Serum or Plasma by Creatinine-based formula (MDRD) <span> (Details : {LOINC code '48642-3' = 'Glomerular filtration rate/1.73 sq M predicted among
             non-blacks by Creatinine-based formula (MDRD)', given as 'Glomerular filtration rate/1.73
             sq M predicted among non-blacks [Volume Rate/Area] in Serum or Plasma by Creatinine-based
             formula (MDRD)'})</span> </p> <p> <b> value</b> : 60 mL/min/1.73m2<span>  (Details: UCUM code mL/min/{1.73_m2} = 'mL/min/{1.73_m2}')</span> </p> <h3> ReferenceRanges</h3> <table> <tr> <td> -</td> </tr> <tr> <td> *</td> </tr> </table> </blockquote> </div> </text> <identifier> 
    <system value="https://intranet.aumc.nl/labvalues"/> <!--     Does not exist     --><value value="1304-03720-eGFR"/> 
  </identifier> <!--     eGFR was measured on April fourth     --><status value="final"/> 
  <code> <!--     Kind of observation = eGFR     --><coding> 
      <system value="http://loinc.org"/> 
      <code value="33914-3"/> 
      <display value="Glomerular filtration rate/1.73 sq M.predicted [Volume Rate/Area] in Serum or Plasma by
       Creatinine-based formula (MDRD)"/> 
    </coding> 
  </code> 
  <subject> 
    <reference value="Patient/f201"/> 
    <display value="Roel"/> 
  </subject> 
  <issued value="2013-04-04T14:34:00+01:00"/> 
  <performer> 
    <reference value="Practitioner/f202"/> 
    <display value="Luigi Maas"/> 
  </performer> <!--    no value element since have only component values and unable to interpret results needs
   clinical interpretation    --><interpretation> 
    <text value="interpretation of results should be assigned based upon the level of kindey function"/> 
  </interpretation> 
  <comment value="GFR estimating equations developed by the Modification of Diet in Renal Disease (MDRD)
   Study Group and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)...."/> <!--     The observation is complete     --><!--     No reliability concerns     --><method> <!--     Method was MDRD     --><coding> 
      <system value="http://snomed.info/id"/> 
      <code value="702668005"/> 
      <display value="MDRD"/> 
    </coding> 
  </method> <!--     The MDRD equation does require race (African American or non-African American), which
   also might not be readily available. For this reason, eGFR values for both African Americans
   and non-African Americans are reported. so use component elements here    --><component> 
    <code> <!--     Kind of observation = eGFR for AA     --><coding> 
        <system value="http://loinc.org"/> 
        <code value="48643-1"/> 
        <display value="Glomerular filtration rate/1.73 sq M predicted among blacks [Volume Rate/?Area] in Serum
         or Plasma by Creatinine-based formula (MDRD)"/> 
      </coding> 
    </code> 
    <valueQuantity> <!--     eGFR=54mL/min/1.73m2     --><value value="60"/> 
      <comparator value="&gt;"/> 
      <unit value="mL/min/1.73m2"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="mL/min/{1.73_m2}"/> 
    </valueQuantity> 
    <referenceRange> 
      <low> 
        <value value="60"/> 
        <unit value="mL/min/1.73m2"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="mL/min/{1.73_m2}"/> 
      </low> 
      <appliesTo> 
        <text value="non-black/african-american"/> 
      </appliesTo> 
      <age> 
        <low> 
          <value value="18"/> 
          <unit value="yrs"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="a"/> 
        </low> 
      </age> 
    </referenceRange> 
  </component> 
  <component> 
    <code> <!--     Kind of observation = eGFR for non AA     --><coding> 
        <system value="http://loinc.org"/> 
        <code value="48642-3"/> 
        <display value="Glomerular filtration rate/1.73 sq M predicted among non-blacks [Volume Rate/Area] in
         Serum or Plasma by Creatinine-based formula (MDRD)"/> 
      </coding> 
    </code> 
    <valueQuantity> <!--     eGFR=54mL/min/1.73m2     --><value value="60"/> 
      <unit value="mL/min/1.73m2"/> 
      <system value="http://unitsofmeasure.org"/> 
      <code value="mL/min/{1.73_m2}"/> 
    </valueQuantity> 
    <referenceRange> 
      <low> 
        <value value="60"/> 
        <unit value="mL/min/1.73m2"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="mL/min/{1.73_m2}"/> 
      </low> 
      <age> 
        <low> 
          <value value="18"/> 
          <unit value="yrs"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="a"/> 
        </low> 
      </age> 
    </referenceRange> 
  </component> 
</Observation> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.