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Packagehl7.fhir.uv.genomics-reporting.r4b
Resource TypeObservation
IdObservation-TxImp06.json
FHIR VersionR4B

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Narrative

Note: links and images are rebased to the (stated) source

Normal metabolizer of Warfarin

Source1

{
  "resourceType": "Observation",
  "id": "TxImp06",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/therapeutic-implication"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/workflow-relatedArtifact",
      "valueRelatedArtifact": {
        "type": "citation",
        "url": "https://cpicpgx.org/guidelines/guideline-for-warfarin-and-cyp2c9-and-vkorc1/"
      }
    }
  ],
  "status": "final",
  "category": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/observation-category",
          "code": "laboratory"
        }
      ]
    },
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/v2-0074",
          "code": "GE"
        }
      ]
    }
  ],
  "code": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
        "code": "therapeutic-implication"
      }
    ]
  },
  "subject": {
    "reference": "Patient/CGPatientExample01"
  },
  "effectiveDateTime": "2019-04-01",
  "performer": [
    {
      "reference": "Organization/ExampleOrg"
    }
  ],
  "derivedFrom": [
    {
      "reference": "Observation/Pgx-geno-1002",
      "display": "CYP2C9*1/*1"
    },
    {
      "reference": "Observation/Pgx-geno-1003",
      "display": "VKORC1 rs9923231 C/T"
    }
  ],
  "component": [
    {
      "code": {
        "coding": [
          {
            "system": "http://loinc.org",
            "code": "51963-7"
          }
        ]
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code": "11289",
            "display": "warfarin"
          }
        ]
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
            "code": "therapeutic-implication"
          }
        ]
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://loinc.org",
            "code": "LA25391-6",
            "display": "Normal metabolizer"
          }
        ]
      }
    },
    {
      "code": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs",
            "code": "conclusion-string"
          }
        ]
      },
      "valueString": "This individual is homozygous for the normal allele for the CYP2C9 gene. Based on the genotype result, this patient is predicted to have normal CYP2C9 function. This individual is also heterozygous for the variant allele for the VKORC1 gene. Expression level of the VKORC1 gene is associated with warfarin sensitivity. Based on the genotype result, this patient is predicted to have medium sensitivity to warfarin. See https://cpicpgx.org/guidelines/guideline-for-warfarin-and-cyp2c9-and-vkorc1/ guidelines for detail."
    }
  ]
}