Observation-example-f205-egfr.json

Real-world patient - egfr estimated gfr

{
  "resourceType": "Observation",
  "id": "f205",

  "text": {
    "status": "generated",
    "div": "<div>\n      <p>\n        <b>Generated Narrative</b>\n      </p>\n      <p>\n        <b>name</b>: \n        <span title=\"Codes: {http://snomed.info/sct 409402009}\">Epidermal Growth Factor Receptor</span>\n      </p>\n      <p>\n        <b>value[x]</b>: 54 mL/min\n      </p>\n      <p>\n        <b>interpretation</b>: \n        <span title=\"Codes: {http://snomed.info/sct 427038005}, {http://hl7.org/fhir/v2/0078 NEG}\">Negative for epidermal growth factor receptor expression (Non-small cell lung cancer)</span>\n      </p>\n      <p>\n        <b>issued</b>: 4-Apr 2013 14:34\n      </p>\n      <p>\n        <b>status</b>: final_\n      </p>\n      <p>\n        <b>reliability</b>: ok\n      </p>\n      <p>\n        <b>method</b>: \n        <span title=\"Codes: {http://snomed.info/sct 129266000}\">Measurement</span>\n      </p>\n      <p>\n        <b>identifier</b>: eGFR value of Roel on April 2013 - 03720 = 1304-03720-eGFR\n      </p>\n      <p>\n        <b>subject</b>: Roel\n      </p>\n      <p>\n        <b>performer</b>: Luigi Maas\n      </p>\n      <h3>ReferenceRanges</h3>\n      <table class=\"grid\">\n        <tr>\n          <td>\n            <b>Low</b>\n          </td>\n          <td>\n            <b>High</b>\n          </td>\n          <td>\n            <b>Meaning</b>\n          </td>\n          <td>\n            <b>Age</b>\n          </td>\n        </tr>\n        <tr>\n          <td> </td>\n          <td>60 mL/min</td>\n          <td> </td>\n          <td> </td>\n        </tr>\n      </table>\n    </div>"
  },
  "name": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "409402009",
        "display": "Epidermal Growth Factor Receptor"
      }
    ]
  },
  "valueQuantity": {
    "value": 54,
    "units": "mL/min",
    "system": "http://snomed.info/sct",
    "code": "258859000"

    "div": "<div><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>comments</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' = '??', 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: http://unitsofmeasure.org code 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: http://unitsofmeasure.org code mL/min/{1.73_m2} = '??')</span></p><h3>ReferenceRanges</h3><table><tr><td>-</td></tr><tr><td>*</td></tr></table></blockquote></div>"

  },
  "interpretation": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "427038005",
        "display": "Negative for epidermal growth factor receptor expression (Non-small cell lung cancer)"
      },
      {
        "system": "http://hl7.org/fhir/v2/0078",
        "code": "NEG"

  "identifier": [
    {
      "system": "https://intranet.aumc.nl/labvalues",
      "value": "1304-03720-eGFR",
      "_value": {
        "fhir_comments": [
          "    Does not exist    "
        ]

      }
    }
  ],
  "status": "final",
  "_status": {
    "fhir_comments": [
      "    eGFR was measured on April fourth    "

    ]
  },
  "issued": "2013-04-04T14:34:00+01:00",
  "status": "final",
  "reliability": "ok",
  "method": {

  "code": {

    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "129266000",
        "display": "Measurement"

        "fhir_comments": [
          "    Kind of observation = eGFR    "
        ],
        "system": "http://loinc.org",
        "code": "33914-3",
        "display": "Glomerular filtration rate/1.73 sq M.predicted [Volume Rate/Area] in Serum or Plasma by Creatinine-based formula (MDRD)"

      }
    ]
  },
  "identifier": {
    "label": "eGFR value of Roel on April 2013 - 03720",
    "system": "https://intranet.aumc.nl/labvalues",
    "value": "1304-03720-eGFR"
  },

  "subject": {
    "reference": "Patient/f201",
    "display": "Roel"
  },
  "issued": "2013-04-04T14:34:00+01:00",

  "performer": [
    {
      "reference": "Practitioner/f202",
      "display": "Luigi Maas"
    }
  ],
  "referenceRange": [

  "interpretation": {
    "fhir_comments": [
      "   no value element since have only component values and unable to interpret results needs clinical interpretation   "
    ],
    "text": "interpretation of results should be assigned based upon the level of kindey function"
  },
  "comments": "GFR estimating equations developed by the Modification of Diet in Renal Disease (MDRD) Study Group and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)....",
  "method": {
    "fhir_comments": [
      "    The observation is complete    ",
      "    No reliability concerns    "
    ],
    "coding": [
      {
        "fhir_comments": [
          "    Method was MDRD    "
        ],
        "system": "http://snomed.info/id",
        "code": "702668005",
        "display": "MDRD"
      }
    ]
  },
  "component": [

    {
      "high": {

      "fhir_comments": [
        "    The MDRD equation does require race (African American or non-African American), which also may not be readily available. For this reason, eGFR values for both African Americans and non-African Americans are reported. so use component elements here   "
      ],
      "code": {
        "coding": [
          {
            "fhir_comments": [
              "    Kind of observation = eGFR for AA    "
            ],
            "system": "http://loinc.org",
            "code": "48643-1",
            "display": "Glomerular filtration rate/1.73 sq M predicted among blacks [Volume Rate/?Area] in Serum or Plasma by Creatinine-based formula (MDRD)"
          }
        ]
      },
      "valueQuantity": {

        "value": 60,
        "units": "mL/min"
      }

        "_value": {
          "fhir_comments": [
            "    eGFR=54mL/min/1.73m2    "
          ]
        },
        "comparator": ">",
        "unit": "mL/min/1.73m2",
        "system": "http://unitsofmeasure.org",
        "code": "mL/min/{1.73_m2}"
      },
      "referenceRange": [
        {
          "low": {
            "value": 60,
            "unit": "mL/min/1.73m2",
            "system": "http://unitsofmeasure.org",
            "code": "mL/min/{1.73_m2}"
          },
          "age": {
            "low": {
              "value": 18,
              "unit": "yrs",
              "system": "http://unitsofmeasure.org",
              "code": "a"
            }
          }
        }
      ]
    },
    {
      "code": {
        "coding": [
          {
            "fhir_comments": [
              "    Kind of observation = eGFR for non AA    "
            ],
            "system": "http://loinc.org",
            "code": "48642-3",
            "display": "Glomerular filtration rate/1.73 sq M predicted among non-blacks [Volume Rate/Area] in Serum or Plasma by Creatinine-based formula (MDRD)"
          }
        ]
      },
      "valueQuantity": {
        "value": 60,
        "_value": {
          "fhir_comments": [
            "    eGFR=54mL/min/1.73m2    "
          ]
        },
        "unit": "mL/min/1.73m2",
        "system": "http://unitsofmeasure.org",
        "code": "mL/min/{1.73_m2}"
      },
      "referenceRange": [
        {
          "low": {
            "value": 60,
            "unit": "mL/min/1.73m2",
            "system": "http://unitsofmeasure.org",
            "code": "mL/min/{1.73_m2}"
          },
          "age": {
            "low": {
              "value": 18,
              "unit": "yrs",
              "system": "http://unitsofmeasure.org",
              "code": "a"
            }
          }
        }
      ]

    }
  ]
}