{
    "resourceType": "Observation",
    "id": "Observation-AutisticBehaviour-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "http://human-phenotype-ontology.org",
                "version": "20221005",
                "code": "HP:0000729",
                "display": "Autistic behaviour"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-PheobeSmitham-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307539"
        }
    },
    "effectiveDateTime": "09/15/2023 15:00:00",
    "valueBoolean": true
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-AutisticBehaviour-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="http://human-phenotype-ontology.org" />
            <version value="20221005" />
            <code value="HP:0000729" />
            <display value="Autistic behaviour" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-PheobeSmitham-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307539" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-09-15T15:00:00Z" />
    <valueBoolean value="true" />
</Observation>

Propose a change to Observation-AutisticBehaviour-Example

{
    "resourceType": "Observation",
    "id": "Observation-BlastPercentage-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "1015521000000107",
                "display": "Percentage blast cells (observable entity)"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-PatrickSammy-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307873"
        }
    },
    "specimen": {
        "identifier": {
            "system": "urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24",
            "value": "RR81234",
            "assigner": {
                "identifier": {
                    "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                    "value": "696B0"
                }
            }
        }
    },
    "valueQuantity": {
        "value": 25,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
    },
    "effectiveDateTime": "2023-08-29"
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-BlastPercentage-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="1015521000000107" />
            <display value="Percentage blast cells (observable entity)" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-PatrickSammy-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307873" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-08-29" />
    <valueQuantity>
        <value value="25" />
        <unit value="%" />
        <system value="http://unitsofmeasure.org" />
        <code value="%" />
    </valueQuantity>
    <specimen>
        <identifier>
            <system value="urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24" />
            <value value="RR81234" />
            <assigner>
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
                    <value value="696B0" />
                </identifier>
            </assigner>
        </identifier>
    </specimen>
</Observation>

Propose a change to Observation-BlastPercentage-Example

{
    "resourceType": "Observation",
    "id": "Observation-BlastPercentageWGSSample-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "1015521000000107",
                "display": "Percentage blast cells (observable entity)"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-PatrickSammy-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307873"
        }
    },
    "specimen": {
        "identifier": {
            "system": "urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24",
            "value": "RR81235",
            "assigner": {
                "identifier": {
                    "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                    "value": "696B0"
                }
            }
        }
    },
    "valueQuantity": {
        "value": 25,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
    },
    "effectiveDateTime": "2023-08-05"
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-BlastPercentageWGSSample-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="1015521000000107" />
            <display value="Percentage blast cells (observable entity)" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-PatrickSammy-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307873" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-08-05" />
    <valueQuantity>
        <value value="25" />
        <unit value="%" />
        <system value="http://unitsofmeasure.org" />
        <code value="%" />
    </valueQuantity>
    <specimen>
        <identifier>
            <system value="urn:oid:2.16.840.1.113883.2.1.3.2.4.18.24" />
            <value value="RR81235" />
            <assigner>
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
                    <value value="696B0" />
                </identifier>
            </assigner>
        </identifier>
    </specimen>
</Observation>

Propose a change to Observation-BlastPercentageWGSSample-Example

{
    "resourceType": "Observation",
    "id": "Observation-Bruising-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "308492005",
                "display": "Bruising"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-PatrickSammy-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307873"
        }
    },
    "effectiveDateTime": "2023-09-03"
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-Bruising-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="308492005" />
            <display value="Bruising" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-PatrickSammy-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307873" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-09-03" />
</Observation>

Propose a change to Observation-Bruising-Example

{
    "resourceType": "Observation",
    "id": "Observation-Cellularity-Example",
    "status": "final",
    "code": {
        "text": "Cellularity"
    },
    "subject": {
        "reference": "Patient/Patient-ZelmaHadjkiss-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307555"
        }
    },
    "specimen": {
        "identifier": {
            "system": "https://fhir.add.nhs.uk/Id/specimenId",
            "value": "RA257630"
        }
    },
    "valueCodeableConcept": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "75540009",
                "display": "High (qualifier value)"
            }
        ]
    },
    "effectiveDateTime": "09/08/2023 10:00:00"
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-Cellularity-Example" />
    <status value="final" />
    <code>
        <text value="Cellularity" />
    </code>
    <subject>
        <reference value="Patient/Patient-ZelmaHadjkiss-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307555" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-09-08T10:00:00Z" />
    <valueCodeableConcept>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="75540009" />
            <display value="High (qualifier value)" />
        </coding>
    </valueCodeableConcept>
    <specimen>
        <identifier>
            <system value="https://fhir.add.nhs.uk/Id/specimenId" />
            <value value="RA257630" />
        </identifier>
    </specimen>
</Observation>

Propose a change to Observation-Cellularity-Example

{
    "resourceType": "Observation",
    "id": "Observation-CellularityKayBurbridge-Example",
    "status": "final",
    "code": {
        "text": "Cellularity"
    },
    "subject": {
        "reference": "Patient/Patient-KayBurbridge-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "8449303541"
        }
    },
    "specimen": {
        "identifier": {
            "system": "https://fhir.add.nhs.uk/Id/specimenId",
            "value": "699F01231423"
        }
    },
    "valueCodeableConcept": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "75540009",
                "display": "High (qualifier value)"
            }
        ]
    },
    "effectiveDateTime": "11/01/2023 11:00:00"
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-CellularityKayBurbridge-Example" />
    <status value="final" />
    <code>
        <text value="Cellularity" />
    </code>
    <subject>
        <reference value="Patient/Patient-KayBurbridge-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="8449303541" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-11-01T11:00:00Z" />
    <valueCodeableConcept>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="75540009" />
            <display value="High (qualifier value)" />
        </coding>
    </valueCodeableConcept>
    <specimen>
        <identifier>
            <system value="https://fhir.add.nhs.uk/Id/specimenId" />
            <value value="699F01231423" />
        </identifier>
    </specimen>
</Observation>

Propose a change to Observation-CellularityKayBurbridge-Example

{
    "resourceType": "Observation",
    "id": "Observation-DelayedSpeechLanguageDevt-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "http://human-phenotype-ontology.org",
                "version": "20221005",
                "code": "HP:0000750",
                "display": "Delayed speech and language development"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-PheobeSmitham-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307539"
        }
    },
    "effectiveDateTime": "09/15/2023 15:00:00",
    "valueBoolean": true
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-DelayedSpeechLanguageDevt-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="http://human-phenotype-ontology.org" />
            <version value="20221005" />
            <code value="HP:0000750" />
            <display value="Delayed speech and language development" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-PheobeSmitham-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307539" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-09-15T15:00:00Z" />
    <valueBoolean value="true" />
</Observation>

Propose a change to Observation-DelayedSpeechLanguageDevt-Example

{
    "resourceType": "Observation",
    "id": "Observation-DiseasePenetrance-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory",
                "code": "R14",
                "display": "Acutely unwell children with a likely monogenic disorder",
                "version": "7"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-JamesMetcalfe-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "7449306524"
        }
    },
    "effectiveDateTime": "2023-10-01",
    "valueCodeableConcept": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "87006007",
                "display": "Dominant autosomal hereditary disorder, incomplete penetrance"
            }
        ]
    }
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-DiseasePenetrance-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory" />
            <version value="7" />
            <code value="R14" />
            <display value="Acutely unwell children with a likely monogenic disorder" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-JamesMetcalfe-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="7449306524" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-10-01" />
    <valueCodeableConcept>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="87006007" />
            <display value="Dominant autosomal hereditary disorder, incomplete penetrance" />
        </coding>
    </valueCodeableConcept>
</Observation>

Propose a change to Observation-DiseasePenetrance-Example

{
    "resourceType": "Observation",
    "id": "Observation-DiseasePenetrancePheobeSmitham-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory",
                "code": "R14",
                "display": "Acutely unwell children with a likely monogenic disorder",
                "version": "7"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-PheobeSmitham-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307539"
        }
    },
    "effectiveDateTime": "09/15/2023 15:00:00",
    "valueCodeableConcept": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "87006007",
                "display": "Dominant autosomal hereditary disorder, incomplete penetrance"
            }
        ]
    }
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-DiseasePenetrancePheobeSmitham-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory" />
            <version value="7" />
            <code value="R14" />
            <display value="Acutely unwell children with a likely monogenic disorder" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-PheobeSmitham-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307539" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-09-15T15:00:00Z" />
    <valueCodeableConcept>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="87006007" />
            <display value="Dominant autosomal hereditary disorder, incomplete penetrance" />
        </coding>
    </valueCodeableConcept>
</Observation>

Propose a change to Observation-DiseasePenetrancePheobeSmitham-Example

{
    "resourceType": "Observation",
    "id": "Observation-DutchLipidScore-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "872541000000104",
                "display": "Dutch Lipid Clinic Network diagnostic criteria for familial hypercholesterolaemia score (observable entity)"
            }
        ],
        "text": "Dutch or (Welsh) Lipid score"
    },
    "subject": {
        "reference": "Patient/Patient-FayMutlow-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307806"
        }
    },
    "effectiveDateTime": "2023-08-05",
    "valueInteger": 7
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-DutchLipidScore-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="872541000000104" />
            <display value="Dutch Lipid Clinic Network diagnostic criteria for familial hypercholesterolaemia score (observable entity)" />
        </coding>
        <text value="Dutch or (Welsh) Lipid score" />
    </code>
    <subject>
        <reference value="Patient/Patient-FayMutlow-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307806" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-08-05" />
    <valueInteger value="7" />
</Observation>

Propose a change to Observation-DutchLipidScore-Example

{
    "resourceType": "Observation",
    "id": "Observation-EnlargedKidney-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "http://human-phenotype-ontology.org",
                "version": "20221005",
                "code": "HP:0000105",
                "display": "Enlarged kidney"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-LindsaySorrell-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307946"
        }
    },
    "effectiveDateTime": "2023-08-05",
    "valueBoolean": true
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-EnlargedKidney-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="http://human-phenotype-ontology.org" />
            <version value="20221005" />
            <code value="HP:0000105" />
            <display value="Enlarged kidney" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-LindsaySorrell-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307946" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-08-05" />
    <valueBoolean value="true" />
</Observation>

Propose a change to Observation-EnlargedKidney-Example

{
    "resourceType": "Observation",
    "id": "Observation-Haemoglobin-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "38082009",
                "display": "Haemoglobin"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-PatrickSammy-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307873"
        }
    },
    "valueQuantity": {
        "value": 83,
        "unit": "g/dl",
        "system": "http://unitsofmeasure.org",
        "code": "g/dL"
    },
    "effectiveDateTime": "2023-09-03"
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-Haemoglobin-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="38082009" />
            <display value="Haemoglobin" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-PatrickSammy-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307873" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-09-03" />
    <valueQuantity>
        <value value="83" />
        <unit value="g/dl" />
        <system value="http://unitsofmeasure.org" />
        <code value="g/dL" />
    </valueQuantity>
</Observation>

Propose a change to Observation-Haemoglobin-Example

{
    "resourceType": "Observation",
    "id": "Observation-HepaticCysts-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "http://human-phenotype-ontology.org",
                "version": "20221005",
                "code": "HP:0001407",
                "display": "Hepatic cysts"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-LindsaySorrell-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307946"
        }
    },
    "effectiveDateTime": "2023-08-05",
    "valueBoolean": false
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-HepaticCysts-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="http://human-phenotype-ontology.org" />
            <version value="20221005" />
            <code value="HP:0001407" />
            <display value="Hepatic cysts" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-LindsaySorrell-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307946" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-08-05" />
    <valueBoolean value="false" />
</Observation>

Propose a change to Observation-HepaticCysts-Example

{
    "resourceType": "Observation",
    "id": "Observation-Immunodefficiency-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "http://human-phenotype-ontology.org",
                "version": "20221005",
                "code": "HP:0002721",
                "display": "Immunodefficiency"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-JamesMetcalfe-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "7449306524"
        }
    },
    "effectiveDateTime": "2023-10-01",
    "valueBoolean": true
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-Immunodefficiency-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="http://human-phenotype-ontology.org" />
            <version value="20221005" />
            <code value="HP:0002721" />
            <display value="Immunodefficiency" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-JamesMetcalfe-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="7449306524" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-10-01" />
    <valueBoolean value="true" />
</Observation>

Propose a change to Observation-Immunodefficiency-Example

{
    "resourceType": "Observation",
    "id": "Observation-IntellectualDisabilityMild-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "http://human-phenotype-ontology.org",
                "version": "20221005",
                "code": "HP:0001256",
                "display": "Intellectual disability, mild"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-JamesLawrenceProbandFather-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307636"
        }
    },
    "effectiveDateTime": "09/15/2023 15:00:00",
    "valueBoolean": true
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-IntellectualDisabilityMild-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="http://human-phenotype-ontology.org" />
            <version value="20221005" />
            <code value="HP:0001256" />
            <display value="Intellectual disability, mild" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-JamesLawrenceProbandFather-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307636" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-09-15T15:00:00Z" />
    <valueBoolean value="true" />
</Observation>

Propose a change to Observation-IntellectualDisabilityMild-Example

{
    "resourceType": "Observation",
    "id": "Observation-IntellectualDisabilityProfound-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "http://human-phenotype-ontology.org",
                "version": "20221005",
                "code": "HP:0002187",
                "display": "Intellectual disability, profound"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-PheobeSmitham-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307539"
        }
    },
    "effectiveDateTime": "09/15/2023 15:00:00",
    "valueBoolean": true
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-IntellectualDisabilityProfound-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="http://human-phenotype-ontology.org" />
            <version value="20221005" />
            <code value="HP:0002187" />
            <display value="Intellectual disability, profound" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-PheobeSmitham-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307539" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-09-15T15:00:00Z" />
    <valueBoolean value="true" />
</Observation>

Propose a change to Observation-IntellectualDisabilityProfound-Example

{
    "resourceType": "Observation",
    "id": "Observation-NatureAndAgeOfHearingLoss-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory",
                "code": "R67.1",
                "display": "Monogenic hearing loss",
                "version": "7"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-MeirLieberman-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307873"
        }
    },
    "effectiveDateTime": "2023-08-05",
    "component":  [
        {
            "code": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "95820000",
                        "display": "Bilateral hearing loss (disorder)"
                    }
                ]
            },
            "valueString": "hearing loss since childhood"
        }
    ]
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-NatureAndAgeOfHearingLoss-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory" />
            <version value="7" />
            <code value="R67.1" />
            <display value="Monogenic hearing loss" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-MeirLieberman-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307873" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-08-05" />
    <component>
        <code>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="95820000" />
                <display value="Bilateral hearing loss (disorder)" />
            </coding>
        </code>
        <valueString value="hearing loss since childhood" />
    </component>
</Observation>

Propose a change to Observation-NatureAndAgeOfHearingLoss-Example

{
    "resourceType": "Observation",
    "id": "Observation-Necrosis-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "405921002",
                "display": "Percentage of neoplasm involved by necrosis (observable entity)"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-ZelmaHadjkiss-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449307555"
        }
    },
    "specimen": {
        "identifier": {
            "system": "https://fhir.add.nhs.uk/Id/specimenId",
            "value": "RA257630"
        }
    },
    "valueQuantity": {
        "value": 5,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
    },
    "effectiveDateTime": "2023-09-08"
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-Necrosis-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="405921002" />
            <display value="Percentage of neoplasm involved by necrosis (observable entity)" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-ZelmaHadjkiss-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449307555" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-09-08" />
    <valueQuantity>
        <value value="5" />
        <unit value="%" />
        <system value="http://unitsofmeasure.org" />
        <code value="%" />
    </valueQuantity>
    <specimen>
        <identifier>
            <system value="https://fhir.add.nhs.uk/Id/specimenId" />
            <value value="RA257630" />
        </identifier>
    </specimen>
</Observation>

Propose a change to Observation-Necrosis-Example

{
    "resourceType": "Observation",
    "id": "Observation-NecrosisKayBurbridge-Example",
    "status": "final",
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "405921002",
                "display": "Percentage of neoplasm involved by necrosis (observable entity)"
            }
        ]
    },
    "subject": {
        "reference": "Patient/Patient-KayBurbridge-Example",
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "8449303541"
        }
    },
    "specimen": {
        "identifier": {
            "system": "https://fhir.add.nhs.uk/Id/specimenId",
            "value": "699F01231423"
        }
    },
    "valueQuantity": {
        "value": 5,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
    },
    "effectiveDateTime": "11/01/2023 11:00:00"
}

<Observation xmlns="http://hl7.org/fhir">
    <id value="Observation-NecrosisKayBurbridge-Example" />
    <status value="final" />
    <code>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="405921002" />
            <display value="Percentage of neoplasm involved by necrosis (observable entity)" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/Patient-KayBurbridge-Example" />
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="8449303541" />
        </identifier>
    </subject>
    <effectiveDateTime value="2023-11-01T11:00:00Z" />
    <valueQuantity>
        <value value="5" />
        <unit value="%" />
        <system value="http://unitsofmeasure.org" />
        <code value="%" />
    </valueQuantity>
    <specimen>
        <identifier>
            <system value="https://fhir.add.nhs.uk/Id/specimenId" />
            <value value="699F01231423" />
        </identifier>
    </specimen>
</Observation>