{
  "resourceType": "Observation",
  "id": "observation-gleason-summary-sven",
  "meta": {
    "profile": [
      "https://npcr.se/fhir/StructureDefinition/npcr-gleason-score-observation"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>Patient-level Gleason summary 4+3=7, derived from targeted biopsy (4+3=7, grade group 3) and systematic biopsy (3+3=6, grade group 1). Higher grade taken as patient-level summary, demonstrating value of MRI-targeted sampling in detecting higher-grade cancer that systematic sampling alone may miss.</p></div>"
  },
  "status": "final",
  "category": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/observation-category",
          "code": "laboratory",
          "display": "Laboratory"
        }
      ]
    }
  ],
  "code": {
    "coding": [
      {
        "system": "http://loinc.org",
        "code": "44641-9",
        "display": "Gleason score in Prostate gland Specimen Qualitative"
      }
    ],
    "text": "Gleason score, patient-level summary"
  },
  "subject": {
    "reference": "Patient/patient-sven",
    "display": "Sven Svensson"
  },
  "effectiveDateTime": "2024-05-22",
  "derivedFrom": [
    {
      "reference": "Observation/observation-gleason-targeted-sven",
      "display": "Gleason from targeted biopsy"
    },
    {
      "reference": "Observation/observation-gleason-systematic-sven",
      "display": "Gleason from systematic biopsy"
    }
  ],
  "component": [
    {
      "code": {
        "coding": [
          {
            "system": "https://npcr.se/fhir/CodeSystem/npcr-gleason-observation-types",
            "code": "primaryGrade"
          }
        ]
      },
      "valueInteger": 4
    },
    {
      "code": {
        "coding": [
          {
            "system": "https://npcr.se/fhir/CodeSystem/npcr-gleason-observation-types",
            "code": "secondaryGrade"
          }
        ]
      },
      "valueInteger": 3
    },
    {
      "code": {
        "coding": [
          {
            "system": "https://npcr.se/fhir/CodeSystem/npcr-gleason-observation-types",
            "code": "gleasonSum"
          }
        ]
      },
      "valueInteger": 7
    },
    {
      "code": {
        "coding": [
          {
            "system": "https://npcr.se/fhir/CodeSystem/npcr-gleason-observation-types",
            "code": "missingFlag"
          }
        ]
      },
      "valueBoolean": false
    }
  ]
}