<Observation xmlns="http://hl7.org/fhir">
  <id value="observation-gleason-summary-sven" />
  <meta>
    <profile value="https://npcr.se/fhir/StructureDefinition/npcr-gleason-score-observation" />
  </meta>
  <text>
    <status value="generated" />
    <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>
  </text>
  <status value="final" />
  <category>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/observation-category" />
      <code value="laboratory" />
      <display value="Laboratory" />
    </coding>
  </category>
  <code>
    <coding>
      <system value="http://loinc.org" />
      <code value="44641-9" />
      <display value="Gleason score in Prostate gland Specimen Qualitative" />
    </coding>
    <text value="Gleason score, patient-level summary" />
  </code>
  <subject>
    <reference value="Patient/patient-sven" />
    <display value="Sven Svensson" />
  </subject>
  <effectiveDateTime value="2024-05-22" />
  <derivedFrom>
    <reference value="Observation/observation-gleason-targeted-sven" />
    <display value="Gleason from targeted biopsy" />
  </derivedFrom>
  <derivedFrom>
    <reference value="Observation/observation-gleason-systematic-sven" />
    <display value="Gleason from systematic biopsy" />
  </derivedFrom>
  <component>
    <code>
      <coding>
        <system value="https://npcr.se/fhir/CodeSystem/npcr-gleason-observation-types" />
        <code value="primaryGrade" />
      </coding>
    </code>
    <valueInteger value="4" />
  </component>
  <component>
    <code>
      <coding>
        <system value="https://npcr.se/fhir/CodeSystem/npcr-gleason-observation-types" />
        <code value="secondaryGrade" />
      </coding>
    </code>
    <valueInteger value="3" />
  </component>
  <component>
    <code>
      <coding>
        <system value="https://npcr.se/fhir/CodeSystem/npcr-gleason-observation-types" />
        <code value="gleasonSum" />
      </coding>
    </code>
    <valueInteger value="7" />
  </component>
  <component>
    <code>
      <coding>
        <system value="https://npcr.se/fhir/CodeSystem/npcr-gleason-observation-types" />
        <code value="missingFlag" />
      </coding>
    </code>
    <valueBoolean value="false" />
  </component>
</Observation>