<Observation xmlns="http://hl7.org/fhir">
  <id value="observation-gleason-targeted-sven" />
  <meta>
    <profile value="https://npcr.se/fhir/StructureDefinition/npcr-gleason-score-targeted-biopsy-observation" />
  </meta>
  <text>
    <status value="generated" />
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>Gleason score 4+3=7 from MR-fusion targeted biopsy, reported as highest Gleason in a single biopsy (NPCR convention 3, preferred since 2023-06-19).</p>
    </div>
  </text>
  <extension url="https://npcr.se/fhir/StructureDefinition/npcr-gleason-definition-type">
    <valueCodeableConcept>
      <coding>
        <system value="https://npcr.se/fhir/CodeSystem/npcr-gleason-definition-type" />
        <code value="3" />
        <display value="Highest Gleason in a single biopsy" />
      </coding>
    </valueCodeableConcept>
  </extension>
  <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, targeted biopsy" />
  </code>
  <subject>
    <reference value="Patient/patient-sven" />
    <display value="Sven Svensson" />
  </subject>
  <effectiveDateTime value="2024-05-22" />
  <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>