Generated Narrative: Composition Composition-GenomicsReport-ctDNA

Document DiagnosticReport Reference: Diagnostic Report for 'Genetic report' for '->Theon SHEFFIELD'

identifier: https://fhir.nwgenomics.nhs.uk/iGene/ReportIdentifier/T26-59XG

status: Final

type: Genetic report

category: Genetics

date: 2025-10-14 15:59:16+0000

author: North West Genomics (Identifier: ODS Organisation Code/699X0)

title: Composition Genomics Report ctDNA

 <section> <title value="Presented Format"/> <code> <coding> <system value="http://loinc.org"/> <code value="77599-9"/> </coding> </code> <text> <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><ul><li>Presented Form</li></ul>This is a PDF document which holds the narrative which ideally would be contained in this Composition resource.</div> </text> <entry> <reference value="urn:uuid:13028359-6a38-4dff-8978-55a57dbdfb56"/> </entry> <entry> <reference value="urn:uuid:d6eeedd1-92d3-45b9-bf33-6401e804425f"/> </entry> </section> <section> <title value="Findings"/> <code> <coding> <system value="http://loinc.org"/> <code value="59776-5"/> <display value="Findings"/> </coding> </code> <text> <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><ul><li>Genomics Findings</li></ul>See PDF</div> </text> </section> <section> <title value="Implications"/> <code> <coding> <system value="http://loinc.org"/> <code value="59768-2"/> <display value="Procedure indications Imp"/> </coding> </code> <text> <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><ul><li>Genomics Implications</li></ul>See PDF</div> </text> </section> </Composition> </resource> </entry> <entry> <fullUrl value="urn:uuid:2160525b-0168-4f40-8ebf-9b053052a62c"/> <resource> <Patient> <id value="Patient-Sheffield"/> <meta> <profile value="https://fhir.nwgenomics.nhs.uk/StructureDefinition/Patient"/> </meta> <language value="en"/> <text> <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="Patient_Patient-Sheffield"> </a><p class="res-header-id"><b>Generated Narrative: Patient Patient-Sheffield</b></p><a name="Patient-Sheffield"> </a><a name="hcPatient-Sheffield"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-Patient.html">Patient</a></p></div><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Theon SHEFFIELD (official) Male, DoB: 1986-09-12 ( Patient internal identifier)</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Record is active">Active:</td><td colspan="3">true</td></tr><tr><td style="background-color: #f3f5da" title="Other Id (see the one above)">Other Id:</td><td colspan="3">National Health Plan Identifier/9737873858 (use: official, )</td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Detail</td><td colspan="3">SPITAL STREET SHEFFIELD S3 9LB (home)</td></tr><tr><td style="background-color: #f3f5da" title="Patient Links">Links:</td><td colspan="3"><ul><li>General Practitioner: Sheffield Medical Centre (Identifier: <a href="NamingSystem-ods-organization-code-namingsystem.html" title="The identifier system for an Organisation registered with the Organisation Data Service (ODS).">ODS Organisation Code</a>/C88622)</li></ul></td></tr></table></div> </text> <identifier> <use value="official"/> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/> <code value="NH"/> </coding> </type> <system value="https://fhir.nhs.uk/Id/nhs-number"/> <value value="9737873858"/> </identifier> <identifier> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/> <code value="PI"/> </coding> </type> <value value="336292"/> <assigner> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code"/> <value value="699X0"/> </identifier> </assigner> </identifier> <active value="true"/> <name> <use value="official"/> <family value="SHEFFIELD"/> <given value="Theon"/> </name> <gender value="male"/> <birthDate value="1986-09-12"/> <address> <use value="home"/> <type value="both"/> <line value="SPITAL STREET"/> <city value="SHEFFIELD"/> <postalCode value="S3 9LB"/> </address> <generalPractitioner> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code"/> <value value="C88622"/> </identifier> <display value="Sheffield Medical Centre"/> </generalPractitioner> </Patient> </resource> </entry> <entry> <fullUrl value="urn:uuid:6e26d6b3-490e-4348-9d6c-37281567d6ec"/> <resource> <ServiceRequest> <id value="ServiceRequest-ctDNA"/> <meta> <versionId value="1.0"/> <profile value="https://fhir.nwgenomics.nhs.uk/StructureDefinition/ServiceRequest"/> </meta> <language value="en"/> <text> <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_ServiceRequest-ctDNA"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest ServiceRequest-ctDNA</b></p><a name="ServiceRequest-ctDNA"> </a><a name="hcServiceRequest-ctDNA"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">version: 1.0</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-ServiceRequest.html">ServiceRequest</a></p></div><p><b>identifier</b>: Filler Identifier/T26-59XG</p><p><b>requisition</b>: Placer Group Number/R26-15AY</p><p><b>status</b>: Active</p><p><b>intent</b>: Order</p><p><b>category</b>: <span title="Codes:{http://snomed.info/sct 116148004}">Molecular genetics procedure</span></p><p><b>code</b>: <span title="Codes:{https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory M4.14}">Non-Small Cell Lung Cancer, Multi-target ctDNA combined Multi-target NGS panel, small variant (EGFR, ALK, BRAF, KRAS, MET exon 14 skipping and copy number variations) and structural variant (ROS1, RET, ALK, NTRK1, NTRK2, NTRK3, MET exon</span></p><p><b>subject</b>: <a href="Bundle-FHIRDocumentGeneticReportBundle-ctDNA.html#urn-uuid-2160525b-0168-4f40-8ebf-9b053052a62c">Theon SHEFFIELD</a></p><p><b>requester</b>: Identifier: <a href="NamingSystem-ods-organization-code-namingsystem.html" title="The identifier system for an Organisation registered with the Organisation Data Service (ODS).">ODS Organisation Code</a>/RHQ</p><p><b>performer</b>: Identifier: <a href="NamingSystem-ods-organization-code-namingsystem.html" title="The identifier system for an Organisation registered with the Organisation Data Service (ODS).">ODS Organisation Code</a>/699X0</p><p><b>reasonCode</b>: <span title="Codes:{https://fhir.nwgenomics.nhs.uk/CodeSystem/GenomicClinicalIndication M4}">M4</span></p><p><b>specimen</b>: <a href="Bundle-FHIRDocumentGeneticReportBundle-ctDNA.html#urn-uuid-b930b4c4-327a-4728-8bb9-f90061914cc5">Specimen: identifier = Filler Identifier; status = available; type = Blood specimen</a></p></div> </text> <identifier> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/> <code value="FILL"/> </coding> </type> <system value="https://fhir.nwgenomics.nhs.uk/iGene/ReportIdentifier"/> <value value="T26-59XG"/> <assigner> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code"/> <value value="699X0"/> </identifier> </assigner> </identifier> <requisition> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/> <code value="PGN"/> </coding> </type> <system value="https://fhir.nwgenomics.nhs.uk/iGene/ReferralIdentifier"/> <value value="R26-15AY"/> <assigner> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code"/> <value value="699X0"/> </identifier> </assigner> </requisition> <status value="active"/> <intent value="order"/> <category> <coding> <system value="http://snomed.info/sct"/> <code value="116148004"/> <display value="Molecular genetics procedure"/> </coding> </category> <code> <coding> <system value="https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory"/> <code value="M4.14"/> </coding> </code> <subject> <reference value="urn:uuid:2160525b-0168-4f40-8ebf-9b053052a62c"/> <identifier> <system value="https://fhir.nhs.uk/Id/nhs-number"/> <value value="9737873858"/> </identifier> <display value="Theon SHEFFIELD"/> </subject> <requester> <type value="Organization"/> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code"/> <value value="RHQ"/> </identifier> </requester> <performer> <type value="Organization"/> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code"/> <value value="699X0"/> </identifier> </performer> <reasonCode> <coding> <system value="https://fhir.nwgenomics.nhs.uk/CodeSystem/GenomicClinicalIndication"/> <code value="M4"/> </coding> </reasonCode> <specimen> <reference value="urn:uuid:b930b4c4-327a-4728-8bb9-f90061914cc5"/> </specimen> </ServiceRequest> </resource> </entry> <entry> <fullUrl value="urn:uuid:b930b4c4-327a-4728-8bb9-f90061914cc5"/> <resource> <Specimen> <id value="Specimen-ctDNA"/> <meta> <versionId value="1.0"/> <profile value="https://fhir.nwgenomics.nhs.uk/StructureDefinition/Specimen"/> </meta> <language value="en"/> <text> <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="Specimen_Specimen-ctDNA"> </a><p class="res-header-id"><b>Generated Narrative: Specimen Specimen-ctDNA</b></p><a name="Specimen-ctDNA"> </a><a name="hcSpecimen-ctDNA"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">version: 1.0</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-Specimen.html">Specimen</a></p></div><p><b>identifier</b>: Filler Identifier/S26-1K1Q</p><p><b>status</b>: Available</p><p><b>type</b>: <span title="Codes:{http://snomed.info/sct 119297000}">Blood specimen</span></p><p><b>subject</b>: <a href="Bundle-FHIRDocumentGeneticReportBundle-ctDNA.html#urn-uuid-2160525b-0168-4f40-8ebf-9b053052a62c">Theon SHEFFIELD</a></p><h3>Collections</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Collected[x]</b></td></tr><tr><td style="display: none">*</td><td>2026-06-29</td></tr></table></div> </text> <identifier> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/> <code value="FILL"/> </coding> </type> <system value="https://fhir.nwgenomics.nhs.uk/iGene/SpecimenIdentifier"/> <value value="S26-1K1Q"/> <assigner> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code"/> <value value="699X0"/> </identifier> </assigner> </identifier> <status value="available"/> <type> <coding> <system value="http://snomed.info/sct"/> <code value="119297000"/> <display value="Blood specimen"/> </coding> </type> <subject> <reference value="urn:uuid:2160525b-0168-4f40-8ebf-9b053052a62c"/> <identifier> <system value="https://fhir.nhs.uk/Id/nhs-number"/> <value value="9737873858"/> </identifier> <display value="Theon SHEFFIELD"/> </subject> <collection> <collectedDateTime value="2026-06-29"/> </collection> </Specimen> </resource> </entry> <entry> <fullUrl value="urn:uuid:0a6ad8ec-b069-4a65-8c65-c7569d8413e3"/> <resource> <DiagnosticReport> <id value="DiagnosticReport-ctDNA"/> <meta> <versionId value="1.0"/> <profile value="https://fhir.nwgenomics.nhs.uk/StructureDefinition/DiagnosticReport"/> </meta> <language value="en"/> <text> <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="DiagnosticReport_DiagnosticReport-ctDNA"> </a><p class="res-header-id"><b>Generated Narrative: DiagnosticReport DiagnosticReport-ctDNA</b></p><a name="DiagnosticReport-ctDNA"> </a><a name="hcDiagnosticReport-ctDNA"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">version: 1.0</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-DiagnosticReport.html">Diagnostic Report</a></p></div><h2><span title="Codes:{https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory M4.14}, {http://snomed.info/sct 1054161000000101}">Genetic report</span> (<span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span>) </h2><table class="grid"><tr><td>Subject</td><td>Theon SHEFFIELD (official) Male, DoB: 1986-09-12 ( Patient internal identifier)</td></tr><tr><td>Relevant Time</td><td>2025-10-14 15:59:16+0000</td></tr><tr><td>Performer</td><td> NW GMSA (Identifier: <a href="NamingSystem-ods-organization-code-namingsystem.html" title="The identifier system for an Organisation registered with the Organisation Data Service (ODS).">ODS Organisation Code</a>/699X0)</td></tr><tr><td>Identifier</td><td> <code>https://fhir.nwgenomics.nhs.uk/iGene/ReportIdentifier</code>/T26-59XG</td></tr></table><p><b>Report Details</b></p><p><b>Coded Conclusions:</b></p><ul><li><span title="Codes:{https://fhir.nwgenomics.nhs.uk/CodeSystem/GenomicTestOutcomeCode 431}">TARGET DETECTED AT A LEVEL REQUIRING CLINICAL ACTION</span></li></ul></div> </text> <identifier> <system value="https://fhir.nwgenomics.nhs.uk/iGene/ReportIdentifier"/> <value value="T26-59XG"/> <assigner> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code"/> <value value="699X0"/> </identifier> </assigner> </identifier> <basedOn> <reference value="urn:uuid:6e26d6b3-490e-4348-9d6c-37281567d6ec"/> <type value="ServiceRequest"/> <identifier> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/> <code value="FILL"/> </coding> </type> <system value="https://fhir.nwgenomics.nhs.uk/iGene/ReportIdentifier"/> <value value="T26-59XG"/> <assigner> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code"/> <value value="699X0"/> </identifier> </assigner> </identifier> </basedOn> <status value="final"/> <category> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/> <code value="GE"/> <display value="Genetics"/> </coding> </category> <code> <coding> <system value="https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory"/> <code value="M4.14"/> </coding> <coding> <system value="http://snomed.info/sct"/> <code value="1054161000000101"/> <display value="Genetic report"/> </coding> </code> <subject> <reference value="urn:uuid:2160525b-0168-4f40-8ebf-9b053052a62c"/> <identifier> <system value="https://fhir.nhs.uk/Id/nhs-number"/> <value value="9737873858"/> </identifier> <display value="Theon SHEFFIELD"/> </subject> <effectiveDateTime value="2025-10-14T15:59:16+00:00"/> <performer> <type value="Organization"/> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code"/> <value value="699X0"/> </identifier> <display value="NW GMSA"/> </performer> <resultsInterpreter> <display value="Jonathan Edgerley"/> </resultsInterpreter> <conclusionCode> <coding> <system value="https://fhir.nwgenomics.nhs.uk/CodeSystem/GenomicTestOutcomeCode"/> <code value="431"/> <display value="TARGET DETECTED AT A LEVEL REQUIRING CLINICAL ACTION"/> </coding> </conclusionCode> <presentedForm> <contentType value="application/pdf"/> <language value="en-GB"/> <url value="urn:uuid:d6eeedd1-92d3-45b9-bf33-6401e804425f"/> <title value="ctDNA Genomic Report for Theon Sheffield"/> </presentedForm> </DiagnosticReport> </resource> </entry> <entry> <fullUrl value="urn:uuid:13028359-6a38-4dff-8978-55a57dbdfb56"/> <resource> <DocumentReference> <id value="DocumentReference-ctDNA"/> <meta> <profile value="https://fhir.nwgenomics.nhs.uk/StructureDefinition/DocumentReference"/> </meta> <language value="en"/> <text> <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="DocumentReference_DocumentReference-ctDNA"> </a><p class="res-header-id"><b>Generated Narrative: DocumentReference DocumentReference-ctDNA</b></p><a name="DocumentReference-ctDNA"> </a><a name="hcDocumentReference-ctDNA"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-DocumentReference.html">DocumentReference</a></p></div><p><b>identifier</b>: <code>http://www.example.org/documentreference/identifier</code>/94bf65ba-cd6c-4601-b339-6d547f424646</p><p><b>status</b>: Current</p><p><b>type</b>: <span title="Codes:{http://snomed.info/sct 1054161000000101}">Genetic report</span></p><p><b>subject</b>: <a href="Bundle-FHIRDocumentGeneticReportBundle-ctDNA.html#urn-uuid-2160525b-0168-4f40-8ebf-9b053052a62c">Theon SHEFFIELD</a></p><p><b>date</b>: 2025-10-14 15:59:16+0000</p><p><b>custodian</b>: NW GMSA (Identifier: <a href="NamingSystem-ods-organization-code-namingsystem.html" title="The identifier system for an Organisation registered with the Organisation Data Service (ODS).">ODS Organisation Code</a>/699X0)</p><blockquote><p><b>content</b></p><h3>Attachments</h3><table class="grid"><tr><td style="display: none">-</td><td><b>ContentType</b></td><td><b>Url</b></td></tr><tr><td style="display: none">*</td><td>application/pdf</td><td><a href="Bundle-FHIRDocumentGeneticReportBundle-ctDNA.html#urn-uuid-d6eeedd1-92d3-45b9-bf33-6401e804425f">Binary: application/pdf (845 bytes base64)</a></td></tr></table></blockquote><blockquote><p><b>context</b></p><p><b>event</b>: <span title="Codes:{https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory M4.14}">Non-Small Cell Lung Cancer, Multi-target ctDNA combined Multi-target NGS panel, small variant (EGFR, ALK, BRAF, KRAS, MET exon 14 skipping and copy number variations) and structural variant (ROS1, RET, ALK, NTRK1, NTRK2, NTRK3, MET exon</span></p><p><b>period</b>: 2025-10-14 15:59:16+0000 --> 2025-10-14 15:59:16+0000</p><p><b>sourcePatientInfo</b>: Identifier: Medical record number/RXR3302855</p><p><b>related</b>: </p><ul><li><a href="Bundle-FHIRDocumentGeneticReportBundle-ctDNA.html#urn-uuid-0a6ad8ec-b069-4a65-8c65-c7569d8413e3">Diagnostic Report for 'Genetic report' for '->Theon SHEFFIELD'</a></li><li><a href="Bundle-FHIRDocumentGeneticReportBundle-ctDNA.html#urn-uuid-6e26d6b3-490e-4348-9d6c-37281567d6ec">ServiceRequest Non-Small Cell Lung Cancer, Multi-target ctDNA combined Multi-target NGS panel, small variant (EGFR, ALK, BRAF, KRAS, MET exon 14 skipping and copy number variations) and structural variant (ROS1, RET, ALK, NTRK1, NTRK2, NTRK3, MET exon</a></li></ul></blockquote></div> </text> <identifier> <system value="http://www.example.org/documentreference/identifier"/> <value value="94bf65ba-cd6c-4601-b339-6d547f424646"/> <assigner> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code"/> <value value="699X0"/> </identifier> </assigner> </identifier> <status value="current"/> <type> <coding> <system value="http://snomed.info/sct"/> <code value="1054161000000101"/> <display value="Genetic report"/> </coding> </type> <subject> <reference value="urn:uuid:2160525b-0168-4f40-8ebf-9b053052a62c"/> <identifier> <system value="https://fhir.nhs.uk/Id/nhs-number"/> <value value="9737873858"/> </identifier> <display value="Theon SHEFFIELD"/> </subject> <date value="2025-10-14T15:59:16+00:00"/> <custodian> <type value="Organization"/> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code"/> <value value="699X0"/> </identifier> <display value="NW GMSA"/> </custodian> <content> <attachment> <contentType value="application/pdf"/> <url value="urn:uuid:d6eeedd1-92d3-45b9-bf33-6401e804425f"/> </attachment> </content> <context> <event> <coding> <system value="https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory"/> <code value="M4.14"/> </coding> </event> <period> <start value="2025-10-14T15:59:16+00:00"/> <end value="2025-10-14T15:59:16+00:00"/> </period> <sourcePatientInfo> <identifier> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/> <code value="MR"/> </coding> </type> <value value="RXR3302855"/> <assigner> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code"/> <value value="RHQ"/> </identifier> </assigner> </identifier> </sourcePatientInfo> <related> <reference value="urn:uuid:0a6ad8ec-b069-4a65-8c65-c7569d8413e3"/> <type value="DiagnosticReport"/> <identifier> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/> <code value="FILL"/> </coding> </type> <system value="https://fhir.nwgenomics.nhs.uk/iGene/ReportIdentifier"/> <value value="T26-59XG"/> <assigner> <identifier> <system value="https://fhir.nhs.uk/Id/ods-organization-code"/> <value value="699X0"/> </identifier> </assigner> </identifier> </related> <related> <reference value="urn:uuid:6e26d6b3-490e-4348-9d6c-37281567d6ec"/> <type value="ServiceRequest"/> <identifier> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/> <code value="FILL"/> </coding> </type> <system value="https://fhir.nwgenomics.nhs.uk/iGene/ReportIdentifier"/> <value value="T26-59XG"/> <assigner> <identifier> 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