{
  "resourceType" : "Observation",
  "id" : "ExampleMelanomaAnnotation",
  "meta" : {
    "profile" : ["https://annotatemd.com/fhir/ig/StructureDefinition/dermatology-image-annotation"]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Observation ExampleMelanomaAnnotation</b></p><a name=\"ExampleMelanomaAnnotation\"> </a><a name=\"hcExampleMelanomaAnnotation\"> </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-dermatology-image-annotation.html\">Dermatology Image Annotation</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category imaging}\">Imaging</span>, <span title=\"Codes:{https://annotatemd.com/fhir/ig/CodeSystem/annotation-type dermatology-annotation}\">Dermatology Annotation</span></p><p><b>code</b>: <span title=\"Codes:{https://annotatemd.com/fhir/ig/CodeSystem/annotation-type lesion-classification}\">Lesion Classification</span></p><p><b>subject</b>: <a href=\"Patient-example-patient.html\">Jane Smith  Female, DoB: 1975-06-15</a></p><p><b>effective</b>: 2026-03-27 14:30:00+0000</p><p><b>issued</b>: 2026-03-27 15:45:00+0000</p><p><b>performer</b>: <a href=\"Practitioner-example-dermatologist.html\">Practitioner Robert Johnson </a></p><p><b>interpretation</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation A}\">Abnormal</span></p><p><b>note</b>: </p><blockquote><div><p>Irregularly bordered lesion with satellite lesions noted superiorly. ABCDE criteria: Asymmetry present, Border irregular, Color variegated, Diameter &gt;6mm.</p>\n</div></blockquote><p><b>bodySite</b>: <span title=\"Codes:{http://snomed.info/sct 40983000}\">Upper arm structure</span></p><p><b>method</b>: <span title=\"Codes:{https://annotatemd.com/fhir/ig/CodeSystem/annotation-method expert-annotation}\">Expert Manual Annotation</span></p><p><b>derivedFrom</b>: <a href=\"DocumentReference-example-clinical-photo.html\">DocumentReference: status = current; type = Photographic image</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{http://snomed.info/sct 106076001}\">Skin finding</span></p><p><b>value</b>: <span title=\"Codes:{http://snomed.info/sct 372244006}\">Malignant melanoma</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{https://annotatemd.com/fhir/ig/CodeSystem/annotation-type confidence-score}\">Confidence Score</span></p><p><b>value</b>: 0.92 score<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  code1 = '1')</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{https://annotatemd.com/fhir/ig/CodeSystem/annotation-type qa-review-status}\">QA Review Status</span></p><p><b>value</b>: <span title=\"Codes:{https://annotatemd.com/fhir/ig/CodeSystem/qa-status approved}\">QA Approved</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{https://annotatemd.com/fhir/ig/CodeSystem/annotation-type inter-annotator-agreement}\">Inter-Annotator Agreement</span></p><p><b>value</b>: 0.87 kappa<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  code1 = '1')</span></p></blockquote></div>"
  },
  "status" : "final",
  "category" : [{
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
      "code" : "imaging"
    }]
  },
  {
    "coding" : [{
      "system" : "https://annotatemd.com/fhir/ig/CodeSystem/annotation-type",
      "code" : "dermatology-annotation"
    }]
  }],
  "code" : {
    "coding" : [{
      "system" : "https://annotatemd.com/fhir/ig/CodeSystem/annotation-type",
      "code" : "lesion-classification",
      "display" : "Lesion Classification"
    }]
  },
  "subject" : {
    "reference" : "Patient/example-patient"
  },
  "effectiveDateTime" : "2026-03-27T14:30:00Z",
  "issued" : "2026-03-27T15:45:00Z",
  "performer" : [{
    "reference" : "Practitioner/example-dermatologist"
  }],
  "interpretation" : [{
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
      "code" : "A",
      "display" : "Abnormal"
    }]
  }],
  "note" : [{
    "text" : "Irregularly bordered lesion with satellite lesions noted superiorly. ABCDE criteria: Asymmetry present, Border irregular, Color variegated, Diameter >6mm."
  }],
  "bodySite" : {
    "coding" : [{
      "system" : "http://snomed.info/sct",
      "code" : "40983000",
      "display" : "Upper arm structure"
    }]
  },
  "method" : {
    "coding" : [{
      "system" : "https://annotatemd.com/fhir/ig/CodeSystem/annotation-method",
      "code" : "expert-annotation",
      "display" : "Expert Manual Annotation"
    }]
  },
  "derivedFrom" : [{
    "reference" : "DocumentReference/example-clinical-photo"
  }],
  "component" : [{
    "code" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "106076001",
        "display" : "Skin finding"
      }]
    },
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "372244006",
        "display" : "Malignant melanoma"
      }]
    }
  },
  {
    "code" : {
      "coding" : [{
        "system" : "https://annotatemd.com/fhir/ig/CodeSystem/annotation-type",
        "code" : "confidence-score"
      }]
    },
    "valueQuantity" : {
      "value" : 0.92,
      "unit" : "score",
      "system" : "http://unitsofmeasure.org",
      "code" : "1"
    }
  },
  {
    "code" : {
      "coding" : [{
        "system" : "https://annotatemd.com/fhir/ig/CodeSystem/annotation-type",
        "code" : "qa-review-status"
      }]
    },
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "https://annotatemd.com/fhir/ig/CodeSystem/qa-status",
        "code" : "approved",
        "display" : "QA Approved"
      }]
    }
  },
  {
    "code" : {
      "coding" : [{
        "system" : "https://annotatemd.com/fhir/ig/CodeSystem/annotation-type",
        "code" : "inter-annotator-agreement"
      }]
    },
    "valueQuantity" : {
      "value" : 0.87,
      "unit" : "kappa",
      "system" : "http://unitsofmeasure.org",
      "code" : "1"
    }
  }]
}