Dermatology Image Annotation FHIR Implementation Guide
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: ExampleMelanomaAnnotation - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Observation ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "ExampleMelanomaAnnotation"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://annotatemd.com/fhir/ig/StructureDefinition/dermatology-image-annotation"^^xsd:anyURI ;
fhir:l <https://annotatemd.com/fhir/ig/StructureDefinition/dermatology-image-annotation>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<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>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:status [ fhir:v "final"] ; # 
  fhir:category ( [
    ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/observation-category"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/observation-category>       ] ;
fhir:code [ fhir:v "imaging" ]     ] )
  ] [
    ( fhir:coding [
fhir:system [
fhir:v "https://annotatemd.com/fhir/ig/CodeSystem/annotation-type"^^xsd:anyURI ;
fhir:l <https://annotatemd.com/fhir/ig/CodeSystem/annotation-type>       ] ;
fhir:code [ fhir:v "dermatology-annotation" ]     ] )
  ] ) ; # 
  fhir:code [
    ( fhir:coding [
fhir:system [
fhir:v "https://annotatemd.com/fhir/ig/CodeSystem/annotation-type"^^xsd:anyURI ;
fhir:l <https://annotatemd.com/fhir/ig/CodeSystem/annotation-type>       ] ;
fhir:code [ fhir:v "lesion-classification" ] ;
fhir:display [ fhir:v "Lesion Classification" ]     ] )
  ] ; # 
  fhir:subject [
fhir:l fhir:Patient/example-patient ;
fhir:reference [ fhir:v "Patient/example-patient" ]
  ] ; # 
  fhir:effective [
a fhir:DateTime ;
fhir:v "2026-03-27T14:30:00Z"^^xsd:dateTime
  ] ; # 
  fhir:issued [ fhir:v "2026-03-27T15:45:00Z"^^xsd:dateTime] ; # 
  fhir:performer ( [
fhir:l fhir:Practitioner/example-dermatologist ;
fhir:reference [ fhir:v "Practitioner/example-dermatologist" ]
  ] ) ; # 
  fhir:interpretation ( [
    ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation>       ] ;
fhir:code [ fhir:v "A" ] ;
fhir:display [ fhir:v "Abnormal" ]     ] )
  ] ) ; # 
  fhir:note ( [
fhir:text [ fhir:v "Irregularly bordered lesion with satellite lesions noted superiorly. ABCDE criteria: Asymmetry present, Border irregular, Color variegated, Diameter >6mm." ]
  ] ) ; # 
  fhir:bodySite [
    ( fhir:coding [
a sct:40983000 ;
fhir:system [
fhir:v "http://snomed.info/sct"^^xsd:anyURI ;
fhir:l <http://snomed.info/sct>       ] ;
fhir:code [ fhir:v "40983000" ] ;
fhir:display [ fhir:v "Upper arm structure" ]     ] )
  ] ; # 
  fhir:method [
    ( fhir:coding [
fhir:system [
fhir:v "https://annotatemd.com/fhir/ig/CodeSystem/annotation-method"^^xsd:anyURI ;
fhir:l <https://annotatemd.com/fhir/ig/CodeSystem/annotation-method>       ] ;
fhir:code [ fhir:v "expert-annotation" ] ;
fhir:display [ fhir:v "Expert Manual Annotation" ]     ] )
  ] ; # 
  fhir:derivedFrom ( [
fhir:l fhir:DocumentReference/example-clinical-photo ;
fhir:reference [ fhir:v "DocumentReference/example-clinical-photo" ]
  ] ) ; # 
  fhir:component ( [
fhir:code [
      ( fhir:coding [
a sct:106076001 ;
fhir:system [
fhir:v "http://snomed.info/sct"^^xsd:anyURI ;
fhir:l <http://snomed.info/sct>         ] ;
fhir:code [ fhir:v "106076001" ] ;
fhir:display [ fhir:v "Skin finding" ]       ] )     ] ;
fhir:value [
a fhir:CodeableConcept ;
      ( fhir:coding [
a sct:372244006 ;
fhir:system [
fhir:v "http://snomed.info/sct"^^xsd:anyURI ;
fhir:l <http://snomed.info/sct>         ] ;
fhir:code [ fhir:v "372244006" ] ;
fhir:display [ fhir:v "Malignant melanoma" ]       ] )     ]
  ] [
fhir:code [
      ( fhir:coding [
fhir:system [
fhir:v "https://annotatemd.com/fhir/ig/CodeSystem/annotation-type"^^xsd:anyURI ;
fhir:l <https://annotatemd.com/fhir/ig/CodeSystem/annotation-type>         ] ;
fhir:code [ fhir:v "confidence-score" ]       ] )     ] ;
fhir:value [
a fhir:Quantity ;
fhir:value [ fhir:v 0.92 ] ;
fhir:unit [ fhir:v "score" ] ;
fhir:system [
fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ;
fhir:l <http://unitsofmeasure.org>       ] ;
fhir:code [ fhir:v "1" ]     ]
  ] [
fhir:code [
      ( fhir:coding [
fhir:system [
fhir:v "https://annotatemd.com/fhir/ig/CodeSystem/annotation-type"^^xsd:anyURI ;
fhir:l <https://annotatemd.com/fhir/ig/CodeSystem/annotation-type>         ] ;
fhir:code [ fhir:v "qa-review-status" ]       ] )     ] ;
fhir:value [
a fhir:CodeableConcept ;
      ( fhir:coding [
fhir:system [
fhir:v "https://annotatemd.com/fhir/ig/CodeSystem/qa-status"^^xsd:anyURI ;
fhir:l <https://annotatemd.com/fhir/ig/CodeSystem/qa-status>         ] ;
fhir:code [ fhir:v "approved" ] ;
fhir:display [ fhir:v "QA Approved" ]       ] )     ]
  ] [
fhir:code [
      ( fhir:coding [
fhir:system [
fhir:v "https://annotatemd.com/fhir/ig/CodeSystem/annotation-type"^^xsd:anyURI ;
fhir:l <https://annotatemd.com/fhir/ig/CodeSystem/annotation-type>         ] ;
fhir:code [ fhir:v "inter-annotator-agreement" ]       ] )     ] ;
fhir:value [
a fhir:Quantity ;
fhir:value [ fhir:v 0.87 ] ;
fhir:unit [ fhir:v "kappa" ] ;
fhir:system [
fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ;
fhir:l <http://unitsofmeasure.org>       ] ;
fhir:code [ fhir:v "1" ]     ]
  ] ) . #