# ExampleMelanomaAnnotation - Dermatology Image Annotation FHIR Implementation Guide v0.1.0

* [**Table of Contents**](toc.md)
* [**Artifacts Summary**](artifacts.md)
* **ExampleMelanomaAnnotation**

## Example Observation: ExampleMelanomaAnnotation

Profile: [Dermatology Image Annotation](StructureDefinition-dermatology-image-annotation.md)

**status**: Final

**category**: Imaging, Dermatology Annotation

**code**: Lesion Classification

**subject**: [Jane Smith Female, DoB: 1975-06-15](Patient-example-patient.md)

**effective**: 2026-03-27 14:30:00+0000

**issued**: 2026-03-27 15:45:00+0000

**performer**: [Practitioner Robert Johnson ](Practitioner-example-dermatologist.md)

**interpretation**: Abnormal

**note**: 

> 

Irregularly bordered lesion with satellite lesions noted superiorly. ABCDE criteria: Asymmetry present, Border irregular, Color variegated, Diameter >6mm.


**bodySite**: Upper arm structure

**method**: Expert Manual Annotation

**derivedFrom**: [DocumentReference: status = current; type = Photographic image](DocumentReference-example-clinical-photo.md)

> **component****code**: Skin finding**value**: Malignant melanoma

> **component****code**: Confidence Score**value**: 0.92 score (Details: UCUM code1 = '1')

> **component****code**: QA Review Status**value**: QA Approved

> **component****code**: Inter-Annotator Agreement**value**: 0.87 kappa (Details: UCUM code1 = '1')



## Resource Content

```json
{
  "resourceType" : "Observation",
  "id" : "ExampleMelanomaAnnotation",
  "meta" : {
    "profile" : ["https://annotatemd.com/fhir/ig/StructureDefinition/dermatology-image-annotation"]
  },
  "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"
    }
  }]
}

```
