Pulmonary Function Testing: An Interoperability on FHIR Implementation Guide
0.1.0 - ci-build

Pulmonary Function Testing: An Interoperability on FHIR Implementation Guide - Local Development build (v0.1.0). See the Directory of published versions

: PFT Bundle - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="pft-bundle"/>
  <type value="collection"/>
  <entry>
    <resource>
      <Composition>
        <id value="pft-composition"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: preliminary</p><p><b>type</b>: <span title="Codes: {http://loinc.org 81458-2}">Pulmonary function test panel</span></p><p><b>category</b>: <span title="Codes: {http://loinc.org 27896-0}">Pulmonary studies (set)</span></p><p><b>encounter</b>: <a href="#Encounter_encounter-01">See above (Encounter/encounter-01)</a></p><p><b>date</b>: 2017-02-20</p><p><b>author</b>: <a href="TODO_PLACEHOLDER">TODO_PLACEHOLDER</a></p><p><b>title</b>: PFT: test panel Observations and DiagnosticReport</p><p><b>custodian</b>: <a href="#Organization_organization-01">See above (Organization/organization-01)</a></p></div>
        </text>
        <status value="preliminary"/>
        <type>
          <coding>
            <system value="http://loinc.org"/>
            <code value="81458-2"/>
            <display value="Pulmonary function test panel"/>
          </coding>
        </type>
        <category>
          <coding>
            <system value="http://loinc.org"/>
            <code value="27896-0"/>
            <display value="Pulmonary studies (set)"/>
          </coding>
        </category>
        <subject>
          <reference value="Patient/patient-01"/>
        </subject>
        <encounter>
          <reference value="Encounter/encounter-01"/>
        </encounter>
        <date value="2017-02-20"/>
        <author>
          <reference value="TODO_PLACEHOLDER"/>
        </author>
        <title value="PFT: test panel Observations and DiagnosticReport"/>
        <custodian>
          <reference value="Organization/organization-01"/>
        </custodian>
        <section>
          <title value="PFT Observations and Technician Comment"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="30954-2"/>
              <display
                       value="Relevant diagnostic tests/laboratory data Narrative"/>
            </coding>
          </code>
          <text>
            <status value="additional"/>
            <div xmlns="http://www.w3.org/1999/xhtml">TECHNICIAN COMMMENTS: No medications in past 24 hr. 400 mcg albuterol given for reversibility testing.</div>
          </text>
          <entry>
            <reference value="SpO2_RESTING"/>
          </entry>
          <section>
            <title value="Spirometry"/>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="81459-0"/>
                <display value="Spirometry panel"/>
              </coding>
              <coding>
                <system value="http://loinc.org"/>
                <code value="81458-2"/>
                <display value="Pulmonary function test panel"/>
              </coding>
            </code>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml">Reference values: GLI 2012 Test quality: Pre: FEV1 - A, FVC - A; Post: FEV1 - A, FVC - B</div>
            </text>
            <entry>
              <reference value="Observation/FVC-PRE"/>
            </entry>
            <entry>
              <reference value="Observation/FVC-PRE-Zscore"/>
            </entry>
            <entry>
              <reference value="Observation/FVC-PRE-percentPredicted"/>
            </entry>
            <entry>
              <reference value="Observation/FVC-POST"/>
            </entry>
            <entry>
              <reference value="Observation/FVC-POST-Zscore"/>
            </entry>
            <entry>
              <reference value="Observation/FVC-POST-percentPredicted"/>
            </entry>
            <entry>
              <reference value="Observation/FVC-POST-mLChange"/>
            </entry>
            <entry>
              <reference value="Observation/FVC-post-percentChange"/>
            </entry>
          </section>
          <section>
            <title value="Slow Vital Capacity (Pre-Bronchodilator)"/>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="81458-2"/>
                <display value="Pulmonary function test panel"/>
              </coding>
            </code>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml">Reference values: VC - Gutierrez 2004; FEV1/VC - GLI 2012</div>
            </text>
          </section>
          <section>
            <title value="Multi-Breath Nitrogen Washout (Post-Bronchodilator)"/>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="81458-2"/>
                <display value="Pulmonary function test panel"/>
              </coding>
            </code>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml">Reference values: Gutierrez 2004; Test quality: QA met</div>
            </text>
          </section>
          <section>
            <title value="Plethysmography (Post-Bronchodilator)"/>
            <code>
              <coding>
                <system value="http://snomed.info/id"/>
                <code value="20552003"/>
                <display value="Plethysmography (procedure)"/>
              </coding>
            </code>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml">Reference values: Gutierrez 2004; Test quality: QA met</div>
            </text>
          </section>
          <section>
            <title value="Diffusing Capacity (Post-Bronchodilator)"/>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="81458-2"/>
                <display value="Pulmonary function test panel"/>
              </coding>
            </code>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml">Reference values: GLI 2017; Test quality: one grade A test; P_B: 721 mmHg</div>
            </text>
          </section>
        </section>
        <section>
          <title value="Pulmonologist interpretation of PFT and diagnosis"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="59769-0"/>
              <display value="Postprocedure diagnosis Narrative"/>
            </coding>
          </code>
          <entry>
            <reference value="DiagnosticReport/diagnostic-report"/>
          </entry>
        </section>
      </Composition>
    </resource>
  </entry>
  <entry>
    <resource>
      <Patient>
        <id value="patient-01"/>
        <text>
          <status value="additional"/>
          <div xmlns="http://www.w3.org/1999/xhtml">This resource is a stub for use in examples.</div>
        </text>
      </Patient>
    </resource>
  </entry>
  <entry>
    <resource>
      <Practitioner>
        <id value="practitioner-01"/>
        <text>
          <status value="additional"/>
          <div xmlns="http://www.w3.org/1999/xhtml">This resource is a stub for use in examples.</div>
        </text>
        <name>
          <text value="Dr. P. Pulmonologist"/>
          <family value="Pulmonologist"/>
          <given value="P."/>
          <prefix value="Dr."/>
        </name>
      </Practitioner>
    </resource>
  </entry>
  <entry>
    <resource>
      <Practitioner>
        <id value="practitioner-02"/>
        <text>
          <status value="additional"/>
          <div xmlns="http://www.w3.org/1999/xhtml">This resource is a stub for use in examples.</div>
        </text>
      </Practitioner>
    </resource>
  </entry>
  <entry>
    <resource>
      <Organization>
        <id value="organization-01"/>
        <text>
          <status value="additional"/>
          <div xmlns="http://www.w3.org/1999/xhtml">This resource is a stub for use in examples.</div>
        </text>
        <type>
          <coding>
            <system value="http://hl7.org/fhir/ValueSet/organization-type"/>
            <version value="4.0.1"/>
            <code value="prov"/>
            <display value="Healthcare Provider"/>
          </coding>
        </type>
        <name value="Sample Pulmonary Function Laboratory"/>
        <telecom>
          <system value="phone"/>
          <value value="p555-345-6789"/>
          <use value="work"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="pftests@lunglab.com"/>
          <use value="work"/>
        </telecom>
        <address>
          <use value="work"/>
          <type value="both"/>
          <text value="Anytown, Anywhere"/>
          <city value="Anytown"/>
          <state value="Anywhere"/>
        </address>
      </Organization>
    </resource>
  </entry>
  <entry>
    <resource>
      <Encounter>
        <id value="encounter-01"/>
        <text>
          <status value="additional"/>
          <div xmlns="http://www.w3.org/1999/xhtml">This resource is a stub for use in examples.</div>
        </text>
        <status value="finished"/>
        <class>
          <code value="outpatient"/>
        </class>
      </Encounter>
    </resource>
  </entry>
  <entry>
    <resource>
      <ServiceRequest>
        <id value="serviceRequest-01"/>
        <text>
          <status value="additional"/>
          <div xmlns="http://www.w3.org/1999/xhtml">This resource is a stub for use in examples.</div>
        </text>
        <status value="completed"/>
        <intent value="order"/>
        <category>
          <coding>
            <system value="http://snomed.info/id"/>
            <code value="108252007"/>
            <display value="Laboratory procedure"/>
          </coding>
        </category>
        <code>
          <coding>
            <system value="http://snomed.info/id"/>
            <code value="23426006"/>
            <display value="Measurement of respiratory function (procedure)"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/patient-01"/>
        </subject>
        <requester>
          <reference value="Practitioner/practitioner-03"/>
        </requester>
      </ServiceRequest>
    </resource>
  </entry>
  <entry>
    <resource>
      <DiagnosticReport>
        <id value="diagnostic-report"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: final</p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/v2-0074 PF}">Pulmonary Function</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 81458-2}">Pulmonary function test panel</span></p><p><b>subject</b>: <a href="#Patient_patient-01">See above (Patient/patient-01)</a></p><p><b>encounter</b>: <a href="#Encounter_encounter-01">See above (Encounter/encounter-01)</a></p><p><b>effective</b>: 2017-02-24</p><p><b>performer</b>: </p><ul><li><a href="#Practitioner_practitioner-02">See above (Practitioner/practitioner-02)</a></li><li><a href="#Organization_organization-01">See above (Organization/organization-01)</a></li></ul><p><b>resultsInterpreter</b>: <a href="#Practitioner_practitioner-01">See above (Practitioner/practitioner-01)</a></p><p><b>result</b>: </p><ul><li><a href="#Observation_FVC-PRE">See above (Observation/FVC-PRE)</a></li><li><a href="#Observation_FVC-PRE-Zscore">See above (Observation/FVC-PRE-Zscore)</a></li><li><a href="#Observation_FVC-PRE-percentPredicted">See above (Observation/FVC-PRE-percentPredicted)</a></li><li><a href="#Observation_FVC-POST">See above (Observation/FVC-POST)</a></li><li><a href="#Observation_FVC-POST-Zscore">See above (Observation/FVC-POST-Zscore)</a></li><li><a href="#Observation_FVC-POST-percentPredicted">See above (Observation/FVC-POST-percentPredicted)</a></li><li><a href="#Observation_FVC-POST-mLChange">See above (Observation/FVC-POST-mLChange)</a></li><li><a href="#Observation_FVC-post-percentChange">See above (Observation/FVC-post-percentChange)</a></li></ul><p><b>conclusion</b>: Moderately severe, partially reversible airflow obstruction.</p></div>
        </text>
        <status value="final"/>
        <category>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
            <code value="PF"/>
            <display value="Pulmonary Function"/>
          </coding>
        </category>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="81458-2"/>
            <display value="Pulmonary function test panel"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/patient-01"/>
        </subject>
        <encounter>
          <reference value="Encounter/encounter-01"/>
        </encounter>
        <effectiveDateTime value="2017-02-24"/>
        <performer>
          <reference value="Practitioner/practitioner-02"/>
        </performer>
        <performer>
          <reference value="Organization/organization-01"/>
        </performer>
        <resultsInterpreter>
          <reference value="Practitioner/practitioner-01"/>
        </resultsInterpreter>
        <result>
          <reference value="Observation/FVC-PRE"/>
        </result>
        <result>
          <reference value="Observation/FVC-PRE-Zscore"/>
        </result>
        <result>
          <reference value="Observation/FVC-PRE-percentPredicted"/>
        </result>
        <result>
          <reference value="Observation/FVC-POST"/>
        </result>
        <result>
          <reference value="Observation/FVC-POST-Zscore"/>
        </result>
        <result>
          <reference value="Observation/FVC-POST-percentPredicted"/>
        </result>
        <result>
          <reference value="Observation/FVC-POST-mLChange"/>
        </result>
        <result>
          <reference value="Observation/FVC-post-percentChange"/>
        </result>
        <conclusion
                    value="Moderately severe, partially reversible airflow obstruction."/>
        <presentedForm>
          <contentType value="application/pdf"/>
          <language value="en-US"/>
          <url
               value="https://www.atsjournals.org/doi/10.1164/rccm.201710-1981ST"/>
          <title value="Sample Pulmonary Function Test"/>
        </presentedForm>
      </DiagnosticReport>
    </resource>
  </entry>
  <entry>
    <resource>
      <Observation>
        <id value="SPO2-RESTING"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: {http://loinc.org 59417-6}">Oxygen saturation in Arterial blood by Pulse oximetry --resting</span></p><p><b>value</b>: 99 %</p></div>
        </text>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="59417-6"/>
            <display
                     value="Oxygen saturation in Arterial blood by Pulse oximetry --resting"/>
          </coding>
        </code>
        <valueQuantity>
          <value value="99"/>
          <unit value="%"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="%"/>
        </valueQuantity>
      </Observation>
    </resource>
  </entry>
  <entry>
    <resource>
      <Observation>
        <id value="FVC-PRE"/>
        <text>
          <status value="additional"/>
          <div xmlns="http://www.w3.org/1999/xhtml">Test quality: A</div>
        </text>
        <status value="final"/>
        <category>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/observation-category"/>
            <version value="4.0.1"/>
            <code value="procedure"/>
            <display value="Procedure"/>
          </coding>
        </category>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="19876-2"/>
            <display
                     value="Forced vital capacity [Volume] Respiratory system by Spirometry --pre bronchodilation"/>
          </coding>
        </code>
        <subject>
          <reference value="Patient/patient-01"/>
        </subject>
        <encounter>
          <reference value="Encounter/encounter-01"/>
        </encounter>
        <effectiveDateTime value="2015-02-07T13:28:17-05:00"/>
        <performer>
          <reference value="Practitioner/practitioner-02"/>
        </performer>
        <performer>
          <reference value="Organization/organization-01"/>
        </performer>
        <valueQuantity>
          <value value="3.9"/>
          <unit value="L"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="L"/>
        </valueQuantity>
        <referenceRange>
          <low>
            <value value="3.7"/>
            <unit value="L"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="L"/>
          </low>
          <type>
            <text value="FVC normal bounds"/>
          </type>
        </referenceRange>
      </Observation>
    </resource>
  </entry>
  <entry>
    <resource>
      <Observation>
        <id value="FVC-PRE-Zscore"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: ">FVC_PRE Z-score</span></p><p><b>value</b>: -1.34 Z-score</p><p><b>derivedFrom</b>: </p><ul><li><a href="#Observation_FVC-PRE">See above (Observation/FVC-PRE)</a></li><li><a href="Observation-FVC-PREREF-predicted.html">Generated Summary: <span title="Codes: {http://loinc.org 19869-7}">Forced vital capacity [Volume] Respiratory system Predicted</span>; Reference value, taken from GLI 2012. Depends on the patient's demographic info. (By Created for PFT example @2021-06-10)</a></li></ul></div>
        </text>
        <status value="final"/>
        <code>
          <text value="FVC_PRE Z-score"/>
        </code>
        <valueQuantity>
          <value value="-1.34"/>
          <unit value="Z-score"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="{Zscore}"/>
        </valueQuantity>
        <derivedFrom>
          <reference value="Observation/FVC-PRE"/>
        </derivedFrom>
        <derivedFrom>
          <reference value="Observation/FVC-PREREF-predicted"/>
        </derivedFrom>
      </Observation>
    </resource>
  </entry>
  <entry>
    <resource>
      <Observation>
        <id value="FVC-PRE-percentPredicted"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: {http://loinc.org 19871-3}">FVC pre bronchodilation measured/predicted</span></p><p><b>value</b>: 82 %</p><p><b>derivedFrom</b>: </p><ul><li><a href="#Observation_FVC-PRE">See above (Observation/FVC-PRE)</a></li><li><a href="Observation-FVC-PREREF-predicted.html">Generated Summary: <span title="Codes: {http://loinc.org 19869-7}">Forced vital capacity [Volume] Respiratory system Predicted</span>; Reference value, taken from GLI 2012. Depends on the patient's demographic info. (By Created for PFT example @2021-06-10)</a></li></ul></div>
        </text>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="19871-3"/>
            <display value="FVC pre bronchodilation measured/predicted"/>
          </coding>
        </code>
        <valueQuantity>
          <value value="82"/>
          <unit value="%"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="%"/>
        </valueQuantity>
        <derivedFrom>
          <reference value="Observation/FVC-PRE"/>
        </derivedFrom>
        <derivedFrom>
          <reference value="Observation/FVC-PREREF-predicted"/>
        </derivedFrom>
      </Observation>
    </resource>
  </entry>
  <entry>
    <resource>
      <Observation>
        <id value="FVC-POST"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: {http://loinc.org 19874-7}">Forced vital capacity [Volume] Respiratory system by Spirometry --post bronchodilation</span></p><p><b>value</b>: 4.7 L</p><h3>ReferenceRanges</h3><table class="grid"><tr><td>-</td><td><b>Low</b></td><td><b>Type</b></td></tr><tr><td>*</td><td>3.7 L</td><td><span title="Codes: ">FVC normal bounds</span></td></tr></table></div>
        </text>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="19874-7"/>
            <display
                     value="Forced vital capacity [Volume] Respiratory system by Spirometry --post bronchodilation"/>
          </coding>
        </code>
        <valueQuantity>
          <value value="4.7"/>
          <unit value="L"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="L"/>
        </valueQuantity>
        <referenceRange>
          <low>
            <value value="3.7"/>
            <unit value="L"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="L"/>
          </low>
          <type>
            <text value="FVC normal bounds"/>
          </type>
        </referenceRange>
      </Observation>
    </resource>
  </entry>
  <entry>
    <resource>
      <Observation>
        <id value="FVC-POST-Zscore"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: ">FVC_POST z-score</span></p><p><b>value</b>: -0.09 Z-score</p><p><b>derivedFrom</b>: <a href="#Observation_FVC-POST">See above (Observation/FVC-POST)</a></p></div>
        </text>
        <status value="final"/>
        <code>
          <text value="FVC_POST z-score"/>
        </code>
        <valueQuantity>
          <value value="-0.09"/>
          <unit value="Z-score"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="{Zscore}"/>
        </valueQuantity>
        <derivedFrom>
          <reference value="Observation/FVC-POST"/>
        </derivedFrom>
      </Observation>
    </resource>
  </entry>
  <entry>
    <resource>
      <Observation>
        <id value="FVC-POST-percentPredicted"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: {http://loinc.org 19873-9}">FVC post bronchodilation measured/predicted</span></p><p><b>value</b>: 99 %</p><p><b>derivedFrom</b>: <a href="#Observation_FVC-POST">See above (Observation/FVC-POST)</a></p></div>
        </text>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="19873-9"/>
            <display value="FVC post bronchodilation measured/predicted"/>
          </coding>
        </code>
        <valueQuantity>
          <value value="99"/>
          <unit value="%"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="%"/>
        </valueQuantity>
        <derivedFrom>
          <reference value="Observation/FVC-POST"/>
        </derivedFrom>
      </Observation>
    </resource>
  </entry>
  <entry>
    <resource>
      <Observation>
        <id value="FVC-POST-mLChange"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: ">FVC POST change (mL)</span></p><p><b>value</b>: 600 mL</p><p><b>derivedFrom</b>: </p><ul><li><a href="#Observation_FVC-PRE">See above (Observation/FVC-PRE)</a></li><li><a href="#Observation_FVC-POST">See above (Observation/FVC-POST)</a></li></ul></div>
        </text>
        <status value="final"/>
        <code>
          <text value="FVC POST change (mL)"/>
        </code>
        <valueQuantity>
          <value value="600"/>
          <unit value="mL"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="mL"/>
        </valueQuantity>
        <derivedFrom>
          <reference value="Observation/FVC-PRE"/>
        </derivedFrom>
        <derivedFrom>
          <reference value="Observation/FVC-POST"/>
        </derivedFrom>
      </Observation>
    </resource>
  </entry>
  <entry>
    <resource>
      <Observation>
        <id value="FVC-post-percentChange"/>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: {http://loinc.org 69982-7}">FVC percent change Respiratory system</span></p><p><b>value</b>: 20 %</p><p><b>derivedFrom</b>: </p><ul><li><a href="#Observation_FVC-PRE">See above (Observation/FVC-PRE)</a></li><li><a href="#Observation_FVC-POST">See above (Observation/FVC-POST)</a></li></ul></div>
        </text>
        <status value="final"/>
        <code>
          <coding>
            <system value="http://loinc.org"/>
            <code value="69982-7"/>
            <display value="FVC percent change Respiratory system"/>
          </coding>
        </code>
        <valueQuantity>
          <value value="20"/>
          <unit value="%"/>
          <system value="http://unitsofmeasure.org"/>
          <code value="%"/>
        </valueQuantity>
        <derivedFrom>
          <reference value="Observation/FVC-PRE"/>
        </derivedFrom>
        <derivedFrom>
          <reference value="Observation/FVC-POST"/>
        </derivedFrom>
      </Observation>
    </resource>
  </entry>
</Bundle>