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Question

How do you distinguish whether a specific molecular marker is found as a result in the TumorMarker profile as opposed to CancerGenomicsReport?  I noticed that the value set under the TumorMarker profile contains markers like HER2, which can also be represented in the CancerGenomicsReport profile. 

Answer

Generally, TumorMarker is different from CancerGenomicsReport in the following way:

  • TumorMarker covers certain serum-based tumor markers, as well as probe tests which are run by more common reference labs (e.g.: LabCorp, Quest). It is meant to address single tests which are returned as an observation/result pair. 
  • CancerGenomicsReport focuses more on genomic sequencing tests. The genomics-related profile structures align as much as possible to the HL7 Clinical Genomics Reporting FHIR IG.

While there are some probe-tests (e.g.: HER2 FISH) which could be found in a genomics report as well as in a simple HL7v2 message or FHIR Observation resource, the modelers made a pragmatic decision not to retrofit the complex modeling required for a genomics sequencing report just to accomodate a minimal set of elements received for a FISH, IHC, or CISH test to name a few. 


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