DiagnosticReport¶

Overview¶

The DiagnosticReport resource represents the findings and interpretation of diagnostic tests such as laboratory panels, radiology studies, and pathology reports. It groups related Observations together with clinical interpretations and conclusions.

DiagnosticReport is the key resource for conveying clinical interpretation and context for a set of results. It includes a narrative conclusion and may reference multiple Observation resources that contain the actual result data.

Common use cases: - Laboratory test results (CBC, metabolic panel) - Radiology reports (X-ray, CT, MRI) - Pathology reports - Cardiology reports (ECG, Echo) - Microbiology culture results - Genetic test reports

Scope and Boundaries: - DiagnosticReport contains interpretation; individual results go in Observation - For images themselves, use ImagingStudy; findings go in DiagnosticReport - Procedure resource records how the specimen was collected - Multiple observations can be grouped into one report

FHIR R4 Specification¶

See the official HL7 specification: https://hl7.org/fhir/R4/diagnosticreport.html

Supported Fields¶

Field	Type	Description
`id`	string	Logical ID of the resource
`meta`	Meta	Resource metadata including versionId and lastUpdated
`status`	code	registered, partial, preliminary, final, amended, corrected, appended, cancelled, entered-in-error
`category`	CodeableConcept[]	Service category (LAB, RAD, PAT, etc.)
`code`	CodeableConcept	Type of report (LOINC code)
`subject`	Reference(Patient)	Patient the report is about
`encounter`	Reference(Encounter)	Health care event related to the report
`effectiveDateTime`	dateTime	Clinically relevant time for the report
`issued`	instant	DateTime this version was made available
`performer`	Reference(Practitioner)[]	Responsible diagnostic service
`result`	Reference(Observation)[]	Observations included in the report
`conclusion`	string	Clinical conclusion (interpretation)
`conclusionCode`	CodeableConcept[]	Codes for the clinical conclusion

Search Parameters¶

Parameter	Type	Description	Example
`_id`	token	Resource ID	`_id=abc123`
`patient`	reference	Patient reference	`patient=Patient/123`
`subject`	reference	Subject reference	`subject=Patient/123`
`code`	token	Report type code	`code=http://loinc.org\\|58410-2`
`category`	token	Service category	`category=LAB`
`status`	token	Report status	`status=final`
`date`	date	Effective date	`date=ge2024-01-01`
`issued`	date	Issue date	`issued=2024-06-15`
`encounter`	reference	Encounter reference	`encounter=Encounter/456`
`performer`	reference	Performer reference	`performer=Practitioner/789`
`result`	reference	Result observation	`result=Observation/obs-1`
`conclusion`	string	Conclusion text	`conclusion=Normal`

Examples¶

Create a DiagnosticReport¶

curl -X POST http://localhost:8080/baseR4/DiagnosticReport \
  -H "Content-Type: application/fhir+json" \
  -d '{
    "resourceType": "DiagnosticReport",
    "status": "final",
    "category": [{
      "coding": [{
        "system": "http://terminology.hl7.org/CodeSystem/v2-0074",
        "code": "LAB",
        "display": "Laboratory"
      }]
    }],
    "code": {
      "coding": [{
        "system": "http://loinc.org",
        "code": "58410-2",
        "display": "Complete blood count (CBC) panel"
      }],
      "text": "Complete blood count (CBC) panel"
    },
    "subject": {"reference": "Patient/patient-001"},
    "effectiveDateTime": "2024-06-15T10:30:00Z",
    "issued": "2024-06-15T11:00:00Z",
    "conclusion": "CBC panel results within normal limits."
  }'

Search DiagnosticReports¶

# By patient
curl "http://localhost:8080/baseR4/DiagnosticReport?patient=Patient/123"

# By category (laboratory reports)
curl "http://localhost:8080/baseR4/DiagnosticReport?category=LAB"

# By code (CBC panel)
curl "http://localhost:8080/baseR4/DiagnosticReport?code=http://loinc.org|58410-2"

# By status (final reports only)
curl "http://localhost:8080/baseR4/DiagnosticReport?status=final"

# By date range
curl "http://localhost:8080/baseR4/DiagnosticReport?date=ge2024-01-01&date=le2024-12-31"

# Combined search
curl "http://localhost:8080/baseR4/DiagnosticReport?patient=Patient/123&category=RAD&status=final"

With _include¶

# Include the patient
curl "http://localhost:8080/baseR4/DiagnosticReport?patient=123&_include=DiagnosticReport:subject"

# Include the observations referenced in results
curl "http://localhost:8080/baseR4/DiagnosticReport?_include=DiagnosticReport:result"

# Include performer (practitioner)
curl "http://localhost:8080/baseR4/DiagnosticReport?_include=DiagnosticReport:performer"

Patient Compartment Search¶

# Get all DiagnosticReports for a patient via compartment
curl "http://localhost:8080/baseR4/Patient/123/DiagnosticReport"

# With category filter
curl "http://localhost:8080/baseR4/Patient/123/DiagnosticReport?category=LAB"

Generator¶

The DiagnosticReportGenerator creates synthetic DiagnosticReport resources with:

Realistic LOINC codes for laboratory panels, radiology studies, and pathology reports
Proper HL7 category codes (LAB, RAD, PAT)
Weighted status distributions (70% final, 15% preliminary, 10% amended, 5% registered)
Realistic conclusion text based on report type
SNOMED conclusion codes

Usage¶

from fhirkit.server.generator import DiagnosticReportGenerator

generator = DiagnosticReportGenerator(seed=42)

# Generate a random diagnostic report
report = generator.generate(
    patient_ref="Patient/123",
    encounter_ref="Encounter/456",
    performer_ref="Practitioner/789",
    result_refs=["Observation/obs-1", "Observation/obs-2"]
)

# Generate a specific type of report
lab_report = generator.generate_lab_panel(
    patient_ref="Patient/123",
    result_refs=["Observation/obs-1", "Observation/obs-2"]
)

radiology_report = generator.generate_radiology_report(
    patient_ref="Patient/123",
    performer_ref="Practitioner/789"
)

pathology_report = generator.generate_pathology_report(
    patient_ref="Patient/123"
)

# Generate batch
reports = generator.generate_batch(
    count=10,
    patient_ref="Patient/123"
)

Clinical Codes¶

Loaded from fixtures/diagnostic_report_codes.json:

Report Types (LOINC)¶

Code	Display	Category
58410-2	Complete blood count (CBC) panel	LAB
24323-8	Comprehensive metabolic panel	LAB
57698-3	Lipid panel	LAB
24356-8	Urinalysis panel	LAB
36643-5	Chest X-ray 2 views	RAD
30746-2	CT head without contrast	RAD
24558-9	MRI brain without contrast	RAD
11526-1	Pathology study	PAT
60567-5	Surgical pathology report	PAT

Categories (HL7 v2-0074)¶

Code	Display
LAB	Laboratory
RAD	Radiology
PAT	Pathology
CUS	Cardiac Ultrasound
NRS	Nursing Service

Conclusion Codes (SNOMED CT)¶

Code	Display
17621005	Normal
263654008	Abnormal
260415000	Not detected
52101004	Present
2667000	Absent
419984006	Inconclusive