To handle complex structured reporting with sections and sequencing of information, the DiagnosticReport would need to be enhanced to include sections, sequencing and or categorization of the observations. Rather than effectively re-recreating Composition inside DiagnosticReport, the proposal is to use Composition and reference it from DiagnosticReport. That way, the DiagnosticReport provides the relevant related data set for a report, while Composition organizes that data in a structured fashion.

To handle this, the proposal is to change presentedForm to a choice, either Attachment or Composition. 

This also will accommodate different presentedForms in structured and/or unstructured format depending on the author and target audience of the DiagnosticReport.