| IB-AllergyIntolerance (AllergyIntolerance) | C | | AllergyIntolerance | There are no (further) constraints on this element Element idAllergyIntolerance Short descriptionAllergy or Intolerance (generally: Risk of adverse reaction to a substance) Alternate namesAllergy, Intolerance, Adverse Reaction DefinitionRisk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.
Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.
AllergyIntolerance Constraints- dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
contained.contained.empty() - dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative
contained.text.empty() - dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty() - dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
contained.where(('#'+id in %resource.descendants().reference).not()).empty() - ait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
verificationStatus='entered-in-error' or clinicalStatus.exists() - ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
verificationStatus!='entered-in-error' or clinicalStatus.empty()
Mappings- rim: Entity. Role, or Act
- rim: Observation[classCode=OBS, moodCode=EVN]
- w5: clinical.general
|
| id | Σ | 0..1 | id | There are no (further) constraints on this element Element idAllergyIntolerance.id Short descriptionLogical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
id |
| meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idAllergyIntolerance.meta Short descriptionMetadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
Meta |
| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idAllergyIntolerance.implicitRules Short descriptionA set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.
This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
uri |
| language | | 0..1 | codeBinding | There are no (further) constraints on this element Element idAllergyIntolerance.language Short descriptionLanguage of the resource content DefinitionThe base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
code BindingA human language. Common Languages (extensible) Binding extensions |
| text | C | 0..1 | Narrative | There are no (further) constraints on this element Element idAllergyIntolerance.text Short descriptionText summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
Narrative ConditionsThe cardinality or value of this element may be affected by these constraints: dom-1 Mappings |
| contained | | 0..* | Resource | There are no (further) constraints on this element Element idAllergyIntolerance.contained Short descriptionContained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
Resource Mappings |
| extension | | 0..* | Extension | Element idAllergyIntolerance.extension Short descriptionAdditional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension SlicingUnordered, Open, by url(Value) Mappings |
| atributosComunes | C | 1..1 | Extension(Complex) | Element idAllergyIntolerance.extension:atributosComunes Short descriptionAtributos Comunes Alternate namesextensions, user content DefinitionAtributos Comunes: ID Paciente, Tipo Elemento, Fecha y Hora registro, Sistema que envía, Autor.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension(Complex) Extension URLhttp://example.org/fhir/StructureDefinition/IB-AtributosComunes ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| mecanismo | C | 0..* | Extension(CodeableConcept) | Element idAllergyIntolerance.extension:mecanismo Short descriptionOptional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension(CodeableConcept) Extension URLhttp://example.org/fhir/StructureDefinition/IB-Mecanismo ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count()) - ext-1: Must have either extensions or value[x], not both
extension.exists() != value.exists()
Mappings |
| id | | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.extension:mecanismo.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.extension:mecanismo.extension Short descriptionAdditional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings |
| url | | 1..1 | uriAuto Value | There are no (further) constraints on this element Element idAllergyIntolerance.extension:mecanismo.url Short descriptionidentifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL.
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
uri Auto valuehttp://example.org/fhir/StructureDefinition/IB-Mecanismo Mappings |
| valueCodeableConcept | | 0..1 | CodeableConcept | Element idAllergyIntolerance.extension:mecanismo.valueCodeableConcept:valueCodeableConcept Short descriptionValue of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
CodeableConcept Mappings |
| modifierExtension | ?! | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.modifierExtension Short descriptionExtensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension Mappings |
| identifier | Σ | 0..* | Identifier | There are no (further) constraints on this element Element idAllergyIntolerance.identifier Short descriptionExternal ids for this item DefinitionThis records identifiers associated with this allergy/intolerance concern that are defined by business processes and/or used to refer to it when a direct URL reference to the resource itself is not appropriate (e.g. in CDA documents, or in written / printed documentation).
Identifier Mappings |
| clinicalStatus | Σ ?! C | 0..1 | codeBinding | Element idAllergyIntolerance.clinicalStatus Short descriptionactive | inactive | resolved DefinitionAfirmación sobre la certeza del posible riesgo futuro de desarrollo de efecto adverso por exposición a la 'Sustancia' identificada. Los SSII pueden optar por no mostrar las entradas de reacciones adversas con valor de estado "Refutado" en la Lista de reacciones adversas. Sin embargo, 'Refutado' puede ser útil para la reconciliación de la lista de reacciones adversas o cuando se comunica entre sistemas.
This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as not currently valid.
code BindingThe clinical status of the allergy or intolerance. AllergyIntoleranceClinicalStatus (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ait-1, ait-2 Mappings- rim: Observation ACT
.inboundRelationship[typeCode=COMP].source[classCode=OBS, code="clinicalStatus", moodCode=EVN].value
- w5: status
- v2: IAM-17
|
| verificationStatus | Σ ?! C | 1..1 | codeBinding | Element idAllergyIntolerance.verificationStatus Short descriptionunconfirmed | confirmed | refuted | entered-in-error DefinitionAfirmación sobre la certeza del posible riesgo futuro de desarrollo de efecto adverso por exposición a la 'Sustancia' identificada. Los SSII pueden optar por no mostrar las entradas de reacciones adversas con valor de estado "Refutado" en la Lista de reacciones adversas. Sin embargo, 'Refutado' puede ser útil para la reconciliación de la lista de reacciones adversas o cuando se comunica entre sistemas.
This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.
code BindingAssertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance. AllergyIntoleranceVerificationStatus (required) ConditionsThe cardinality or value of this element may be affected by these constraints: ait-1, ait-2 Mappings- rim: Observation ACT
.inboundRelationship[typeCode=COMP].source[classCode=OBS, code="verificationStatus", moodCode=EVN].value
- w5: status
- v2: IAM-17
|
| type | Σ | 1..1 | codeBinding | There are no (further) constraints on this element Element idAllergyIntolerance.type Short descriptionallergy | intolerance - Underlying mechanism (if known) Alternate namesCategory, Class DefinitionIdentification of the underlying physiological mechanism for the reaction risk.
Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians may not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts may not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.
code BindingIdentification of the underlying physiological mechanism for a Reaction Risk. AllergyIntoleranceType (required) Mappings- v2: IAM-9
- rim: code
- w5: class
|
| category | Σ | 0..* | codeBinding | Element idAllergyIntolerance.category Short descriptionfood | medication | environment | biologic Alternate namesCategory, Type, Reaction Type, Class DefinitionCada una de las sustancias del listado pertenecerá a una de las tres opciones.
Se calculará a partir del campo sustancia.
Posibles valores: ME - Medicamento, AL - Alimento, OT - Otros.
This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to search for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender.
code BindingCategory of an identified substance. AllergyIntoleranceCategory (required) Mappings- v2: AL1-2
- rim: value < IntoleranceValue (Agent)
- w5: class
- v2: IAM.2
|
| criticality | Σ | 0..1 | codeBinding | Element idAllergyIntolerance.criticality Short descriptionlow | high | unable-to-assess Alternate namesSeverity, Seriousness, Contra-indication, Risk Definition. Baja: La exposición a la sustancia es poco probable que dé como resultado un daño crítico que ponga en peligro la vida. La exposición futura a la 'Sustancia' identificada debe considerarse una contraindicación relativa en circunstancias clínicas normales. Alta: La exposición a la sustancia puede provocar un daño grave y ser potencialmente mortal. La exposición futura a la 'Sustancia' identificada debe considerarse una contraindicación absoluta en circunstancias clínicas normales. Indeterminado: No se puede evaluar con información disponible.
The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere).
Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.
code BindingEstimate of the potential clinical harm, or seriousness, of a reaction to an identified substance. AllergyIntoleranceCriticality (required) Mappings- v2: AL1-4
- rim: inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]
- w5: grade
|
| code | Σ | 1..1 | CodeableConcept | There are no (further) constraints on this element Element idAllergyIntolerance.code Short descriptionCode that identifies the allergy or intolerance Alternate namesCode DefinitionCode for an allergy or intolerance statement (either a positive or a negated/excluded statement). This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., "Latex"), an allergy or intolerance condition (e.g., "Latex allergy"), or a negated/excluded code for a specific substance or class (e.g., "No latex allergy") or a general or categorical negated statement (e.g., "No known allergy", "No known drug allergies").
It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.
When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship.
The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.
CodeableConcept BindingType of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies. AllergyIntolerance Substance/Product, Condition and Negation Codes (example) Mappings- v2: AL1-3 / IAM-3
- rim: substance/product:
.participation[typeCode=CAGNT].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]
negated/excluded substance/product:
.participation[typeCode=CAGNT, negationInd=true].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]
positive or negated/excluded condition/situation:
Observation.code=ASSERTION; Observation.value
- w5: what
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.code.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.code.extension Short descriptionAdditional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings |
| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idAllergyIntolerance.code.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Coding Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
|
| id | | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.code.coding.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.code.coding.extension Short descriptionAdditional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings |
| system | Σ | 1..1 | uriBindingAuto Value | Element idAllergyIntolerance.code.coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Need to be unambiguous about the source of the definition of the symbol.
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
uri Bindinghttps://www.hl7.org/fhir/valueset-allergyintolerance-code.html (required) Auto valuehttp://snomed.info/sct Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
|
| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.code.coding.version Short descriptionVersion of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
string Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
|
| code | Σ | 0..1 | code | There are no (further) constraints on this element Element idAllergyIntolerance.code.coding.code Short descriptionSymbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Need to refer to a particular code in the system.
code Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
|
| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.code.coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
string Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
|
| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idAllergyIntolerance.code.coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
boolean Mappings- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
|
| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.code.text Short descriptionPlain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Very often the text is the same as a displayName of one of the codings.
string Mappings- v2: C*E.9. But note many systems use C*E.2 for this
- rim: ./originalText[mediaType/code="text/plain"]/data
- orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
|
| patient | Σ | 1..1 | Reference(Patient) | There are no (further) constraints on this element Element idAllergyIntolerance.patient Short descriptionWho the sensitivity is for Alternate namesPatient DefinitionThe patient who has the allergy or intolerance.
Reference(Patient) Mappings- v2: (PID-3)
- rim: .participation[typeCode=SBJ].role[classCode=PAT]
- w5: who.focus
|
| onset[x] | | 0..1 | | Element idAllergyIntolerance.onset[x] Short descriptionWhen allergy or intolerance was identified DefinitionLos sistemas informáticos deberían ofertar una edad, unos años trascurridos, un año o una fecha y a partir del valor introducido calcular la fecha. Se almacenará la fecha calculada aunque sea aproximada. Cuando el cálculo de como resultado un año se almacenará 15/06/año.
- rim: effectiveTime.low
- w5: when.init
- v2: IAM-11
- v2: AL1-6
|
| onsetDateTime | | | dateTime | Data type dateTime |
| onsetAge | | | Age | Data type Age |
| onsetPeriod | | | Period | Data type Period |
| onsetRange | | | Range | Data type Range |
| assertedDate | | 0..1 | dateTime | There are no (further) constraints on this element Element idAllergyIntolerance.assertedDate Short descriptionDate record was believed accurate DefinitionThe date on which the existance of the AllergyIntolerance was first asserted or acknowledged.
dateTime Mappings- v2: IAM-20
- rim: .participation[typeCode=AUT].time
- w5: when.recorded
|
| recorder | | 0..1 | Reference(Practitioner | Patient) | There are no (further) constraints on this element Element idAllergyIntolerance.recorder Short descriptionWho recorded the sensitivity Alternate namesAuthor DefinitionIndividual who recorded the record and takes responsibility for its content.
Reference(Practitioner | Patient) Mappings- rim: .participation[typeCode=AUT].role
- w5: who.author
|
| asserter | Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner) | There are no (further) constraints on this element Element idAllergyIntolerance.asserter Short descriptionSource of the information about the allergy Alternate namesSource, Informant DefinitionThe source of the information about the allergy that is recorded.
The recorder takes repsonsibility for the content, but can reference the source from where they got it.
Reference(Patient | RelatedPerson | Practitioner) Mappings- v2: IAM-14 (if patient) / IAM-18 (if practitioner)
- rim: .participation[typeCode=INF].role
- w5: who.source
|
| lastOccurrence | | 0..1 | dateTime | Element idAllergyIntolerance.lastOccurrence Short descriptionDate(/time) of last known occurrence of a reaction DefinitionLos sistemas informáticos debería ofertar una edad, unos años trascurridos, un año o una fecha y a partir del valor introducido calcular la fecha.
This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.
dateTime Mappings- rim: outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)].effectiveTime
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| note | | 0..* | Annotation | Element idAllergyIntolerance.note Short descriptionAdditional text not captured in other fields DefinitionTexto breve limitado a 255 caracteres.
For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes.
Annotation Mappings- rim: subjectOf.observationEvent[code="annotation"].value
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| id | | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.note.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.note.extension Short descriptionAdditional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings |
| author[x] | Σ | 0..1 | | There are no (further) constraints on this element Element idAllergyIntolerance.note.author[x] Short descriptionIndividual responsible for the annotation DefinitionThe individual responsible for making the annotation.
- v2: N/A
- rim: Act.participant[typeCode=AUT].role
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| authorString | | | string | There are no (further) constraints on this element Data typestring |
| authorReference | | | Reference(Practitioner | Patient | RelatedPerson) | There are no (further) constraints on this element Data typeReference(Practitioner | Patient | RelatedPerson) |
| time | Σ | 0..1 | dateTime | There are no (further) constraints on this element Element idAllergyIntolerance.note.time Short descriptionWhen the annotation was made DefinitionIndicates when this particular annotation was made.
dateTime Mappings- v2: N/A
- rim: Act.effectiveTime
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| text | C | 1..1 | string | Element idAllergyIntolerance.note.text Short descriptionThe annotation - text content DefinitionTexto breve limitado a 255 caracteres.
string Constraints- maxLenght: Longitud máxima 255 caracteres
value.lenght <256
Mappings |
| reaction | | 0..* | BackboneElement | There are no (further) constraints on this element Element idAllergyIntolerance.reaction Short descriptionAdverse Reaction Events linked to exposure to substance DefinitionDetails about each adverse reaction event linked to exposure to the identified substance.
BackboneElement Constraints- ele-1: All FHIR elements must have a @value or children
hasValue() | (children().count() > id.count())
Mappings- rim: outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)]
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| id | | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.extension Short descriptionAdditional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension Mappings |
| modifierExtension | Σ ?! | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.modifierExtension Short descriptionExtensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension Mappings |
| substance | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance Short descriptionSpecific substance or pharmaceutical product considered to be responsible for event DefinitionIdentification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'.
Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identifed as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.
CodeableConcept BindingCodes defining the type of the substance (including pharmaceutical products). Substance Code (example) Mappings- rim: outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].participation[typeCode=CSM].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]
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| id | | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance.extension Short descriptionAdditional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings |
| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Coding Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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| id | | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance.coding.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance.coding.extension Short descriptionAdditional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings |
| system | Σ | 0..1 | uriAuto Value | Element idAllergyIntolerance.reaction.substance.coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Need to be unambiguous about the source of the definition of the symbol.
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
uri Auto valuehttp://snomed.info/sct Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
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| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance.coding.version Short descriptionVersion of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
string Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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| code | Σ | 0..1 | code | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance.coding.code Short descriptionSymbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Need to refer to a particular code in the system.
code Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance.coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
string Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance.coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
boolean Mappings- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.substance.text Short descriptionPlain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Very often the text is the same as a displayName of one of the codings.
string Mappings- v2: C*E.9. But note many systems use C*E.2 for this
- rim: ./originalText[mediaType/code="text/plain"]/data
- orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
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| manifestation | | 1..* | CodeableConcept | Element idAllergyIntolerance.reaction.manifestation Short descriptionClinical symptoms/signs associated with the Event Alternate namesSymptoms, Signs DefinitionClinical symptoms and/or signs that are observed or associated with the adverse reaction event.
Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.
CodeableConcept BindingClinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event. SNOMED CT Clinical Findings (example) Mappings- v2: AL1-5
- rim: code
- v2: IAM-5
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| id | | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.extension Short descriptionAdditional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings |
| coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding Short descriptionCode defined by a terminology system DefinitionA reference to a code defined by a terminology system.
Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Coding Mappings- v2: C*E.1-8, C*E.10-22
- rim: union(., ./translation)
- orim: fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
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| id | | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding.id Short descriptionxml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
string Mappings |
| extension | | 0..* | Extension | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding.extension Short descriptionAdditional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Extension SlicingUnordered, Open, by url(Value) Extensions are always sliced by (at least) url Mappings |
| system | Σ | 0..1 | uriAuto Value | Element idAllergyIntolerance.reaction.manifestation.coding.system Short descriptionIdentity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code.
Need to be unambiguous about the source of the definition of the symbol.
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
uri Auto valuehttp://snomed.info/sct Mappings- v2: C*E.3
- rim: ./codeSystem
- orim: fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
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| version | Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding.version Short descriptionVersion of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
string Mappings- v2: C*E.7
- rim: ./codeSystemVersion
- orim: fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
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| code | Σ | 0..1 | code | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding.code Short descriptionSymbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Need to refer to a particular code in the system.
code Mappings- v2: C*E.1
- rim: ./code
- orim: fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
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| display | Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding.display Short descriptionRepresentation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system.
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
string Mappings- v2: C*E.2 - but note this is not well followed
- rim: CV.displayName
- orim: fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
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| userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.coding.userSelected Short descriptionIf this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
boolean Mappings- v2: Sometimes implied by being first
- rim: CD.codingRationale
- orim: fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
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| text | Σ | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.manifestation.text Short descriptionPlain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
Very often the text is the same as a displayName of one of the codings.
string Mappings- v2: C*E.9. But note many systems use C*E.2 for this
- rim: ./originalText[mediaType/code="text/plain"]/data
- orim: fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
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| description | | 0..1 | string | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.description Short descriptionDescription of the event as a whole Alternate namesNarrative, Text DefinitionText description about the reaction as a whole, including details of the manifestation if required.
Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.
string Mappings |
| onset | | 0..1 | dateTime | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.onset Short descriptionDate(/time) when manifestations showed DefinitionRecord of the date and/or time of the onset of the Reaction.
dateTime Mappings- v2: AL1-6
- rim: effectiveTime.low
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| severity | | 0..1 | codeBinding | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.severity Short descriptionmild | moderate | severe (of event as a whole) DefinitionClinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.
It is acknowledged that this assessment is very subjective. There may be some some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.
code BindingClinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations. AllergyIntoleranceSeverity (required) Mappings- rim: inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]
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| exposureRoute | | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.exposureRoute Short descriptionHow the subject was exposed to the substance DefinitionIdentification of the route by which the subject was exposed to the substance.
Coding of the route of exposure with a terminology should be used wherever possible.
CodeableConcept BindingA coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject. SNOMED CT Route Codes (example) Mappings- rim: outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].routeCode
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| note | | 0..* | Annotation | There are no (further) constraints on this element Element idAllergyIntolerance.reaction.note Short descriptionText about event not captured in other fields DefinitionAdditional text about the adverse reaction event not captured in other fields.
Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.
Annotation Mappings- rim: subjectOf.observationEvent[code="annotation"].value
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