{
"description": "An allergy or intolerance describes a patient’s tendency towards hypersensitivity to a certain substance, so that an unwanted physiological reaction is expected after exposure to the substance, while most people would not exhibit such a reaction to that amount. The observed physiological changes are usually the result of an immunological reaction.\\r\\nThe substances can be categorized as follows:\\r\\n* Medicine\\r\\n* Medicine category\\r\\n* Ingredient/addition\\r\\n* Nutrition\\r\\n* Environmental factor\\r\\n* Animal\\r\\n* Plants\\r\\n* Chemicals\\r\\n* Inhaled allergenic",
"_filename": "nl-core-AllergyIntolerance.json",
"package_name": "nictiz.fhir.nl.r4.nl-core",
"date": null,
"derivation": "constraint",
"publisher": "Nictiz",
"fhirVersion": "4.0.1",
"purpose": "A derived profile from [zib-AllergyIntolerance](http://nictiz.nl/fhir/StructureDefinition/zib-AllergyIntolerance) to provide a version better suited for implementation purposes. This profile augments the base profile with elements found in the various use cases that have adopted the zib.",
"name": "NlcoreAllergyIntolerance",
"mapping": [ {
"uri": "https://zibs.nl/wiki/AllergyIntolerance-v3.3(2020EN)",
"name": "zib AllergyIntolerance-v3.3(2020EN)",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"abstract": false,
"copyright": "Copyright and related rights waived via CC0, https://creativecommons.org/publicdomain/zero/1.0/. This does not apply to information from third parties, for example a medical terminology system. The implementer alone is responsible for identifying and obtaining any necessary licenses or authorizations to utilize third party IP in connection with the specification or otherwise.",
"type": "AllergyIntolerance",
"experimental": null,
"resourceType": "StructureDefinition",
"title": "nl core AllergyIntolerance",
"package_version": "0.12.0-beta.4",
"snapshot": {
"element": [ {
"constraint": [ {
"key": "ait-1",
"human": "AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.",
"xpath": "f:verificationStatus/f:coding/f:code/@value='entered-in-error' or exists(f:clinicalStatus)",
"severity": "error",
"expression": "verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()"
}, {
"key": "ait-2",
"human": "AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error",
"xpath": "not(f:verificationStatus/f:coding/f:code/@value='entered-in-error') or not(exists(f:clinicalStatus))",
"severity": "error",
"expression": "verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()"
}, {
"key": "dom-2",
"human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources",
"xpath": "not(parent::f:contained and f:contained)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.contained.empty()"
}, {
"key": "dom-3",
"human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource",
"xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()"
}, {
"key": "dom-4",
"human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated",
"xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()"
}, {
"key": "dom-5",
"human": "If a resource is contained in another resource, it SHALL NOT have a security label",
"xpath": "not(exists(f:contained/*/f:meta/f:security))",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "error",
"expression": "contained.meta.security.empty()"
}, {
"key": "dom-6",
"human": "A resource should have narrative for robust management",
"xpath": "exists(f:text/h:div)",
"source": "http://hl7.org/fhir/StructureDefinition/DomainResource",
"severity": "warning",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice",
"valueBoolean": true
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation",
"valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time."
} ],
"expression": "text.`div`.exists()"
} ],
"path": "AllergyIntolerance",
"min": 0,
"definition": "Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.",
"isModifier": false,
"short": "AllergyIntolerance",
"mapping": [ {
"map": "Entity. Role, or Act",
"identity": "rim"
}, {
"map": "Observation[classCode=OBS, moodCode=EVN]",
"identity": "rim"
}, {
"map": "NL-CM:8.2.1",
"comment": "AllergyIntolerance",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"alias": [ "Allergy", "Intolerance", "Adverse Reaction", "AllergieIntolerantie", "nl-core-AllergyIntolerance" ],
"max": "*",
"id": "AllergyIntolerance",
"comment": "The zib defines certain allergy statuses in the AllergieStatusCodelijst (NL-CM:8.2.5 AllergyStatus). These statuses are represented using both the FHIR elements `AllergyIntolerance.clinicalStatus` and `AllergyIntolerance.verificationStatus`; most of the zib codes map to a `.clinicalStatus` code, but the zib code _nullified_ can only be represented by `.verificationStatus` = _entered-in-error_.\r\n\r\nFor both these FHIR elements, a separate ConceptMap is defined. Although both ConceptMaps include _unmatched_ concepts, together they provide an _equal_ mapping of each AllergieStatusCodelijst concept. Therefore, there's no need to include the zib code using the ext-CodeSpecification extension, as would normally be expected in these situations.",
"base": {
"max": "*",
"min": 0,
"path": "AllergyIntolerance"
},
"isSummary": false
}, {
"path": "AllergyIntolerance.id",
"min": 0,
"definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.",
"isModifier": false,
"short": "Logical id of this artifact",
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"max": "1",
"id": "AllergyIntolerance.id",
"comment": "The only time that a resource does not have an id is when it is being submitted to the server using a create operation.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.id"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.meta",
"min": 0,
"definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.",
"isModifier": false,
"short": "Metadata about the resource",
"type": [ {
"code": "Meta"
} ],
"max": "1",
"id": "AllergyIntolerance.meta",
"base": {
"max": "1",
"min": 0,
"path": "Resource.meta"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.implicitRules",
"min": 0,
"definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.",
"isModifier": true,
"short": "A set of rules under which this content was created",
"type": [ {
"code": "uri"
} ],
"max": "1",
"id": "AllergyIntolerance.implicitRules",
"comment": "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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.",
"base": {
"max": "1",
"min": 0,
"path": "Resource.implicitRules"
},
"isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.language",
"min": 0,
"definition": "The base language in which the resource is written.",
"isModifier": false,
"short": "Language of the resource content",
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "preferred",
"valueSet": "http://hl7.org/fhir/ValueSet/languages",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet",
"valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Language"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding",
"valueBoolean": true
} ],
"description": "A human language."
},
"max": "1",
"id": "AllergyIntolerance.language",
"comment": "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).",
"base": {
"max": "1",
"min": 0,
"path": "Resource.language"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.text",
"min": 0,
"definition": "A human-readable narrative that contains a summary of the resource and can 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.",
"isModifier": false,
"short": "Text summary of the resource, for human interpretation",
"mapping": [ {
"map": "Act.text?",
"identity": "rim"
} ],
"type": [ {
"code": "Narrative"
} ],
"alias": [ "narrative", "html", "xhtml", "display" ],
"max": "1",
"id": "AllergyIntolerance.text",
"comment": "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 information is added later.",
"base": {
"max": "1",
"min": 0,
"path": "DomainResource.text"
},
"isSummary": false
}, {
"path": "AllergyIntolerance.contained",
"min": 0,
"definition": "These 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.",
"isModifier": false,
"short": "Contained, inline Resources",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Resource"
} ],
"alias": [ "inline resources", "anonymous resources", "contained resources" ],
"max": "*",
"id": "AllergyIntolerance.contained",
"comment": "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. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.contained"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "AllergyIntolerance.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "AllergyIntolerance.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "AllergyIntolerance.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"min": 0,
"definition": "May 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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "AllergyIntolerance.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "DomainResource.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them",
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.identifier",
"requirements": "Allows identification of the AllergyIntolerance as it is known by various participating systems and in a way that remains consistent across servers.",
"min": 0,
"definition": "Business identifiers assigned to this AllergyIntolerance by the performer or other systems which remain constant as the resource is updated and propagates from server to server.",
"isModifier": false,
"short": "External ids for this item",
"mapping": [ {
"map": "FiveWs.identifier",
"identity": "w5"
}, {
"map": "IAM-7",
"identity": "v2"
}, {
"map": "id",
"identity": "rim"
} ],
"type": [ {
"code": "Identifier"
} ],
"max": "*",
"id": "AllergyIntolerance.identifier",
"comment": "This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.",
"base": {
"max": "*",
"min": 0,
"path": "AllergyIntolerance.identifier"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.clinicalStatus",
"min": 0,
"definition": "Statement on the status of the patient’s hypersensitivity.",
"isModifier": true,
"short": "AllergyStatus",
"mapping": [ {
"map": "FiveWs.status",
"identity": "w5"
}, {
"map": "Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"clinicalStatus\", moodCode=EVN].value",
"identity": "rim"
}, {
"map": "NL-CM:8.2.5",
"comment": "AllergyStatus",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1",
"_valueSet": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap",
"valueCanonical": "http://nictiz.nl/fhir/ConceptMap/AllergieStatusCodelijst-to-AllergyIntoleranceClinicalStatusCodes"
} ]
},
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AllergyIntoleranceClinicalStatus"
} ],
"description": "Use ConceptMap AllergieStatusCodelijst_to_AllergyIntoleranceClinicalStatusCodes to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceClinicalStatusCodes."
},
"alias": [ "AllergieStatus" ],
"max": "1",
"id": "AllergyIntolerance.clinicalStatus",
"condition": [ "ait-1", "ait-2" ],
"comment": "See the comment on the root element for guidance on mapping zib AllergyStatus to FHIR.",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.clinicalStatus"
},
"isModifierReason": "This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as no longer active.",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.verificationStatus",
"min": 0,
"definition": "Statement on the status of the patient’s hypersensitivity.",
"isModifier": true,
"short": "AllergyStatus",
"mapping": [ {
"map": "FiveWs.status",
"identity": "w5"
}, {
"map": "Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code=\"verificationStatus\", moodCode=EVN].value",
"identity": "rim"
}, {
"map": "NL-CM:8.2.5",
"comment": "AllergyStatus",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1",
"_valueSet": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap",
"valueCanonical": "http://nictiz.nl/fhir/ConceptMap/AllergieStatusCodelijst-to-AllergyIntoleranceVerificationStatus"
} ]
},
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AllergyIntoleranceVerificationStatus"
} ],
"description": "Use ConceptMap AllergieStatusCodelijst_to_AllergyIntoleranceVerificationStatus to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceVerificationStatusCodes."
},
"alias": [ "AllergieStatus" ],
"max": "1",
"id": "AllergyIntolerance.verificationStatus",
"condition": [ "ait-1", "ait-2" ],
"comment": "See the comment on the root element for guidance on mapping zib AllergyStatus to FHIR.",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.verificationStatus"
},
"isModifierReason": "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.",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.type",
"min": 0,
"definition": "Identification of the underlying physiological mechanism for the reaction risk.",
"isModifier": false,
"short": "allergy | intolerance - Underlying mechanism (if known)",
"mapping": [ {
"map": "FiveWs.class",
"identity": "w5"
}, {
"map": "IAM-9",
"identity": "v2"
}, {
"map": "code",
"identity": "rim"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AllergyIntoleranceType"
} ],
"description": "Identification of the underlying physiological mechanism for a Reaction Risk."
},
"alias": [ "Category", "Class" ],
"max": "1",
"id": "AllergyIntolerance.type",
"comment": "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 might 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 might 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.",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.type"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.category",
"min": 0,
"definition": "Identifies the allergy category such as medication, food or environment.",
"isModifier": false,
"short": "AllergyCategory",
"mapping": [ {
"map": "FiveWs.class",
"identity": "w5"
}, {
"map": "AL1-2",
"identity": "v2"
}, {
"map": "value < IntoleranceValue (Agent)",
"identity": "rim"
}, {
"map": "NL-CM:8.2.4",
"comment": "AllergyCategory",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1",
"_valueSet": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap",
"valueCanonical": "http://nictiz.nl/fhir/ConceptMap/AllergieCategorieCodelijst-to-AllergyIntoleranceCategory"
} ]
},
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AllergyIntoleranceCategory"
} ],
"description": "Use ConceptMap AllergieCategorieCodelijst_to_AllergyIntoleranceCategory to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceCategory."
},
"alias": [ "Category", "Type", "Reaction Type", "Class", "AllergieCategorie" ],
"max": "1",
"id": "AllergyIntolerance.category",
"comment": "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](search.html) 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.",
"base": {
"max": "*",
"min": 0,
"path": "AllergyIntolerance.category"
},
"isSummary": true
}, {
"path": "AllergyIntolerance.category.id",
"min": 0,
"definition": "unique id for the element within a resource (for internal references)",
"isModifier": false,
"short": "xml:id (or equivalent in JSON)",
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "AllergyIntolerance.category.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "AllergyIntolerance.category.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "AllergyIntolerance.category.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "AllergyIntolerance.category.extension",
"min": 0,
"definition": "Optional Extension Element - found in all resources.",
"isModifier": false,
"short": "Optional Extensions Element",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification" ]
} ],
"sliceName": "allergyCategoryCodelist",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"alias": [ "extensions", "user content" ],
"max": "1",
"id": "AllergyIntolerance.category.extension:allergyCategoryCodelist",
"condition": [ "ele-1" ],
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"path": "AllergyIntolerance.category.extension.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "AllergyIntolerance.category.extension:allergyCategoryCodelist.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "AllergyIntolerance.category.extension.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "AllergyIntolerance.category.extension:allergyCategoryCodelist.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"path": "AllergyIntolerance.category.extension.url",
"min": 1,
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"isModifier": false,
"short": "identifies the meaning of the extension",
"fixedUri": "http://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "uri"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "AllergyIntolerance.category.extension:allergyCategoryCodelist.url",
"comment": "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.",
"base": {
"max": "1",
"min": 1,
"path": "Extension.url"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.category.extension.value[x]",
"min": 0,
"definition": "Identifies the allergy category such as medication, food or environment.",
"isModifier": false,
"short": "AllergyCategory",
"mapping": [ {
"map": "N/A",
"identity": "rim"
}, {
"map": "NL-CM:8.2.4",
"comment": "AllergyCategory",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "required",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.2--20200901000000"
},
"alias": [ "AllergieCategorie" ],
"max": "1",
"id": "AllergyIntolerance.category.extension:allergyCategoryCodelist.value[x]",
"base": {
"max": "1",
"min": 0,
"path": "Extension.value[x]"
},
"isSummary": false
}, {
"path": "AllergyIntolerance.category.value",
"min": 0,
"definition": "Primitive value for code",
"isModifier": false,
"short": "Primitive value for code",
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/regex",
"valueString": "[^\\s]+(\\s[^\\s]+)*"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "AllergyIntolerance.category.value",
"base": {
"max": "1",
"min": 0,
"path": "string.value"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.criticality",
"min": 0,
"definition": "Critical extent is defined as “the potential severity of future reactions.” This represents a clinical evaluation of the worst case scenario for a future reaction. It can be based on the severity of past reactions, the dose and manner of exposure which caused reactions in the past, and the life-threatening potential of the type of reaction. Critical extent is a property of the allergy, and not of the reaction itself.",
"isModifier": false,
"short": "Criticality",
"mapping": [ {
"map": "FiveWs.grade",
"identity": "w5"
}, {
"map": "AL1-4",
"identity": "v2"
}, {
"map": "inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]",
"identity": "rim"
}, {
"map": "NL-CM:8.2.7",
"comment": "Criticality",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1",
"_valueSet": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap",
"valueCanonical": "http://nictiz.nl/fhir/ConceptMap/MateVanKritiekZijnCodelijst-to-AllergyIntoleranceCriticality"
} ]
},
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AllergyIntoleranceCriticality"
} ],
"description": "Use ConceptMap MateVanKritiekZijnCodelijst_to_AllergyIntoleranceCriticality to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceCriticality."
},
"alias": [ "Severity", "Seriousness", "Contra-indication", "Risk", "MateVanKritiekZijn" ],
"max": "1",
"id": "AllergyIntolerance.criticality",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.criticality"
},
"isSummary": true
}, {
"path": "AllergyIntolerance.criticality.id",
"min": 0,
"definition": "unique id for the element within a resource (for internal references)",
"isModifier": false,
"short": "xml:id (or equivalent in JSON)",
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "AllergyIntolerance.criticality.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "AllergyIntolerance.criticality.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the resource. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"slicing": {
"rules": "open",
"ordered": false,
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "AllergyIntolerance.criticality.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "AllergyIntolerance.criticality.extension",
"min": 0,
"definition": "Optional Extension Element - found in all resources.",
"isModifier": false,
"short": "Optional Extensions Element",
"mapping": [ {
"map": "n/a",
"identity": "rim"
}, {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification" ]
} ],
"sliceName": "criticalExtentCodelist",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "normative"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-normative-version",
"valueCode": "4.0.0"
} ],
"alias": [ "extensions", "user content" ],
"max": "1",
"id": "AllergyIntolerance.criticality.extension:criticalExtentCodelist",
"condition": [ "ele-1" ],
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"path": "AllergyIntolerance.criticality.extension.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "AllergyIntolerance.criticality.extension:criticalExtentCodelist.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "AllergyIntolerance.criticality.extension.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "AllergyIntolerance.criticality.extension:criticalExtentCodelist.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"path": "AllergyIntolerance.criticality.extension.url",
"min": 1,
"definition": "Source of the definition for the extension code - a logical name or a URL.",
"isModifier": false,
"short": "identifies the meaning of the extension",
"fixedUri": "http://nictiz.nl/fhir/StructureDefinition/ext-CodeSpecification",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "uri"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "AllergyIntolerance.criticality.extension:criticalExtentCodelist.url",
"comment": "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.",
"base": {
"max": "1",
"min": 1,
"path": "Extension.url"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.criticality.extension.value[x]",
"min": 0,
"definition": "Critical extent is defined as “the potential severity of future reactions.” This represents a clinical evaluation of the worst case scenario for a future reaction. It can be based on the severity of past reactions, the dose and manner of exposure which caused reactions in the past, and the life-threatening potential of the type of reaction. Critical extent is a property of the allergy, and not of the reaction itself.",
"isModifier": false,
"short": "Criticality",
"mapping": [ {
"map": "N/A",
"identity": "rim"
}, {
"map": "NL-CM:8.2.7",
"comment": "Criticality",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "required",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.4--20200901000000"
},
"alias": [ "MateVanKritiekZijn" ],
"max": "1",
"id": "AllergyIntolerance.criticality.extension:criticalExtentCodelist.value[x]",
"base": {
"max": "1",
"min": 0,
"path": "Extension.value[x]"
},
"isSummary": false
}, {
"path": "AllergyIntolerance.criticality.value",
"min": 0,
"definition": "Primitive value for code",
"isModifier": false,
"short": "Primitive value for code",
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
}, {
"url": "http://hl7.org/fhir/StructureDefinition/regex",
"valueString": "[^\\s]+(\\s[^\\s]+)*"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "AllergyIntolerance.criticality.value",
"base": {
"max": "1",
"min": 0,
"path": "string.value"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.code",
"min": 0,
"definition": "Substance, group of substances or environmental factor to which the patient is allergic or hypersensitive.",
"isModifier": false,
"short": "CausativeAgent",
"mapping": [ {
"map": "FiveWs.what[x]",
"identity": "w5"
}, {
"map": "AL1-3 / IAM-3",
"identity": "v2"
}, {
"map": "substance/product:\r\r.participation[typeCode=CAGNT].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]\r\rnegated/excluded substance/product:\r\r.participation[typeCode=CAGNT, negationInd=true].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]\r\rpositive or negated/excluded condition/situation:\r\rObservation.code=ASSERTION; Observation.value",
"identity": "rim"
}, {
"map": "NL-CM:8.2.2",
"comment": "CausativeAgent",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "required",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.2--20200901000000",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AllergyIntoleranceCode"
} ],
"description": "Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies."
},
"alias": [ "Code", "VeroorzakendeStof" ],
"max": "1",
"id": "AllergyIntolerance.code",
"comment": "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, UNII, and ATC. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.\r\rWhen 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.\r\rThe '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.",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.code"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.patient",
"min": 1,
"definition": "The patient who has the allergy or intolerance.",
"isModifier": false,
"short": "Who the sensitivity is for",
"mapping": [ {
"map": "FiveWs.subject[x]",
"identity": "w5"
}, {
"map": "(PID-3)",
"identity": "v2"
}, {
"map": ".participation[typeCode=SBJ].role[classCode=PAT]",
"identity": "rim"
}, {
"map": "FiveWs.subject",
"identity": "w5"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient" ]
} ],
"alias": [ "Patient" ],
"max": "1",
"id": "AllergyIntolerance.patient",
"base": {
"max": "1",
"min": 1,
"path": "AllergyIntolerance.patient"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.encounter",
"min": 0,
"definition": "The encounter when the allergy or intolerance was asserted.",
"isModifier": false,
"short": "Encounter when the allergy or intolerance was asserted",
"mapping": [ {
"map": "FiveWs.context",
"identity": "w5"
}, {
"map": ".inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Encounter" ]
} ],
"max": "1",
"id": "AllergyIntolerance.encounter",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.encounter"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.onset[x]",
"min": 0,
"definition": "Estimated or actual date, date-time, or age when allergy or intolerance was identified.",
"isModifier": false,
"short": "When allergy or intolerance was identified",
"mapping": [ {
"map": "FiveWs.init",
"identity": "w5"
}, {
"map": "effectiveTime.low",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "type"
} ]
},
"type": [ {
"code": "dateTime"
}, {
"code": "Age"
}, {
"code": "Period"
}, {
"code": "Range"
}, {
"code": "string"
} ],
"max": "1",
"id": "AllergyIntolerance.onset[x]",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.onset[x]"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.onset[x]",
"min": 0,
"definition": "The date and time at which the allergy or undesired reaction was determined. This can be an exact date and time, or a rough indication of the date (such as only the year, or the month and the year).",
"isModifier": false,
"short": "StartDateTime",
"mapping": [ {
"map": "FiveWs.init",
"identity": "w5"
}, {
"map": "effectiveTime.low",
"identity": "rim"
}, {
"map": "NL-CM:8.2.6",
"comment": "StartDateTime",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "dateTime"
} ],
"sliceName": "onsetDateTime",
"alias": [ "BeginDatumTijd" ],
"max": "1",
"id": "AllergyIntolerance.onset[x]:onsetDateTime",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.onset[x]"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.recordedDate",
"min": 0,
"definition": "The recordedDate represents when this particular AllergyIntolerance record was created in the system, which is often a system-generated date.",
"isModifier": false,
"short": "Date first version of the resource instance was recorded",
"mapping": [ {
"map": "FiveWs.recorded",
"identity": "w5"
}, {
"map": "IAM-13",
"identity": "v2"
}, {
"map": ".participation[typeCode=AUT].time",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"max": "1",
"id": "AllergyIntolerance.recordedDate",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.recordedDate"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.recorder",
"min": 0,
"definition": "Individual who recorded the record and takes responsibility for its content.",
"isModifier": false,
"short": "Who recorded the sensitivity",
"mapping": [ {
"map": "FiveWs.author",
"identity": "w5"
}, {
"map": ".participation[typeCode=AUT].role",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson" ]
} ],
"alias": [ "Author" ],
"max": "1",
"id": "AllergyIntolerance.recorder",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.recorder"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.asserter",
"min": 0,
"definition": "The source of the information about the allergy that is recorded.",
"isModifier": false,
"short": "Source of the information about the allergy",
"mapping": [ {
"map": "FiveWs.source",
"identity": "w5"
}, {
"map": "IAM-14 (if patient) / IAM-18 (if practitioner)",
"identity": "v2"
}, {
"map": ".participation[typeCode=INF].role",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole" ]
} ],
"alias": [ "Source", "Informant" ],
"max": "1",
"id": "AllergyIntolerance.asserter",
"comment": "The recorder takes responsibility for the content, but can reference the source from where they got it.",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.asserter"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.lastOccurrence",
"min": 0,
"definition": "Entry of the last time a hypersensitive reaction took place.",
"isModifier": false,
"short": "LastReactionDateTime",
"mapping": [ {
"map": "outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)].effectiveTime",
"identity": "rim"
}, {
"map": "NL-CM:8.2.8",
"comment": "LastReactionDateTime",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "dateTime"
} ],
"alias": [ "LaatsteReactieDatumTijd" ],
"max": "1",
"id": "AllergyIntolerance.lastOccurrence",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.lastOccurrence"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.note",
"min": 0,
"definition": "Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.",
"isModifier": false,
"short": "Additional text not captured in other fields",
"mapping": [ {
"map": "subjectOf.observationEvent[code=\"annotation\"].value",
"identity": "rim"
} ],
"type": [ {
"code": "Annotation"
} ],
"max": "1",
"id": "AllergyIntolerance.note",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "AllergyIntolerance.note"
},
"isSummary": false
}, {
"path": "AllergyIntolerance.note.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "AllergyIntolerance.note.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "AllergyIntolerance.note.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"slicing": {
"rules": "open",
"description": "Extensions are always sliced by (at least) url",
"discriminator": [ {
"path": "url",
"type": "value"
} ]
},
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "AllergyIntolerance.note.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.note.author[x]",
"min": 0,
"definition": "The individual responsible for making the annotation.",
"isModifier": false,
"short": "Individual responsible for the annotation",
"mapping": [ {
"map": "N/A",
"identity": "v2"
}, {
"map": "Act.participant[typeCode=AUT].role",
"identity": "rim"
} ],
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/Patient", "http://hl7.org/fhir/StructureDefinition/RelatedPerson", "http://hl7.org/fhir/StructureDefinition/Organization" ]
}, {
"code": "string"
} ],
"max": "1",
"id": "AllergyIntolerance.note.author[x]",
"comment": "Organization is used when there's no need for specific attribution as to who made the comment.",
"base": {
"max": "1",
"min": 0,
"path": "Annotation.author[x]"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.note.time",
"min": 0,
"definition": "Indicates when this particular annotation was made.",
"isModifier": false,
"short": "When the annotation was made",
"mapping": [ {
"map": "N/A",
"identity": "v2"
}, {
"map": "Act.effectiveTime",
"identity": "rim"
} ],
"type": [ {
"code": "dateTime"
} ],
"max": "1",
"id": "AllergyIntolerance.note.time",
"base": {
"max": "1",
"min": 0,
"path": "Annotation.time"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.note.text",
"min": 1,
"definition": "Textual explanation of the hypersensitivity which cannot be entered in any of the other fields.",
"isModifier": false,
"short": "Comment",
"mapping": [ {
"map": "N/A",
"identity": "v2"
}, {
"map": "Act.text",
"identity": "rim"
}, {
"map": "NL-CM:8.2.9",
"comment": "Comment",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "markdown"
} ],
"alias": [ "Toelichting" ],
"max": "1",
"id": "AllergyIntolerance.note.text",
"base": {
"max": "1",
"min": 1,
"path": "Annotation.text"
},
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.reaction",
"min": 0,
"definition": "Details about each adverse reaction event linked to exposure to the identified substance.",
"isModifier": false,
"short": "Reaction",
"mapping": [ {
"map": "outBoundRelationship[typeCode=SUBJ].target[classCode=OBS, moodCode=EVN, code <= CommonClinicalObservationType, value <= ObservationValue (Reaction Type)]",
"identity": "rim"
}, {
"map": "NL-CM:8.2.10",
"comment": "Reaction",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "BackboneElement"
} ],
"alias": [ "Reactie" ],
"max": "*",
"id": "AllergyIntolerance.reaction",
"base": {
"max": "*",
"min": 0,
"path": "AllergyIntolerance.reaction"
},
"isSummary": false
}, {
"path": "AllergyIntolerance.reaction.id",
"min": 0,
"definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
"isModifier": false,
"short": "Unique id for inter-element referencing",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "http://hl7.org/fhirpath/System.String",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
"valueUrl": "string"
} ]
} ],
"representation": [ "xmlAttr" ],
"max": "1",
"id": "AllergyIntolerance.reaction.id",
"base": {
"max": "1",
"min": 0,
"path": "Element.id"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "AllergyIntolerance.reaction.extension",
"min": 0,
"definition": "May be used to represent additional information that is not part of the basic definition of the element. 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 can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.",
"isModifier": false,
"short": "Additional content defined by implementations",
"mapping": [ {
"map": "n/a",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content" ],
"max": "*",
"id": "AllergyIntolerance.reaction.extension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "Element.extension"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
}, {
"key": "ext-1",
"human": "Must have either extensions or value[x], not both",
"xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
"source": "http://hl7.org/fhir/StructureDefinition/Extension",
"severity": "error",
"expression": "extension.exists() != value.exists()"
} ],
"path": "AllergyIntolerance.reaction.modifierExtension",
"requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).",
"min": 0,
"definition": "May 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 in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 can 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.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).",
"isModifier": true,
"short": "Extensions that cannot be ignored even if unrecognized",
"mapping": [ {
"map": "N/A",
"identity": "rim"
} ],
"type": [ {
"code": "Extension"
} ],
"alias": [ "extensions", "user content", "modifiers" ],
"max": "*",
"id": "AllergyIntolerance.reaction.modifierExtension",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "BackboneElement.modifierExtension"
},
"isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them",
"isSummary": true
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.reaction.substance",
"min": 0,
"definition": "More specific indication of the substance that caused the reaction. This can be a specific substance from a group of substances to which the patient is allergic or hypersensitive.",
"isModifier": false,
"short": "SpecificSubstance",
"mapping": [ {
"map": "outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].participation[typeCode=CSM].role[classCode=ADMM].player[classCode=MAT, determinerCode=KIND, code <= ExposureAgentEntityType]",
"identity": "rim"
}, {
"map": "NL-CM:8.2.12",
"comment": "SpecificSubstance",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "required",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.121.11.1--20200901000000",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "SubstanceCode"
} ],
"description": "Codes defining the type of the substance (including pharmaceutical products)."
},
"alias": [ "SpecifiekeStof" ],
"max": "1",
"id": "AllergyIntolerance.reaction.substance",
"comment": "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 identified 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'.",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.reaction.substance"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.reaction.manifestation",
"min": 1,
"definition": "The content specifications of the reaction that takes place when the patient is exposed to the causative substance.",
"isModifier": false,
"short": "Symptom",
"mapping": [ {
"map": "AL1-5",
"identity": "v2"
}, {
"map": "code",
"identity": "rim"
}, {
"map": "NL-CM:8.2.11",
"comment": "Symptom",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "extensible",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.5--20200901000000",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "Manifestation"
} ],
"description": "Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event."
},
"alias": [ "Symptoms", "Signs", "Symptoom" ],
"max": "*",
"id": "AllergyIntolerance.reaction.manifestation",
"comment": "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.",
"base": {
"max": "*",
"min": 1,
"path": "AllergyIntolerance.reaction.manifestation"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.reaction.description",
"min": 0,
"definition": "Textual description of the reaction as a whole.",
"isModifier": false,
"short": "ReactionDescription",
"mapping": [ {
"map": "text",
"identity": "rim"
}, {
"map": "NL-CM:8.2.13",
"comment": "ReactionDescription",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "string"
} ],
"alias": [ "Narrative", "Text", "ReactieBeschrijving" ],
"max": "1",
"id": "AllergyIntolerance.reaction.description",
"comment": "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.",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.reaction.description"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.reaction.onset",
"min": 0,
"definition": "Date and time at which the reaction took place. This may also be just the date or a partial date, in the event that the exact date is unknown.",
"isModifier": false,
"short": "ReactionTime",
"mapping": [ {
"map": "AL1-6",
"identity": "v2"
}, {
"map": "effectiveTime.low",
"identity": "rim"
}, {
"map": "NL-CM:8.2.17",
"comment": "ReactionTime",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "dateTime"
} ],
"alias": [ "ReactieTijdstip" ],
"max": "1",
"id": "AllergyIntolerance.reaction.onset",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.reaction.onset"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.reaction.severity",
"min": 0,
"definition": "The severity of the reaction as a result of exposure to the causative substance.",
"isModifier": false,
"short": "Severity",
"mapping": [ {
"map": "inboundRelationship[typeCode=SUBJ].source[classCode=OBS, moodCode=EVN, code=SEV, value <= SeverityObservation (Severity Level)]",
"identity": "rim"
}, {
"map": "NL-CM:8.2.14",
"comment": "Severity",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "code"
} ],
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1",
"_valueSet": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap",
"valueCanonical": "http://nictiz.nl/fhir/ConceptMap/ErnstCodelijst-to-AllergyIntoleranceSeverity"
} ]
},
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "AllergyIntoleranceSeverity"
} ],
"description": "Use ConceptMap ErnstCodelijst_to_AllergyIntoleranceSeverity to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceSeverity."
},
"alias": [ "Ernst" ],
"max": "1",
"id": "AllergyIntolerance.reaction.severity",
"comment": "It is acknowledged that this assessment is very subjective. There may be some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.reaction.severity"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.reaction.exposureRoute",
"min": 0,
"definition": "Way in which the patient came into contact with the causative agent or the way in which the agent was administered.",
"isModifier": false,
"short": "RouteOfExposure",
"mapping": [ {
"map": "outBoundRelationship[typeCode=SAS].target[classCode=SBADM, code <= ExposureCode].routeCode",
"identity": "rim"
}, {
"map": "NL-CM:8.2.15",
"comment": "RouteOfExposure",
"identity": "zib-allergyintolerance-v3.3-2020EN"
} ],
"type": [ {
"code": "CodeableConcept"
} ],
"binding": {
"strength": "required",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.8.2.12--20200901000000",
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName",
"valueString": "RouteOfAdministration"
} ],
"description": "A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject."
},
"alias": [ "WijzeVanBlootstelling" ],
"max": "1",
"id": "AllergyIntolerance.reaction.exposureRoute",
"comment": "Coding of the route of exposure with a terminology should be used wherever possible.",
"base": {
"max": "1",
"min": 0,
"path": "AllergyIntolerance.reaction.exposureRoute"
},
"isSummary": false
}, {
"constraint": [ {
"key": "ele-1",
"human": "All FHIR elements must have a @value or children",
"xpath": "@value|f:*|h:div",
"source": "http://hl7.org/fhir/StructureDefinition/Element",
"severity": "error",
"expression": "hasValue() or (children().count() > id.count())"
} ],
"path": "AllergyIntolerance.reaction.note",
"min": 0,
"definition": "Additional text about the adverse reaction event not captured in other fields.",
"isModifier": false,
"short": "Text about event not captured in other fields",
"mapping": [ {
"map": "subjectOf.observationEvent[code=\"annotation\"].value",
"identity": "rim"
} ],
"type": [ {
"code": "Annotation"
} ],
"max": "*",
"id": "AllergyIntolerance.reaction.note",
"comment": "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.",
"base": {
"max": "*",
"min": 0,
"path": "AllergyIntolerance.reaction.note"
},
"isSummary": false
} ]
},
"status": "draft",
"id": "20169a9d-de41-4010-ada8-480ee06461c5",
"kind": "resource",
"url": "http://nictiz.nl/fhir/StructureDefinition/nl-core-AllergyIntolerance",
"version": null,
"differential": {
"element": [ {
"id": "AllergyIntolerance",
"path": "AllergyIntolerance",
"alias": [ "nl-core-AllergyIntolerance" ]
}, {
"id": "AllergyIntolerance.patient",
"path": "AllergyIntolerance.patient",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient" ]
} ]
} ]
},
"contact": [ {
"name": "Nictiz",
"telecom": [ {
"use": "work",
"value": "https://www.nictiz.nl",
"system": "url"
} ]
} ],
"baseDefinition": "http://nictiz.nl/fhir/StructureDefinition/zib-AllergyIntolerance"
}