{
"description": "The diagnostic insight that the patient has developed a reaction as a result of exposure to a specific substance or group of substances.",
"_filename": "cio-Reaction.json",
"package_name": "nictiz.fhir.nl.r4.cio",
"date": null,
"derivation": "constraint",
"publisher": "Nictiz",
"fhirVersion": "4.0.1",
"purpose": "This AllergyIntolerance resource represents the Reaction building block for implementations following the information standard [CiO](https://informatiestandaarden.nictiz.nl/wiki/Landingspagina_Contra-indicaties_en_Overgevoeligheden). This profile is based on the Dutch zib ('Zorginformatiebouwsteen', i.e. Health and Care Information Model) Reaction that will be part of the 2024 prepublication. Therefore it has no dependency on a corresponding nl-core profile and mappings to zib concepts are not defined. Instead mappings to the CiO data set have been added. It is the intention to derive this profile from a more general nl-core-Reaction profile in the future.",
"name": "CioReaction",
"mapping": [ {
"uri": "https://decor.nictiz.nl/pub/cio/cio-html-20231214T100742/ds-2.16.840.1.113883.2.4.3.11.60.26.1.2-2020-04-02T000000.html",
"name": "ART-DECOR Dataset Contraindications and hypersensitivities 2.0.0-beta.2 20231214",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"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": "cio Reaction",
"package_version": "1.0.0-beta.2",
"status": "draft",
"id": "b304cb39-27db-4de0-9db6-b1cbc58f4de5",
"kind": "resource",
"url": "http://nictiz.nl/fhir/StructureDefinition/cio-Reaction",
"version": "1.0.0-beta.2",
"differential": {
"element": [ {
"id": "AllergyIntolerance",
"path": "AllergyIntolerance",
"alias": [ "Reactie" ],
"short": "Reaction",
"comment": "Note that not all concepts within the Reaction building block are mapped to elements within this profile. To convey the complete Reaction building block, an AllergyIntolerance resource conforming to this profile SHOULD always be used together with an instance conforming to the [cio-Condition](http://nictiz.nl/fhir/StructureDefinition/cio-Condition) profile, as well as an instance conforming to the [cio-RegistrationData](http://nictiz.nl/fhir/StructureDefinition/cio-RegistrationData) profile wherein `Provenance.target` refers to the AllergyIntolerance and Condition resources.",
"mapping": [ {
"map": "cio-dataelement-20-464",
"comment": "Reaction",
"identity": "cio-dataset-200-beta2-20231214"
} ]
}, {
"id": "AllergyIntolerance.extension",
"min": 3,
"path": "AllergyIntolerance.extension"
}, {
"id": "AllergyIntolerance.extension:type",
"min": 1,
"path": "AllergyIntolerance.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-AllergyIntolerance-Type" ]
} ],
"sliceName": "type"
}, {
"id": "AllergyIntolerance.extension:type.value[x]",
"path": "AllergyIntolerance.extension.value[x]",
"patternCodeableConcept": {
"coding": [ {
"code": "281647001",
"system": "http://snomed.info/sct"
} ]
}
}, {
"id": "AllergyIntolerance.extension:diagnosticInsightDate",
"min": 1,
"path": "AllergyIntolerance.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/allergyintolerance-assertedDate" ]
} ],
"sliceName": "diagnosticInsightDate"
}, {
"id": "AllergyIntolerance.extension:diagnosticInsightDate.value[x]",
"path": "AllergyIntolerance.extension.value[x]",
"alias": [ "DiagnostischInzichtDatum" ],
"short": "DiagnosticInsightDate",
"mapping": [ {
"map": "cio-dataelement-20-811",
"comment": "DiagnosticInsightDate",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "Date (and time) at which the health professional obtained the diagnostic insight."
}, {
"id": "AllergyIntolerance.extension:wayOfDetermination",
"path": "AllergyIntolerance.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-WayOfDetermination" ]
} ],
"sliceName": "wayOfDetermination"
}, {
"id": "AllergyIntolerance.extension:wayOfDetermination.value[x]",
"path": "AllergyIntolerance.extension.value[x]",
"mapping": [ {
"map": "cio-dataelement-20-813",
"comment": "WayOfDetermination",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "The way in which the reaction is determined."
}, {
"id": "AllergyIntolerance.extension:relationCondition",
"min": 1,
"path": "AllergyIntolerance.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-RelationCondition" ]
} ],
"sliceName": "relationCondition"
}, {
"id": "AllergyIntolerance.extension:relationHypersensitivity",
"path": "AllergyIntolerance.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-RelationHypersensitivity" ]
} ],
"sliceName": "relationHypersensitivity"
}, {
"id": "AllergyIntolerance.extension:relationHypersensitivity.value[x]",
"path": "AllergyIntolerance.extension.value[x]",
"mapping": [ {
"map": "cio-dataelement-20-823",
"comment": "RelationHypersensitivity",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "Relation to the underlying hypersensitivity."
}, {
"id": "AllergyIntolerance.extension:relationReaction",
"path": "AllergyIntolerance.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-Reaction.RelationReaction" ]
} ],
"sliceName": "relationReaction"
}, {
"id": "AllergyIntolerance.extension:relationReaction.value[x]",
"path": "AllergyIntolerance.extension.value[x]",
"mapping": [ {
"map": "cio-dataelement-20-879",
"comment": "RelationReaction",
"identity": "cio-dataset-200-beta2-20231214"
} ]
}, {
"id": "AllergyIntolerance.identifier",
"min": 1,
"path": "AllergyIntolerance.identifier",
"alias": [ "Identificatienummer" ],
"short": "IdentificationNumber",
"mapping": [ {
"map": "cio-dataelement-20-780",
"comment": "IdentificationNumber",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "Globally unique number that identifies the instantiation of the information model. The number is composed of an identification of the issuer organization and a unique number assigned by this organization."
}, {
"id": "AllergyIntolerance.clinicalStatus",
"path": "AllergyIntolerance.clinicalStatus",
"alias": [ "AandoeningAanwezigheid" ],
"short": "ConditionPresence",
"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/AandoeningAanwezigheidCodelijst-to-AllergyIntoleranceClinicalStatusCodes"
} ]
},
"description": "Use ConceptMap AandoeningAanwezigheidCodelijst_to_AllergyIntoleranceClinicalStatusCodes to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceClinicalStatusCodes."
},
"mapping": [ {
"map": "cio-dataelement-20-790",
"comment": "ConditionPresence",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "The presence of the condition. This is independent of the diagnostic insight for the condition. The presence status indicates whether the condition is present, no longer present (after having been present) or has been proven not to be present (not having been present)."
}, {
"id": "AllergyIntolerance.clinicalStatus.coding",
"min": 1,
"path": "AllergyIntolerance.clinicalStatus.coding",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "value"
} ]
}
}, {
"id": "AllergyIntolerance.clinicalStatus.coding:conditionPresenceCodelist",
"max": "1",
"min": 1,
"path": "AllergyIntolerance.clinicalStatus.coding",
"binding": {
"strength": "required",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.26.11.20--20231120132919",
"description": "In addition to a coding from this ValueSet, the corresponding coding from the FHIR base ValueSet SHALL be communicated. The ConceptMap can be used to relate these two ValueSets."
},
"sliceName": "conditionPresenceCodelist"
}, {
"id": "AllergyIntolerance.verificationStatus",
"path": "AllergyIntolerance.verificationStatus",
"alias": [ "ZekerheidStatus" ],
"short": "CertaintyStatus",
"binding": {
"strength": "required",
"valueSet": "http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1",
"_valueSet": {
"extension": [ {
"url": "http://hl7.org/fhir/StructureDefinition/11179-permitted-value-conceptmap",
"valueCanonical": "http://nictiz.nl/fhir/ConceptMap/ZekerheidStatusCodelijst-to-AllergyIntoleranceVerificationStatus"
} ]
},
"description": "Use ConceptMap ZekerheidStatusCodelijst_to_AllergyIntoleranceVerificationStatus to translate terminology from the functional model to profile terminology in ValueSet AllergyIntoleranceVerificationStatusCodes."
},
"mapping": [ {
"map": "cio-dataelement-20-812",
"comment": "CertaintyStatus",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "Indicates the conviction of the health professional with respect to the reaction as interpretation of the condition."
}, {
"id": "AllergyIntolerance.verificationStatus.coding",
"min": 1,
"path": "AllergyIntolerance.verificationStatus.coding",
"slicing": {
"rules": "open",
"discriminator": [ {
"path": "$this",
"type": "value"
} ]
}
}, {
"id": "AllergyIntolerance.verificationStatus.coding:certaintyStatusCodelist",
"max": "1",
"min": 1,
"path": "AllergyIntolerance.verificationStatus.coding",
"binding": {
"strength": "required",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.26.11.15--20231120120828",
"description": "In addition to a coding from this ValueSet, the corresponding coding from the FHIR base ValueSet SHALL be communicated. The ConceptMap can be used to relate these two ValueSets."
},
"sliceName": "certaintyStatusCodelist"
}, {
"id": "AllergyIntolerance.type",
"max": "0",
"path": "AllergyIntolerance.type",
"comment": "Due to the required binding on this element it is not possible to use it to indicate that an AllergyIntolerance resource conforming to this profile represents an instance of the Reaction building block. Therefore the `.type` element from R5 (with a preferred binding) is implicitly pre-adopted via the [AllergyIntolerance-Type extension](http://nictiz.nl/fhir/StructureDefinition/ext-AllergyIntolerance-Type)."
}, {
"path": "AllergyIntolerance.code",
"min": 1,
"definition": "The substance that (presumably) caused the reaction.",
"short": "CausativeSubstance",
"mapping": [ {
"map": "cio-dataelement-20-466",
"comment": "CausativeSubstance",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"binding": {
"strength": "required",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.26.11.30--20231129132424"
},
"alias": [ "VeroorzakendeStof" ],
"id": "AllergyIntolerance.code",
"comment": "Strictly speaking the concept CausativeSubstance belongs on `.reaction.substance` (on which it is mapped as well), but since it must be clinically safe to only process the `.code` and ignore the `.reaction.substance`, it has been chosen to map this concept here as well."
}, {
"id": "AllergyIntolerance.patient",
"path": "AllergyIntolerance.patient",
"type": [ {
"code": "Reference",
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Patient", "http://nictiz.nl/fhir/StructureDefinition/nl-core-Patient" ]
} ]
}, {
"id": "AllergyIntolerance.recordedDate",
"path": "AllergyIntolerance.recordedDate",
"alias": [ "RegistratieDatumTijd" ],
"short": "RegistrationDateTime",
"mapping": [ {
"map": "cio-dataelement-20-783",
"comment": "RegistrationDateTime",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "Date and time when the information was recorded in the patient's record."
}, {
"id": "AllergyIntolerance.recorder",
"path": "AllergyIntolerance.recorder",
"type": [ {
"code": "Reference",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/pattern-NlCoreHealthProfessionalReference" ],
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole" ]
} ],
"alias": [ "Auteur" ],
"short": "Author",
"mapping": [ {
"map": "cio-dataelement-20-781",
"comment": "Author",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "The person who is responsible for entering the information in the patient's record."
}, {
"id": "AllergyIntolerance.asserter",
"min": 1,
"path": "AllergyIntolerance.asserter",
"type": [ {
"code": "Reference",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/pattern-NlCoreHealthProfessionalReference" ],
"targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Practitioner", "http://hl7.org/fhir/StructureDefinition/PractitionerRole", "http://nictiz.nl/fhir/StructureDefinition/nl-core-HealthProfessional-PractitionerRole" ]
} ],
"alias": [ "DiagnoseSteller" ],
"short": "Diagnostician",
"mapping": [ {
"map": "cio-dataelement-20-809",
"comment": "Diagnostician",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "The health professional that acquired the diagnostic insight of the reaction. This can be a different individual than the person who recorded the diagnostic insight."
}, {
"id": "AllergyIntolerance.reaction",
"max": "1",
"min": 1,
"path": "AllergyIntolerance.reaction"
}, {
"id": "AllergyIntolerance.reaction.extension:exposureDateTime",
"path": "AllergyIntolerance.reaction.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/openEHR-exposureDate" ]
} ],
"sliceName": "exposureDateTime"
}, {
"id": "AllergyIntolerance.reaction.extension:exposureDateTime.value[x]",
"path": "AllergyIntolerance.reaction.extension.value[x]",
"short": "ExposureDateTime",
"comment": "Ideally, one would use the [openEHR-exposureDescription extension](http://hl7.org/fhir/StructureDefinition/openEHR-exposureDescription) to convey more information regarding the chosen moment of exposure. However, since there is only one Comment concept within the CiO data set, `.reaction.note.text` should be used instead.\r\n\r\nNote that even though this extension states it's related to the 'first exposure', it has been deemed suitable to represent the ExposureDateTime concept based on [this discussion on openEHR Discourse](https://discourse.openehr.org/t/meaning-of-initial-exposure-in-adverse-reaction-event/4679).",
"mapping": [ {
"map": "cio-dataelement-20-817",
"comment": "ExposureDateTime",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "Moment of exposure to the substance. This may be a vague date.\r\n\r\nIf a user would like to provide more information about the chosen moment of exposure, they may use the comment field to do so."
}, {
"id": "AllergyIntolerance.reaction.extension:latencyReaction",
"path": "AllergyIntolerance.reaction.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://nictiz.nl/fhir/StructureDefinition/ext-Reaction.LatencyReaction" ]
} ],
"sliceName": "latencyReaction"
}, {
"id": "AllergyIntolerance.reaction.extension:latencyReaction.value[x]",
"path": "AllergyIntolerance.reaction.extension.value[x]",
"mapping": [ {
"map": "cio-dataelement-20-884",
"comment": "LatencyReaction",
"identity": "cio-dataset-200-beta2-20231214"
} ]
}, {
"id": "AllergyIntolerance.reaction.extension:durationReaction",
"path": "AllergyIntolerance.reaction.extension",
"type": [ {
"code": "Extension",
"profile": [ "http://hl7.org/fhir/StructureDefinition/allergyintolerance-duration" ]
} ],
"sliceName": "durationReaction"
}, {
"id": "AllergyIntolerance.reaction.extension:durationReaction.value[x]",
"path": "AllergyIntolerance.reaction.extension.value[x]",
"alias": [ "TijdsduurReactie" ],
"short": "DurationReaction",
"mapping": [ {
"map": "cio-dataelement-20-885",
"comment": "DurationReaction",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "The length of time during which symptoms of the reaction were present."
}, {
"id": "AllergyIntolerance.reaction.substance",
"min": 1,
"path": "AllergyIntolerance.reaction.substance",
"alias": [ "VeroorzakendeStof" ],
"short": "CausativeSubstance",
"binding": {
"strength": "required",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.26.11.30--20231129132424"
},
"mapping": [ {
"map": "cio-dataelement-20-466",
"comment": "CausativeSubstance",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "The substance that (presumably) caused the reaction."
}, {
"id": "AllergyIntolerance.reaction.manifestation.text",
"min": 1,
"path": "AllergyIntolerance.reaction.manifestation.text",
"alias": [ "ReactieVerschijnsel" ],
"short": "ReactionPhenomenon",
"mapping": [ {
"map": "cio-dataelement-20-465",
"comment": "ReactionPhenomenon",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "The substantive specifications of the reaction (symptoms) that occurs when the patient is exposed to the substance."
}, {
"id": "AllergyIntolerance.reaction.onset",
"min": 1,
"path": "AllergyIntolerance.reaction.onset",
"alias": [ "AandoeningBeginDatumTijd" ],
"short": "ConditionStartDateTime",
"mapping": [ {
"map": "cio-dataelement-20-460",
"comment": "ConditionStartDateTime",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "Date and possibly time when the condition started. One will often use the start date of the first symptom. It may be a vague date."
}, {
"id": "AllergyIntolerance.reaction.exposureRoute",
"path": "AllergyIntolerance.reaction.exposureRoute",
"alias": [ "WijzeVanBlootstelling" ],
"short": "RouteOfExposure",
"binding": {
"strength": "required",
"valueSet": "http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.9.12.1--20200901000000"
},
"mapping": [ {
"map": "cio-dataelement-20-469",
"comment": "RouteOfExposure",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "Way in which the patient came into contact with the causative substance or the way in which the substance was administered."
}, {
"id": "AllergyIntolerance.reaction.note",
"max": "1",
"path": "AllergyIntolerance.reaction.note"
}, {
"id": "AllergyIntolerance.reaction.note.text",
"path": "AllergyIntolerance.reaction.note.text",
"alias": [ "Toelichting" ],
"short": "Comment",
"mapping": [ {
"map": "cio-dataelement-20-818",
"comment": "Comment",
"identity": "cio-dataset-200-beta2-20231214"
} ],
"definition": "Textual explanation of the reaction which cannot be expressed in any of the other fields."
} ]
},
"contact": [ {
"name": "Nictiz",
"telecom": [ {
"use": "work",
"value": "https://www.nictiz.nl",
"system": "url"
} ]
} ],
"baseDefinition": "http://hl7.org/fhir/StructureDefinition/AllergyIntolerance"
}