HL7 FHIR JP Core ImplementationGuide
1.1.0a - ci-build Japan flag

HL7 FHIR JP Core ImplementationGuide - Local Development build (v1.1.0a). See the Directory of published versions

Resource Profile: JP Core AllergyIntolerance Profile

項目内容
定義URL http://jpfhir.jp/fhir/core/StructureDefinition/JP_AllergyIntolerance
Version 1.1.0a
Name

JP_AllergyIntolerance

Title

JP Core AllergyIntolerance Profile

Status Active ( 2022-09-26 )
Copyright

FHIR Japanese implementation research working group in Japan Association of Medical Informatics (JAMI)

このプロファイルはAllergyIntoleranceリソースに対して、患者のアレルギー不耐症に関するデータを送受信するための制約と拡張を定めるものである。


本プロファイルは、患者のアレルギー不耐症とその臨床的な評価を表現するJP_AllergyIntoleranceリソースの記録・更新・検索を行う上で、準拠するべき必須となる要素や、サポートすべき拡張、用語、検索パラメータを定義する。

スコープ

  • JP_AllergyIntoleranceリソースは患者のアレルギー不耐症を表現する。具体的には、特定の物質または物質群への将来の暴露に対して有害反応を起こす傾向、または患者に対する潜在的なリスクを表現する
  • アレルギー不耐症の対象物質は、医薬品(適切な用量で正しく投与された場合)、化学物質、食べ物、植物や動物に由来する物質、または昆虫刺傷からの毒などである

想定シナリオ

本プロファイルは、以下のようなユースケースを想定する。

  • JP_AllergyIntoleranceリソースの記録・更新・検索

プロファイル定義

Usage:

プロファイル詳細

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance 0..*AllergyIntoleranceAllergy or Intolerance (generally: Risk of adverse reaction to a substance). アレルギー不耐症 (特定の物質への暴露で生じた有害反応)
... text 0..1NarrativeText summary of the resource, for human interpretation. このリソースを人間が解釈するためのテキスト要約
... clinicalStatus 0..1CodeableConceptactive | inactive | resolved (アクティブ | 非アクティブ | 解決済み)
... verificationStatus 0..1CodeableConceptunconfirmed | confirmed | refuted | entered-in-error (未確認 | 確認済み | 否定された | 入力エラー)
... type 0..1codeallergy | intolerance - Underlying mechanism (if known) (アレルギー | 不耐症)
... category 0..*codefood | medication | environment | biologic (食品 | 薬品 | 環境 | 生体)
... criticality 0..1codelow | high | unable-to-assess (低い | 高い | 評価できない)
... code 0..1CodeableConceptCode that identifies the allergy or intolerance. このアレルギー不耐症の識別コード
Binding: JP Core AllergyIntolerance ValueSet (example)
... patient 1..1Reference(JP Core Patient Profile)Who the sensitivity is for. このアレルギー不耐症を有する患者
... encounter 0..1Reference(JP Core Encounter Profile)Encounter when the allergy or intolerance was asserted. このアレルギー不耐症が判明した受療の状況(外来、入院、救急、在宅など)
... onset[x] 0..1dateTime, Age, Period, Range, stringWhen allergy or intolerance was identified. このアレルギー不耐症のオンセット
... recordedDate 0..1dateTimeDate first version of the resource instance was recorded. このアレルギー不耐症が初めて記録された日時
... recorder 0..1Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson)Who recorded the sensitivity. 誰がこのアレルギー不耐症を記録したか
... asserter 0..1Reference(JP Core Patient Profile | RelatedPerson | JP Core Practitioner Profile | JP Core PractitionerRole Profile)Source of the information about the allergy. このアレルギー不耐症の情報源
... lastOccurrence 0..1dateTimeDate(/time) of last known occurrence of a reaction. このアレルギー不耐症が最も直近に発生した日時
... note 0..*AnnotationAdditional text not captured in other fields. 他のフィールド要素では記述できない追加テキスト
... reaction 0..*BackboneElementAdverse Reaction Events linked to exposure to substance. このアレルゲンへの暴露に関連する有害反応
.... substance 0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event. 有害反応の原因と考えられる特定の物質または医薬品
.... manifestation 1..*CodeableConceptClinical symptoms/signs associated with the Event. この有害反応に関連する症状や兆候
.... description 0..1stringDescription of the event as a whole. この有害反応に関する全般的な記述
.... onset 0..1dateTimeDate(/time) when manifestations showed. この有害反応がみられた日時
.... severity 0..1codemild | moderate | severe (of event as a whole) (軽度 | 中度 | 重度)
.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance. 患者がこの物質にどのように暴露したか
.... note 0..*AnnotationText about event not captured in other fields. 他のフィールド要素では記述できない追加テキスト

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C0..*AllergyIntoleranceAllergy or Intolerance (generally: Risk of adverse reaction to a substance). アレルギー不耐症 (特定の物質への暴露で生じた有害反応)
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation. このリソースを人間が解釈するためのテキスト要約
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal ids for this item
... clinicalStatus ?!ΣC0..1CodeableConceptactive | inactive | resolved (アクティブ | 非アクティブ | 解決済み)
Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.

... verificationStatus ?!ΣC0..1CodeableConceptunconfirmed | confirmed | refuted | entered-in-error (未確認 | 確認済み | 否定された | 入力エラー)
Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

... type Σ0..1codeallergy | intolerance - Underlying mechanism (if known) (アレルギー | 不耐症)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.

... category Σ0..*codefood | medication | environment | biologic (食品 | 薬品 | 環境 | 生体)
Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.


... criticality Σ0..1codelow | high | unable-to-assess (低い | 高い | 評価できない)
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... code Σ0..1CodeableConceptCode that identifies the allergy or intolerance. このアレルギー不耐症の識別コード
Binding: JP Core AllergyIntolerance ValueSet (example)
... patient Σ1..1Reference(JP Core Patient Profile)Who the sensitivity is for. このアレルギー不耐症を有する患者
... encounter 0..1Reference(JP Core Encounter Profile)Encounter when the allergy or intolerance was asserted. このアレルギー不耐症が判明した受療の状況(外来、入院、救急、在宅など)
... onset[x] 0..1When allergy or intolerance was identified. このアレルギー不耐症のオンセット
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
.... onsetStringstring
... recordedDate 0..1dateTimeDate first version of the resource instance was recorded. このアレルギー不耐症が初めて記録された日時
... recorder 0..1Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson)Who recorded the sensitivity. 誰がこのアレルギー不耐症を記録したか
... asserter Σ0..1Reference(JP Core Patient Profile | RelatedPerson | JP Core Practitioner Profile | JP Core PractitionerRole Profile)Source of the information about the allergy. このアレルギー不耐症の情報源
... lastOccurrence 0..1dateTimeDate(/time) of last known occurrence of a reaction. このアレルギー不耐症が最も直近に発生した日時
... note 0..*AnnotationAdditional text not captured in other fields. 他のフィールド要素では記述できない追加テキスト
... reaction 0..*BackboneElementAdverse Reaction Events linked to exposure to substance. このアレルゲンへの暴露に関連する有害反応
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... substance 0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event. 有害反応の原因と考えられる特定の物質または医薬品
Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).

.... manifestation 1..*CodeableConceptClinical symptoms/signs associated with the Event. この有害反応に関連する症状や兆候
Binding: SNOMEDCTClinicalFindings (example): Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.


.... description 0..1stringDescription of the event as a whole. この有害反応に関する全般的な記述
.... onset 0..1dateTimeDate(/time) when manifestations showed. この有害反応がみられた日時
.... severity 0..1codemild | moderate | severe (of event as a whole) (軽度 | 中度 | 重度)
Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance. 患者がこの物質にどのように暴露したか
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... note 0..*AnnotationText about event not captured in other fields. 他のフィールド要素では記述できない追加テキスト

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
AllergyIntolerance.languagepreferredCommonLanguages
Max Binding: AllLanguages
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
AllergyIntolerance.typerequiredAllergyIntoleranceType
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
AllergyIntolerance.codeexampleJP_AllergyIntolerance_VS
AllergyIntolerance.reaction.substanceexampleSubstanceCode
AllergyIntolerance.reaction.manifestationexampleSNOMEDCTClinicalFindings
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
AllergyIntolerance.reaction.exposureRouteexampleSNOMEDCTRouteCodes

Constraints

IdGradePathDetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
ait-2errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
dom-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: 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()
dom-4errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6Best PracticeAllergyIntoleranceA resource should have narrative for robust management
: text.`div`.exists()
ele-1errorAllergyIntolerance.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorAllergyIntolerance.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorAllergyIntolerance.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorAllergyIntolerance.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorAllergyIntolerance.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.clinicalStatusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.verificationStatusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.categoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.criticalityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.patientAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.encounterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.onset[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.recordedDateAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.recorderAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.asserterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.lastOccurrenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reactionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reaction.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorAllergyIntolerance.reaction.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorAllergyIntolerance.reaction.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorAllergyIntolerance.reaction.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorAllergyIntolerance.reaction.substanceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reaction.manifestationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reaction.descriptionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reaction.onsetAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reaction.severityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reaction.exposureRouteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reaction.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance 0..*AllergyIntoleranceAllergy or Intolerance (generally: Risk of adverse reaction to a substance). アレルギー不耐症 (特定の物質への暴露で生じた有害反応)
... text 0..1NarrativeText summary of the resource, for human interpretation. このリソースを人間が解釈するためのテキスト要約
... clinicalStatus 0..1CodeableConceptactive | inactive | resolved (アクティブ | 非アクティブ | 解決済み)
... verificationStatus 0..1CodeableConceptunconfirmed | confirmed | refuted | entered-in-error (未確認 | 確認済み | 否定された | 入力エラー)
... type 0..1codeallergy | intolerance - Underlying mechanism (if known) (アレルギー | 不耐症)
... category 0..*codefood | medication | environment | biologic (食品 | 薬品 | 環境 | 生体)
... criticality 0..1codelow | high | unable-to-assess (低い | 高い | 評価できない)
... code 0..1CodeableConceptCode that identifies the allergy or intolerance. このアレルギー不耐症の識別コード
Binding: JP Core AllergyIntolerance ValueSet (example)
... patient 1..1Reference(JP Core Patient Profile)Who the sensitivity is for. このアレルギー不耐症を有する患者
... encounter 0..1Reference(JP Core Encounter Profile)Encounter when the allergy or intolerance was asserted. このアレルギー不耐症が判明した受療の状況(外来、入院、救急、在宅など)
... onset[x] 0..1dateTime, Age, Period, Range, stringWhen allergy or intolerance was identified. このアレルギー不耐症のオンセット
... recordedDate 0..1dateTimeDate first version of the resource instance was recorded. このアレルギー不耐症が初めて記録された日時
... recorder 0..1Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson)Who recorded the sensitivity. 誰がこのアレルギー不耐症を記録したか
... asserter 0..1Reference(JP Core Patient Profile | RelatedPerson | JP Core Practitioner Profile | JP Core PractitionerRole Profile)Source of the information about the allergy. このアレルギー不耐症の情報源
... lastOccurrence 0..1dateTimeDate(/time) of last known occurrence of a reaction. このアレルギー不耐症が最も直近に発生した日時
... note 0..*AnnotationAdditional text not captured in other fields. 他のフィールド要素では記述できない追加テキスト
... reaction 0..*BackboneElementAdverse Reaction Events linked to exposure to substance. このアレルゲンへの暴露に関連する有害反応
.... substance 0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event. 有害反応の原因と考えられる特定の物質または医薬品
.... manifestation 1..*CodeableConceptClinical symptoms/signs associated with the Event. この有害反応に関連する症状や兆候
.... description 0..1stringDescription of the event as a whole. この有害反応に関する全般的な記述
.... onset 0..1dateTimeDate(/time) when manifestations showed. この有害反応がみられた日時
.... severity 0..1codemild | moderate | severe (of event as a whole) (軽度 | 中度 | 重度)
.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance. 患者がこの物質にどのように暴露したか
.... note 0..*AnnotationText about event not captured in other fields. 他のフィールド要素では記述できない追加テキスト

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C0..*AllergyIntoleranceAllergy or Intolerance (generally: Risk of adverse reaction to a substance). アレルギー不耐症 (特定の物質への暴露で生じた有害反応)
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... language 0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred): A human language.

Additional BindingsPurpose
AllLanguagesMax Binding
... text 0..1NarrativeText summary of the resource, for human interpretation. このリソースを人間が解釈するためのテキスト要約
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierExternal ids for this item
... clinicalStatus ?!ΣC0..1CodeableConceptactive | inactive | resolved (アクティブ | 非アクティブ | 解決済み)
Binding: AllergyIntoleranceClinicalStatusCodes (required): The clinical status of the allergy or intolerance.

... verificationStatus ?!ΣC0..1CodeableConceptunconfirmed | confirmed | refuted | entered-in-error (未確認 | 確認済み | 否定された | 入力エラー)
Binding: AllergyIntoleranceVerificationStatusCodes (required): Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

... type Σ0..1codeallergy | intolerance - Underlying mechanism (if known) (アレルギー | 不耐症)
Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.

... category Σ0..*codefood | medication | environment | biologic (食品 | 薬品 | 環境 | 生体)
Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.


... criticality Σ0..1codelow | high | unable-to-assess (低い | 高い | 評価できない)
Binding: AllergyIntoleranceCriticality (required): Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

... code Σ0..1CodeableConceptCode that identifies the allergy or intolerance. このアレルギー不耐症の識別コード
Binding: JP Core AllergyIntolerance ValueSet (example)
... patient Σ1..1Reference(JP Core Patient Profile)Who the sensitivity is for. このアレルギー不耐症を有する患者
... encounter 0..1Reference(JP Core Encounter Profile)Encounter when the allergy or intolerance was asserted. このアレルギー不耐症が判明した受療の状況(外来、入院、救急、在宅など)
... onset[x] 0..1When allergy or intolerance was identified. このアレルギー不耐症のオンセット
.... onsetDateTimedateTime
.... onsetAgeAge
.... onsetPeriodPeriod
.... onsetRangeRange
.... onsetStringstring
... recordedDate 0..1dateTimeDate first version of the resource instance was recorded. このアレルギー不耐症が初めて記録された日時
... recorder 0..1Reference(JP Core Practitioner Profile | JP Core PractitionerRole Profile | JP Core Patient Profile | RelatedPerson)Who recorded the sensitivity. 誰がこのアレルギー不耐症を記録したか
... asserter Σ0..1Reference(JP Core Patient Profile | RelatedPerson | JP Core Practitioner Profile | JP Core PractitionerRole Profile)Source of the information about the allergy. このアレルギー不耐症の情報源
... lastOccurrence 0..1dateTimeDate(/time) of last known occurrence of a reaction. このアレルギー不耐症が最も直近に発生した日時
... note 0..*AnnotationAdditional text not captured in other fields. 他のフィールド要素では記述できない追加テキスト
... reaction 0..*BackboneElementAdverse Reaction Events linked to exposure to substance. このアレルゲンへの暴露に関連する有害反応
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... substance 0..1CodeableConceptSpecific substance or pharmaceutical product considered to be responsible for event. 有害反応の原因と考えられる特定の物質または医薬品
Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).

.... manifestation 1..*CodeableConceptClinical symptoms/signs associated with the Event. この有害反応に関連する症状や兆候
Binding: SNOMEDCTClinicalFindings (example): Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.


.... description 0..1stringDescription of the event as a whole. この有害反応に関する全般的な記述
.... onset 0..1dateTimeDate(/time) when manifestations showed. この有害反応がみられた日時
.... severity 0..1codemild | moderate | severe (of event as a whole) (軽度 | 中度 | 重度)
Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

.... exposureRoute 0..1CodeableConceptHow the subject was exposed to the substance. 患者がこの物質にどのように暴露したか
Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

.... note 0..*AnnotationText about event not captured in other fields. 他のフィールド要素では記述できない追加テキスト

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet
AllergyIntolerance.languagepreferredCommonLanguages
Max Binding: AllLanguages
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
AllergyIntolerance.typerequiredAllergyIntoleranceType
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
AllergyIntolerance.codeexampleJP_AllergyIntolerance_VS
AllergyIntolerance.reaction.substanceexampleSubstanceCode
AllergyIntolerance.reaction.manifestationexampleSNOMEDCTClinicalFindings
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
AllergyIntolerance.reaction.exposureRouteexampleSNOMEDCTRouteCodes

Constraints

IdGradePathDetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
ait-2errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
dom-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: 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()
dom-4errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6Best PracticeAllergyIntoleranceA resource should have narrative for robust management
: text.`div`.exists()
ele-1errorAllergyIntolerance.metaAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.implicitRulesAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.languageAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.textAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorAllergyIntolerance.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorAllergyIntolerance.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorAllergyIntolerance.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorAllergyIntolerance.identifierAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.clinicalStatusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.verificationStatusAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.typeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.categoryAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.criticalityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.codeAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.patientAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.encounterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.onset[x]All FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.recordedDateAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.recorderAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.asserterAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.lastOccurrenceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reactionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reaction.extensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorAllergyIntolerance.reaction.extensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorAllergyIntolerance.reaction.modifierExtensionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1errorAllergyIntolerance.reaction.modifierExtensionMust have either extensions or value[x], not both
: extension.exists() != value.exists()
ele-1errorAllergyIntolerance.reaction.substanceAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reaction.manifestationAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reaction.descriptionAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reaction.onsetAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reaction.severityAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reaction.exposureRouteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ele-1errorAllergyIntolerance.reaction.noteAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())

 

Other representations of profile: CSV, Excel, Schematron

必須要素

本プロファイルに準拠するためには、次の項目の値が存在しなければならない。

  • patient : 本リソースを所有する患者

Extensions定義

本プロファイルで追加定義された拡張はない。

利用方法

OperationおよびSearch Parameter 一覧

Search Parameter一覧

コンフォーマンス パラメータ
SHALL identifier token GET [base]/AllergyIntolerance?identifier=http://myhospital.com/fhir/allergyintolerance|123
SHOULD patient reference GET [base]/AllergyIntolerance?patient=Patient/123
MAY patient,date reference,date GET [base]/AllergyIntolerance?patient=Patient/123&date=ge2021-08-24
MAY patient,clinicalstatus reference,code GET [base]/AllergyIntolerance?patient=Patient/123&clinicalstatus=active
MAY patient,verificationstatus reference,code GET [base]/AllergyIntolerance?patient=Patient/123&verificationstatus=confirmed
MAY patient,type reference,code GET [base]/AllergyIntolerance?patient=Patient/123&type=allergy
MAY patient,category reference,code GET [base]/AllergyIntolerance?patient=Patient/123&category=food
MAY patient,criticality reference,code GET [base]/AllergyIntolerance?patient=Patient/123&criticality=high
必須検索パラメータ

本プロファイルに準拠するためには、以下の検索パラメータをサポートしなければならない(SHALL

  1. 検索パラメータidentifierを指定し、レコードIDなどの識別子によりAllergyIntoleranceを検索

    GET [base]/AllergyIntolerance?identifier={system|}[code]
    

    例:

    GET [base]/AllergyIntolerance?identifier=http://myhospital.com/fhir/allergyintolerance|123
    

    指定された識別子に一致するAllergyIntoleranceリソースを含むBundleを検索する。

推奨検索パラメータ

本プロファイルに準拠するためには、以下の検索パラメータをサポートすることが推奨される(SHOULD)

  1. 検索パラメータpatientを指定し、該当するすべてのAllergyIntoleranceを検索

    GET [base]/AllergyIntolerance?patient={reference}
    

    例:

    GET [base]/AllergyIntolerance?patient=Patient/123
    

    指定された患者のすべてのAllergyIntoleranceを含むBundleを返却する。

追加検索パラメータ

オプションとして次の検索パラメータをサポートすることができる(MAY)

  1. 検索パラメータpatientとdateの組みを指定し、該当するすべてのAllergyIntoleranceを検索

    • dateに対する次の比較演算子のサポートを含む: gt,lt,ge,le
    • AND検索のオプションのサポートを含む (例えば.date=[date]&date=[date]]&…)
     GET [base]/AllergyIntolerance?patient={reference}&date={gt|lt|ge|le}[date]{&date={gt|lt|ge|le}[date]&...}
    

    例:

     GET [base]/AllergyIntolerance?patient=Patient/123&date=ge2021-08-24
    

    指定された患者および日付のすべてのAllergyIntoleranceを含むBundleを返却する。

  2. 検索パラメータpatientとclinicalstatusの組みを指定し、該当するすべてのAllergyIntoleranceを検索

    • OR検索のサポートを含む(例えば clinicalstatus={system|}[code],{system|}[code],…)
     GET [base]/AllergyIntolerance?patient={reference}&clinicalstatus={system|}[code]{,{system|}[code],...}
    

    例:

     GET [base]/AllergyIntolerance?patient=Patient/123&clinicalstatus=active
    
     GET [base]/AllergyIntolerance?patient=Patient/123&clinicalstatus=http://hl7.org/fhir/ValueSet/allergyintoleranceclinical|active
    

    指定された患者およびステータスのすべてのAllergyIntoleranceを含むBundleを返却する。

  3. 検索パラメータpatientとverificationstatus組みを指定し、該当するすべてのAllergyIntoleranceを検索

    • OR検索のサポートを含む(例えば verificationstatus={system|}[code],{system|}[code],…)
     GET [base]/AllergyIntolerance?patient={reference}&verificationstatus={system|}[code]{,{system|}[code],...}
    

    例:

     GET [base]/AllergyIntolerance?patient=Patient/123&verificationstatus=confirmed
    
     GET [base]/AllergyIntolerance?patient=Patient/123&verificationstatus=http://hl7.org/fhir/ValueSet/allergyintoleranceverification|confirmed
    

    指定された患者およびステータスのすべてのAllergyIntoleranceを含むBundleを返却する。

  4. 検索パラメータpatientとtype組みを指定し、該当するすべてのAllergyIntoleranceを検索

    • OR検索のサポートを含む(例えば type={system|}[code],{system|}[code],…)
     GET [base]/AllergyIntolerance?patient={reference}&type={system|}[code]{,{system|}[code],...}
    

    例:

     GET [base]/AllergyIntolerance?patient=Patient/123&type=allergy
    
     GET [base]/AllergyIntolerance?patient=Patient/123&category=http://hl7.org/fhir/ValueSet/allergy-intolerance-type|allergy
    

    指定された患者およびステータスのすべてのAllergyIntoleranceを含むBundleを返却する。

  5. 検索パラメータpatientとcategory組みを指定し、該当するすべてのAllergyIntoleranceを検索

    • OR検索のサポートを含む(例えば category={system|}[code],{system|}[code],…)
     GET [base]/AllergyIntolerance?patient={reference}&category={system|}[code]{,{system|}[code],...}
    

    例:

     GET [base]/AllergyIntolerance?patient=Patient/123&category=food
    
     GET [base]/AllergyIntolerance?patient=Patient/123&category=http://hl7.org/fhir/ValueSet/condition-category|food
    

指定された患者およびステータスのすべてのAllergyIntoleranceを含むBundleを返却する。

  1. 検索パラメータpatientとcriticality組みを指定し、該当するすべてのAllergyIntoleranceを検索

    • OR検索のサポートを含む(例えば criticality={system|}[code],{system|}[code],…)

      GET [base]/AllergyIntolerance?patient={reference}&criticality={system|}[code]{,{system|}[code],...}
      

      例:

      GET [base]/AllergyIntolerance?patient=Patient/123&&criticality=high
      
      GET [base]/AllergyIntolerance?patient=Patient/123&criticality=http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|high
      

      指定された患者およびステータスのすべてのAllergyIntoleranceを含むBundleを返却する。

オプション検索パラメータ

本プロファイルで追加定義されたオプション検索パラメータはない。

サンプル

注意事項

  • 例えば、患者に「既知のアレルギー・なし」が記録されている状態で、新規に「カニアレルギー・あり」の記録を追加する際には「既知のアレルギー・なし」の記録を削除すべきである。同様に、患者に「カニアレルギー・あり」が記録されている状態で「既知のアレルギー・なし」を記録しようとした際には、システムはこの矛盾を検出するべきである。
  • アレルギーの否定を表現する方法について。本プロファイルが継承するプロファイル(AllergyIntolerance R4.0.1)では「既知のアレルギー・なし」を表現するために、No known allergy(SNOMED-CT:716186003)等を用いることが例示されている。一方で、本プロファイルの要素であるcodeのバインド先として例示するJP Core AllergyIntolerance Value Setには「既知のアレルギー・なし」等に相当する表現がない。そのため、本プロファイルを継承するプロファイルが、JP Core AllergyIntolerance Value Setを利用する場合には、否定されたアレルギーを表現するために、アレルギーの有無を区別する要素を追加するなどの措置を取ることを想定している。なお、本プロファイルはこのValue Setの利用を要求・推奨するものではないため、他のValue Setを使う選択肢もある。
  • いずれについても詳細は、Negated Allergies and Intolerancesを参照のこと。