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HdBe-AllergyIntolerance

CBB	Description	Status
HdBe-AllergyIntolerance	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. The substances can be categorized as follows: Medicine Medicine category Ingredient/addition Nutrition Environmental factor Animal Plants Chemicals Inhaled allergenic Purpose Documenting and communicating allergies and intolerances is an important part of medical registration. It concerns the core of patient safety in general and medication safety in particular. In the execution of research, treatment and care, these patient characteristics constantly have to be taken into account. In principle, allergies and intolerances are also disorders and also could be entered as a problem. Nevertheless, these are usually entered separately. Allergies/Intolerances have a lot in common with warnings (Alert). An important difference is that with allergies and intolerances, a lot of detailed information is recorded on things such as the reactions to the causative substance. Furthermore, not every warning is a problem or medical condition. Evidence Base Complete medicinal allergies are insufficient when it comes to reactions to exposure to food products, items (such as bandages and band-aids), plants and animals. For these items, the standard allows the use of free text or the use of SNOMED CT code. However, no validated value set is currently available for this purpose for SNOMED CT.	active

CBB

Description

Status

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. The substances can be categorized as follows:

Medicine
Medicine category
Ingredient/addition
Nutrition
Environmental factor
Animal
Plants
Chemicals
Inhaled allergenic

Purpose

Documenting and communicating allergies and intolerances is an important part of medical registration. It concerns the core of patient safety in general and medication safety in particular. In the execution of research, treatment and care, these patient characteristics constantly have to be taken into account. In principle, allergies and intolerances are also disorders and also could be entered as a problem. Nevertheless, these are usually entered separately. Allergies/Intolerances have a lot in common with warnings (Alert). An important difference is that with allergies and intolerances, a lot of detailed information is recorded on things such as the reactions to the causative substance. Furthermore, not every warning is a problem or medical condition.

Evidence Base

Complete medicinal allergies are insufficient when it comes to reactions to exposure to food products, items (such as bandages and band-aids), plants and animals. For these items, the standard allows the use of free text or the use of SNOMED CT code. However, no validated value set is currently available for this purpose for SNOMED CT.

active

AllergyIntolerance			AllergyIntolerance	Element id AllergyIntolerance Short description AllergyIntolerance Definition Root concept of the AllergyIntolerance information model. This root concept contains all data elements of the AllergyIntolerance information model. Data type AllergyIntolerance Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id AllergyIntolerance.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
CausativeAgent		1..1	CodeableConceptBinding	Element id AllergyIntolerance.CausativeAgent Short description CausativeAgent Definition Substance, group of substances or environmental factor to which the patient is allergic or hypersensitive. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding Belgian refset for causative agent, no drug CausativeAgent (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
AllergyCategory		0..1	CodeableConceptBinding	Element id AllergyIntolerance.AllergyCategory Short description AllergyCategory Definition Identifies the allergy category such as medication, food or environment. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding AllergyCategory codes AllergyCategory (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
AllergyStatus		0..1	CodeableConceptBinding	Element id AllergyIntolerance.AllergyStatus Short description AllergyStatus Definition Statement on the status of the patient’s hypersensitivity. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding AllergyStatus codes AllergyStatus (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
StartDateTime		0..1	dateTime	Element id AllergyIntolerance.StartDateTime Short description StartDateTime 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). Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
Criticality		0..1	CodeableConceptBinding	Element id AllergyIntolerance.Criticality Short description Criticality 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. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding Criticality codes CriticalExtent (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
LastReactionDateTime		0..1	dateTime	Element id AllergyIntolerance.LastReactionDateTime Short description LastReactionDateTime Definition Entry of the last time a hypersensitive reaction took place. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
Comment		0..1	string	Element id AllergyIntolerance.Comment Short description Comment Definition Textual explanation of the hypersensitivity which cannot be entered in any of the other fields. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
Reaction		0..*	BackboneElement	Element id AllergyIntolerance.Reaction Short description Reaction Definition Container of the Reaction concept. This container contains all data elements of the Reaction concept. Data type BackboneElement Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
id		0..1	string	There are no (further) constraints on this element Element id AllergyIntolerance.Reaction.id Short description Unique id for inter-element referencing Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Data type string Mappings rim: n/a
extension	I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.Reaction.extension Short description Additional content defined by implementations Alternate names extensions, user content 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. Comments 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. Data type Extension Sliced: Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
modifierExtension	Σ ?! I	0..*	Extension	There are no (further) constraints on this element Element id AllergyIntolerance.Reaction.modifierExtension Short description Extensions that cannot be ignored even if unrecognized Alternate names extensions, user content, modifiers 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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). 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. Comments 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. Data type Extension Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()` Mappings rim: n/a rim: N/A
Symptom		1..*	CodeableConceptBinding	Element id AllergyIntolerance.Reaction.Symptom Short description Symptom Definition The content specifications of the reaction that takes place when the patient is exposed to the causative substance. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding Symptom codes Symptom (extensible) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
SpecificSubstance		0..1	CodeableConceptBinding	Element id AllergyIntolerance.Reaction.SpecificSubstance Short description SpecificSubstance 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. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding Belgian refset for causative agent, no drug CausativeAgent (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
ReactionDescription		0..1	string	Element id AllergyIntolerance.Reaction.ReactionDescription Short description ReactionDescription Definition Textual description of the reaction as a whole. Comments Note that FHIR strings SHALL NOT exceed 1MB in size Data type string Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a
Severity		0..1	CodeableConceptBinding	Element id AllergyIntolerance.Reaction.Severity Short description Severity Definition The severity of the reaction as a result of exposure to the causative substance. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding Severity codes CriticalExtent (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
RouteOfExposure		0..1	CodeableConceptBinding	Element id AllergyIntolerance.Reaction.RouteOfExposure Short description RouteOfExposure Definition Way in which the patient came into contact with the causative agent or the way in which the agent was administered. Comments Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. Data type CodeableConcept Binding RouteOfExposure codes RouteOfExposure (required) Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
ReactionTime		0..1	dateTime	Element id AllergyIntolerance.Reaction.ReactionTime Short description ReactionTime 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. Data type dateTime Constraints ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` Mappings rim: n/a

AllergyIntolerance		0..*
AllergyIntolerance.CausativeAgent	CodeableConcept	1..1
AllergyIntolerance.AllergyCategory	CodeableConcept	0..1
AllergyIntolerance.AllergyStatus	CodeableConcept	0..1
AllergyIntolerance.StartDateTime	dateTime	0..1
AllergyIntolerance.Criticality	CodeableConcept	0..1
AllergyIntolerance.LastReactionDateTime	dateTime	0..1
AllergyIntolerance.Comment	string	0..1
AllergyIntolerance.Reaction	BackboneElement	0..*
AllergyIntolerance.Reaction.Symptom	CodeableConcept	1..*
AllergyIntolerance.Reaction.SpecificSubstance	CodeableConcept	0..1
AllergyIntolerance.Reaction.ReactionDescription	string	0..1
AllergyIntolerance.Reaction.Severity	CodeableConcept	0..1
AllergyIntolerance.Reaction.RouteOfExposure	CodeableConcept	0..1
AllergyIntolerance.Reaction.ReactionTime	dateTime	0..1

AllergyIntolerance
Definition	Root concept of the AllergyIntolerance information model. This root concept contains all data elements of the AllergyIntolerance information model.
Cardinality	0...*
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
AllergyIntolerance.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
AllergyIntolerance.extension
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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
AllergyIntolerance.CausativeAgent
Definition	Substance, group of substances or environmental factor to which the patient is allergic or hypersensitive.
Cardinality	1...1
Type	CodeableConcept
Binding	Belgian refset for causative agent, no drug CausativeAgent (required)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
AllergyIntolerance.AllergyCategory
Definition	Identifies the allergy category such as medication, food or environment.
Cardinality	0...1
Type	CodeableConcept
Binding	AllergyCategory codes AllergyCategory (required)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
AllergyIntolerance.AllergyStatus
Definition	Statement on the status of the patient’s hypersensitivity.
Cardinality	0...1
Type	CodeableConcept
Binding	AllergyStatus codes AllergyStatus (required)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
AllergyIntolerance.StartDateTime
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).
Cardinality	0...1
Type	dateTime
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
AllergyIntolerance.Criticality
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.
Cardinality	0...1
Type	CodeableConcept
Binding	Criticality codes CriticalExtent (required)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
AllergyIntolerance.LastReactionDateTime
Definition	Entry of the last time a hypersensitive reaction took place.
Cardinality	0...1
Type	dateTime
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
AllergyIntolerance.Comment
Definition	Textual explanation of the hypersensitivity which cannot be entered in any of the other fields.
Cardinality	0...1
Type	string
Comments	Note that FHIR strings SHALL NOT exceed 1MB in size
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
AllergyIntolerance.Reaction
Definition	Container of the Reaction concept. This container contains all data elements of the Reaction concept.
Cardinality	0...*
Type	BackboneElement
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
AllergyIntolerance.Reaction.id
Definition	Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality	0...1
Type	string
Mappings	rim: n/a
AllergyIntolerance.Reaction.extension
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.
Cardinality	0...*
Type	Extension
Alias	extensions, user content
Comments	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.
Slicing	Unordered, Open, by url(Value)
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
AllergyIntolerance.Reaction.modifierExtension
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. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Cardinality	0...*
Type	Extension
Modifier	True
Summary	True
Alias	extensions, user content, modifiers
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.
Comments	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.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())` ext-1: Must have either extensions or value[x], not both `extension.exists() != value.exists()`
Mappings	rim: n/a rim: N/A
AllergyIntolerance.Reaction.Symptom
Definition	The content specifications of the reaction that takes place when the patient is exposed to the causative substance.
Cardinality	1...*
Type	CodeableConcept
Binding	Symptom codes Symptom (extensible)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
AllergyIntolerance.Reaction.SpecificSubstance
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.
Cardinality	0...1
Type	CodeableConcept
Binding	Belgian refset for causative agent, no drug CausativeAgent (required)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
AllergyIntolerance.Reaction.ReactionDescription
Definition	Textual description of the reaction as a whole.
Cardinality	0...1
Type	string
Comments	Note that FHIR strings SHALL NOT exceed 1MB in size
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a
AllergyIntolerance.Reaction.Severity
Definition	The severity of the reaction as a result of exposure to the causative substance.
Cardinality	0...1
Type	CodeableConcept
Binding	Severity codes CriticalExtent (required)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
AllergyIntolerance.Reaction.RouteOfExposure
Definition	Way in which the patient came into contact with the causative agent or the way in which the agent was administered.
Cardinality	0...1
Type	CodeableConcept
Binding	RouteOfExposure codes RouteOfExposure (required)
Comments	Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a v2: CE/CNE/CWE rim: CD orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
AllergyIntolerance.Reaction.ReactionTime
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.
Cardinality	0...1
Type	dateTime
Invariants	ele-1: All FHIR elements must have a @value or children `hasValue() or (children().count() > id.count())`
Mappings	rim: n/a

Example instances

AllergyIntolerance
CausativeAgent	419442005 - Ethanol (code by SNOMED CT)
AllergyCategory	418471000 - Propensity to adverse reactions to food (code by SNOMED CT)
AllergyStatus	55561003 - Active (code by SNOMED CT)
StartDateTime	2010
criticality	24484000 - Severe (code by SNOMED CT)
LastReactionDateTime	2019-04-21
Comment	Allergic reactions seems to get more severe over time.
reaction	---
reaction.Symptom	126485001 - Urticaria (code by SNOMED CT)
Reaction.SpecificSubstance
Reaction.ReactionDescription
reaction.Severity	24484000 - Severe (code by SNOMED CT)
Reaction.RouteOfExposure	26643006 - Oral route (code by SNOMED CT)
Reaction.ReactionTime	2019-04-21

zib AllergyIntolerance-v3.3 difference

Concept	Category	Description
Description	textual	Removed known issues as they contain Dutch context (G-standard).
`CausativeAgent`	terminology	Replaced existing Codelists with valueSet CausativeAgent which contains Belgian SNOMED refset with code: 751000172100.
`AllergyCategory`	terminology	Added SNOMED CT code for unknown to AllergyCategory valueSet and replaced Other value with SNOMED CT code.
`AllergyStatus`	terminology	Replaced AllergyStatus valueSet values with SNOMED CT codes of active and inactive, which are equal to the values in the AllergyIntolerance-v4.0 2021 pre-adopt version.
`Reaction.Symptom`	terminology	Added SNOMED CT code for unknown to Symptom valueSet and replaced Other value with SNOMED CT code.
`Reaction.Severity`	terminology	Replaced valueSet with CriticalExtent valueSet, which is also used at the `criticality` element, because the codes in the valueset overlap. Morerover, the reaction can not be registered as a fatal reaction too.
`Reaction.SpecificSubstance`	terminology	Replaced existing Codelists with valueSet CausativeAgent which contains Belgian SNOMED refset with code: 751000172100.

Terminology Bindings

Path	Name	Strength	URL
CausativeAgent	CausativeAgent	required	https://fhir.healthdata.be/ValueSet/CausativeAgent
AllergyCategory	AllergyCategory	required	https://fhir.healthdata.be/ValueSet/AllergyCategory
AllergyStatus	AllergyStatus	required	https://fhir.healthdata.be/ValueSet/AllergyStatus
Criticality	CriticalExtent	required	https://fhir.healthdata.be/ValueSet/CriticalExtent
Reaction.Symptom	Symptom	extensible	https://fhir.healthdata.be/ValueSet/Symptom
Reaction.SpecificSubstance	CausativeAgent	required	https://fhir.healthdata.be/ValueSet/CausativeAgent
Reaction.Severity	CriticalExtent	required	https://fhir.healthdata.be/ValueSet/CriticalExtent
Reaction.RouteOfExposure	RouteOfExposure	required	https://fhir.healthdata.be/ValueSet/RouteOfExposure