{ "resourceType": "StructureDefinition", "id": "shr-adverse-ToxicReaction", "text": { "status": "generated", "div": "
\n

SHR ToxicReaction Profile

\n

A grade 3 or 4 adverse reaction to medication, radiation treatment, or other therapy.

\n

SHR Mapping Summary

\n 

shr.adverse.ToxicReaction maps to AdverseEvent:\n  CodeableConcept maps to type \n  Details maps to description\n  Subject maps to subject\n  OccurrenceTime maps to date\n  SeriousAdverseEvent maps to seriousness\n  Outcome maps to outcome\n  Author maps to recorder \n  AdverseEventAttribution maps to suspectEntity.instance\n  AdverseEventAttribution.Certainty maps to suspectEntity.causalityAssessment\t\n  AssociatedStudy maps to study\n

\n
" }, "url": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-adverse-ToxicReaction", "identifier": [ { "system": "http://standardhealthrecord.org", "value": "shr.adverse.ToxicReaction" } ], "version": "0.0.1", "name": "SHR ToxicReaction Profile", "status": "draft", "date": "2017-12-20", "publisher": "The MITRE Corporation: Standard Health Record Collaborative", "contact": [ { "telecom": [ { "system": "url", "value": "http://standardhealthrecord.org" } ] } ], "description": "A grade 3 or 4 adverse reaction to medication, radiation treatment, or other therapy.", "fhirVersion": "3.0.1", "mapping": [ { "identity": "w5", "uri": "http://hl7.org/fhir/w5", "name": "W5 Mapping" }, { "identity": "rim", "uri": "http://hl7.org/v3", "name": "RIM Mapping" } ], "kind": "resource", "abstract": false, "type": "AdverseEvent", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/AdverseEvent", "derivation": "constraint", "snapshot": { "element": [ { "id": "AdverseEvent:shr-adverse-ToxicReaction", "path": "AdverseEvent", "short": "SHR ToxicReaction Profile", "definition": "A grade 3 or 4 adverse reaction to medication, radiation treatment, or other therapy.", "alias": [ "AE" ], "min": 0, "max": "*", "constraint": [ { "key": "dom-2", "severity": "error", "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources", "expression": "contained.contained.empty()", "xpath": "not(parent::f:contained and f:contained)", "source": "DomainResource" }, { "key": "dom-1", "severity": "error", "human": "If the resource is contained in another resource, it SHALL NOT contain any narrative", "expression": "contained.text.empty()", "xpath": "not(parent::f:contained and f:text)", "source": "DomainResource" }, { "key": "dom-4", "severity": "error", "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated", "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()", "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))", "source": "DomainResource" }, { "key": "dom-3", "severity": "error", "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource", "expression": "contained.where(('#'+id in %resource.descendants().reference).not()).empty()", "xpath": "not(exists(for $id in f:contained/*/@id return $id[not(ancestor::f:contained/parent::*/descendant::f:reference/@value=concat('#', $id))]))", "source": "DomainResource" } ], "mapping": [ { "identity": "rim", "map": "Entity. Role, or Act" }, { "identity": "w5", "map": "clinical.general" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.id", "path": "AdverseEvent.id", "short": "Logical id of this artifact", "definition": "The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.", "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.", "min": 0, "max": "1", "base": { "path": "Resource.id", "min": 0, "max": "1" }, "type": [ { "code": "id" } ], "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.meta", "path": "AdverseEvent.meta", "short": "Metadata about the resource", "definition": "The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.", "min": 0, "max": "1", "base": { "path": "Resource.meta", "min": 0, "max": "1" }, "type": [ { "code": "Meta" } ], "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.implicitRules", "path": "AdverseEvent.implicitRules", "short": "A set of rules under which this content was created", "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.", "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. \n\nThis element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.", "min": 0, "max": "1", "base": { "path": "Resource.implicitRules", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "isModifier": true, "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.language", "path": "AdverseEvent.language", "short": "Language of the resource content", "definition": "The base language in which the resource is written.", "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).", "min": 0, "max": "1", "base": { "path": "Resource.language", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet", "valueReference": { "reference": "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 } ], "strength": "extensible", "description": "A human language.", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/languages" } } }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.text", "path": "AdverseEvent.text", "short": "Text summary of the resource, for human interpretation", "definition": "A human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.", "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 in formation is added later.", "alias": [ "narrative", "html", "xhtml", "display" ], "min": 0, "max": "1", "base": { "path": "DomainResource.text", "min": 0, "max": "1" }, "type": [ { "code": "Narrative" } ], "condition": [ "dom-1" ], "mapping": [ { "identity": "rim", "map": "Act.text?" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.contained", "path": "AdverseEvent.contained", "short": "Contained, inline Resources", "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.", "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.", "alias": [ "inline resources", "anonymous resources", "contained resources" ], "min": 0, "max": "*", "base": { "path": "DomainResource.contained", "min": 0, "max": "*" }, "type": [ { "code": "Resource" } ], "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension", "path": "AdverseEvent.extension", "slicing": { "id": "77", "discriminator": [ { "type": "value", "path": "url" } ], "ordered": false, "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:relatedencounter", "path": "AdverseEvent.extension", "sliceName": "relatedencounter", "definition": "If content was generated during a patient encounter, related encounter is the encounter where the information was gained.", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RelatedEncounter-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:informant", "path": "AdverseEvent.extension", "sliceName": "informant", "definition": "The person or entity that provided the information in the entry, as distinct from who created the entry, e.g. the subject (patient), medical professional, family member, device or software program.", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Informant-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:focalsubject", "path": "AdverseEvent.extension", "sliceName": "focalsubject", "definition": "For use when FHIR's subject does not allow the desired type of Subject in the Finding.Subject field.", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubject-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:focalsubjectreference", "path": "AdverseEvent.extension", "sliceName": "focalsubjectreference", "definition": "For use when FHIR's subject does not allow the desired type of Subject in the Finding.Subject field.", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubjectReference-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:findingmethod", "path": "AdverseEvent.extension", "sliceName": "findingmethod", "definition": "The technique used to create the finding, for example, the specific imaging technical, lab test code, or assessment vehicle.", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FindingMethod-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:findingstatus", "path": "AdverseEvent.extension", "sliceName": "findingstatus", "definition": "Indicates whether the finding is preliminary, amended, final, etc..", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FindingStatus-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:evidence", "path": "AdverseEvent.extension", "sliceName": "evidence", "definition": "A symptom, observation, or other item, for example, a radiology report, that serves as evidence for the current assessment.", "min": 0, "max": "*", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-Evidence-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:adverseeventgrade", "path": "AdverseEvent.extension", "sliceName": "adverseeventgrade", "definition": "A coded value specifying the level of injury suffered by the subject for whom the event is reported, using the CTCAE coding system.", "min": 1, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-adverse-AdverseEventGrade-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:adverseeventgrade.id", "path": "AdverseEvent.extension.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:adverseeventgrade.extension:extension", "path": "AdverseEvent.extension.extension", "sliceName": "extension", "short": "Extension", "definition": "An Extension", "min": 0, "max": "0", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:adverseeventgrade.url", "path": "AdverseEvent.extension.url", "representation": [ "xmlAttr" ], "short": "identifies the meaning of the extension", "definition": "Source of the definition for the extension code - a logical name or a 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.", "min": 1, "max": "1", "base": { "path": "Extension.url", "min": 1, "max": "1" }, "type": [ { "code": "uri" } ], "fixedUri": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-adverse-AdverseEventGrade-extension", "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:adverseeventgrade.valueCodeableConcept", "path": "AdverseEvent.extension.valueCodeableConcept", "short": "Value of extension", "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).", "min": 1, "max": "1", "base": { "path": "Extension.value[x]", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "required", "valueSetReference": { "reference": "http://standardhealthrecord.org/shr/adverse/vs/ToxicReactionVS" } }, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory", "path": "AdverseEvent.extension", "sliceName": "causecategory", "definition": "Whether the adverse event is attributed to a treatment, course of the disease, unrelated to either, or unknown.", "min": 1, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-adverse-CauseCategory-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.id", "path": "AdverseEvent.extension.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.extension:extension", "path": "AdverseEvent.extension.extension", "sliceName": "extension", "short": "Extension", "definition": "An Extension", "min": 0, "max": "0", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.url", "path": "AdverseEvent.extension.url", "representation": [ "xmlAttr" ], "short": "identifies the meaning of the extension", "definition": "Source of the definition for the extension code - a logical name or a 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.", "min": 1, "max": "1", "base": { "path": "Extension.url", "min": 1, "max": "1" }, "type": [ { "code": "uri" } ], "fixedUri": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-adverse-CauseCategory-extension", "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept", "path": "AdverseEvent.extension.valueCodeableConcept", "short": "Value of extension", "definition": "Value of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).", "min": 1, "max": "1", "base": { "path": "Extension.value[x]", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "binding": { "strength": "required", "valueSetReference": { "reference": "http://standardhealthrecord.org/shr/adverse/vs/AttributionCategoryVS" } }, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.id", "path": "AdverseEvent.extension.valueCodeableConcept.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.extension", "path": "AdverseEvent.extension.valueCodeableConcept.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.coding", "path": "AdverseEvent.extension.valueCodeableConcept.coding", "slicing": { "id": "76", "discriminator": [ { "type": "value", "path": "path" } ], "ordered": false, "rules": "open" }, "short": "Code defined by a terminology system", "definition": "A reference to a code defined by a terminology system.", "comment": "Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.", "requirements": "Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings.", "min": 0, "max": "*", "type": [ { "code": "Coding" } ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1-8, C*E.10-22" }, { "identity": "rim", "map": "union(., ./translation)" }, { "identity": "orim", "map": "fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.coding:Fixed_treatment", "path": "AdverseEvent.extension.valueCodeableConcept.coding", "sliceName": "Fixed_treatment", "definition": "A reference to a code defined by a terminology system.", "min": 0, "max": "*", "type": [ { "code": "Coding" } ], "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.coding:Fixed_treatment.id", "path": "AdverseEvent.extension.valueCodeableConcept.coding.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.coding:Fixed_treatment.extension", "path": "AdverseEvent.extension.valueCodeableConcept.coding.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "description": "Extensions are always sliced by (at least) url", "rules": "open" }, "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.coding:Fixed_treatment.system", "path": "AdverseEvent.extension.valueCodeableConcept.coding.system", "short": "Identity of the terminology system", "definition": "The identification of the code system that defines the meaning of the symbol in the code.", "comment": "The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.", "requirements": "Need to be unambiguous about the source of the definition of the symbol.", "min": 0, "max": "1", "type": [ { "code": "uri" } ], "fixedUri": "http://standardhealthrecord.org/shr/adverse/cs/AttributionCategoryCS", "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.3" }, { "identity": "rim", "map": "./codeSystem" }, { "identity": "orim", "map": "fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.coding:Fixed_treatment.version", "path": "AdverseEvent.extension.valueCodeableConcept.coding.version", "short": "Version of the system - if relevant", "definition": "The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.", "comment": "Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.", "min": 0, "max": "1", "type": [ { "code": "string" } ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.7" }, { "identity": "rim", "map": "./codeSystemVersion" }, { "identity": "orim", "map": "fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.coding:Fixed_treatment.code", "path": "AdverseEvent.extension.valueCodeableConcept.coding.code", "short": "Symbol in syntax defined by the system", "definition": "A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).", "requirements": "Need to refer to a particular code in the system.", "min": 0, "max": "1", "type": [ { "code": "code" } ], "fixedCode": "treatment", "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.1" }, { "identity": "rim", "map": "./code" }, { "identity": "orim", "map": "fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.coding:Fixed_treatment.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "AdverseEvent.extension.valueCodeableConcept.coding.display", "short": "Representation defined by the system", "definition": "A representation of the meaning of the code in the system, following the rules of the system.", "requirements": "Need to be able to carry a human-readable meaning of the code for readers that do not know the system.", "min": 0, "max": "1", "type": [ { "code": "string" } ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.2 - but note this is not well followed" }, { "identity": "rim", "map": "CV.displayName" }, { "identity": "orim", "map": "fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.coding:Fixed_treatment.userSelected", "path": "AdverseEvent.extension.valueCodeableConcept.coding.userSelected", "short": "If this coding was chosen directly by the user", "definition": "Indicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays).", "comment": "Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.", "requirements": "This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.", "min": 0, "max": "1", "type": [ { "code": "boolean" } ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "Sometimes implied by being first" }, { "identity": "rim", "map": "CD.codingRationale" }, { "identity": "orim", "map": "fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\\#true a [ fhir:source \"true\"; fhir:target dt:CDCoding.codingRationale\\#O ]" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "AdverseEvent.extension.valueCodeableConcept.text", "short": "Plain text representation of the concept", "definition": "A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.", "comment": "Very often the text is the same as a displayName of one of the codings.", "requirements": "The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.", "min": 0, "max": "1", "type": [ { "code": "string" } ], "isSummary": true, "mapping": [ { "identity": "v2", "map": "C*E.9. But note many systems use C*E.2 for this" }, { "identity": "rim", "map": "./originalText[mediaType/code=\"text/plain\"]/data" }, { "identity": "orim", "map": "fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:actiontaken", "path": "AdverseEvent.extension", "sliceName": "actiontaken", "definition": "The action taken as a result of the adverse reaction. May include changing or discontinuing medication, reducing dose, etc.", "min": 0, "max": "*", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-adverse-ActionTaken-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.modifierExtension", "path": "AdverseEvent.modifierExtension", "short": "Extensions that cannot be ignored", "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. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.", "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "isModifier": true, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.identifier", "path": "AdverseEvent.identifier", "short": "Business identifier for the event", "definition": "The identifier(s) of this adverse event that are assigned by business processes and/or used to refer to it when a direct URL reference to the resource itsefl is not appropriate.", "min": 0, "max": "1", "type": [ { "code": "Identifier" } ], "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.category", "path": "AdverseEvent.category", "short": "AE | PAE \rAn adverse event is an event that caused harm to a patient, an adverse reaction is a something that is a subject-specific event that is a result of an exposure to a medication, food, device or environmental substance, a potential adverse event is something that occurred and that could have caused harm to a patient but did not", "definition": "The type of event which is important to characterize what occurred and caused harm to the subject, or had the potential to cause harm to the subject.", "min": 0, "max": "1", "type": [ { "code": "code" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "AdverseEventCategory" } ], "strength": "required", "description": "Overall categorization of the event, e.g. real or potential", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/adverse-event-category" } }, "mapping": [ { "identity": "w5", "map": "class" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.type", "path": "AdverseEvent.type", "short": "actual | potential", "definition": "This element defines the specific type of event that occurred or that was prevented from occurring.", "min": 1, "max": "1", "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "strength": "required", "valueSetReference": { "reference": "http://standardhealthrecord.org/shr/adverse/vs/MedDRAVS" } }, "mapping": [ { "identity": "w5", "map": "what" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.subject", "path": "AdverseEvent.subject", "short": "Subject or group impacted by event", "definition": "This subject or group impacted by the event. With a prospective adverse event, there will be no subject as the adverse event was prevented.", "alias": [ "patient" ], "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-Patient" }, { "code": "Reference", "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-device-Device" } ], "isSummary": true, "mapping": [ { "identity": "w5", "map": "who" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.date", "path": "AdverseEvent.date", "short": "When the event occurred", "definition": "The date (and perhaps time) when the adverse event occurred.", "min": 0, "max": "1", "type": [ { "code": "dateTime" } ], "isSummary": true, "mapping": [ { "identity": "w5", "map": "when.init" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.reaction", "path": "AdverseEvent.reaction", "short": "Adverse Reaction Events linked to exposure to substance", "definition": "Includes information about the reaction that occurred as a result of exposure to a substance (for example, a drug or a chemical).", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition" } ], "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.location", "path": "AdverseEvent.location", "short": "Location where adverse event occurred", "definition": "The information about where the adverse event occurred.", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Location" } ], "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.seriousness", "path": "AdverseEvent.seriousness", "short": "Mild | Moderate | Severe", "definition": "Describes the seriousness or severity of the adverse event.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "strength": "required", "valueSetReference": { "reference": "http://standardhealthrecord.org/shr/core/vs/YesNoUnknownVS" } } }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.outcome", "path": "AdverseEvent.outcome", "short": "resolved | recovering | ongoing | resolvedWithSequelae | fatal | unknown", "definition": "Describes the type of outcome from the adverse event.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "AdverseEventOutcome" } ], "strength": "required", "description": "TODO (and should this be required?)", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/adverse-event-outcome" } } }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.recorder", "path": "AdverseEvent.recorder", "short": "Who recorded the adverse event", "definition": "Information on who recorded the adverse event. May be the patient or a practitioner.", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-Patient" }, { "code": "Reference", "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-RelatedPerson" } ], "isSummary": true, "mapping": [ { "identity": "w5", "map": "who.author" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.eventParticipant", "path": "AdverseEvent.eventParticipant", "short": "Who was involved in the adverse event or the potential adverse event", "definition": "Parties that may or should contribute or have contributed information to the Act. Such information includes information leading to the decision to perform the Act and how to perform the Act (e.g. consultant), information that the Act itself seeks to reveal (e.g. informant of clinical history), or information about what Act was performed (e.g. informant witness).", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Device" } ], "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.description", "path": "AdverseEvent.description", "short": "Description of the adverse event", "definition": "Describes the adverse event in text.", "min": 0, "max": "1", "type": [ { "code": "string" } ], "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.suspectEntity", "path": "AdverseEvent.suspectEntity", "short": "The suspected agent causing the adverse event", "definition": "Describes the entity that is suspected to have caused the adverse event.", "min": 0, "max": "*", "type": [ { "code": "BackboneElement" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() | (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "Element" } ], "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.suspectEntity.id", "path": "AdverseEvent.suspectEntity.id", "representation": [ "xmlAttr" ], "short": "xml:id (or equivalent in JSON)", "definition": "unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.suspectEntity.extension", "path": "AdverseEvent.suspectEntity.extension", "short": "Additional Content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "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.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.suspectEntity.modifierExtension", "path": "AdverseEvent.suspectEntity.modifierExtension", "short": "Extensions that cannot be ignored", "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 that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.", "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.", "alias": [ "extensions", "user content", "modifiers" ], "min": 0, "max": "*", "base": { "path": "BackboneElement.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "isModifier": true, "isSummary": true, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.suspectEntity.instance", "path": "AdverseEvent.suspectEntity.instance", "short": "Refers to the specific entity that caused the adverse event", "definition": "Identifies the actual instance of what caused the adverse event. May be a substance, medication, medication administration, medication statement or a device.", "alias": [ "Substance or Medication or Device" ], "min": 1, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-Substance" } ], "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.suspectEntity.causality", "path": "AdverseEvent.suspectEntity.causality", "short": "causality1 | causality2", "definition": "causality1 | causality2.", "min": 0, "max": "1", "type": [ { "code": "code" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "AdverseEventCausality" } ], "strength": "required", "description": "TODO", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/adverse-event-causality" } } }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.suspectEntity.causalityAssessment", "path": "AdverseEvent.suspectEntity.causalityAssessment", "short": "assess1 | assess2", "definition": "assess1 | assess2.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "strength": "required", "valueSetReference": { "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeValueScaleVS" } } }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.suspectEntity.causalityProductRelatedness", "path": "AdverseEvent.suspectEntity.causalityProductRelatedness", "short": "AdverseEvent.suspectEntity.causalityProductRelatedness", "definition": "AdverseEvent.suspectEntity.causalityProductRelatedness.", "min": 0, "max": "1", "type": [ { "code": "string" } ], "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.suspectEntity.causalityMethod", "path": "AdverseEvent.suspectEntity.causalityMethod", "short": "method1 | method2", "definition": "method1 | method2.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "AdverseEventCausalityMethod" } ], "strength": "example", "description": "TODO", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/adverse-event-causality-method" } } }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.suspectEntity.causalityAuthor", "path": "AdverseEvent.suspectEntity.causalityAuthor", "short": "AdverseEvent.suspectEntity.causalityAuthor", "definition": "AdverseEvent.suspectEntity.causalityAuthor.", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Practitioner" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/PractitionerRole" } ], "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.suspectEntity.causalityResult", "path": "AdverseEvent.suspectEntity.causalityResult", "short": "result1 | result2", "definition": "result1 | result2.", "min": 0, "max": "1", "type": [ { "code": "CodeableConcept" } ], "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "AdverseEventCausalityResult" } ], "strength": "example", "description": "TODO", "valueSetReference": { "reference": "http://hl7.org/fhir/ValueSet/adverse-event-causality-result" } } }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.subjectMedicalHistory", "path": "AdverseEvent.subjectMedicalHistory", "short": "AdverseEvent.subjectMedicalHistory", "definition": "AdverseEvent.subjectMedicalHistory.", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Condition" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Observation" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/AllergyIntolerance" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/FamilyMemberHistory" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Immunization" }, { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/Procedure" } ], "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.referenceDocument", "path": "AdverseEvent.referenceDocument", "short": "AdverseEvent.referenceDocument", "definition": "AdverseEvent.referenceDocument.", "min": 0, "max": "*", "type": [ { "code": "Reference", "targetProfile": "http://hl7.org/fhir/StructureDefinition/DocumentReference" } ], "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.study", "path": "AdverseEvent.study", "short": "AdverseEvent.study", "definition": "AdverseEvent.study.", "min": 0, "max": "1", "type": [ { "code": "Reference", "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-research-Study" } ], "isSummary": true } ] }, "differential": { "element": [ { "id": "AdverseEvent:shr-adverse-ToxicReaction", "path": "AdverseEvent", "short": "SHR ToxicReaction Profile", "definition": "A grade 3 or 4 adverse reaction to medication, radiation treatment, or other therapy." }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:relatedencounter", "path": "AdverseEvent.extension", "sliceName": "relatedencounter", "definition": "If content was generated during a patient encounter, related encounter is the encounter where the information was gained.", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-RelatedEncounter-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:informant", "path": "AdverseEvent.extension", "sliceName": "informant", "definition": "The person or entity that provided the information in the entry, as distinct from who created the entry, e.g. the subject (patient), medical professional, family member, device or software program.", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-base-Informant-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:focalsubject", "path": "AdverseEvent.extension", "sliceName": "focalsubject", "definition": "For use when FHIR's subject does not allow the desired type of Subject in the Finding.Subject field.", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubject-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:focalsubjectreference", "path": "AdverseEvent.extension", "sliceName": "focalsubjectreference", "definition": "For use when FHIR's subject does not allow the desired type of Subject in the Finding.Subject field.", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FocalSubjectReference-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:findingmethod", "path": "AdverseEvent.extension", "sliceName": "findingmethod", "definition": "The technique used to create the finding, for example, the specific imaging technical, lab test code, or assessment vehicle.", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FindingMethod-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:findingstatus", "path": "AdverseEvent.extension", "sliceName": "findingstatus", "definition": "Indicates whether the finding is preliminary, amended, final, etc..", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-FindingStatus-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:evidence", "path": "AdverseEvent.extension", "sliceName": "evidence", "definition": "A symptom, observation, or other item, for example, a radiology report, that serves as evidence for the current assessment.", "min": 0, "max": "*", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-finding-Evidence-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:adverseeventgrade", "path": "AdverseEvent.extension", "sliceName": "adverseeventgrade", "definition": "A coded value specifying the level of injury suffered by the subject for whom the event is reported, using the CTCAE coding system.", "min": 1, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-adverse-AdverseEventGrade-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:adverseeventgrade.valueCodeableConcept", "path": "AdverseEvent.extension.valueCodeableConcept", "binding": { "strength": "required", "valueSetReference": { "reference": "http://standardhealthrecord.org/shr/adverse/vs/ToxicReactionVS" } } }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory", "path": "AdverseEvent.extension", "sliceName": "causecategory", "definition": "Whether the adverse event is attributed to a treatment, course of the disease, unrelated to either, or unknown.", "min": 1, "max": "1", "type": [ { "code": "Extension", "profile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-adverse-CauseCategory-extension" } ] }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept", "path": "AdverseEvent.extension.valueCodeableConcept" }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.coding", "path": "AdverseEvent.extension.valueCodeableConcept.coding", "slicing": { "id": "76", "discriminator": [ { "type": "value", "path": "path" } ], "ordered": false, "rules": "open" } }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.coding:Fixed_treatment", "path": "AdverseEvent.extension.valueCodeableConcept.coding", "sliceName": "Fixed_treatment", "definition": "A reference to a code defined by a terminology system.", "min": 0, "max": "*", "type": [ { "code": "Coding" } ], "isSummary": true }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.coding:Fixed_treatment.system", "path": "AdverseEvent.extension.valueCodeableConcept.coding.system", "fixedUri": "http://standardhealthrecord.org/shr/adverse/cs/AttributionCategoryCS" }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:causecategory.valueCodeableConcept.coding:Fixed_treatment.code", "path": "AdverseEvent.extension.valueCodeableConcept.coding.code", "fixedCode": "treatment" }, { "id": "AdverseEvent:shr-adverse-ToxicReaction.extension:actiontaken", "path": "AdverseEvent.extension", "sliceName": "actiontaken", "definition": "The action taken as a result of the adverse reaction. 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