{
  "resourceType": "StructureDefinition",
  "id": "shr-adverse-ToxicReaction",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>SHR ToxicReaction Profile</b></p>\n  <p>A grade 3 or 4 adverse reaction to medication, radiation treatment, or other therapy.</p>\n  <p><b>SHR Mapping Summary</b></p>\n  <p><pre>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</pre></p>\n</div>"
  },
  "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",
  "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. 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.type",
        "path": "AdverseEvent.type",
        "min": 1,
        "max": "1",
        "binding": {
          "strength": "required",
          "valueSetReference": {
            "reference": "http://standardhealthrecord.org/shr/adverse/vs/MedDRAVS"
          }
        }
      },
      {
        "id": "AdverseEvent:shr-adverse-ToxicReaction.subject",
        "path": "AdverseEvent.subject",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-Patient"
          },
          {
            "code": "Reference",
            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-device-Device"
          }
        ]
      },
      {
        "id": "AdverseEvent:shr-adverse-ToxicReaction.seriousness",
        "path": "AdverseEvent.seriousness",
        "binding": {
          "strength": "required",
          "valueSetReference": {
            "reference": "http://standardhealthrecord.org/shr/core/vs/YesNoUnknownVS"
          }
        }
      },
      {
        "id": "AdverseEvent:shr-adverse-ToxicReaction.recorder",
        "path": "AdverseEvent.recorder",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-Patient"
          },
          {
            "code": "Reference",
            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-RelatedPerson"
          }
        ]
      },
      {
        "id": "AdverseEvent:shr-adverse-ToxicReaction.suspectEntity",
        "path": "AdverseEvent.suspectEntity"
      },
      {
        "id": "AdverseEvent:shr-adverse-ToxicReaction.suspectEntity.instance",
        "path": "AdverseEvent.suspectEntity.instance",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-entity-Substance"
          }
        ]
      },
      {
        "id": "AdverseEvent:shr-adverse-ToxicReaction.suspectEntity.causalityAssessment",
        "path": "AdverseEvent.suspectEntity.causalityAssessment",
        "binding": {
          "strength": "required",
          "valueSetReference": {
            "reference": "http://standardhealthrecord.org/shr/core/vs/QualitativeValueScaleVS"
          }
        }
      },
      {
        "id": "AdverseEvent:shr-adverse-ToxicReaction.study",
        "path": "AdverseEvent.study",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": "http://standardhealthrecord.org/fhir/StructureDefinition/shr-research-Study"
          }
        ]
      }
    ]
  }
}