臺灣核心實作指引(TW Core IG)
0.3.2 - Trial Use

This page is part of the 臺灣核心實作指引(TW Core IG) (v0.3.2: Releases) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

Resource Profile: TW Core AllergyIntolerance

Official URL: https://twcore.mohw.gov.tw/ig/twcore/StructureDefinition/AllergyIntolerance-twcore Version: 0.3.2
Active as of 2024-12-12 Computable Name: TWCoreAllergyIntolerance

此臺灣核心-過敏或不耐症（TW Core AllergyIntolerance） Profile說明本IG如何進一步定義FHIR的AllergyIntolerance Resource以呈現過敏與不耐症的詳細資料。

Resource AllergyIntolerance - 內容

這是指一個人在接觸某種物質後，可能會出現的對該個人來說獨有的有害或不想要的生理反應的風險。

範圍與使用

這是一份關於臨床評估過敏或不耐症的紀錄；一個人對於在未來接觸特定物質或類別物質時，可能出現不良反應的傾向或潛在風險。

當這種傾向被識別出來時，會記錄有關反應事件的資訊或證據，該事件是由於個人接觸已識別的物質或類別物質而觸發的，特點是對該個人來說特有的有害或不希望的生理反應。

物質包括但不限於：對個人以適當劑量正確施用的治療性物質、食物、從植物或動物中提取的材料（material）、或昆蟲叮咬的毒液。

國際HL7給FHIR審稿人的注意事項，實作者亦可留意

目前這個 resource （R4版） 面臨的開放性問題包括：

  • 這個 resource 代表一種對某些物質的過敏狀態，包含支援事件和（或）症狀的清單，但與事件通報沒有直接關係；當 FHIR 中加入不良事件通報 resource（s）和（或） profiles 時，將重新評估此事。
  • 其他的 HL7 模型和 openEHR archetype 包含了「暴露日期（exposure date）」，但在調查的任何系統中都未發現此資料項目，因此它將被當作一個擴充資料項目（更適合於不良事件通報）。

界限與關聯

這個 resource 提供一個統一的位置，在健康紀錄中記錄關於對某些物質或產品的不良反應的各種臨床描述，包括：

  • 評估個人在再次接觸時可能會有的潛在反應
  • 紀錄每次接觸後反應的詳細資訊，如果沒有反應也要記錄下來

使用這個 resource 來記錄有關不良反應風險存在的資訊，目的是：

  • 支援個人的直接臨床照護
  • 作為管理不良反應或過敏/不耐症清單的一部分
  • 促進有關不良反應傾向和事件的資訊交流
  • 幫助通報不良反應
  • 支援如臨床決策支援和警示等電腦化的基於知識的活動

用於記錄對廣泛物質的不良反應資訊，包括：生物和血品、藥物製劑中的賦形劑（Excipients）、食物、金屬鹽、以及有機化學化合物。

不良反應可能是：

  • 過敏（通常是I型過敏反應，加上其他「類過敏」反應，包括偽過敏）
  • 不耐症（通常是非免疫性的不良反應，這些反應沒有被確定或認為是過敏或「類過敏」的，並且在某種程度上是特異性的或個別特有的[即在類似情況下，並非預期會在大多數或所有病人中發生的反應]）

在臨床實務中，區分過敏或不耐症是困難的，可能也不實際。通常「過敏」一詞被相當泛化地使用，可能與「不耐症」重疊，這兩個概念之間的界限可能不是很明確或被理解。如上所述，「不耐症」一詞通常應用於不良反應的傾向，這種傾向要麼被確定（在可能的範圍內），要麼被認為不是過敏或「類過敏」的。如果無法確定某個特定的傾向狀態是過敏還是不耐症，那麼應該從 resource 中省略該類型（type）資料項目。識別反應的type不代表對病人的嚴重性或傷害風險的評估，若要進行這類的評估，應該透過記錄臨床表現和評估危急程度來明確表達。

每個人對過敏或不耐症的敏感性是獨特的，這與食物或藥物的毒性、過量、藥物間的交互作用等情況引起的反應不同（這些是在相同情況下任何人都可能發生的反應）。

在沒有識別出可能導致的物質（包括藥品產品）或物質類別的情況下，不應記錄不良反應事件或表現的風險。如果不確定某一特定物質是原因，可以使用「verificationStatus」資料項目來記錄這種不確定性。如果有多個可能的物質可能導致反應/表現，則應為每種物質使用這個 resource 的單獨實例進行記錄，並將「verificationStatus」設定為「未確認（unconfirmed）」，以便在臨床系統中支援不良反應檢查。如果後來證明某種物質、劑量或類別不是某一反應的原因，則「verificationStatus」可以修改為「否認其正確性/已駁斥（refuted）」。

這個 resource 旨在允許記錄關於特定物質（例如：阿莫西林、牡蠣或蜜蜂蜇傷毒素）或藥品產品，或者物質的類別（例如：青霉素）的資訊。如果記錄了物質類別，則可以根據每次接觸的情況記錄確切的物質。

這個 FHIR resource 的範圍專注於識別一個在大多數臨床系統中使用或適合大多數常見臨床情境的實用資料集；如果需要，可以使用擴充資料項目來添加更多細節。在需要擴充的臨床情況包括：詳細的過敏科/免疫科評估、通報給監管機構、或在臨床試驗中使用等。

在健康記錄裡記錄任何不良反應涉及臨床評估，評估的是如果個人將來再次接觸到相同的物質/產品/類別時，可能會面臨的潛在風險。換句話說，這相當於一個相對的不宜使用提示，如果沒有更多資訊顯示更高的潛在風險，則應將預設的「危急程度（criticality）」設定為「低風險（Low Risk）」。如果醫生認為讓個人再次接觸該物質/產品不安全，比如發生生命威脅的過敏性休克，那麼「危急程度（criticality）」應該改為「高風險（High Risk）」。

向監管機構提交的正式不良事件報告是一份包含了除了不良反應具體細節外還有廣泛資訊的文件。這份報告可以使用這個 resource 的部分內容，並根據不同地區的要求添加額外資料。

不良反應或過敏/不耐症清單是記錄了個人對未來接觸某物質、產品、類別時所有已識別的不良反應傾向，並提供了查看每次反應事件細節（例如：反應表現）的機會。

當臨床醫生需要評估未來反應的可能性時，第一手重要資訊包括：

  • 關於之前接觸後臨床表現的聲明
  • 資訊/報告來源
  • 「危急程度」標記

從每次接觸事件中，我們可以獲得更進一步的資訊，並且如果記錄中有的話，還可以連接到其他的詳細資訊，如病史、檢查和診斷等。

過敏不耐症與風險評估

AllergyIntolerance 描述的是對某種物質或產品有反應的特定風險類型，而風險評估（RiskAssessment） 則是針對個人的一般風險，這種風險通常不是基於某種反應。

過敏或不耐症與免疫接種反應

疫描接種反應（Immunization.reaction） 可能表示某人對某物質過敏或不耐症。如果確定是這樣的情況，應該另外創建一筆過敏或不耐症（AllergyIntolerance）紀錄來指出這一點，因為大部分系統不會去查詢過去的疫苗接種反應。

注意誤用的情況

  • 過敏或不耐症清單是為了保障病人安全而設，用來在開藥和安排飲食時提供決策支援，並指導臨床治療。但是那些由如光、熱、冷、壓力、振動等物理刺激引發的反應，這些可能看起來像是過敏或不耐症反應，應該在問題清單中作為病情、問題或診斷（Condition）紀錄，而不是用過敏或不耐症（AllergyIntolerance）來記錄。
  • 不應該用來記錄不良事件，這包括臨床流程、介入措施或產品的失敗情況。例如：錯誤使用藥物或物質、給藥劑量不正確、標籤錯誤、因介入措施或處置導致的傷害、藥品過量/中毒等情況。
  • 不應作為不良事件報告的代用品。如上所述，它可以作為不良事件報告的一部分使用。
  • 不適合用來記錄警示。警示應該使用標記（Flag） 或在涉及特定事件時，使用檢測到的問題（DetectedIssue）。
  • 不應用於記錄治療無效的情況。

這個 resource 被 醫療不良事件（AdverseEvent）、臨床臆斷（ClinicalImpression）、家庭成員病史（FamilyMemberHistory） 和 營養醫令（NutritionOrder）參照。

Usage:

Formal Views of Profile Content

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

This structure is derived from AllergyIntolerance

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance 0..* AllergyIntolerance 過敏或不耐症（通常指：對某種物質有不良反應的風險）
... id 0..1 id 不重複的ID用以識別儲存在特定FHIR Server中的AllergyIntolerance紀錄，通常又稱為邏輯性ID。
... meta 0..1 Meta 此AllergyIntolerance Resource的metadata
... implicitRules 0..1 uri 創建此內容所依據的一組規則
... text 0..1 Narrative AllergyIntolerance Resource之內容摘要以供人閱讀
... identifier 0..* Identifier 過敏或不耐症之外部識別碼
... clinicalStatus S 0..1 CodeableConceptTW active | inactive | resolved ，過敏或不耐症的臨床狀態。
Binding: AllergyIntoleranceClinicalStatusCodes (required): 應填入所綁定值集中的其中一個代碼。

... verificationStatus S 0..1 CodeableConceptTW unconfirmed | confirmed | refuted | entered-in-error ，一個人對特定物質產生反應的可能性或風險有多確定的陳述。
Binding: AllergyIntoleranceVerificationStatusCodes (required): 應填入所綁定值集中的其中一個代碼。

... type 0..1 code allergy | intolerance - 根本原因或運作機制（如果知道）。
Binding: AllergyIntoleranceType (required): 確定反應風險的基本生理機制；應填入所綁定值集中的其中一個代碼。

... category 0..* code food | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): 確定的物質的類別；應填入所綁定值集中的其中一個代碼。

... criticality 0..1 code low | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): 對已識別物質的反應的潛在臨床危害程度，或稱嚴重性估計；應填入所綁定值集中的其中一個代碼。

... code S 1..1 CodeableConceptTW 表明此過敏或不耐症的代碼
Binding: AllergyIntoleranceSubstance/Product,ConditionAndNegationCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

... patient S 1..1 Reference(TW Core Patient) 誰有此過敏或不耐受？
... encounter 0..1 Reference(TW Core Encounter) 過敏或不耐症被確認時的就醫事件(Encounter)
... onset[x] 0..1 dateTime, Age, Period, Range, string 過敏或不耐症被識別的時間
... recordedDate S 0..1 dateTime resource實例的第一個版本被記錄的日期
... recorder S 0..1 Reference(TW Core Practitioner | TW Core PractitionerRole | TW Core Patient | TW Core RelatedPerson) 誰記錄了過敏或不耐受
... asserter 0..1 Reference(TW Core Patient | TW Core RelatedPerson | TW Core Practitioner | TW Core PractitionerRole) 關於過敏的資訊來源
... lastOccurrence 0..1 dateTime 最後一次已知反應發生的日期（/時間）
... note S 0..* Annotation 其他欄位中沒有記錄的額外文字陳述
... reaction S 0..* BackboneElement 暴露於此過敏或不耐症物質的不良反應
.... substance 0..1 CodeableConceptTW 被認為是事件原因的特定物質或醫藥產品
Binding: SubstanceCode (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

.... manifestation S 1..* CodeableConceptTW 與此事件相關的臨床症狀/體徵
Binding: SNOMEDCTClinicalFindings (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

.... description 0..1 string 對整個活動的描述
.... onset 0..1 dateTime 症狀顯現的日期（/時間）
.... severity 0..1 code mild | moderate | severe
Binding: AllergyIntoleranceSeverity (required): 整個事件的程度，應填入所綁定值集中的其中一個代碼。

.... exposureRoute 0..1 CodeableConceptTW 此對象如何接觸到該物質
Binding: SNOMEDCTRouteCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

.... note 0..* Annotation 其他資料項目未記錄之關於事件的文字表述

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
AllergyIntolerance.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1
from the FHIR Standard
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1
from the FHIR Standard
AllergyIntolerance.typerequiredAllergyIntoleranceType
http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
from the FHIR Standard
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1
from the FHIR Standard
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1
from the FHIR Standard
AllergyIntolerance.codeextensibleAllergyIntoleranceSubstance/Product,ConditionAndNegationCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-code
from the FHIR Standard
AllergyIntolerance.reaction.substanceextensibleSubstanceCode
http://hl7.org/fhir/ValueSet/substance-code
from the FHIR Standard
AllergyIntolerance.reaction.manifestationextensibleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
from the FHIR Standard
AllergyIntolerance.reaction.exposureRouteextensibleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard
NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C 0..* AllergyIntolerance 過敏或不耐症（通常指：對某種物質有不良反應的風險）
ait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
... id Σ 0..1 id 不重複的ID用以識別儲存在特定FHIR Server中的AllergyIntolerance紀錄，通常又稱為邏輯性ID。
... meta Σ 0..1 Meta 此AllergyIntolerance Resource的metadata
ele-1: All FHIR elements must have a @value or children
... implicitRules ?!Σ 0..1 uri 創建此內容所依據的一組規則
ele-1: All FHIR elements must have a @value or children
... text 0..1 Narrative AllergyIntolerance Resource之內容摘要以供人閱讀
ele-1: All FHIR elements must have a @value or children
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... identifier Σ 0..* Identifier 過敏或不耐症之外部識別碼
ele-1: All FHIR elements must have a @value or children
... clinicalStatus S 0..1 CodeableConceptTW active | inactive | resolved ，過敏或不耐症的臨床狀態。
Binding: AllergyIntoleranceClinicalStatusCodes (required): 應填入所綁定值集中的其中一個代碼。


ele-1: All FHIR elements must have a @value or children
... verificationStatus S 0..1 CodeableConceptTW unconfirmed | confirmed | refuted | entered-in-error ，一個人對特定物質產生反應的可能性或風險有多確定的陳述。
Binding: AllergyIntoleranceVerificationStatusCodes (required): 應填入所綁定值集中的其中一個代碼。


ele-1: All FHIR elements must have a @value or children
... type Σ 0..1 code allergy | intolerance - 根本原因或運作機制（如果知道）。
Binding: AllergyIntoleranceType (required): 確定反應風險的基本生理機制；應填入所綁定值集中的其中一個代碼。


ele-1: All FHIR elements must have a @value or children
... category Σ 0..* code food | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): 確定的物質的類別；應填入所綁定值集中的其中一個代碼。


ele-1: All FHIR elements must have a @value or children
... criticality Σ 0..1 code low | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): 對已識別物質的反應的潛在臨床危害程度，或稱嚴重性估計；應填入所綁定值集中的其中一個代碼。


ele-1: All FHIR elements must have a @value or children
... code S 1..1 CodeableConceptTW 表明此過敏或不耐症的代碼
Binding: AllergyIntoleranceSubstance/Product,ConditionAndNegationCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。


ele-1: All FHIR elements must have a @value or children
... patient SΣ 1..1 Reference(TW Core Patient) 誰有此過敏或不耐受？
ele-1: All FHIR elements must have a @value or children
... encounter 0..1 Reference(TW Core Encounter) 過敏或不耐症被確認時的就醫事件(Encounter)
ele-1: All FHIR elements must have a @value or children
... onset[x] 0..1 過敏或不耐症被識別的時間
ele-1: All FHIR elements must have a @value or children
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
... recordedDate S 0..1 dateTime resource實例的第一個版本被記錄的日期
ele-1: All FHIR elements must have a @value or children
... recorder S 0..1 Reference(TW Core Practitioner | TW Core PractitionerRole | TW Core Patient | TW Core RelatedPerson) 誰記錄了過敏或不耐受
ele-1: All FHIR elements must have a @value or children
... asserter Σ 0..1 Reference(TW Core Patient | TW Core RelatedPerson | TW Core Practitioner | TW Core PractitionerRole) 關於過敏的資訊來源
ele-1: All FHIR elements must have a @value or children
... lastOccurrence 0..1 dateTime 最後一次已知反應發生的日期（/時間）
ele-1: All FHIR elements must have a @value or children
... note S 0..* Annotation 其他欄位中沒有記錄的額外文字陳述
ele-1: All FHIR elements must have a @value or children
... reaction S 0..* BackboneElement 暴露於此過敏或不耐症物質的不良反應
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... substance 0..1 CodeableConceptTW 被認為是事件原因的特定物質或醫藥產品
Binding: SubstanceCode (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。


ele-1: All FHIR elements must have a @value or children
.... manifestation S 1..* CodeableConceptTW 與此事件相關的臨床症狀/體徵
Binding: SNOMEDCTClinicalFindings (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。


ele-1: All FHIR elements must have a @value or children
.... description 0..1 string 對整個活動的描述
ele-1: All FHIR elements must have a @value or children
.... onset 0..1 dateTime 症狀顯現的日期（/時間）
ele-1: All FHIR elements must have a @value or children
.... severity 0..1 code mild | moderate | severe
Binding: AllergyIntoleranceSeverity (required): 整個事件的程度，應填入所綁定值集中的其中一個代碼。


ele-1: All FHIR elements must have a @value or children
.... exposureRoute 0..1 CodeableConceptTW 此對象如何接觸到該物質
Binding: SNOMEDCTRouteCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。


ele-1: All FHIR elements must have a @value or children
.... note 0..* Annotation 其他資料項目未記錄之關於事件的文字表述
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
AllergyIntolerance.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1
from the FHIR Standard
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1
from the FHIR Standard
AllergyIntolerance.typerequiredAllergyIntoleranceType
http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
from the FHIR Standard
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1
from the FHIR Standard
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1
from the FHIR Standard
AllergyIntolerance.codeextensibleAllergyIntoleranceSubstance/Product,ConditionAndNegationCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-code
from the FHIR Standard
AllergyIntolerance.reaction.substanceextensibleSubstanceCode
http://hl7.org/fhir/ValueSet/substance-code
from the FHIR Standard
AllergyIntolerance.reaction.manifestationextensibleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
from the FHIR Standard
AllergyIntolerance.reaction.exposureRouteextensibleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
ait-2errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
dom-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceAllergyIntoleranceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C 0..* AllergyIntolerance 過敏或不耐症（通常指：對某種物質有不良反應的風險）
ait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
... id Σ 0..1 id 不重複的ID用以識別儲存在特定FHIR Server中的AllergyIntolerance紀錄，通常又稱為邏輯性ID。
... meta Σ 0..1 Meta 此AllergyIntolerance Resource的metadata
... implicitRules ?!Σ 0..1 uri 創建此內容所依據的一組規則
... text 0..1 Narrative AllergyIntolerance Resource之內容摘要以供人閱讀
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier 過敏或不耐症之外部識別碼
... clinicalStatus S 0..1 CodeableConceptTW active | inactive | resolved ，過敏或不耐症的臨床狀態。
Binding: AllergyIntoleranceClinicalStatusCodes (required): 應填入所綁定值集中的其中一個代碼。

... verificationStatus S 0..1 CodeableConceptTW unconfirmed | confirmed | refuted | entered-in-error ，一個人對特定物質產生反應的可能性或風險有多確定的陳述。
Binding: AllergyIntoleranceVerificationStatusCodes (required): 應填入所綁定值集中的其中一個代碼。

... type Σ 0..1 code allergy | intolerance - 根本原因或運作機制（如果知道）。
Binding: AllergyIntoleranceType (required): 確定反應風險的基本生理機制；應填入所綁定值集中的其中一個代碼。

... category Σ 0..* code food | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): 確定的物質的類別；應填入所綁定值集中的其中一個代碼。


... criticality Σ 0..1 code low | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): 對已識別物質的反應的潛在臨床危害程度，或稱嚴重性估計；應填入所綁定值集中的其中一個代碼。

... code S 1..1 CodeableConceptTW 表明此過敏或不耐症的代碼
Binding: AllergyIntoleranceSubstance/Product,ConditionAndNegationCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

... patient SΣ 1..1 Reference(TW Core Patient) 誰有此過敏或不耐受？
... encounter 0..1 Reference(TW Core Encounter) 過敏或不耐症被確認時的就醫事件(Encounter)
... onset[x] 0..1 過敏或不耐症被識別的時間
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
... recordedDate S 0..1 dateTime resource實例的第一個版本被記錄的日期
... recorder S 0..1 Reference(TW Core Practitioner | TW Core PractitionerRole | TW Core Patient | TW Core RelatedPerson) 誰記錄了過敏或不耐受
... asserter Σ 0..1 Reference(TW Core Patient | TW Core RelatedPerson | TW Core Practitioner | TW Core PractitionerRole) 關於過敏的資訊來源
... lastOccurrence 0..1 dateTime 最後一次已知反應發生的日期（/時間）
... note S 0..* Annotation 其他欄位中沒有記錄的額外文字陳述
... reaction S 0..* BackboneElement 暴露於此過敏或不耐症物質的不良反應
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... substance 0..1 CodeableConceptTW 被認為是事件原因的特定物質或醫藥產品
Binding: SubstanceCode (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

.... manifestation S 1..* CodeableConceptTW 與此事件相關的臨床症狀/體徵
Binding: SNOMEDCTClinicalFindings (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。


.... description 0..1 string 對整個活動的描述
.... onset 0..1 dateTime 症狀顯現的日期（/時間）
.... severity 0..1 code mild | moderate | severe
Binding: AllergyIntoleranceSeverity (required): 整個事件的程度，應填入所綁定值集中的其中一個代碼。

.... exposureRoute 0..1 CodeableConceptTW 此對象如何接觸到該物質
Binding: SNOMEDCTRouteCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

.... note 0..* Annotation 其他資料項目未記錄之關於事件的文字表述

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
AllergyIntolerance.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1
from the FHIR Standard
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1
from the FHIR Standard
AllergyIntolerance.typerequiredAllergyIntoleranceType
http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
from the FHIR Standard
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1
from the FHIR Standard
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1
from the FHIR Standard
AllergyIntolerance.codeextensibleAllergyIntoleranceSubstance/Product,ConditionAndNegationCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-code
from the FHIR Standard
AllergyIntolerance.reaction.substanceextensibleSubstanceCode
http://hl7.org/fhir/ValueSet/substance-code
from the FHIR Standard
AllergyIntolerance.reaction.manifestationextensibleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
from the FHIR Standard
AllergyIntolerance.reaction.exposureRouteextensibleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
ait-2errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
dom-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceAllergyIntoleranceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Differential View

This structure is derived from AllergyIntolerance

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance 0..* AllergyIntolerance 過敏或不耐症（通常指：對某種物質有不良反應的風險）
... id 0..1 id 不重複的ID用以識別儲存在特定FHIR Server中的AllergyIntolerance紀錄，通常又稱為邏輯性ID。
... meta 0..1 Meta 此AllergyIntolerance Resource的metadata
... implicitRules 0..1 uri 創建此內容所依據的一組規則
... text 0..1 Narrative AllergyIntolerance Resource之內容摘要以供人閱讀
... identifier 0..* Identifier 過敏或不耐症之外部識別碼
... clinicalStatus S 0..1 CodeableConceptTW active | inactive | resolved ，過敏或不耐症的臨床狀態。
Binding: AllergyIntoleranceClinicalStatusCodes (required): 應填入所綁定值集中的其中一個代碼。

... verificationStatus S 0..1 CodeableConceptTW unconfirmed | confirmed | refuted | entered-in-error ，一個人對特定物質產生反應的可能性或風險有多確定的陳述。
Binding: AllergyIntoleranceVerificationStatusCodes (required): 應填入所綁定值集中的其中一個代碼。

... type 0..1 code allergy | intolerance - 根本原因或運作機制（如果知道）。
Binding: AllergyIntoleranceType (required): 確定反應風險的基本生理機制；應填入所綁定值集中的其中一個代碼。

... category 0..* code food | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): 確定的物質的類別；應填入所綁定值集中的其中一個代碼。

... criticality 0..1 code low | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): 對已識別物質的反應的潛在臨床危害程度，或稱嚴重性估計；應填入所綁定值集中的其中一個代碼。

... code S 1..1 CodeableConceptTW 表明此過敏或不耐症的代碼
Binding: AllergyIntoleranceSubstance/Product,ConditionAndNegationCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

... patient S 1..1 Reference(TW Core Patient) 誰有此過敏或不耐受？
... encounter 0..1 Reference(TW Core Encounter) 過敏或不耐症被確認時的就醫事件(Encounter)
... onset[x] 0..1 dateTime, Age, Period, Range, string 過敏或不耐症被識別的時間
... recordedDate S 0..1 dateTime resource實例的第一個版本被記錄的日期
... recorder S 0..1 Reference(TW Core Practitioner | TW Core PractitionerRole | TW Core Patient | TW Core RelatedPerson) 誰記錄了過敏或不耐受
... asserter 0..1 Reference(TW Core Patient | TW Core RelatedPerson | TW Core Practitioner | TW Core PractitionerRole) 關於過敏的資訊來源
... lastOccurrence 0..1 dateTime 最後一次已知反應發生的日期（/時間）
... note S 0..* Annotation 其他欄位中沒有記錄的額外文字陳述
... reaction S 0..* BackboneElement 暴露於此過敏或不耐症物質的不良反應
.... substance 0..1 CodeableConceptTW 被認為是事件原因的特定物質或醫藥產品
Binding: SubstanceCode (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

.... manifestation S 1..* CodeableConceptTW 與此事件相關的臨床症狀/體徵
Binding: SNOMEDCTClinicalFindings (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

.... description 0..1 string 對整個活動的描述
.... onset 0..1 dateTime 症狀顯現的日期（/時間）
.... severity 0..1 code mild | moderate | severe
Binding: AllergyIntoleranceSeverity (required): 整個事件的程度，應填入所綁定值集中的其中一個代碼。

.... exposureRoute 0..1 CodeableConceptTW 此對象如何接觸到該物質
Binding: SNOMEDCTRouteCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

.... note 0..* Annotation 其他資料項目未記錄之關於事件的文字表述

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
AllergyIntolerance.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1
from the FHIR Standard
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1
from the FHIR Standard
AllergyIntolerance.typerequiredAllergyIntoleranceType
http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
from the FHIR Standard
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1
from the FHIR Standard
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1
from the FHIR Standard
AllergyIntolerance.codeextensibleAllergyIntoleranceSubstance/Product,ConditionAndNegationCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-code
from the FHIR Standard
AllergyIntolerance.reaction.substanceextensibleSubstanceCode
http://hl7.org/fhir/ValueSet/substance-code
from the FHIR Standard
AllergyIntolerance.reaction.manifestationextensibleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
from the FHIR Standard
AllergyIntolerance.reaction.exposureRouteextensibleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C 0..* AllergyIntolerance 過敏或不耐症（通常指：對某種物質有不良反應的風險）
ait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
... id Σ 0..1 id 不重複的ID用以識別儲存在特定FHIR Server中的AllergyIntolerance紀錄，通常又稱為邏輯性ID。
... meta Σ 0..1 Meta 此AllergyIntolerance Resource的metadata
ele-1: All FHIR elements must have a @value or children
... implicitRules ?!Σ 0..1 uri 創建此內容所依據的一組規則
ele-1: All FHIR elements must have a @value or children
... text 0..1 Narrative AllergyIntolerance Resource之內容摘要以供人閱讀
ele-1: All FHIR elements must have a @value or children
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... identifier Σ 0..* Identifier 過敏或不耐症之外部識別碼
ele-1: All FHIR elements must have a @value or children
... clinicalStatus S 0..1 CodeableConceptTW active | inactive | resolved ，過敏或不耐症的臨床狀態。
Binding: AllergyIntoleranceClinicalStatusCodes (required): 應填入所綁定值集中的其中一個代碼。


ele-1: All FHIR elements must have a @value or children
... verificationStatus S 0..1 CodeableConceptTW unconfirmed | confirmed | refuted | entered-in-error ，一個人對特定物質產生反應的可能性或風險有多確定的陳述。
Binding: AllergyIntoleranceVerificationStatusCodes (required): 應填入所綁定值集中的其中一個代碼。


ele-1: All FHIR elements must have a @value or children
... type Σ 0..1 code allergy | intolerance - 根本原因或運作機制（如果知道）。
Binding: AllergyIntoleranceType (required): 確定反應風險的基本生理機制；應填入所綁定值集中的其中一個代碼。


ele-1: All FHIR elements must have a @value or children
... category Σ 0..* code food | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): 確定的物質的類別；應填入所綁定值集中的其中一個代碼。


ele-1: All FHIR elements must have a @value or children
... criticality Σ 0..1 code low | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): 對已識別物質的反應的潛在臨床危害程度，或稱嚴重性估計；應填入所綁定值集中的其中一個代碼。


ele-1: All FHIR elements must have a @value or children
... code S 1..1 CodeableConceptTW 表明此過敏或不耐症的代碼
Binding: AllergyIntoleranceSubstance/Product,ConditionAndNegationCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。


ele-1: All FHIR elements must have a @value or children
... patient SΣ 1..1 Reference(TW Core Patient) 誰有此過敏或不耐受？
ele-1: All FHIR elements must have a @value or children
... encounter 0..1 Reference(TW Core Encounter) 過敏或不耐症被確認時的就醫事件(Encounter)
ele-1: All FHIR elements must have a @value or children
... onset[x] 0..1 過敏或不耐症被識別的時間
ele-1: All FHIR elements must have a @value or children
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
... recordedDate S 0..1 dateTime resource實例的第一個版本被記錄的日期
ele-1: All FHIR elements must have a @value or children
... recorder S 0..1 Reference(TW Core Practitioner | TW Core PractitionerRole | TW Core Patient | TW Core RelatedPerson) 誰記錄了過敏或不耐受
ele-1: All FHIR elements must have a @value or children
... asserter Σ 0..1 Reference(TW Core Patient | TW Core RelatedPerson | TW Core Practitioner | TW Core PractitionerRole) 關於過敏的資訊來源
ele-1: All FHIR elements must have a @value or children
... lastOccurrence 0..1 dateTime 最後一次已知反應發生的日期（/時間）
ele-1: All FHIR elements must have a @value or children
... note S 0..* Annotation 其他欄位中沒有記錄的額外文字陳述
ele-1: All FHIR elements must have a @value or children
... reaction S 0..* BackboneElement 暴露於此過敏或不耐症物質的不良反應
ele-1: All FHIR elements must have a @value or children
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... substance 0..1 CodeableConceptTW 被認為是事件原因的特定物質或醫藥產品
Binding: SubstanceCode (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。


ele-1: All FHIR elements must have a @value or children
.... manifestation S 1..* CodeableConceptTW 與此事件相關的臨床症狀/體徵
Binding: SNOMEDCTClinicalFindings (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。


ele-1: All FHIR elements must have a @value or children
.... description 0..1 string 對整個活動的描述
ele-1: All FHIR elements must have a @value or children
.... onset 0..1 dateTime 症狀顯現的日期（/時間）
ele-1: All FHIR elements must have a @value or children
.... severity 0..1 code mild | moderate | severe
Binding: AllergyIntoleranceSeverity (required): 整個事件的程度，應填入所綁定值集中的其中一個代碼。


ele-1: All FHIR elements must have a @value or children
.... exposureRoute 0..1 CodeableConceptTW 此對象如何接觸到該物質
Binding: SNOMEDCTRouteCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。


ele-1: All FHIR elements must have a @value or children
.... note 0..* Annotation 其他資料項目未記錄之關於事件的文字表述
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
AllergyIntolerance.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1
from the FHIR Standard
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1
from the FHIR Standard
AllergyIntolerance.typerequiredAllergyIntoleranceType
http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
from the FHIR Standard
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1
from the FHIR Standard
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1
from the FHIR Standard
AllergyIntolerance.codeextensibleAllergyIntoleranceSubstance/Product,ConditionAndNegationCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-code
from the FHIR Standard
AllergyIntolerance.reaction.substanceextensibleSubstanceCode
http://hl7.org/fhir/ValueSet/substance-code
from the FHIR Standard
AllergyIntolerance.reaction.manifestationextensibleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
from the FHIR Standard
AllergyIntolerance.reaction.exposureRouteextensibleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
ait-2errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
dom-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceAllergyIntoleranceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. AllergyIntolerance C 0..* AllergyIntolerance 過敏或不耐症（通常指：對某種物質有不良反應的風險）
ait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
... id Σ 0..1 id 不重複的ID用以識別儲存在特定FHIR Server中的AllergyIntolerance紀錄，通常又稱為邏輯性ID。
... meta Σ 0..1 Meta 此AllergyIntolerance Resource的metadata
... implicitRules ?!Σ 0..1 uri 創建此內容所依據的一組規則
... text 0..1 Narrative AllergyIntolerance Resource之內容摘要以供人閱讀
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier 過敏或不耐症之外部識別碼
... clinicalStatus S 0..1 CodeableConceptTW active | inactive | resolved ，過敏或不耐症的臨床狀態。
Binding: AllergyIntoleranceClinicalStatusCodes (required): 應填入所綁定值集中的其中一個代碼。

... verificationStatus S 0..1 CodeableConceptTW unconfirmed | confirmed | refuted | entered-in-error ，一個人對特定物質產生反應的可能性或風險有多確定的陳述。
Binding: AllergyIntoleranceVerificationStatusCodes (required): 應填入所綁定值集中的其中一個代碼。

... type Σ 0..1 code allergy | intolerance - 根本原因或運作機制（如果知道）。
Binding: AllergyIntoleranceType (required): 確定反應風險的基本生理機制；應填入所綁定值集中的其中一個代碼。

... category Σ 0..* code food | medication | environment | biologic
Binding: AllergyIntoleranceCategory (required): 確定的物質的類別；應填入所綁定值集中的其中一個代碼。


... criticality Σ 0..1 code low | high | unable-to-assess
Binding: AllergyIntoleranceCriticality (required): 對已識別物質的反應的潛在臨床危害程度，或稱嚴重性估計；應填入所綁定值集中的其中一個代碼。

... code S 1..1 CodeableConceptTW 表明此過敏或不耐症的代碼
Binding: AllergyIntoleranceSubstance/Product,ConditionAndNegationCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

... patient SΣ 1..1 Reference(TW Core Patient) 誰有此過敏或不耐受？
... encounter 0..1 Reference(TW Core Encounter) 過敏或不耐症被確認時的就醫事件(Encounter)
... onset[x] 0..1 過敏或不耐症被識別的時間
.... onsetDateTime dateTime
.... onsetAge Age
.... onsetPeriod Period
.... onsetRange Range
.... onsetString string
... recordedDate S 0..1 dateTime resource實例的第一個版本被記錄的日期
... recorder S 0..1 Reference(TW Core Practitioner | TW Core PractitionerRole | TW Core Patient | TW Core RelatedPerson) 誰記錄了過敏或不耐受
... asserter Σ 0..1 Reference(TW Core Patient | TW Core RelatedPerson | TW Core Practitioner | TW Core PractitionerRole) 關於過敏的資訊來源
... lastOccurrence 0..1 dateTime 最後一次已知反應發生的日期（/時間）
... note S 0..* Annotation 其他欄位中沒有記錄的額外文字陳述
... reaction S 0..* BackboneElement 暴露於此過敏或不耐症物質的不良反應
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... substance 0..1 CodeableConceptTW 被認為是事件原因的特定物質或醫藥產品
Binding: SubstanceCode (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

.... manifestation S 1..* CodeableConceptTW 與此事件相關的臨床症狀/體徵
Binding: SNOMEDCTClinicalFindings (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。


.... description 0..1 string 對整個活動的描述
.... onset 0..1 dateTime 症狀顯現的日期（/時間）
.... severity 0..1 code mild | moderate | severe
Binding: AllergyIntoleranceSeverity (required): 整個事件的程度，應填入所綁定值集中的其中一個代碼。

.... exposureRoute 0..1 CodeableConceptTW 此對象如何接觸到該物質
Binding: SNOMEDCTRouteCodes (extensible): 應填入所綁定值集中適合的代碼，確定無適合的代碼才可以使用其他值集的代碼來表示。

.... note 0..* Annotation 其他資料項目未記錄之關於事件的文字表述

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
AllergyIntolerance.languagepreferredCommonLanguages
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Additional Bindings Purpose
AllLanguages Max Binding
AllergyIntolerance.clinicalStatusrequiredAllergyIntoleranceClinicalStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1
from the FHIR Standard
AllergyIntolerance.verificationStatusrequiredAllergyIntoleranceVerificationStatusCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1
from the FHIR Standard
AllergyIntolerance.typerequiredAllergyIntoleranceType
http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
from the FHIR Standard
AllergyIntolerance.categoryrequiredAllergyIntoleranceCategory
http://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1
from the FHIR Standard
AllergyIntolerance.criticalityrequiredAllergyIntoleranceCriticality
http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1
from the FHIR Standard
AllergyIntolerance.codeextensibleAllergyIntoleranceSubstance/Product,ConditionAndNegationCodes
http://hl7.org/fhir/ValueSet/allergyintolerance-code
from the FHIR Standard
AllergyIntolerance.reaction.substanceextensibleSubstanceCode
http://hl7.org/fhir/ValueSet/substance-code
from the FHIR Standard
AllergyIntolerance.reaction.manifestationextensibleSNOMEDCTClinicalFindings
http://hl7.org/fhir/ValueSet/clinical-findings
from the FHIR Standard
AllergyIntolerance.reaction.severityrequiredAllergyIntoleranceSeverity
http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
from the FHIR Standard
AllergyIntolerance.reaction.exposureRouteextensibleSNOMEDCTRouteCodes
http://hl7.org/fhir/ValueSet/route-codes
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
ait-1errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error.
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()
ait-2errorAllergyIntoleranceAllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error
: verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()
dom-2errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorAllergyIntoleranceIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5errorAllergyIntoleranceIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceAllergyIntoleranceA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

 

Other representations of profile: CSV, Excel, Schematron

Notes:

以下概述了此Profile所需的RESTful FHIR互動功能。有關TW Core IG支援的RESTful互動功能的完整清單，請參閱TW Core Server能力聲明。

建議應該支援以下查詢參數：

  1. 建議應該（SHOULD） 支援透過查詢參數 _id 查詢所有AllergyIntolerance：
    (如何透過token查詢)
    GET [base]/AllergyIntolerance?_id=[id]
    GET [base]/AllergyIntolerance/[id]

    例子：
    (1) GET [base]/AllergyIntolerance?_id=all-nut-example
    (2) GET [base]/AllergyIntolerance/all-nut-example

  2. 建議應該（SHOULD） 支援透過查詢參數 clinical-status 查詢所有AllergyIntolerance：
    (如何透過token查詢)
    GET [base]/AllergyIntolerance?clinical-status=[code]

    例子：
    (1) GET [base]/AllergyIntolerance?clinical-status=active