Order Catalog Implementation Guide
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Order Catalog Implementation Guide, published by HL7 International - Orders and Observations Work Group. This is not an authorized publication; it is the continuous build for version current). This version is based on the current content of https://github.com/HL7/fhir-order-catalog/ and changes regularly. See the Directory of published versions

Resource Profile: ContraindicationDefinition Profile

Official URL: http://hl7.org/fhir/uv/order-catalog/StructureDefinition/ContraindicationDefinition Version: current
Draft as of 2023-07-08 Computable Name: ContraindicationDefinition

This profile constrains the base resource ClinicalUseDefinition to represent a contraindication associated with a healthcare item (medication, device, test, service …) described in a catalog

Usage:

Formal Views of Profile Content

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

This structure is derived from ClinicalUseDefinition

NameFlagsCard.TypeDescription & Constraintsdoco
.. ClinicalUseDefinition 0..*ClinicalUseDefinitionA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
... type 1..1codeindication | contraindication | interaction | undesirable-effect | warning
Fixed Value: contraindication
... contraindication 1..1BackboneElementSpecifics for when this is a contraindication
... indication 0..0
... undesirableEffect 0..0
... warning 0..0

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. ClinicalUseDefinition C0..*ClinicalUseDefinitionA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... contained 0..*ResourceContained, inline Resources
... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... contraindication ΣC1..1BackboneElementSpecifics for when this is a contraindication
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
ClinicalUseDefinition.typerequiredFixed Value: contraindication

Constraints

IdGradePath(s)DetailsRequirements
cud-1errorClinicalUseDefinitionIndication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance
: (ClinicalUseDefinition.indication.count() + ClinicalUseDefinition.contraindication.count() + ClinicalUseDefinition.interaction.count() + ClinicalUseDefinition.undesirableEffect.count() + ClinicalUseDefinition.warning.count()) < 2
dom-2errorClinicalUseDefinitionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorClinicalUseDefinitionIf 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorClinicalUseDefinitionIf 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-5errorClinicalUseDefinitionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceClinicalUseDefinitionA 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
.. ClinicalUseDefinition C0..*ClinicalUseDefinitionA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness identifier for this issue
... type Σ1..1codeindication | contraindication | interaction | undesirable-effect | warning
Binding: ClinicalUseDefinitionType (required): Overall defining type of this clinical use definition.


Fixed Value: contraindication
... category Σ0..*CodeableConceptA categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
Binding: ClinicalUseDefinitionCategory (preferred): A categorisation for a clinical use information item.


... subject Σ0..*Reference(MedicinalProductDefinition | Medication | ActivityDefinition | PlanDefinition | Device | DeviceDefinition | Substance | NutritionProduct | BiologicallyDerivedProduct)The medication, product, substance, device, procedure etc. for which this is an indication
... status Σ0..1CodeableConceptWhether this is a current issue or one that has been retired etc
Binding: PublicationStatus (preferred): The lifecycle status of an artifact.

... contraindication ΣC1..1BackboneElementSpecifics for when this is a contraindication
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... diseaseSymptomProcedure Σ0..1CodeableReference(ObservationDefinition)The situation that is being documented as contraindicating against this item
Binding: DiseaseSymptomProcedure (example): A symptom, disease or procedure.

.... diseaseStatus Σ0..1CodeableReference(ObservationDefinition)The status of the disease or symptom for the contraindication
Binding: DiseaseStatus (example): The status of a disease or symptom.

.... comorbidity Σ0..*CodeableReference(ObservationDefinition)A comorbidity (concurrent condition) or coinfection
Binding: DiseaseSymptomProcedure (example): A symptom, disease or procedure.


.... indication Σ0..*Reference(ClinicalUseDefinition)The indication which this is a contraidication for
.... applicability 0..1ExpressionAn expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements
.... otherTherapy Σ0..*BackboneElementInformation about use of the product in relation to other therapies described as part of the contraindication
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... relationshipType Σ1..1CodeableConceptThe type of relationship between the product indication/contraindication and another therapy
Binding: TherapyRelationshipType (preferred): Classification of relationship between a therapy and a contraindication or an indication.

..... treatment Σ1..1CodeableReference(MedicinalProductDefinition | Medication | Substance | SubstanceDefinition | NutritionProduct | BiologicallyDerivedProduct | ActivityDefinition)Reference to a specific medication, substance etc. as part of an indication or contraindication
Binding: Therapy (example): A therapy.

... population Σ0..*Reference(Group)The population group to which this applies
... library Σ0..*canonical(Library)Logic used by the clinical use definition

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
ClinicalUseDefinition.languagerequiredAllLanguages
ClinicalUseDefinition.typerequiredFixed Value: contraindication
ClinicalUseDefinition.categorypreferredClinicalUseDefinitionCategory
ClinicalUseDefinition.statuspreferredPublicationStatus
ClinicalUseDefinition.contraindication.diseaseSymptomProcedureexampleDiseaseSymptomProcedure
ClinicalUseDefinition.contraindication.diseaseStatusexampleDiseaseStatus
ClinicalUseDefinition.contraindication.comorbidityexampleDiseaseSymptomProcedure
ClinicalUseDefinition.contraindication.otherTherapy.relationshipTypepreferredTherapyRelationshipType
ClinicalUseDefinition.contraindication.otherTherapy.treatmentexampleTherapy
ClinicalUseDefinition.indication.diseaseSymptomProcedureexampleDiseaseSymptomProcedure
ClinicalUseDefinition.indication.diseaseStatusexampleDiseaseStatus
ClinicalUseDefinition.indication.comorbidityexampleDiseaseSymptomProcedure
ClinicalUseDefinition.indication.intendedEffectpreferredProductIntendedUse
ClinicalUseDefinition.interaction.interactant.item[x]exampleInteractant
ClinicalUseDefinition.interaction.typeexampleInteractionType
ClinicalUseDefinition.interaction.effectexampleInteractionEffect
ClinicalUseDefinition.interaction.incidenceexampleInteractionIncidence
ClinicalUseDefinition.interaction.managementexampleInteractionManagement
ClinicalUseDefinition.undesirableEffect.symptomConditionEffectexampleUndesirableEffectSymptom
ClinicalUseDefinition.undesirableEffect.classificationexampleUndesirableEffectClassification
ClinicalUseDefinition.undesirableEffect.frequencyOfOccurrenceexampleUndesirablEffectFrequency
ClinicalUseDefinition.warning.codeexampleWarningType

Constraints

IdGradePath(s)DetailsRequirements
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()

This structure is derived from ClinicalUseDefinition

Summary

Mandatory: 1 element
Fixed Value: 1 element
Prohibited: 4 elements

Differential View

This structure is derived from ClinicalUseDefinition

NameFlagsCard.TypeDescription & Constraintsdoco
.. ClinicalUseDefinition 0..*ClinicalUseDefinitionA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
... type 1..1codeindication | contraindication | interaction | undesirable-effect | warning
Fixed Value: contraindication
... contraindication 1..1BackboneElementSpecifics for when this is a contraindication
... indication 0..0
... undesirableEffect 0..0
... warning 0..0

doco Documentation for this format

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ClinicalUseDefinition C0..*ClinicalUseDefinitionA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... contained 0..*ResourceContained, inline Resources
... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... contraindication ΣC1..1BackboneElementSpecifics for when this is a contraindication
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
ClinicalUseDefinition.typerequiredFixed Value: contraindication

Constraints

IdGradePath(s)DetailsRequirements
cud-1errorClinicalUseDefinitionIndication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance
: (ClinicalUseDefinition.indication.count() + ClinicalUseDefinition.contraindication.count() + ClinicalUseDefinition.interaction.count() + ClinicalUseDefinition.undesirableEffect.count() + ClinicalUseDefinition.warning.count()) < 2
dom-2errorClinicalUseDefinitionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorClinicalUseDefinitionIf 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().ofType(canonical) | %resource.descendants().ofType(uri) | %resource.descendants().ofType(url))) or descendants().where(reference = '#').exists() or descendants().where(ofType(canonical) = '#').exists() or descendants().where(ofType(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4errorClinicalUseDefinitionIf 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-5errorClinicalUseDefinitionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceClinicalUseDefinitionA 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
.. ClinicalUseDefinition C0..*ClinicalUseDefinitionA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness identifier for this issue
... type Σ1..1codeindication | contraindication | interaction | undesirable-effect | warning
Binding: ClinicalUseDefinitionType (required): Overall defining type of this clinical use definition.


Fixed Value: contraindication
... category Σ0..*CodeableConceptA categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
Binding: ClinicalUseDefinitionCategory (preferred): A categorisation for a clinical use information item.


... subject Σ0..*Reference(MedicinalProductDefinition | Medication | ActivityDefinition | PlanDefinition | Device | DeviceDefinition | Substance | NutritionProduct | BiologicallyDerivedProduct)The medication, product, substance, device, procedure etc. for which this is an indication
... status Σ0..1CodeableConceptWhether this is a current issue or one that has been retired etc
Binding: PublicationStatus (preferred): The lifecycle status of an artifact.

... contraindication ΣC1..1BackboneElementSpecifics for when this is a contraindication
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... diseaseSymptomProcedure Σ0..1CodeableReference(ObservationDefinition)The situation that is being documented as contraindicating against this item
Binding: DiseaseSymptomProcedure (example): A symptom, disease or procedure.

.... diseaseStatus Σ0..1CodeableReference(ObservationDefinition)The status of the disease or symptom for the contraindication
Binding: DiseaseStatus (example): The status of a disease or symptom.

.... comorbidity Σ0..*CodeableReference(ObservationDefinition)A comorbidity (concurrent condition) or coinfection
Binding: DiseaseSymptomProcedure (example): A symptom, disease or procedure.


.... indication Σ0..*Reference(ClinicalUseDefinition)The indication which this is a contraidication for
.... applicability 0..1ExpressionAn expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements
.... otherTherapy Σ0..*BackboneElementInformation about use of the product in relation to other therapies described as part of the contraindication
..... id 0..1stringUnique id for inter-element referencing
..... extension 0..*ExtensionAdditional content defined by implementations
..... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
..... relationshipType Σ1..1CodeableConceptThe type of relationship between the product indication/contraindication and another therapy
Binding: TherapyRelationshipType (preferred): Classification of relationship between a therapy and a contraindication or an indication.

..... treatment Σ1..1CodeableReference(MedicinalProductDefinition | Medication | Substance | SubstanceDefinition | NutritionProduct | BiologicallyDerivedProduct | ActivityDefinition)Reference to a specific medication, substance etc. as part of an indication or contraindication
Binding: Therapy (example): A therapy.

... population Σ0..*Reference(Group)The population group to which this applies
... library Σ0..*canonical(Library)Logic used by the clinical use definition

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
ClinicalUseDefinition.languagerequiredAllLanguages
ClinicalUseDefinition.typerequiredFixed Value: contraindication
ClinicalUseDefinition.categorypreferredClinicalUseDefinitionCategory
ClinicalUseDefinition.statuspreferredPublicationStatus
ClinicalUseDefinition.contraindication.diseaseSymptomProcedureexampleDiseaseSymptomProcedure
ClinicalUseDefinition.contraindication.diseaseStatusexampleDiseaseStatus
ClinicalUseDefinition.contraindication.comorbidityexampleDiseaseSymptomProcedure
ClinicalUseDefinition.contraindication.otherTherapy.relationshipTypepreferredTherapyRelationshipType
ClinicalUseDefinition.contraindication.otherTherapy.treatmentexampleTherapy
ClinicalUseDefinition.indication.diseaseSymptomProcedureexampleDiseaseSymptomProcedure
ClinicalUseDefinition.indication.diseaseStatusexampleDiseaseStatus
ClinicalUseDefinition.indication.comorbidityexampleDiseaseSymptomProcedure
ClinicalUseDefinition.indication.intendedEffectpreferredProductIntendedUse
ClinicalUseDefinition.interaction.interactant.item[x]exampleInteractant
ClinicalUseDefinition.interaction.typeexampleInteractionType
ClinicalUseDefinition.interaction.effectexampleInteractionEffect
ClinicalUseDefinition.interaction.incidenceexampleInteractionIncidence
ClinicalUseDefinition.interaction.managementexampleInteractionManagement
ClinicalUseDefinition.undesirableEffect.symptomConditionEffectexampleUndesirableEffectSymptom
ClinicalUseDefinition.undesirableEffect.classificationexampleUndesirableEffectClassification
ClinicalUseDefinition.undesirableEffect.frequencyOfOccurrenceexampleUndesirablEffectFrequency
ClinicalUseDefinition.warning.codeexampleWarningType

Constraints

IdGradePath(s)DetailsRequirements
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()

This structure is derived from ClinicalUseDefinition

Summary

Mandatory: 1 element
Fixed Value: 1 element
Prohibited: 4 elements

 

Other representations of profile: CSV, Excel, Schematron