Medication Scheme Implementation Guide
1.0.0 - draft Estonia flag

Medication Scheme Implementation Guide, published by TEHIK. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/TEHIK-EE/ig-ee-medication-scheme/ and changes regularly. See the Directory of published versions

Resource Profile: EETISRenalFailureDS - Detailed Descriptions

Draft as of 2024-02-22

Definitions for the ee-tis-renal-failure-ds resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. ClinicalUseDefinition
Definition

A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure.

ShortA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
Control0..*
Is Modifierfalse
Must Supportfalse
Summaryfalse
Invariantscud-1: Indication, 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-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
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 (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-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
2. ClinicalUseDefinition.implicitRules
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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supportfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. ClinicalUseDefinition.contained
Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

ShortContained, inline Resources
Comments

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. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

Control10..1*
This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
TypeMedicationResource
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
6. ClinicalUseDefinition.extension
Definition

An Extension


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensionAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Must Supportfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on ClinicalUseDefinition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 8. ClinicalUseDefinition.extension:affected
    Slice Nameaffected
    Definition

    Kasutusel viitamaks ravimiskeemi ridadele, millel on koostoimeid.

    ShortMedicationStatements affected by interactions.
    Control0..*
    TypeExtension(ExtensionEETISAffectedMedicationStatements) (Extension Type: Reference(EETISMedicationStatement))
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    10. ClinicalUseDefinition.extension:link
    Slice Namelink
    Definition

    Link mis viib lehele, kus on teemast rohkem ja täpsemat informatsiooni.

    ShortAdditional information from external source.
    Control0..*
    TypeExtension(ExtensionEETISAdditionalInformationLink) (Extension Type: string)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    12. ClinicalUseDefinition.extension:nephrotoxic
    Slice Namenephrotoxic
    Definition

    Nefrotoksilisus

    ShortIs the medication nephrotoxic or not.
    Control0..*
    TypeExtension(ExtensionEETISNephrotoxic) (Extension Type: boolean)
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    14. ClinicalUseDefinition.extension:dosageModification
    Slice NamedosageModification
    Definition

    Annustamise soovitused.

    ShortRecommendation for dosaging
    Control0..*
    TypeExtension(ExtensionEETISDosageModification) (Complex Extension)
    Is Modifierfalse
    Must Supportfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    16. ClinicalUseDefinition.extension:relatedObservation
    Slice NamerelatedObservation
    Definition

    Kasutusel viitamaks observationile/conditionile, mis mõjutavad neerufunktsiooni.

    ShortObservation/Condition which triggers renal function alert.
    Control0..*
    TypeExtension(ExtensionEETISRelatedObservationOrCondition) (Extension Type: Reference(Observation, Condition))
    Is Modifierfalse
    Must Supportfalse
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    18. ClinicalUseDefinition.modifierExtension
    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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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.

    Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

    ShortExtensions that cannot be ignored
    Comments

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
    Must Supportfalse
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    20. ClinicalUseDefinition.type
    Definition

    indication | contraindication | interaction | undesirable-effect | warning.

    Shortindication | contraindication | interaction | undesirable-effect | warning
    Control1..1
    BindingThe codes SHALL be taken from ClinicalUseDefinitionTypehttp://hl7.org/fhir/ValueSet/clinical-use-definition-type|5.0.0
    (required to http://hl7.org/fhir/ValueSet/clinical-use-definition-type|5.0.0)

    Overall defining type of this clinical use definition.

    Typecode
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Must Supportfalse
    Summarytrue
    Fixed Valueundesirable-effect
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    22. ClinicalUseDefinition.category
    Definition

    A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy and Lactation", "Overdose", "Effects on Ability to Drive and Use Machines".

    ShortRenBase drugFormGroup ja failureDegreeA categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
    Control0..*
    BindingThe codes SHOULD be taken from ClinicalUseDefinitionCategoryhttp://hl7.org/fhir/ValueSet/clinical-use-definition-category
    (preferred to http://hl7.org/fhir/ValueSet/clinical-use-definition-category)

    A categorisation for a clinical use information item.

    TypeCodeableConcept
    Is Modifierfalse
    Must Supportfalse
    Summarytrue
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    SlicingThis element introduces a set of slices on ClinicalUseDefinition.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ coding
    • 24. ClinicalUseDefinition.category:drugFormGroup
      Slice NamedrugFormGroup
      Definition

      A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy and Lactation", "Overdose", "Effects on Ability to Drive and Use Machines".

      ShortA categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
      Control0..1*
      BindingThe codes SHOULD be taken from ClinicalUseDefinitionCategoryhttp://hl7.org/fhir/ValueSet/clinical-use-definition-category
      (preferred to http://hl7.org/fhir/ValueSet/clinical-use-definition-category)

      A categorisation for a clinical use information item.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      26. ClinicalUseDefinition.category:drugFormGroup.coding
      Definition

      A reference to a code defined by a terminology system.

      Short0 | 1 | 2 | 3 | 4 | 5| This is a fake system for example. Do NOT use it!Code defined by a terminology system
      Comments

      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.

      Control10..*
      TypeCoding
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

      Pattern Value{
        "system" : "https://fhir.ee/drug-form-group"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      28. ClinicalUseDefinition.category:failureDegree
      Slice NamefailureDegree
      Definition

      A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy and Lactation", "Overdose", "Effects on Ability to Drive and Use Machines".

      ShortA categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
      Control0..1*
      BindingThe codes SHOULD be taken from ClinicalUseDefinitionCategoryhttp://hl7.org/fhir/ValueSet/clinical-use-definition-category
      (preferred to http://hl7.org/fhir/ValueSet/clinical-use-definition-category)

      A categorisation for a clinical use information item.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      30. ClinicalUseDefinition.category:failureDegree.coding
      Definition

      A reference to a code defined by a terminology system.

      ShortFailure degree 0-4. Neerupuudulikkuse aste: number + selgitus. This is a fake system for example. Do NOT use it!Code defined by a terminology system
      Comments

      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.

      Control10..*
      TypeCoding
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

      Pattern Value{
        "system" : "https://fhir.ee/failure-degree"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      32. ClinicalUseDefinition.category:additionalInformation
      Slice NameadditionalInformation
      Definition

      A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy and Lactation", "Overdose", "Effects on Ability to Drive and Use Machines".

      ShortA categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
      Control0..1*
      BindingThe codes SHOULD be taken from ClinicalUseDefinitionCategoryhttp://hl7.org/fhir/ValueSet/clinical-use-definition-category
      (preferred to http://hl7.org/fhir/ValueSet/clinical-use-definition-category)

      A categorisation for a clinical use information item.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      34. ClinicalUseDefinition.category:additionalInformation.coding
      Definition

      A reference to a code defined by a terminology system.

      ShortThis is a fake system for example. Do NOT use itCode defined by a terminology system
      Comments

      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.

      Control10..*
      TypeCoding
      Is Modifierfalse
      Summarytrue
      Requirements

      Allows for alternative encodings within a code system, and translations to other code systems.

      Pattern Value{
        "system" : "https://fhir.ee/additional-information"
      }
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      36. ClinicalUseDefinition.subject
      Definition

      The medication, product, substance, device, procedure etc. for which this is an indication.

      Shortmedication that may cause renal function failureThe medication, product, substance, device, procedure etc. for which this is an indication
      Control10..*
      TypeReference(Medication, MedicinalProductDefinition, ActivityDefinition, PlanDefinition, Device, DeviceDefinition, Substance, NutritionProduct, BiologicallyDerivedProduct)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      38. ClinicalUseDefinition.subject.reference
      Definition

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      ShortLiteral reference, Relative, internal or absolute URL
      Comments

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Control0..1
      This element is affected by the following invariants: ref-2, ref-1
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      40. ClinicalUseDefinition.subject.display
      Definition

      Plain text narrative that identifies the resource in addition to the resource reference.

      ShortText alternative for the resource
      Comments

      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

      Control0..1
      This element is affected by the following invariants: ref-2
      Typestring
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Summarytrue
      Pattern ValueName of the medication/active inredient. Siia toimeaine nimetus
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      42. ClinicalUseDefinition.contraindication
      Definition

      Specifics for when this is a contraindication.

      ShortSpecifics for when this is a contraindication
      Control0..01
      This element is affected by the following invariants: cud-1
      TypeBackboneElement
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      45. ClinicalUseDefinition.indication
      Definition

      Specifics for when this is an indication.

      ShortSpecifics for when this is an indication
      Control0..01
      This element is affected by the following invariants: cud-1
      TypeBackboneElement
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      48. ClinicalUseDefinition.population
      Definition

      The population group to which this applies.

      ShortThe population group to which this applies
      Control0..0*
      TypeReference(Group)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      50. ClinicalUseDefinition.library
      Definition

      Logic used by the clinical use definition.

      ShortLogic used by the clinical use definition
      Control0..0*
      Typecanonical(Library)
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      52. ClinicalUseDefinition.undesirableEffect
      Definition

      Klassifikatsioon RenBase järgi ja kirjeldus kui palju annust tuleks muuta


      Describe the possible undesirable effects (negative outcomes) from the use of the medicinal product as treatment.

      ShortClassification A/B/C/D and description how the dosage must be adjustedA possible negative outcome from the use of this treatment
      Control0..1
      This element is affected by the following invariants: cud-1
      TypeBackboneElement
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      54. ClinicalUseDefinition.undesirableEffect.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored even if unrecognized
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Summarytrue
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content, modifiers
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      56. ClinicalUseDefinition.undesirableEffect.classification
      Definition

      High level classification of the effect.

      Shortklassifikatsioon (A/B/C/D) + selle tekst nt C, text: Annust või annustamise vahemikku tuleb kohandadaHigh level classification of the effect
      Control0..1
      BindingFor example codes, see UndesirableEffectClassificationhttp://hl7.org/fhir/ValueSet/undesirable-effect-classification
      (example to http://hl7.org/fhir/ValueSet/undesirable-effect-classification)

      Use this fictive system https://fhir.ee/synbase-warning-classification


      A categorisation for an undesirable effect.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Guidance on how to interpret the contents of this table can be foundhere

      0. ClinicalUseDefinition
      2. ClinicalUseDefinition.contained
      Control1..1
      TypeMedication
      4. ClinicalUseDefinition.extension
      SlicingThis element introduces a set of slices on ClinicalUseDefinition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 6. ClinicalUseDefinition.extension:affected
        Slice Nameaffected
        Control0..*
        TypeExtension(ExtensionEETISAffectedMedicationStatements) (Extension Type: Reference(EETISMedicationStatement))
        8. ClinicalUseDefinition.extension:link
        Slice Namelink
        Control0..*
        TypeExtension(ExtensionEETISAdditionalInformationLink) (Extension Type: string)
        10. ClinicalUseDefinition.extension:nephrotoxic
        Slice Namenephrotoxic
        Control0..*
        TypeExtension(ExtensionEETISNephrotoxic) (Extension Type: boolean)
        12. ClinicalUseDefinition.extension:dosageModification
        Slice NamedosageModification
        Control0..*
        TypeExtension(ExtensionEETISDosageModification) (Complex Extension)
        14. ClinicalUseDefinition.extension:relatedObservation
        Slice NamerelatedObservation
        Control0..*
        TypeExtension(ExtensionEETISRelatedObservationOrCondition) (Extension Type: Reference(Observation, Condition))
        16. ClinicalUseDefinition.type
        Fixed Valueundesirable-effect
        18. ClinicalUseDefinition.category
        ShortRenBase drugFormGroup ja failureDegree
        SlicingThis element introduces a set of slices on ClinicalUseDefinition.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ coding
        • 20. ClinicalUseDefinition.category:drugFormGroup
          Slice NamedrugFormGroup
          Control0..1
          22. ClinicalUseDefinition.category:drugFormGroup.coding
          Short0 | 1 | 2 | 3 | 4 | 5| This is a fake system for example. Do NOT use it!
          Control1..?
          Pattern Value{
            "system" : "https://fhir.ee/drug-form-group"
          }
          24. ClinicalUseDefinition.category:failureDegree
          Slice NamefailureDegree
          Control0..1
          26. ClinicalUseDefinition.category:failureDegree.coding
          ShortFailure degree 0-4. Neerupuudulikkuse aste: number + selgitus. This is a fake system for example. Do NOT use it!
          Control1..?
          Pattern Value{
            "system" : "https://fhir.ee/failure-degree"
          }
          28. ClinicalUseDefinition.category:additionalInformation
          Slice NameadditionalInformation
          Control0..1
          30. ClinicalUseDefinition.category:additionalInformation.coding
          ShortThis is a fake system for example. Do NOT use it
          Control1..?
          Pattern Value{
            "system" : "https://fhir.ee/additional-information"
          }
          32. ClinicalUseDefinition.subject
          Shortmedication that may cause renal function failure
          Control1..?
          TypeReference(Medication)
          34. ClinicalUseDefinition.subject.display
          Pattern ValueName of the medication/active inredient. Siia toimeaine nimetus
          36. ClinicalUseDefinition.contraindication
          Control0..0
          38. ClinicalUseDefinition.indication
          Control0..0
          40. ClinicalUseDefinition.population
          Control0..0
          42. ClinicalUseDefinition.library
          Control0..0
          44. ClinicalUseDefinition.undesirableEffect
          Definition

          Klassifikatsioon RenBase järgi ja kirjeldus kui palju annust tuleks muuta

          ShortClassification A/B/C/D and description how the dosage must be adjusted
          46. ClinicalUseDefinition.undesirableEffect.classification
          Shortklassifikatsioon (A/B/C/D) + selle tekst nt C, text: Annust või annustamise vahemikku tuleb kohandada
          BindingFor example codes, see UndesirableEffectClassification
          (example to http://hl7.org/fhir/ValueSet/undesirable-effect-classification)

          Use this fictive system https://fhir.ee/synbase-warning-classification

          Guidance on how to interpret the contents of this table can be foundhere

          0. ClinicalUseDefinition
          Definition

          A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure.

          ShortA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
          Control0..*
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantscud-1: Indication, 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-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          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 (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-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          2. ClinicalUseDefinition.id
          Definition

          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

          ShortLogical id of this artifact
          Comments

          Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

          Control0..1
          Typeid
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          4. ClinicalUseDefinition.meta
          Definition

          The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

          ShortMetadata about the resource
          Control0..1
          TypeMeta
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. ClinicalUseDefinition.implicitRules
          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. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

          ShortA set of rules under which this content was created
          Comments

          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. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

          Control0..1
          Typeuri
          Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies its meaning or interpretation
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. ClinicalUseDefinition.language
          Definition

          The base language in which the resource is written.

          ShortLanguage of the resource content
          Comments

          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).

          Control0..1
          BindingThe codes SHALL be taken from AllLanguages
          (required to http://hl7.org/fhir/ValueSet/all-languages|5.0.0)

          IETF language tag for a human language

          Typecode
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. ClinicalUseDefinition.text
          Definition

          A human-readable narrative that contains a summary of the resource and can 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.

          ShortText summary of the resource, for human interpretation
          Comments

          Contained resources do not have a 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 information is added later.

          Control0..1
          This element is affected by the following invariants: dom-6
          TypeNarrative
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate Namesnarrative, html, xhtml, display
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. ClinicalUseDefinition.contained
          Definition

          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

          ShortContained, inline Resources
          Comments

          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. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

          Control1..1
          This element is affected by the following invariants: dom-2, dom-4, dom-3, dom-5
          TypeMedication
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Alternate Namesinline resources, anonymous resources, contained resources
          14. ClinicalUseDefinition.extension
          Definition

          An Extension

          ShortExtension
          Control0..*
          TypeExtension
          Is Modifierfalse
          Must Supportfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on ClinicalUseDefinition.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 16. ClinicalUseDefinition.extension:affected
            Slice Nameaffected
            Definition

            Kasutusel viitamaks ravimiskeemi ridadele, millel on koostoimeid.

            ShortMedicationStatements affected by interactions.
            Control0..*
            TypeExtension(ExtensionEETISAffectedMedicationStatements) (Extension Type: Reference(EETISMedicationStatement))
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            18. ClinicalUseDefinition.extension:link
            Slice Namelink
            Definition

            Link mis viib lehele, kus on teemast rohkem ja täpsemat informatsiooni.

            ShortAdditional information from external source.
            Control0..*
            TypeExtension(ExtensionEETISAdditionalInformationLink) (Extension Type: string)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            20. ClinicalUseDefinition.extension:nephrotoxic
            Slice Namenephrotoxic
            Definition

            Nefrotoksilisus

            ShortIs the medication nephrotoxic or not.
            Control0..*
            TypeExtension(ExtensionEETISNephrotoxic) (Extension Type: boolean)
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            22. ClinicalUseDefinition.extension:dosageModification
            Slice NamedosageModification
            Definition

            Annustamise soovitused.

            ShortRecommendation for dosaging
            Control0..*
            TypeExtension(ExtensionEETISDosageModification) (Complex Extension)
            Is Modifierfalse
            Must Supportfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            24. ClinicalUseDefinition.extension:relatedObservation
            Slice NamerelatedObservation
            Definition

            Kasutusel viitamaks observationile/conditionile, mis mõjutavad neerufunktsiooni.

            ShortObservation/Condition which triggers renal function alert.
            Control0..*
            TypeExtension(ExtensionEETISRelatedObservationOrCondition) (Extension Type: Reference(Observation, Condition))
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            26. ClinicalUseDefinition.modifierExtension
            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 and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Must Supportfalse
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            28. ClinicalUseDefinition.identifier
            Definition

            Business identifier for this issue.

            ShortBusiness identifier for this issue
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            30. ClinicalUseDefinition.type
            Definition

            indication | contraindication | interaction | undesirable-effect | warning.

            Shortindication | contraindication | interaction | undesirable-effect | warning
            Control1..1
            BindingThe codes SHALL be taken from ClinicalUseDefinitionType
            (required to http://hl7.org/fhir/ValueSet/clinical-use-definition-type|5.0.0)

            Overall defining type of this clinical use definition.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summarytrue
            Fixed Valueundesirable-effect
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            32. ClinicalUseDefinition.category
            Definition

            A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy and Lactation", "Overdose", "Effects on Ability to Drive and Use Machines".

            ShortRenBase drugFormGroup ja failureDegree
            Control0..*
            BindingThe codes SHOULD be taken from ClinicalUseDefinitionCategory
            (preferred to http://hl7.org/fhir/ValueSet/clinical-use-definition-category)

            A categorisation for a clinical use information item.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            SlicingThis element introduces a set of slices on ClinicalUseDefinition.category. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ coding
            • 34. ClinicalUseDefinition.category:drugFormGroup
              Slice NamedrugFormGroup
              Definition

              A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy and Lactation", "Overdose", "Effects on Ability to Drive and Use Machines".

              ShortA categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
              Control0..1
              BindingThe codes SHOULD be taken from ClinicalUseDefinitionCategory
              (preferred to http://hl7.org/fhir/ValueSet/clinical-use-definition-category)

              A categorisation for a clinical use information item.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              36. ClinicalUseDefinition.category:drugFormGroup.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              This element is affected by the following invariants: ele-1
              Typeid
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              38. ClinicalUseDefinition.category:drugFormGroup.extension
              Definition

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              ShortAdditional content defined by implementations
              Comments

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Control0..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Alternate Namesextensions, user content
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on ClinicalUseDefinition.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 40. ClinicalUseDefinition.category:drugFormGroup.coding
                Definition

                A reference to a code defined by a terminology system.

                Short0 | 1 | 2 | 3 | 4 | 5| This is a fake system for example. Do NOT use it!
                Comments

                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.

                Control1..*
                TypeCoding
                Is Modifierfalse
                Summarytrue
                Requirements

                Allows for alternative encodings within a code system, and translations to other code systems.

                Pattern Value{
                  "system" : "https://fhir.ee/drug-form-group"
                }
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                42. ClinicalUseDefinition.category:drugFormGroup.text
                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.

                ShortPlain text representation of the concept
                Comments

                Very often the text is the same as a displayName of one of the codings.

                Control0..1
                Typestring
                Is Modifierfalse
                Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                Summarytrue
                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.

                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                44. ClinicalUseDefinition.category:failureDegree
                Slice NamefailureDegree
                Definition

                A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy and Lactation", "Overdose", "Effects on Ability to Drive and Use Machines".

                ShortA categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
                Control0..1
                BindingThe codes SHOULD be taken from ClinicalUseDefinitionCategory
                (preferred to http://hl7.org/fhir/ValueSet/clinical-use-definition-category)

                A categorisation for a clinical use information item.

                TypeCodeableConcept
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                46. ClinicalUseDefinition.category:failureDegree.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                This element is affected by the following invariants: ele-1
                Typeid
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                48. ClinicalUseDefinition.category:failureDegree.extension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                ShortAdditional content defined by implementations
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Alternate Namesextensions, user content
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on ClinicalUseDefinition.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 50. ClinicalUseDefinition.category:failureDegree.coding
                  Definition

                  A reference to a code defined by a terminology system.

                  ShortFailure degree 0-4. Neerupuudulikkuse aste: number + selgitus. This is a fake system for example. Do NOT use it!
                  Comments

                  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.

                  Control1..*
                  TypeCoding
                  Is Modifierfalse
                  Summarytrue
                  Requirements

                  Allows for alternative encodings within a code system, and translations to other code systems.

                  Pattern Value{
                    "system" : "https://fhir.ee/failure-degree"
                  }
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  52. ClinicalUseDefinition.category:failureDegree.text
                  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.

                  ShortPlain text representation of the concept
                  Comments

                  Very often the text is the same as a displayName of one of the codings.

                  Control0..1
                  Typestring
                  Is Modifierfalse
                  Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                  Summarytrue
                  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.

                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  54. ClinicalUseDefinition.category:additionalInformation
                  Slice NameadditionalInformation
                  Definition

                  A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy and Lactation", "Overdose", "Effects on Ability to Drive and Use Machines".

                  ShortA categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
                  Control0..1
                  BindingThe codes SHOULD be taken from ClinicalUseDefinitionCategory
                  (preferred to http://hl7.org/fhir/ValueSet/clinical-use-definition-category)

                  A categorisation for a clinical use information item.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  56. ClinicalUseDefinition.category:additionalInformation.id
                  Definition

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  ShortUnique id for inter-element referencing
                  Control0..1
                  This element is affected by the following invariants: ele-1
                  Typeid
                  Is Modifierfalse
                  XML FormatIn the XML format, this property is represented as an attribute.
                  Summaryfalse
                  58. ClinicalUseDefinition.category:additionalInformation.extension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                  ShortAdditional content defined by implementations
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifierfalse
                  Summaryfalse
                  Alternate Namesextensions, user content
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingThis element introduces a set of slices on ClinicalUseDefinition.category.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                  • value @ url
                  • 60. ClinicalUseDefinition.category:additionalInformation.coding
                    Definition

                    A reference to a code defined by a terminology system.

                    ShortThis is a fake system for example. Do NOT use it
                    Comments

                    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.

                    Control1..*
                    TypeCoding
                    Is Modifierfalse
                    Summarytrue
                    Requirements

                    Allows for alternative encodings within a code system, and translations to other code systems.

                    Pattern Value{
                      "system" : "https://fhir.ee/additional-information"
                    }
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    62. ClinicalUseDefinition.category:additionalInformation.text
                    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.

                    ShortPlain text representation of the concept
                    Comments

                    Very often the text is the same as a displayName of one of the codings.

                    Control0..1
                    Typestring
                    Is Modifierfalse
                    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                    Summarytrue
                    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.

                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    64. ClinicalUseDefinition.subject
                    Definition

                    The medication, product, substance, device, procedure etc. for which this is an indication.

                    Shortmedication that may cause renal function failure
                    Control1..*
                    TypeReference(Medication)
                    Is Modifierfalse
                    Must Supportfalse
                    Summarytrue
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    66. ClinicalUseDefinition.subject.id
                    Definition

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    ShortUnique id for inter-element referencing
                    Control0..1
                    This element is affected by the following invariants: ele-1
                    Typeid
                    Is Modifierfalse
                    XML FormatIn the XML format, this property is represented as an attribute.
                    Summaryfalse
                    68. ClinicalUseDefinition.subject.extension
                    Definition

                    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                    ShortAdditional content defined by implementations
                    Comments

                    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                    Control0..*
                    TypeExtension
                    Is Modifierfalse
                    Summaryfalse
                    Alternate Namesextensions, user content
                    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingThis element introduces a set of slices on ClinicalUseDefinition.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                    • value @ url
                    • 70. ClinicalUseDefinition.subject.reference
                      Definition

                      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                      ShortLiteral reference, Relative, internal or absolute URL
                      Comments

                      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                      Control0..1
                      This element is affected by the following invariants: ref-2, ref-1
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      72. ClinicalUseDefinition.subject.type
                      Definition

                      The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                      The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                      ShortType the reference refers to (e.g. "Patient") - must be a resource in resources
                      Comments

                      This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.

                      Control0..1
                      BindingUnless not suitable, these codes SHALL be taken from ResourceType
                      (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                      Aa resource (or, for logical models, the URI of the logical model).

                      Typeuri
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      74. ClinicalUseDefinition.subject.identifier
                      Definition

                      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                      ShortLogical reference, when literal reference is not known
                      Comments

                      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                      This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

                      NoteThis is a business identifier, not a resource identifier (see discussion)
                      Control0..1
                      This element is affected by the following invariants: ref-2
                      TypeIdentifier
                      Is Modifierfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      76. ClinicalUseDefinition.subject.display
                      Definition

                      Plain text narrative that identifies the resource in addition to the resource reference.

                      ShortText alternative for the resource
                      Comments

                      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                      Control0..1
                      This element is affected by the following invariants: ref-2
                      Typestring
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Summarytrue
                      Pattern ValueName of the medication/active inredient. Siia toimeaine nimetus
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      78. ClinicalUseDefinition.status
                      Definition

                      Whether this is a current issue or one that has been retired etc.

                      ShortWhether this is a current issue or one that has been retired etc
                      Control0..1
                      BindingThe codes SHOULD be taken from PublicationStatus
                      (preferred to http://hl7.org/fhir/ValueSet/publication-status)

                      The lifecycle status of an artifact.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      80. ClinicalUseDefinition.contraindication
                      Definition

                      Specifics for when this is a contraindication.

                      ShortSpecifics for when this is a contraindication
                      Control0..0
                      This element is affected by the following invariants: cud-1
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      96. ClinicalUseDefinition.indication
                      Definition

                      Specifics for when this is an indication.

                      ShortSpecifics for when this is an indication
                      Control0..0
                      This element is affected by the following invariants: cud-1
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      109. ClinicalUseDefinition.interaction
                      Definition

                      Specifics for when this is an interaction.

                      ShortSpecifics for when this is an interaction
                      Control0..1
                      This element is affected by the following invariants: cud-1
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      111. ClinicalUseDefinition.interaction.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      113. ClinicalUseDefinition.interaction.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      115. ClinicalUseDefinition.interaction.modifierExtension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                      ShortExtensions that cannot be ignored even if unrecognized
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                      Summarytrue
                      Requirements

                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                      Alternate Namesextensions, user content, modifiers
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      117. ClinicalUseDefinition.interaction.interactant
                      Definition

                      The specific medication, product, food, substance etc. or laboratory test that interacts.

                      ShortThe specific medication, product, food etc. or laboratory test that interacts
                      Control0..*
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      119. ClinicalUseDefinition.interaction.interactant.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      121. ClinicalUseDefinition.interaction.interactant.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      123. ClinicalUseDefinition.interaction.interactant.modifierExtension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                      ShortExtensions that cannot be ignored even if unrecognized
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                      Summarytrue
                      Requirements

                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                      Alternate Namesextensions, user content, modifiers
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      125. ClinicalUseDefinition.interaction.interactant.item[x]
                      Definition

                      The specific medication, product, food, substance etc. or laboratory test that interacts.

                      ShortThe specific medication, product, food etc. or laboratory test that interacts
                      Control1..1
                      BindingFor example codes, see Interactant
                      (example to http://hl7.org/fhir/ValueSet/interactant)

                      An interactant - a substance that may have a clinically significant effect on another.

                      TypeChoice of: Reference(MedicinalProductDefinition, Medication, Substance, NutritionProduct, BiologicallyDerivedProduct, ObservationDefinition), CodeableConcept
                      [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      127. ClinicalUseDefinition.interaction.type
                      Definition

                      The type of the interaction e.g. drug-drug interaction, drug-food interaction, drug-lab test interaction.

                      ShortThe type of the interaction e.g. drug-drug interaction, drug-lab test interaction
                      Control0..1
                      BindingFor example codes, see InteractionType
                      (example to http://hl7.org/fhir/ValueSet/interaction-type)

                      A categorisation for an interaction between two substances.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      129. ClinicalUseDefinition.interaction.effect
                      Definition

                      The effect of the interaction, for example "reduced gastric absorption of primary medication".

                      ShortThe effect of the interaction, for example "reduced gastric absorption of primary medication"
                      Control0..1
                      BindingFor example codes, see InteractionEffect
                      (example to http://hl7.org/fhir/ValueSet/interaction-effect)

                      A interaction effect of clinical use of a medication or other substance.

                      TypeCodeableReference(ObservationDefinition)
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      131. ClinicalUseDefinition.interaction.incidence
                      Definition

                      The incidence of the interaction, e.g. theoretical, observed.

                      ShortThe incidence of the interaction, e.g. theoretical, observed
                      Control0..1
                      BindingFor example codes, see InteractionIncidence
                      (example to http://hl7.org/fhir/ValueSet/interaction-incidence)

                      A categorisation for incidence of occurence of an interaction.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      133. ClinicalUseDefinition.interaction.management
                      Definition

                      Actions for managing the interaction.

                      ShortActions for managing the interaction
                      Control0..*
                      BindingFor example codes, see InteractionManagement
                      (example to http://hl7.org/fhir/ValueSet/interaction-management)

                      A type of management for an interaction of a medication or other substance.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      135. ClinicalUseDefinition.population
                      Definition

                      The population group to which this applies.

                      ShortThe population group to which this applies
                      Control0..0
                      TypeReference(Group)
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      137. ClinicalUseDefinition.library
                      Definition

                      Logic used by the clinical use definition.

                      ShortLogic used by the clinical use definition
                      Control0..0
                      Typecanonical(Library)
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      139. ClinicalUseDefinition.undesirableEffect
                      Definition

                      Klassifikatsioon RenBase järgi ja kirjeldus kui palju annust tuleks muuta

                      ShortClassification A/B/C/D and description how the dosage must be adjusted
                      Control0..1
                      This element is affected by the following invariants: cud-1
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      141. ClinicalUseDefinition.undesirableEffect.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      143. ClinicalUseDefinition.undesirableEffect.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      145. ClinicalUseDefinition.undesirableEffect.modifierExtension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                      ShortExtensions that cannot be ignored even if unrecognized
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                      Summarytrue
                      Requirements

                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                      Alternate Namesextensions, user content, modifiers
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      147. ClinicalUseDefinition.undesirableEffect.symptomConditionEffect
                      Definition

                      The situation in which the undesirable effect may manifest.

                      ShortThe situation in which the undesirable effect may manifest
                      Control0..1
                      BindingFor example codes, see UndesirableEffectSymptom
                      (example to http://hl7.org/fhir/ValueSet/undesirable-effect-symptom)

                      An undesirable effect of clinical use.

                      TypeCodeableReference(ObservationDefinition)
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      149. ClinicalUseDefinition.undesirableEffect.classification
                      Definition

                      High level classification of the effect.

                      Shortklassifikatsioon (A/B/C/D) + selle tekst nt C, text: Annust või annustamise vahemikku tuleb kohandada
                      Control0..1
                      BindingFor example codes, see UndesirableEffectClassification
                      (example to http://hl7.org/fhir/ValueSet/undesirable-effect-classification)

                      Use this fictive system https://fhir.ee/synbase-warning-classification

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      151. ClinicalUseDefinition.undesirableEffect.frequencyOfOccurrence
                      Definition

                      How often the effect is seen.

                      ShortHow often the effect is seen
                      Control0..1
                      BindingFor example codes, see UndesirablEffectFrequency
                      (example to http://hl7.org/fhir/ValueSet/undesirable-effect-frequency)

                      A categorisation for a frequency of occurence of an undesirable effect.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      153. ClinicalUseDefinition.warning
                      Definition

                      A critical piece of information about environmental, health or physical risks or hazards that serve as caution to the user. For example 'Do not operate heavy machinery', 'May cause drowsiness', or 'Get medical advice/attention if you feel unwell'.

                      ShortCritical environmental, health or physical risks or hazards. For example 'Do not operate heavy machinery', 'May cause drowsiness'
                      Control0..1
                      This element is affected by the following invariants: cud-1
                      TypeBackboneElement
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      155. ClinicalUseDefinition.warning.id
                      Definition

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      ShortUnique id for inter-element referencing
                      Control0..1
                      This element is affected by the following invariants: ele-1
                      Typestring
                      Is Modifierfalse
                      XML FormatIn the XML format, this property is represented as an attribute.
                      Summaryfalse
                      157. ClinicalUseDefinition.warning.extension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      ShortAdditional content defined by implementations
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifierfalse
                      Summaryfalse
                      Alternate Namesextensions, user content
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      159. ClinicalUseDefinition.warning.modifierExtension
                      Definition

                      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                      ShortExtensions that cannot be ignored even if unrecognized
                      Comments

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Control0..*
                      TypeExtension
                      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                      Summarytrue
                      Requirements

                      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                      Alternate Namesextensions, user content, modifiers
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      161. ClinicalUseDefinition.warning.description
                      Definition

                      A textual definition of this warning, with formatting.

                      ShortA textual definition of this warning, with formatting
                      Control0..1
                      Typemarkdown
                      Is Modifierfalse
                      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      163. ClinicalUseDefinition.warning.code
                      Definition

                      A coded or unformatted textual definition of this warning.

                      ShortA coded or unformatted textual definition of this warning
                      Control0..1
                      BindingFor example codes, see WarningType
                      (example to http://hl7.org/fhir/ValueSet/warning-type)

                      Classification of warning type.

                      TypeCodeableConcept
                      Is Modifierfalse
                      Must Supportfalse
                      Summarytrue
                      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))