Stream: implementers
Topic: AllergyIntolerance - GP Data
Jonathan Homer (Mar 03 2016 at 15:34):
Hi, I’m currently looking at modelling primary care data using FHIR and have a particular question regarding the AllergyIntolerance resource. A common way of representing allergies in GP care management systems is to record the allergy or adverse reaction as a coded statement e.g. ‘Adverse reaction to penicillins’ (SCTID: 292954005). The actual substance responsible for the adverse reaction is not recorded and a mapping may or may not exist in the source system. Even if a substance mapping does exist, it feels right that the original statement should also be preserved. The AllergyIntolerance resource drives you down the route of recording a substance, which I think is actually a much more solid approach. However, this does result in a disparity when trying to model the GP data. I’m struggling with which way to go when creating a Structure Definition to best represent this model. Any thoughts or ideas regarding direction would be greatly welcomed.
David Hay (Mar 03 2016 at 16:49):
But substance can be a class - could you not just use that?
Jonathan Homer (Mar 03 2016 at 17:40):
David, thanks for the reply. I had interpreted ‘class’ as being a class of substances, for example Penicillin is a class of antibiotics substances. The above coded example ‘Adverse reaction to penicillins’ is actually a disorder as opposed to a substance or a class of substances. However, my interpretation could well be wrong?
David Hay (Mar 03 2016 at 21:19):
I was imagining (rightly or wrongly) that a substance class could be 'Penicillins' - thus meeting your use case...
Peter Jordan (Mar 04 2016 at 02:08):
@Jonathan Homer 'Adverse reaction to penicillins' is a fully defined concept in SNOMED CT and, as such, has a causative agent attribute of 'Penicillin -class of antibiotic- (substance)' (SCTID: 373270004). Therefore the SNOMED CT expression derived from the Stated Concept Definition provides the relevant substance class. All fine, IF your system understands SNOMED CT compositional grammar!
Grahame Grieve (Mar 05 2016 at 01:03):
Jonathon, the substance can be a 'class' in the sense that 'peniciliins' is a class
Last updated: Apr 12 2022 at 19:14 UTC
