15.7 Resource ClinicalUseDefinition - Content

Name	Flags	Card.	Type	Description & Constraints      Filter: Bindings Constraints Obligations
ClinicalUseDefinition	TU N		DomainResource	A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure + Rule: Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance + Rule: ClinicalUseDefinition.contraindication can only be used when type is 'contraindication' + Rule: ClinicalUseDefinition.indication can only be used when type is 'indication' + Rule: ClinicalUseDefinition.undesirableEffect can only be used when type is 'undesirable-effect' + Rule: ClinicalUseDefinition.interaction can only be used when type is 'interaction' + Rule: ClinicalUseDefinition.warning can only be used when type is 'warning' Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
identifier	Σ	0..*	Identifier	Business identifier for this issue
type	Σ	1..1	code	indication | contraindication | interaction | undesirable-effect | warning Binding: Clinical Use Definition Type ( Required )
category	Σ	0..*	CodeableConcept	A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose" Binding: Clinical Use Definition Category ( Preferred )
subject	Σ	1..*	Reference CodeableReference ( MedicinalProductDefinition | Medication | ActivityDefinition | PlanDefinition | Device | DeviceDefinition | SubstanceDefinition | NutritionProduct | BiologicallyDerivedProduct )	The medication, product, substance, device, procedure etc. for which this is an indication, contraindication, interaction, undesirable effect, or warning Binding: SNOMED CT Medication Codes ( Example )
status	?! Σ	0..1	CodeableConcept	Whether this is a current issue or one that has been retired etc Binding: PublicationStatus ( Preferred )
contraindication undesirableEffect	Σ C	0..1	BackboneElement	A possible negative outcome from the use of this treatment
symptomConditionEffect	Σ	0..1	CodeableReference ( ObservationDefinition )	The situation in which the undesirable effect may manifest Binding: Undesirable Effect Symptom ( Example )
classification	Σ	0..1	CodeableConcept	High level classification of the effect Binding: Undesirable Effect Classification ( Example )
frequencyOfOccurrence	Σ	0..1	CodeableConcept	How often the effect is seen Binding: Undesirabl Effect Frequency ( Example )
management	Σ	0..*	CodeableConcept	Actions for managing the undesirable effect Binding: Interaction Management ( Example )
indication	Σ C	0..1	BackboneElement	Specifics for when this is a contraindication an indication
diseaseSymptomProcedure	Σ	0..1	CodeableReference ( ObservationDefinition )	The situation that is being documented as contraindicating against an indication for this item Binding: Disease Symptom Procedure ( Example )
diseaseStatus	Σ	0..1	CodeableReference ( ObservationDefinition )	The status of the disease or symptom for the contraindication indication Binding: Disease Status ( Example )
comorbidity	Σ	0..*	CodeableReference ( ObservationDefinition )	A comorbidity (concurrent condition) or coinfection as part of the indication Binding: Disease Symptom Procedure ( Example )
indication intendedEffect	Σ	0..*	Reference CodeableReference ( ClinicalUseDefinition ObservationDefinition )	The indication which intended effect, aim or strategy to be achieved Binding: Product Intended Use ( Preferred )
duration[x]	Σ	0..1		Timing or duration information
durationRange			Range
durationString			string
undesirableEffect	Σ	0..*	see undesirableEffect	An unwanted side effect or negative outcome of the subject of this is a contraindication resource when being used for this indication
applicability		0..1	Expression	An expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements
otherTherapy	Σ	0..*	BackboneElement	Information about use of the product in relation to other therapies described as part of the contraindication
relationshipType	Σ	1..1	CodeableConcept	The type of relationship between the product indication/contraindication and another therapy Binding: Therapy Relationship Type ( Preferred )
treatment	Σ	1..1	CodeableReference ( MedicinalProductDefinition | Medication | SubstanceDefinition | NutritionProduct | BiologicallyDerivedProduct | ActivityDefinition )	Reference to a specific medication, substance etc. as part of an indication or contraindication Binding: Therapy ( Example )
indication contraindication	Σ C	0..1	BackboneElement	Specifics for when this is an indication a contraindication
diseaseSymptomProcedure	Σ	0..1	CodeableReference ( ObservationDefinition )	The situation that is being documented as an indication for contraindicating against this item Binding: Disease Symptom Procedure ( Example )
diseaseStatus	Σ	0..1	CodeableReference ( ObservationDefinition )	The status of the disease or symptom for the indication contraindication Binding: Disease Status ( Example )
comorbidity	Σ	0..*	CodeableReference ( ObservationDefinition )	A comorbidity (concurrent condition) or coinfection as part of the indication Binding: Disease Symptom Procedure ( Example )
intendedEffect indication	Σ	0..*	see indication )	The intended effect, aim or strategy to be achieved Binding: Product Intended Use ( Preferred ) indication which this is a contraindication for duration[x] Σ 0..1 Timing or duration information
durationRange Range applicability durationString string		0..1	Σ Expression	An unwanted side effect expression that returns true or negative outcome of false, indicating whether the subject of this resource when being used for this indication is applicable or not, after having applied its other elements
applicability management	Σ	0..*	Expression CodeableConcept	Actions for managing the indication is applicable or not, after having applied its other elements contraindication Binding: Interaction Management ( Example )
otherTherapy	Σ	0..*	see otherTherapy	Information about use of the medicinal product in relation to other therapies described as part of the indication contraindication
interaction	Σ C	0..1	BackboneElement	Specifics for when this is an interaction
interactant	Σ	0..*	BackboneElement	The specific medication, product, food etc. or laboratory test that interacts
item[x]	Σ	1..1		The specific medication, product, food etc. or laboratory test that interacts Binding: Interactant ( Example )
itemReference			Reference ( MedicinalProductDefinition | Medication | SubstanceDefinition | NutritionProduct | BiologicallyDerivedProduct | ObservationDefinition )
itemCodeableConcept			CodeableConcept
route		0..1	CodeableConcept	The route by which the item is administered to cause the interaction Binding: SNOMED CT Route Codes ( Example )
type	Σ	0..1	CodeableConcept	The type of the interaction e.g. drug-drug interaction, drug-lab test interaction Binding: Interaction Type ( Example )
effect	Σ	0..1	CodeableReference ( ObservationDefinition )	The effect of the interaction, for example "reduced gastric absorption of primary medication" Binding: Interaction Effect ( Example )
incidence	Σ	0..1	CodeableConcept	The incidence of the interaction, e.g. theoretical, observed Binding: Interaction Incidence ( Example )
management	Σ	0..*	CodeableConcept	Actions for managing the interaction Binding: Interaction Management ( Example )
severity	Σ	0..1	CodeableConcept	The severity of the interaction Binding: Allergy Intolerance Severity ( Example )
population	Σ	0..*	Reference ( Group )	The population group to which this applies
library	Σ	0..*	canonical ( Library )	Logic used by the clinical use definition
warning	Σ C	0..1	BackboneElement	Critical environmental, health or physical risks or hazards. For example 'Do not operate heavy machinery', 'May cause drowsiness'
description	Σ	0..1	markdown	A textual definition of this warning, with formatting
code	Σ	0..1	CodeableConcept	A coded or unformatted textual definition of this warning Binding: Warning Type ( Example )
Documentation for this format

See the Extensions for this resource

<ClinicalUseDefinition xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier for this issue --></identifier>
 <type value="[code]"/><!-- 1..1 indication | contraindication | interaction | undesirable-effect | warning -->
 <category><!-- 0..* CodeableConcept A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose" --></category>
 <|
   |
   </subject>
 <</status>
 <
  <</diseaseSymptomProcedure>
  <</diseaseStatus>
  <</comorbidity>
  <</indication>
  <</applicability>
  <
   <</relationshipType>
   <|
     |
     </treatment>
  </otherTherapy>
 </contraindication>

 <subject><!-- 1..* CodeableReference(ActivityDefinition|
   BiologicallyDerivedProduct|Device|DeviceDefinition|Medication|
   MedicinalProductDefinition|NutritionProduct|PlanDefinition|
   SubstanceDefinition) The medication, product, substance, device, procedure etc. for which this is an indication, contraindication, interaction, undesirable effect, or warning --></subject>

 <status><!-- 0..1 CodeableConcept Whether this is a current issue or one that has been retired etc --></status>
 <undesirableEffect>  <!-- I 0..1 A possible negative outcome from the use of this treatment -->
  <symptomConditionEffect><!-- 0..1 CodeableReference(ObservationDefinition) The situation in which the undesirable effect may manifest --></symptomConditionEffect>
  <classification><!-- 0..1 CodeableConcept High level classification of the effect --></classification>
  <frequencyOfOccurrence><!-- 0..1 CodeableConcept How often the effect is seen --></frequencyOfOccurrence>
  <management><!-- 0..* CodeableConcept Actions for managing the undesirable effect --></management>
 </undesirableEffect>

 <indication>  <!-- I 0..1 Specifics for when this is an indication -->
  <diseaseSymptomProcedure><!-- 0..1 CodeableReference(ObservationDefinition) The situation that is being documented as an indication for this item --></diseaseSymptomProcedure>
  <diseaseStatus><!-- 0..1 CodeableReference(ObservationDefinition) The status of the disease or symptom for the indication --></diseaseStatus>
  <</comorbidity>
  <</intendedEffect>

  <comorbidity><!-- 0..* CodeableReference(ObservationDefinition) A comorbidity or coinfection as part of the indication --></comorbidity>
  <intendedEffect><!-- 0..* CodeableReference(ObservationDefinition) The intended effect, aim or strategy to be achieved --></intendedEffect>

  <duration[x]><!-- 0..1 Range|string Timing or duration information --></duration[x]>
  <</undesirableEffect>

  <undesirableEffect><!-- 0..* Content as for ClinicalUseDefinition.undesirableEffect An unwanted side effect or negative outcome of the subject of this resource when being used for this indication --></undesirableEffect>

  <applicability><!-- 0..1 Expression An expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements --></applicability>
  <</otherTherapy>

  <otherTherapy>  <!-- 0..* Information about use of the product in relation to other therapies described as part of the contraindication -->
   <relationshipType><!-- 1..1 CodeableConcept The type of relationship between the product indication/contraindication and another therapy --></relationshipType>
   <treatment><!-- 1..1 CodeableReference(ActivityDefinition|
     BiologicallyDerivedProduct|Medication|MedicinalProductDefinition|
     NutritionProduct|SubstanceDefinition) Reference to a specific medication, substance etc. as part of an indication or contraindication --></treatment>

  </otherTherapy>

 </indication>
 <contraindication>  <!-- I 0..1 Specifics for when this is a contraindication -->
  <diseaseSymptomProcedure><!-- 0..1 CodeableReference(ObservationDefinition) The situation that is being documented as contraindicating against this item --></diseaseSymptomProcedure>
  <diseaseStatus><!-- 0..1 CodeableReference(ObservationDefinition) The status of the disease or symptom for the contraindication --></diseaseStatus>
  <comorbidity><!-- 0..* CodeableReference(ObservationDefinition) A comorbidity (concurrent condition) or coinfection --></comorbidity>
  <indication><!-- 0..* Content as for ClinicalUseDefinition.indication The indication which this is a contraindication for --></indication>
  <applicability><!-- 0..1 Expression An expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements --></applicability>
  <management><!-- 0..* CodeableConcept Actions for managing the contraindication --></management>
  <otherTherapy><!-- 0..* Content as for ClinicalUseDefinition.indication.otherTherapy Information about use of the product in relation to other therapies described as part of the contraindication --></otherTherapy>
 </contraindication>

 <interaction>  <!-- I 0..1 Specifics for when this is an interaction -->
  <interactant>  <!-- 0..* The specific medication, product, food etc. or laboratory test that interacts -->
   <item[x]><!-- 1..1 Reference(BiologicallyDerivedProduct|Medication|
     MedicinalProductDefinition|NutritionProduct|ObservationDefinition|
     SubstanceDefinition)|CodeableConcept The specific medication, product, food etc. or laboratory test that interacts --></item[x]>
   <route><!-- 0..1 CodeableConcept The route by which the item is administered to cause the interaction --></route>

  </interactant>
  <type><!-- 0..1 CodeableConcept The type of the interaction e.g. drug-drug interaction, drug-lab test interaction --></type>
  <effect><!-- 0..1 CodeableReference(ObservationDefinition) The effect of the interaction, for example "reduced gastric absorption of primary medication" --></effect>
  <incidence><!-- 0..1 CodeableConcept The incidence of the interaction, e.g. theoretical, observed --></incidence>
  <management><!-- 0..* CodeableConcept Actions for managing the interaction --></management>
  <severity><!-- 0..1 CodeableConcept The severity of the interaction --></severity>

 </interaction>
 <population><!-- 0..* Reference(Group) The population group to which this applies --></population>
 <library><!-- 0..* canonical(Library) Logic used by the clinical use definition --></library>
 <
  <</symptomConditionEffect>
  <</classification>
  <</frequencyOfOccurrence>
 </undesirableEffect>

 <warning>  <!-- I 0..1 Critical environmental, health or physical risks or hazards. For example 'Do not operate heavy machinery', 'May cause drowsiness' -->
  <description value="[markdown]"/><!-- 0..1 A textual definition of this warning, with formatting -->
  <code><!-- 0..1 CodeableConcept A coded or unformatted textual definition of this warning --></code>
 </warning>
</ClinicalUseDefinition>

{
  "resourceType" : "ClinicalUseDefinition",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifier for this issue
  "type" : "<code>", // R!  indication | contraindication | interaction | undesirable-effect | warning
  "category" : [{ CodeableConcept }], // A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
  "|
   |
   
  "
  "
    "
    "
    "
    "
    "
    "
      "
      "|
     |
     
    }]

  "subject" : [{ CodeableReference(ActivityDefinition|
   BiologicallyDerivedProduct|Device|DeviceDefinition|Medication|
   MedicinalProductDefinition|NutritionProduct|PlanDefinition|
   SubstanceDefinition) }], // R!  The medication, product, substance, device, procedure etc. for which this is an indication, contraindication, interaction, undesirable effect, or warning

  "status" : { CodeableConcept }, // Whether this is a current issue or one that has been retired etc
  "undesirableEffect" : { // I A possible negative outcome from the use of this treatment
    "symptomConditionEffect" : { CodeableReference(ObservationDefinition) }, // The situation in which the undesirable effect may manifest
    "classification" : { CodeableConcept }, // High level classification of the effect
    "frequencyOfOccurrence" : { CodeableConcept }, // How often the effect is seen
    "management" : [{ CodeableConcept }] // Actions for managing the undesirable effect

  },
  "indication" : { // I Specifics for when this is an indication
    "diseaseSymptomProcedure" : { CodeableReference(ObservationDefinition) }, // The situation that is being documented as an indication for this item
    "diseaseStatus" : { CodeableReference(ObservationDefinition) }, // The status of the disease or symptom for the indication
    "
    "

    "comorbidity" : [{ CodeableReference(ObservationDefinition) }], // A comorbidity or coinfection as part of the indication
    "intendedEffect" : [{ CodeableReference(ObservationDefinition) }], // The intended effect, aim or strategy to be achieved

    // duration[x]: Timing or duration information. One of these 2:
    "durationRange" : { Range },
    "durationString" : "<string>",
    "

    "undesirableEffect" : [{ Content as for ClinicalUseDefinition.undesirableEffect }], // An unwanted side effect or negative outcome of the subject of this resource when being used for this indication

    "applicability" : { Expression }, // An expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements
    "

    "otherTherapy" : [{ // Information about use of the product in relation to other therapies described as part of the contraindication
      "relationshipType" : { CodeableConcept }, // R!  The type of relationship between the product indication/contraindication and another therapy
      "treatment" : { CodeableReference(ActivityDefinition|
     BiologicallyDerivedProduct|Medication|MedicinalProductDefinition|
     NutritionProduct|SubstanceDefinition) } // R!  Reference to a specific medication, substance etc. as part of an indication or contraindication

    }]
  },
  "contraindication" : { // I Specifics for when this is a contraindication
    "diseaseSymptomProcedure" : { CodeableReference(ObservationDefinition) }, // The situation that is being documented as contraindicating against this item
    "diseaseStatus" : { CodeableReference(ObservationDefinition) }, // The status of the disease or symptom for the contraindication
    "comorbidity" : [{ CodeableReference(ObservationDefinition) }], // A comorbidity (concurrent condition) or coinfection
    "indication" : [{ Content as for ClinicalUseDefinition.indication }], // The indication which this is a contraindication for
    "applicability" : { Expression }, // An expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements
    "management" : [{ CodeableConcept }], // Actions for managing the contraindication
    "otherTherapy" : [{ Content as for ClinicalUseDefinition.indication.otherTherapy }] // Information about use of the product in relation to other therapies described as part of the contraindication

  },
  "interaction" : { // I Specifics for when this is an interaction
    "interactant" : [{ // The specific medication, product, food etc. or laboratory test that interacts
      // item[x]: The specific medication, product, food etc. or laboratory test that interacts. One of these 2:
      "itemReference" : { Reference(BiologicallyDerivedProduct|Medication|
     MedicinalProductDefinition|NutritionProduct|ObservationDefinition|
     SubstanceDefinition) },
      " }

      "itemCodeableConcept" : { CodeableConcept },
      "route" : { CodeableConcept } // The route by which the item is administered to cause the interaction

    }],
    "type" : { CodeableConcept }, // The type of the interaction e.g. drug-drug interaction, drug-lab test interaction
    "effect" : { CodeableReference(ObservationDefinition) }, // The effect of the interaction, for example "reduced gastric absorption of primary medication"
    "incidence" : { CodeableConcept }, // The incidence of the interaction, e.g. theoretical, observed
    "

    "management" : [{ CodeableConcept }], // Actions for managing the interaction
    "severity" : { CodeableConcept } // The severity of the interaction

  },
  "population" : [{ Reference(Group) }], // The population group to which this applies
  "library" : ["<canonical(Library)>"], // Logic used by the clinical use definition
  "
    "
    "
    "
  },

  "warning" : { // I Critical environmental, health or physical risks or hazards. For example 'Do not operate heavy machinery', 'May cause drowsiness'
    "description" : "<markdown>", // A textual definition of this warning, with formatting
    "code" : { CodeableConcept } // A coded or unformatted textual definition of this warning
  }
}

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:ClinicalUseDefinition;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from 
  # from 

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension

  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business identifier for this issue
  fhir:type [ code ] ; # 1..1 indication | contraindication | interaction | undesirable-effect | warning
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
  fhir:|
  
  fhir:
  fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
      fhir:
      fhir:|
  
    ] ... ) ;

  fhir:subject  ( [ CodeableReference(ActivityDefinition|BiologicallyDerivedProduct|Device|DeviceDefinition|Medication|
  MedicinalProductDefinition|NutritionProduct|PlanDefinition|SubstanceDefinition) ] ... ) ; # 1..* The medication, product, substance, device, procedure etc. for which this is an indication, contraindication, interaction, undesirable effect, or warning

  fhir:status [ CodeableConcept ] ; # 0..1 Whether this is a current issue or one that has been retired etc
  fhir:undesirableEffect [ # 0..1 I A possible negative outcome from the use of this treatment
    fhir:symptomConditionEffect [ CodeableReference(ObservationDefinition) ] ; # 0..1 The situation in which the undesirable effect may manifest
    fhir:classification [ CodeableConcept ] ; # 0..1 High level classification of the effect
    fhir:frequencyOfOccurrence [ CodeableConcept ] ; # 0..1 How often the effect is seen
    fhir:management  ( [ CodeableConcept ] ... ) ; # 0..* Actions for managing the undesirable effect

  ] ;
  fhir:indication [ # 0..1 I Specifics for when this is an indication
    fhir:diseaseSymptomProcedure [ CodeableReference(ObservationDefinition) ] ; # 0..1 The situation that is being documented as an indication for this item
    fhir:diseaseStatus [ CodeableReference(ObservationDefinition) ] ; # 0..1 The status of the disease or symptom for the indication
    fhir:
    fhir:

    fhir:comorbidity  ( [ CodeableReference(ObservationDefinition) ] ... ) ; # 0..* A comorbidity or coinfection as part of the indication
    fhir:intendedEffect  ( [ CodeableReference(ObservationDefinition) ] ... ) ; # 0..* The intended effect, aim or strategy to be achieved

    # duration[x] : 0..1 Timing or duration information. One of these 2
      fhir:duration [  a fhir:Range ; Range ]
      fhir: ]
    fhir:

      fhir:duration [  a fhir:String ; string ]
    fhir:undesirableEffect  ( [ See ClinicalUseDefinition.undesirableEffect ] ... ) ; # 0..* An unwanted side effect or negative outcome of the subject of this resource when being used for this indication

    fhir:applicability [ Expression ] ; # 0..1 An expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements
    fhir:

    fhir:otherTherapy ( [ # 0..* Information about use of the product in relation to other therapies described as part of the contraindication
      fhir:relationshipType [ CodeableConcept ] ; # 1..1 The type of relationship between the product indication/contraindication and another therapy
      fhir:treatment [ CodeableReference(ActivityDefinition|BiologicallyDerivedProduct|Medication|
  MedicinalProductDefinition|NutritionProduct|SubstanceDefinition) ] ; # 1..1 Reference to a specific medication, substance etc. as part of an indication or contraindication

    ] ... ) ;
  ] ;
  fhir:contraindication [ # 0..1 I Specifics for when this is a contraindication
    fhir:diseaseSymptomProcedure [ CodeableReference(ObservationDefinition) ] ; # 0..1 The situation that is being documented as contraindicating against this item
    fhir:diseaseStatus [ CodeableReference(ObservationDefinition) ] ; # 0..1 The status of the disease or symptom for the contraindication
    fhir:comorbidity  ( [ CodeableReference(ObservationDefinition) ] ... ) ; # 0..* A comorbidity (concurrent condition) or coinfection
    fhir:indication  ( [ See ClinicalUseDefinition.indication ] ... ) ; # 0..* The indication which this is a contraindication for
    fhir:applicability [ Expression ] ; # 0..1 An expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements
    fhir:management  ( [ CodeableConcept ] ... ) ; # 0..* Actions for managing the contraindication
    fhir:otherTherapy  ( [ See ClinicalUseDefinition.indication.otherTherapy ] ... ) ; # 0..* Information about use of the product in relation to other therapies described as part of the contraindication

  ] ;
  fhir:interaction [ # 0..1 I Specifics for when this is an interaction
    fhir:interactant ( [ # 0..* The specific medication, product, food etc. or laboratory test that interacts
      # item[x] : 1..1 The specific medication, product, food etc. or laboratory test that interacts. One of these 2
        fhir:item [  a fhir:Reference ; Reference(BiologicallyDerivedProduct|Medication|MedicinalProductDefinition|
  NutritionProduct|ObservationDefinition|SubstanceDefinition) ]
        fhir:item [  a fhir:CodeableConcept ; CodeableConcept ]
      fhir:route [ CodeableConcept ] ; # 0..1 The route by which the item is administered to cause the interaction

    ] ... ) ;
    fhir:type [ CodeableConcept ] ; # 0..1 The type of the interaction e.g. drug-drug interaction, drug-lab test interaction
    fhir:effect [ CodeableReference(ObservationDefinition) ] ; # 0..1 The effect of the interaction, for example "reduced gastric absorption of primary medication"
    fhir:incidence [ CodeableConcept ] ; # 0..1 The incidence of the interaction, e.g. theoretical, observed
    fhir:management  ( [ CodeableConcept ] ... ) ; # 0..* Actions for managing the interaction
    fhir:severity [ CodeableConcept ] ; # 0..1 The severity of the interaction

  ] ;
  fhir:population  ( [ Reference(Group) ] ... ) ; # 0..* The population group to which this applies
  fhir:library  ( [ canonical(Library) ] ... ) ; # 0..* Logic used by the clinical use definition
  fhir:
    fhir:
    fhir:
    fhir:
  ] ;

  fhir:warning [ # 0..1 I Critical environmental, health or physical risks or hazards. For example 'Do not operate heavy machinery', 'May cause drowsiness'
    fhir:description [ markdown ] ; # 0..1 A textual definition of this warning, with formatting
    fhir:code [ CodeableConcept ] ; # 0..1 A coded or unformatted textual definition of this warning
  ] ;
]

Changes from both R4 and R4B

This resource did not exist in Release R4

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .

Name	Flags	Card.	Type	Description & Constraints      Filter: Bindings Constraints Obligations
ClinicalUseDefinition	TU N		DomainResource	A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure + Rule: Indication, Contraindication, Interaction, UndesirableEffect and Warning cannot be used in the same instance + Rule: ClinicalUseDefinition.contraindication can only be used when type is 'contraindication' + Rule: ClinicalUseDefinition.indication can only be used when type is 'indication' + Rule: ClinicalUseDefinition.undesirableEffect can only be used when type is 'undesirable-effect' + Rule: ClinicalUseDefinition.interaction can only be used when type is 'interaction' + Rule: ClinicalUseDefinition.warning can only be used when type is 'warning' Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
identifier	Σ	0..*	Identifier	Business identifier for this issue
type	Σ	1..1	code	indication | contraindication | interaction | undesirable-effect | warning Binding: Clinical Use Definition Type ( Required )
category	Σ	0..*	CodeableConcept	A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose" Binding: Clinical Use Definition Category ( Preferred )
subject	Σ	1..*	Reference CodeableReference ( MedicinalProductDefinition | Medication | ActivityDefinition | PlanDefinition | Device | DeviceDefinition | SubstanceDefinition | NutritionProduct | BiologicallyDerivedProduct )	The medication, product, substance, device, procedure etc. for which this is an indication, contraindication, interaction, undesirable effect, or warning Binding: SNOMED CT Medication Codes ( Example )
status	?! Σ	0..1	CodeableConcept	Whether this is a current issue or one that has been retired etc Binding: PublicationStatus ( Preferred )
contraindication undesirableEffect	Σ C	0..1	BackboneElement	A possible negative outcome from the use of this treatment
symptomConditionEffect	Σ	0..1	CodeableReference ( ObservationDefinition )	The situation in which the undesirable effect may manifest Binding: Undesirable Effect Symptom ( Example )
classification	Σ	0..1	CodeableConcept	High level classification of the effect Binding: Undesirable Effect Classification ( Example )
frequencyOfOccurrence	Σ	0..1	CodeableConcept	How often the effect is seen Binding: Undesirabl Effect Frequency ( Example )
management	Σ	0..*	CodeableConcept	Actions for managing the undesirable effect Binding: Interaction Management ( Example )
indication	Σ C	0..1	BackboneElement	Specifics for when this is a contraindication an indication
diseaseSymptomProcedure	Σ	0..1	CodeableReference ( ObservationDefinition )	The situation that is being documented as contraindicating against an indication for this item Binding: Disease Symptom Procedure ( Example )
diseaseStatus	Σ	0..1	CodeableReference ( ObservationDefinition )	The status of the disease or symptom for the contraindication indication Binding: Disease Status ( Example )
comorbidity	Σ	0..*	CodeableReference ( ObservationDefinition )	A comorbidity (concurrent condition) or coinfection as part of the indication Binding: Disease Symptom Procedure ( Example )
indication intendedEffect	Σ	0..*	Reference CodeableReference ( ClinicalUseDefinition ObservationDefinition )	The indication which intended effect, aim or strategy to be achieved Binding: Product Intended Use ( Preferred )
duration[x]	Σ	0..1		Timing or duration information
durationRange			Range
durationString			string
undesirableEffect	Σ	0..*	see undesirableEffect	An unwanted side effect or negative outcome of the subject of this is a contraindication resource when being used for this indication
applicability		0..1	Expression	An expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements
otherTherapy	Σ	0..*	BackboneElement	Information about use of the product in relation to other therapies described as part of the contraindication
relationshipType	Σ	1..1	CodeableConcept	The type of relationship between the product indication/contraindication and another therapy Binding: Therapy Relationship Type ( Preferred )
treatment	Σ	1..1	CodeableReference ( MedicinalProductDefinition | Medication | SubstanceDefinition | NutritionProduct | BiologicallyDerivedProduct | ActivityDefinition )	Reference to a specific medication, substance etc. as part of an indication or contraindication Binding: Therapy ( Example )
indication contraindication	Σ C	0..1	BackboneElement	Specifics for when this is an indication a contraindication
diseaseSymptomProcedure	Σ	0..1	CodeableReference ( ObservationDefinition )	The situation that is being documented as an indication for contraindicating against this item Binding: Disease Symptom Procedure ( Example )
diseaseStatus	Σ	0..1	CodeableReference ( ObservationDefinition )	The status of the disease or symptom for the indication contraindication Binding: Disease Status ( Example )
comorbidity	Σ	0..*	CodeableReference ( ObservationDefinition )	A comorbidity (concurrent condition) or coinfection as part of the indication Binding: Disease Symptom Procedure ( Example )
intendedEffect indication	Σ	0..*	see indication )	The intended effect, aim or strategy to be achieved Binding: Product Intended Use ( Preferred ) indication which this is a contraindication for duration[x] Σ 0..1 Timing or duration information
durationRange Range applicability durationString string		0..1	Σ Expression	An unwanted side effect expression that returns true or negative outcome of false, indicating whether the subject of this resource when being used for this indication is applicable or not, after having applied its other elements
applicability management	Σ	0..*	Expression CodeableConcept	Actions for managing the indication is applicable or not, after having applied its other elements contraindication Binding: Interaction Management ( Example )
otherTherapy	Σ	0..*	see otherTherapy	Information about use of the medicinal product in relation to other therapies described as part of the indication contraindication
interaction	Σ C	0..1	BackboneElement	Specifics for when this is an interaction
interactant	Σ	0..*	BackboneElement	The specific medication, product, food etc. or laboratory test that interacts
item[x]	Σ	1..1		The specific medication, product, food etc. or laboratory test that interacts Binding: Interactant ( Example )
itemReference			Reference ( MedicinalProductDefinition | Medication | SubstanceDefinition | NutritionProduct | BiologicallyDerivedProduct | ObservationDefinition )
itemCodeableConcept			CodeableConcept
route		0..1	CodeableConcept	The route by which the item is administered to cause the interaction Binding: SNOMED CT Route Codes ( Example )
type	Σ	0..1	CodeableConcept	The type of the interaction e.g. drug-drug interaction, drug-lab test interaction Binding: Interaction Type ( Example )
effect	Σ	0..1	CodeableReference ( ObservationDefinition )	The effect of the interaction, for example "reduced gastric absorption of primary medication" Binding: Interaction Effect ( Example )
incidence	Σ	0..1	CodeableConcept	The incidence of the interaction, e.g. theoretical, observed Binding: Interaction Incidence ( Example )
management	Σ	0..*	CodeableConcept	Actions for managing the interaction Binding: Interaction Management ( Example )
severity	Σ	0..1	CodeableConcept	The severity of the interaction Binding: Allergy Intolerance Severity ( Example )
population	Σ	0..*	Reference ( Group )	The population group to which this applies
library	Σ	0..*	canonical ( Library )	Logic used by the clinical use definition
warning	Σ C	0..1	BackboneElement	Critical environmental, health or physical risks or hazards. For example 'Do not operate heavy machinery', 'May cause drowsiness'
description	Σ	0..1	markdown	A textual definition of this warning, with formatting
code	Σ	0..1	CodeableConcept	A coded or unformatted textual definition of this warning Binding: Warning Type ( Example )
Documentation for this format

See the Extensions for this resource

<ClinicalUseDefinition xmlns="http://hl7.org/fhir"> 
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business identifier for this issue --></identifier>
 <type value="[code]"/><!-- 1..1 indication | contraindication | interaction | undesirable-effect | warning -->
 <category><!-- 0..* CodeableConcept A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose" --></category>
 <|
   |
   </subject>
 <</status>
 <
  <</diseaseSymptomProcedure>
  <</diseaseStatus>
  <</comorbidity>
  <</indication>
  <</applicability>
  <
   <</relationshipType>
   <|
     |
     </treatment>
  </otherTherapy>
 </contraindication>

 <subject><!-- 1..* CodeableReference(ActivityDefinition|
   BiologicallyDerivedProduct|Device|DeviceDefinition|Medication|
   MedicinalProductDefinition|NutritionProduct|PlanDefinition|
   SubstanceDefinition) The medication, product, substance, device, procedure etc. for which this is an indication, contraindication, interaction, undesirable effect, or warning --></subject>

 <status><!-- 0..1 CodeableConcept Whether this is a current issue or one that has been retired etc --></status>
 <undesirableEffect>  <!-- I 0..1 A possible negative outcome from the use of this treatment -->
  <symptomConditionEffect><!-- 0..1 CodeableReference(ObservationDefinition) The situation in which the undesirable effect may manifest --></symptomConditionEffect>
  <classification><!-- 0..1 CodeableConcept High level classification of the effect --></classification>
  <frequencyOfOccurrence><!-- 0..1 CodeableConcept How often the effect is seen --></frequencyOfOccurrence>
  <management><!-- 0..* CodeableConcept Actions for managing the undesirable effect --></management>
 </undesirableEffect>

 <indication>  <!-- I 0..1 Specifics for when this is an indication -->
  <diseaseSymptomProcedure><!-- 0..1 CodeableReference(ObservationDefinition) The situation that is being documented as an indication for this item --></diseaseSymptomProcedure>
  <diseaseStatus><!-- 0..1 CodeableReference(ObservationDefinition) The status of the disease or symptom for the indication --></diseaseStatus>
  <</comorbidity>
  <</intendedEffect>

  <comorbidity><!-- 0..* CodeableReference(ObservationDefinition) A comorbidity or coinfection as part of the indication --></comorbidity>
  <intendedEffect><!-- 0..* CodeableReference(ObservationDefinition) The intended effect, aim or strategy to be achieved --></intendedEffect>

  <duration[x]><!-- 0..1 Range|string Timing or duration information --></duration[x]>
  <</undesirableEffect>

  <undesirableEffect><!-- 0..* Content as for ClinicalUseDefinition.undesirableEffect An unwanted side effect or negative outcome of the subject of this resource when being used for this indication --></undesirableEffect>

  <applicability><!-- 0..1 Expression An expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements --></applicability>
  <</otherTherapy>

  <otherTherapy>  <!-- 0..* Information about use of the product in relation to other therapies described as part of the contraindication -->
   <relationshipType><!-- 1..1 CodeableConcept The type of relationship between the product indication/contraindication and another therapy --></relationshipType>
   <treatment><!-- 1..1 CodeableReference(ActivityDefinition|
     BiologicallyDerivedProduct|Medication|MedicinalProductDefinition|
     NutritionProduct|SubstanceDefinition) Reference to a specific medication, substance etc. as part of an indication or contraindication --></treatment>

  </otherTherapy>

 </indication>
 <contraindication>  <!-- I 0..1 Specifics for when this is a contraindication -->
  <diseaseSymptomProcedure><!-- 0..1 CodeableReference(ObservationDefinition) The situation that is being documented as contraindicating against this item --></diseaseSymptomProcedure>
  <diseaseStatus><!-- 0..1 CodeableReference(ObservationDefinition) The status of the disease or symptom for the contraindication --></diseaseStatus>
  <comorbidity><!-- 0..* CodeableReference(ObservationDefinition) A comorbidity (concurrent condition) or coinfection --></comorbidity>
  <indication><!-- 0..* Content as for ClinicalUseDefinition.indication The indication which this is a contraindication for --></indication>
  <applicability><!-- 0..1 Expression An expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements --></applicability>
  <management><!-- 0..* CodeableConcept Actions for managing the contraindication --></management>
  <otherTherapy><!-- 0..* Content as for ClinicalUseDefinition.indication.otherTherapy Information about use of the product in relation to other therapies described as part of the contraindication --></otherTherapy>
 </contraindication>

 <interaction>  <!-- I 0..1 Specifics for when this is an interaction -->
  <interactant>  <!-- 0..* The specific medication, product, food etc. or laboratory test that interacts -->
   <item[x]><!-- 1..1 Reference(BiologicallyDerivedProduct|Medication|
     MedicinalProductDefinition|NutritionProduct|ObservationDefinition|
     SubstanceDefinition)|CodeableConcept The specific medication, product, food etc. or laboratory test that interacts --></item[x]>
   <route><!-- 0..1 CodeableConcept The route by which the item is administered to cause the interaction --></route>

  </interactant>
  <type><!-- 0..1 CodeableConcept The type of the interaction e.g. drug-drug interaction, drug-lab test interaction --></type>
  <effect><!-- 0..1 CodeableReference(ObservationDefinition) The effect of the interaction, for example "reduced gastric absorption of primary medication" --></effect>
  <incidence><!-- 0..1 CodeableConcept The incidence of the interaction, e.g. theoretical, observed --></incidence>
  <management><!-- 0..* CodeableConcept Actions for managing the interaction --></management>
  <severity><!-- 0..1 CodeableConcept The severity of the interaction --></severity>

 </interaction>
 <population><!-- 0..* Reference(Group) The population group to which this applies --></population>
 <library><!-- 0..* canonical(Library) Logic used by the clinical use definition --></library>
 <
  <</symptomConditionEffect>
  <</classification>
  <</frequencyOfOccurrence>
 </undesirableEffect>

 <warning>  <!-- I 0..1 Critical environmental, health or physical risks or hazards. For example 'Do not operate heavy machinery', 'May cause drowsiness' -->
  <description value="[markdown]"/><!-- 0..1 A textual definition of this warning, with formatting -->
  <code><!-- 0..1 CodeableConcept A coded or unformatted textual definition of this warning --></code>
 </warning>
</ClinicalUseDefinition>

{
  "resourceType" : "ClinicalUseDefinition",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business identifier for this issue
  "type" : "<code>", // R!  indication | contraindication | interaction | undesirable-effect | warning
  "category" : [{ CodeableConcept }], // A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
  "|
   |
   
  "
  "
    "
    "
    "
    "
    "
    "
      "
      "|
     |
     
    }]

  "subject" : [{ CodeableReference(ActivityDefinition|
   BiologicallyDerivedProduct|Device|DeviceDefinition|Medication|
   MedicinalProductDefinition|NutritionProduct|PlanDefinition|
   SubstanceDefinition) }], // R!  The medication, product, substance, device, procedure etc. for which this is an indication, contraindication, interaction, undesirable effect, or warning

  "status" : { CodeableConcept }, // Whether this is a current issue or one that has been retired etc
  "undesirableEffect" : { // I A possible negative outcome from the use of this treatment
    "symptomConditionEffect" : { CodeableReference(ObservationDefinition) }, // The situation in which the undesirable effect may manifest
    "classification" : { CodeableConcept }, // High level classification of the effect
    "frequencyOfOccurrence" : { CodeableConcept }, // How often the effect is seen
    "management" : [{ CodeableConcept }] // Actions for managing the undesirable effect

  },
  "indication" : { // I Specifics for when this is an indication
    "diseaseSymptomProcedure" : { CodeableReference(ObservationDefinition) }, // The situation that is being documented as an indication for this item
    "diseaseStatus" : { CodeableReference(ObservationDefinition) }, // The status of the disease or symptom for the indication
    "
    "

    "comorbidity" : [{ CodeableReference(ObservationDefinition) }], // A comorbidity or coinfection as part of the indication
    "intendedEffect" : [{ CodeableReference(ObservationDefinition) }], // The intended effect, aim or strategy to be achieved

    // duration[x]: Timing or duration information. One of these 2:
    "durationRange" : { Range },
    "durationString" : "<string>",
    "

    "undesirableEffect" : [{ Content as for ClinicalUseDefinition.undesirableEffect }], // An unwanted side effect or negative outcome of the subject of this resource when being used for this indication

    "applicability" : { Expression }, // An expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements
    "

    "otherTherapy" : [{ // Information about use of the product in relation to other therapies described as part of the contraindication
      "relationshipType" : { CodeableConcept }, // R!  The type of relationship between the product indication/contraindication and another therapy
      "treatment" : { CodeableReference(ActivityDefinition|
     BiologicallyDerivedProduct|Medication|MedicinalProductDefinition|
     NutritionProduct|SubstanceDefinition) } // R!  Reference to a specific medication, substance etc. as part of an indication or contraindication

    }]
  },
  "contraindication" : { // I Specifics for when this is a contraindication
    "diseaseSymptomProcedure" : { CodeableReference(ObservationDefinition) }, // The situation that is being documented as contraindicating against this item
    "diseaseStatus" : { CodeableReference(ObservationDefinition) }, // The status of the disease or symptom for the contraindication
    "comorbidity" : [{ CodeableReference(ObservationDefinition) }], // A comorbidity (concurrent condition) or coinfection
    "indication" : [{ Content as for ClinicalUseDefinition.indication }], // The indication which this is a contraindication for
    "applicability" : { Expression }, // An expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements
    "management" : [{ CodeableConcept }], // Actions for managing the contraindication
    "otherTherapy" : [{ Content as for ClinicalUseDefinition.indication.otherTherapy }] // Information about use of the product in relation to other therapies described as part of the contraindication

  },
  "interaction" : { // I Specifics for when this is an interaction
    "interactant" : [{ // The specific medication, product, food etc. or laboratory test that interacts
      // item[x]: The specific medication, product, food etc. or laboratory test that interacts. One of these 2:
      "itemReference" : { Reference(BiologicallyDerivedProduct|Medication|
     MedicinalProductDefinition|NutritionProduct|ObservationDefinition|
     SubstanceDefinition) },
      " }

      "itemCodeableConcept" : { CodeableConcept },
      "route" : { CodeableConcept } // The route by which the item is administered to cause the interaction

    }],
    "type" : { CodeableConcept }, // The type of the interaction e.g. drug-drug interaction, drug-lab test interaction
    "effect" : { CodeableReference(ObservationDefinition) }, // The effect of the interaction, for example "reduced gastric absorption of primary medication"
    "incidence" : { CodeableConcept }, // The incidence of the interaction, e.g. theoretical, observed
    "

    "management" : [{ CodeableConcept }], // Actions for managing the interaction
    "severity" : { CodeableConcept } // The severity of the interaction

  },
  "population" : [{ Reference(Group) }], // The population group to which this applies
  "library" : ["<canonical(Library)>"], // Logic used by the clinical use definition
  "
    "
    "
    "
  },

  "warning" : { // I Critical environmental, health or physical risks or hazards. For example 'Do not operate heavy machinery', 'May cause drowsiness'
    "description" : "<markdown>", // A textual definition of this warning, with formatting
    "code" : { CodeableConcept } // A coded or unformatted textual definition of this warning
  }
}

@prefix fhir: <http://hl7.org/fhir/> .


[ a fhir:ClinicalUseDefinition;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from 
  # from 

  # from Resource: fhir:id, fhir:meta, fhir:implicitRules, and fhir:language
  # from DomainResource: fhir:text, fhir:contained, fhir:extension, and fhir:modifierExtension

  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business identifier for this issue
  fhir:type [ code ] ; # 1..1 indication | contraindication | interaction | undesirable-effect | warning
  fhir:category  ( [ CodeableConcept ] ... ) ; # 0..* A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
  fhir:|
  
  fhir:
  fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
      fhir:
      fhir:|
  
    ] ... ) ;

  fhir:subject  ( [ CodeableReference(ActivityDefinition|BiologicallyDerivedProduct|Device|DeviceDefinition|Medication|
  MedicinalProductDefinition|NutritionProduct|PlanDefinition|SubstanceDefinition) ] ... ) ; # 1..* The medication, product, substance, device, procedure etc. for which this is an indication, contraindication, interaction, undesirable effect, or warning

  fhir:status [ CodeableConcept ] ; # 0..1 Whether this is a current issue or one that has been retired etc
  fhir:undesirableEffect [ # 0..1 I A possible negative outcome from the use of this treatment
    fhir:symptomConditionEffect [ CodeableReference(ObservationDefinition) ] ; # 0..1 The situation in which the undesirable effect may manifest
    fhir:classification [ CodeableConcept ] ; # 0..1 High level classification of the effect
    fhir:frequencyOfOccurrence [ CodeableConcept ] ; # 0..1 How often the effect is seen
    fhir:management  ( [ CodeableConcept ] ... ) ; # 0..* Actions for managing the undesirable effect

  ] ;
  fhir:indication [ # 0..1 I Specifics for when this is an indication
    fhir:diseaseSymptomProcedure [ CodeableReference(ObservationDefinition) ] ; # 0..1 The situation that is being documented as an indication for this item
    fhir:diseaseStatus [ CodeableReference(ObservationDefinition) ] ; # 0..1 The status of the disease or symptom for the indication
    fhir:
    fhir:

    fhir:comorbidity  ( [ CodeableReference(ObservationDefinition) ] ... ) ; # 0..* A comorbidity or coinfection as part of the indication
    fhir:intendedEffect  ( [ CodeableReference(ObservationDefinition) ] ... ) ; # 0..* The intended effect, aim or strategy to be achieved

    # duration[x] : 0..1 Timing or duration information. One of these 2
      fhir:duration [  a fhir:Range ; Range ]
      fhir: ]
    fhir:

      fhir:duration [  a fhir:String ; string ]
    fhir:undesirableEffect  ( [ See ClinicalUseDefinition.undesirableEffect ] ... ) ; # 0..* An unwanted side effect or negative outcome of the subject of this resource when being used for this indication

    fhir:applicability [ Expression ] ; # 0..1 An expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements
    fhir:

    fhir:otherTherapy ( [ # 0..* Information about use of the product in relation to other therapies described as part of the contraindication
      fhir:relationshipType [ CodeableConcept ] ; # 1..1 The type of relationship between the product indication/contraindication and another therapy
      fhir:treatment [ CodeableReference(ActivityDefinition|BiologicallyDerivedProduct|Medication|
  MedicinalProductDefinition|NutritionProduct|SubstanceDefinition) ] ; # 1..1 Reference to a specific medication, substance etc. as part of an indication or contraindication

    ] ... ) ;
  ] ;
  fhir:contraindication [ # 0..1 I Specifics for when this is a contraindication
    fhir:diseaseSymptomProcedure [ CodeableReference(ObservationDefinition) ] ; # 0..1 The situation that is being documented as contraindicating against this item
    fhir:diseaseStatus [ CodeableReference(ObservationDefinition) ] ; # 0..1 The status of the disease or symptom for the contraindication
    fhir:comorbidity  ( [ CodeableReference(ObservationDefinition) ] ... ) ; # 0..* A comorbidity (concurrent condition) or coinfection
    fhir:indication  ( [ See ClinicalUseDefinition.indication ] ... ) ; # 0..* The indication which this is a contraindication for
    fhir:applicability [ Expression ] ; # 0..1 An expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements
    fhir:management  ( [ CodeableConcept ] ... ) ; # 0..* Actions for managing the contraindication
    fhir:otherTherapy  ( [ See ClinicalUseDefinition.indication.otherTherapy ] ... ) ; # 0..* Information about use of the product in relation to other therapies described as part of the contraindication

  ] ;
  fhir:interaction [ # 0..1 I Specifics for when this is an interaction
    fhir:interactant ( [ # 0..* The specific medication, product, food etc. or laboratory test that interacts
      # item[x] : 1..1 The specific medication, product, food etc. or laboratory test that interacts. One of these 2
        fhir:item [  a fhir:Reference ; Reference(BiologicallyDerivedProduct|Medication|MedicinalProductDefinition|
  NutritionProduct|ObservationDefinition|SubstanceDefinition) ]
        fhir:item [  a fhir:CodeableConcept ; CodeableConcept ]
      fhir:route [ CodeableConcept ] ; # 0..1 The route by which the item is administered to cause the interaction

    ] ... ) ;
    fhir:type [ CodeableConcept ] ; # 0..1 The type of the interaction e.g. drug-drug interaction, drug-lab test interaction
    fhir:effect [ CodeableReference(ObservationDefinition) ] ; # 0..1 The effect of the interaction, for example "reduced gastric absorption of primary medication"
    fhir:incidence [ CodeableConcept ] ; # 0..1 The incidence of the interaction, e.g. theoretical, observed
    fhir:management  ( [ CodeableConcept ] ... ) ; # 0..* Actions for managing the interaction
    fhir:severity [ CodeableConcept ] ; # 0..1 The severity of the interaction

  ] ;
  fhir:population  ( [ Reference(Group) ] ... ) ; # 0..* The population group to which this applies
  fhir:library  ( [ canonical(Library) ] ... ) ; # 0..* Logic used by the clinical use definition
  fhir:
    fhir:
    fhir:
    fhir:
  ] ;

  fhir:warning [ # 0..1 I Critical environmental, health or physical risks or hazards. For example 'Do not operate heavy machinery', 'May cause drowsiness'
    fhir:description [ markdown ] ; # 0..1 A textual definition of this warning, with formatting
    fhir:code [ CodeableConcept ] ; # 0..1 A coded or unformatted textual definition of this warning
  ] ;
]

Changes from both R4 and R4B

This resource did not exist in Release R4

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .