HypersensitivityIntolerance-v1.0(2024EN)

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General information

Name: nl.zorg.HypersensitivityIntolerance NL.png
Version: 1.0
HCIM Status:Final
Release: 2024
Release status: Prepublished
Release date: 15-04-2024

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Metadata

DCM::CoderList Zib-centrum
DCM::ContactInformation.Address *
DCM::ContactInformation.Name *
DCM::ContactInformation.Telecom *
DCM::ContentAuthorList Zib-centrum
DCM::CreationDate 22-05-2023
DCM::DeprecatedDate
DCM::DescriptionLanguage nl
DCM::EndorsingAuthority.Address
DCM::EndorsingAuthority.Name *
DCM::EndorsingAuthority.Telecom
DCM::Id 2.16.840.1.113883.2.4.3.11.60.40.3.8.6
DCM::KeywordList
DCM::LifecycleStatus Final
DCM::ModelerList *
DCM::Name nl.zorg.OvergevoeligheidIntolerantie
DCM::PublicationDate 15-04-2024
DCM::PublicationStatus Prepublished
DCM::ReviewerList Zib-centrum
DCM::RevisionDate 21-11-2023
DCM::Supersedes
DCM::Version 1.0
HCIM::PublicationLanguage EN

Revision History

Only available in Dutch

Publicatieversie 1.0 (15-04-2024)

ZIB-1167 Accordatiestatus in ZIB AllergieIntolerantie
ZIB-1340 Ontkenning van een overgevoeligheid In AllergieIntolerantie
ZIB-1370 Verschillende waardenlijsten voor status in zib-problem en zib-allergyintolerance
ZIB-2183 Toevoegen Zekerheid aan Zib AllergieIntollerantie

Concept

The tendency to develop an adverse physical reaction when exposed to a specific substance, group of substances or type of radiation.

Purpose

Information regarding a patient's propensity to een adverse reaction indicates that an undesirable reaction may occur upon exposure to the specified substance, group of substances or radiation. This may be a reason for the healthcare provider to monitor the specified substance, group of substances or radiation.

Evidence Base

Note on zib HypersensitivityIntolerance Not everyone gives the same meaning to the terms Hypersensitivity and Intolerance. There is more consensus about the term Allergy. The term Hypersensitivity generally serves as broader than Allergy. The name HypersensitivityIntolerance for the root concept of the zib indicates that this zib broadly covers all diagnoses that boil down to the patient's tendency to develop an undesirable reaction when exposed to a specific substance, group of substances or type of radiation.
This tendency may have been demonstrated by additional diagnostic tests, but can also be assumed based on the nature of the reaction(s) and/or the number of reactions that occurred when exposed to the substance(s) or radiation. HypersensitivityIntolerance covers, among other things, medicines, food ingredients, inhalation allergens (e.g. pollen), insect venom and contact allergens (e.g. nickel and latex).
 
The Hypersensitivity Intolerance zib is based on the zib DiagnosticInsight, because it concerns a diagnosis. The main difference is the container 'Agent' instead of 'Reason'. In addition, only 1 diagnosis can be recorded and no differential diagnosis, because a different hypersensitivity also implies a different agent. For this reason, Agens also has cardinality 1.
Just like DiagnosticInsight, HypersensitivityIntolerance has a reference to Condition, because it concerns the diagnostic interpretation of the condition.
 
The cardinality of the reference to Condition is 0..1, because in the case of a denial of a hypersensitivity or intolerance there is no condition to which that diagnosis relates. To represent that a patient is not aware of, for example, an allergy to penicillin or that an allergy to penicillin has been excluded, one should use the zib Exclusion with a reference to HypersensitivityIntolerance. In this case, the instance of HypersensitivityIntolerance does not refer to a Condition.


Functionality (informative) EHRs already offer the option to distinguish between recording a new diagnosis or changing a diagnosis. Similar functionality is also necessary when it concerns a hypersensitivity or intolerance. When recording a new hypersensitivity or intolerance, the EHR must create a new Condition and have the new instance of HypersensitivityIntolerance refer to it.
Because hypersensitivity or intolerance is a diagnosis, the EHR must also make it possible to change a 'normal' diagnosis to a hypersensitivity or intolerance and vice versa. In the event of such a change, the EHR must have the new instance of HypersensitivityIntolerance or DiagnosticInsight refer to the same Condition as the previous instance of HypersensitivityIntolerance or DiagnosticInsight.
In order to be able to distinguish between a 'normal' diagnosis and a hypersensitivity or intolerance, the EHR should preferably have meta-knowledge of whether or not a diagnosis concerns a hypersensitivity or intolerance and, on that basis, offer the correct subset of the diagnosis list. If not, there is no validation as to whether the diagnosis chosen by the user is a 'normal' diagnosis or a hypersensitivity or intolerance.

Information Model


Condition-v1.0(2024EN)#DiagnosisNameCodelist#5039#5031#5055#RadiationCodelist#5046#5044#DegreeOfCertaintyCodelist#5029#5030HealthProfessional-v4.0(2024EN)#WayOfDeterminationCodelist#5032#AgentHPKCodelist#AgentAllergicAgentCodelist#AgentThesaurus122Codelist#AgentSNKCodelist#AgentSSKCodelist#5040#CategoryCodelist#5041#5038#CriticalExtentCodelist#5051#5042HypersensitivityIntolerance-v1.0Model(2024EN).png


Type Id Concept Card. Definition DefinitionCode Reference
Block.png NL-CM:8.6.1 Arrowdown.pngHypersensitivityIntolerance This is a reference to the rootconcept of information model HypersensitivityIntolerance.
420134006 Propensity to adverse reaction
Verwijzing.png NL-CM:8.6.2 Arrowright.pngCondition 0..1 The condition of which the hypersensitivity or intolerance is the interpretation.
365860008 General clinical state finding
Block.png Condition
CD.png NL-CM:8.6.3 Arrowright.pngCertaintyStatus 1 Indicates the conviction of the health professional with respect to the hypersensitivity or intolerance as interpretation of the condition.
List2.png DegreeOfCertaintyCodelist
CD.png NL-CM:8.6.4 Arrowright.pngWayOfDetermination 1 The way in which the hypersensitivity or intlerance is determined.
418775008 Finding method
List2.png WayOfDeterminationCodelist
CD.png NL-CM:8.6.5 Arrowright.pngCategory 1..* Identifies the category of the agent to which the hypersensitivity or intolerance relates, such as medicines and nutritional substances.
List2.png CategoryCodelist
Folder.png NL-CM:8.6.6 Arrowdown.pngDiagnosis 1 Container of the Diagnosis concept. This container contains all data elements of the Diagnosis concept.

Represents the hypersensitivity as interpretation of the condition.

CD.png NL-CM:8.6.7 Arrowright.pngDiagnosisName 1 The term with associated code that the care professional selects from the used code list to specify the diagnosis.
439401001 Diagnosis
List2.png DiagnosisNameCodelist
ST.png NL-CM:8.6.8 Arrowright.pngFurtherSpecificationDiagnosisName 0..1 A more detailed description of the name of the hypersensitivity or intolerance in free text, when this detail is not available in the used code list.
330341000146107 Narrative comments on diagnosis
TS.png NL-CM:8.6.9 Arrowright.pngDiagnosticInsightDate 1 Date (and time) at which the care professional obtained the diagnostic insight.
432213005 Date of diagnosis
Verwijzing.png NL-CM:8.6.10 Arrowright.pngDiagnostician::HealthProfessional 1 The care professional that acquired the diagnostic insight regarding the hypersensitivity or intolerance. This can be a different individual than the person who recorded the diagnostic insight.
PRF performer
Block.png HealthProfessional
CD.png NL-CM:8.6.11 Arrowright.pngExpectedRiskUponExposure 0..1 The healthcare professional's assessment of the expected severity of the reaction upon future exposure to the substance, group of substances or environmental factor to which the patient is hypersensitive or intolerant.
340271000146105 Expected severity of reaction
List2.png CriticalExtentCodelist
ST.png NL-CM:8.6.12 Arrowright.pngComment 0..1 Textual explanation of the hypersensitivity or intolerance which cannot be entered in any of the other fields.
48767-8 Annotation comment [Interpretation] Narrative
Folder.png NL-CM:8.6.13 Arrowdown.pngAgent 1 Container of the Agent concept. This container contains all data elements of the Agent concept.
246075003 Causative agent
CD.png NL-CM:8.6.14 Arrowright.pngRadiation (0..1) Radiation as trigger for an adverse reaction.
82107009 Radiation
List2.png RadiationCodelist
CD.png NL-CM:8.6.15 Arrowright.pngSubstance (0..1) The substance or group of substances that trigger a reaction in the patient upon exposure.
105590001 Substance
List2.png AgentAllergicAgentCodelist
List2.png AgentHPKCodelist
List2.png AgentSNKCodelist
List2.png AgentSSKCodelist
List2.png AgentThesaurus122Codelist

Columns Concept and DefinitionCode: hover over the values for more information
For explanation of the symbols, please see the legend page List2.png

Example Instances

Only available in Dutch

OvergevoeligheidIntolerantie
DiagnostischInzichtDatum 07-10-2023 12-12-2023
ZekerheidsStatus In Overweging Bevestigd
WijzeVanVaststellen Vastgesteld op basis van anamnese. Vastgesteld op basis van het klinisch beeld en aanvullend onderzoek
Categorie Voedingsmiddelen
VerwachtRisicoBijBlootstelling Licht Licht
Diagnose
DiagnoseNaam Lactose-intolerantie Lactose-intolerantie
NadereSpecificatieDiagnoseNaam
Agens
Stof Lactose Lactose
Toelichting
Diagnosesteller::Zorgverlener
Naam Drs. L.J. Verhagen Drs. L.J. Verhagen
Specialisme Huisarts Huisarts
AandoeningOfGesteldheid
PeriodeAanwezig
StartDatumTijd 19-08-2023 19-08-2023
StatusDatum 07-10-2023 12-12-2023
Ernst Matig Matig
OvergevoeligheidIntolerantie
DiagnostischInzichtDatum 08-08-2023
ZekerheidsStatus Waarschijnlijk
WijzeVanVaststellen Vastgesteld op basis van het klinisch beeld en aanvullend onderzoek.
Categorie Geneesmiddelen, Voedingsmiddelen.
VerwachtRisicoBijBlootstelling Ernstig
Diagnose
DiagnoseNaam Neiging tot nadelige reactie op stof
NadereSpecificatieDiagnoseNaam
Agens
Stof Carmine
Toelichting Vastgesteld middels provocatietest.
Diagnosesteller::Zorgverlener
Naam Mevr. E. Süshel
Specialisme Allergologie
AandoeningOfGesteldheid
PeriodeAanwezig
StartDatumTijd 05-2023
StatusDatum 07-10-2023
Ernst Matig
OvergevoeligheidIntolerantie
DiagnostischInzichtDatum 02-05-2023
ZekerheidsStatus Bevestigd
WijzeVanVaststellen Vastgesteld op basis van het klinisch beeld en aanvullend onderzoek.
Categorie Geneesmiddelen
VerwachtRisicoBijBlootstelling Mild
Diagnose
DiagnoseNaam Geneesmiddelovergevoeligheid
NadereSpecificatieDiagnoseNaam
Agens
Stof Rituximab
Toelichting Anafylactoïde reacties bij een hogere pompstand dan 5-6. Meerdere positieve challenges en negatieve dechallenges, passend bij rituximab geïnduceerde cellysis.
Diagnosesteller::Zorgverlener
Naam Mevr. C. van Aa
Specialisme Neurologie
AandoeningOfGesteldheid
PeriodeAanwezig
StartDatumTijd 15-02-2023
StatusDatum 02-05-2023
Ernst Matig

Instructions

A hypersensitivity or intolerance always refers to the condition of which it is the interpretation. If > 1 instance of hypersensitivity or intolerance, reaction or diagnostic insight refers to the same condition, then the instantiation with the most recent diagnosis date represents the current diagnostic insight.

Valuesets

AgentAllergicAgentCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.8.6.5 Binding: Required
Conceptname Codesystem name Codesystem OID
SNOMED CT: ^98061000146100|Dutch total non-drug allergen simple reference set| SNOMED CT 2.16.840.1.113883.6.96

AgentHPKCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.8.6.6 Binding: Required
Conceptname Codesystem name Codesystem OID
All values G-Standaard Handels Product Kode (HPK) 2.16.840.1.113883.2.4.4.7

AgentSNKCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.8.6.7 Binding: Required
Conceptname Codesystem name Codesystem OID
All values G-standaard Stofnaamcode (SNK) 2.16.840.1.113883.2.4.4.1.750

AgentSSKCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.8.6.8 Binding: Required
Conceptname Codesystem name Codesystem OID
All values G-standaard Stofnaamcode i.c.m. toedieningsweg (SSK) 2.16.840.1.113883.2.4.4.1.725

AgentThesaurus122Codelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.8.6.9 Binding: Required
Conceptname Codesystem name Codesystem OID
All values G-standaard Ongewenste medicatiegroepen 2.16.840.1.113883.2.4.4.1.902.122

CategoryCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.8.6.10 Binding: Required
Conceptname Conceptcode Codesystem name Codesystem OID Description
Voedingsmiddelen NTB SNOMED CT 2.16.840.1.113883.6.96 Voedingsmiddelen
Geneesmiddelen NTB SNOMED CT 2.16.840.1.113883.6.96 Geneesmiddelen
Inhalatieallergenen NTB SNOMED CT 2.16.840.1.113883.6.96 Inhalatieallergenen
Contactallergenen NTB SNOMED CT 2.16.840.1.113883.6.96 Contactallergenen
Insectengif NTB SNOMED CT 2.16.840.1.113883.6.96 Insectengif
Straling NTB SNOMED CT 2.16.840.1.113883.6.96 Straling
Other OTH NullFlavor 2.16.840.1.113883.5.1008 Anders

CriticalExtentCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.8.6.11 Binding: Required
Conceptname Conceptcode Codesystem name Codesystem OID Description
Mild 255604002 SNOMED CT 2.16.840.1.113883.6.96 Mild
Severe 24484000 SNOMED CT 2.16.840.1.113883.6.96 Ernstig

DegreeOfCertaintyCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.8.6.2 Binding: Required
Conceptname Conceptcode Codesystem name Codesystem OID Description
Suspected 415684004 SNOMED CT 2.16.840.1.113883.6.96 Vermoedelijk
Known possible 410590009 SNOMED CT 2.16.840.1.113883.6.96 Mogelijk
Confirmed present 410605003 SNOMED CT 2.16.840.1.113883.6.96 Bevestigd
Probably not present 410593006 SNOMED CT 2.16.840.1.113883.6.96 Onwaarschijnlijk

DiagnosisNameCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.8.6.3 Binding: Required
Conceptname Codesystem name Codesystem OID
All values DHD Diagnosethesaurus 2.16.840.1.113883.2.4.3.120.5.1
All values ICPC-1 NL 2.16.840.1.113883.2.4.4.31.1
All values SNOMED CT 2.16.840.1.113883.6.96

RadiationCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.8.6.1 Binding: Extensible
Conceptname Conceptcode Codesystem name Codesystem OID Description
Radioactivity 32888000 SNOMED CT 2.16.840.1.113883.6.96 Radioactieve straling
Sunlight 49926000 SNOMED CT 2.16.840.1.113883.6.96 Zonlicht
Ultraviolet radiation 41355003 SNOMED CT 2.16.840.1.113883.6.96 UV-licht
Radiant heat 285337003 SNOMED CT 2.16.840.1.113883.6.96 Warmtestraling
Radio wave 52799000 SNOMED CT 2.16.840.1.113883.6.96 Radiogolven
Other OTH NullFlavor 2.16.840.1.113883.5.1008 Anders

WayOfDeterminationCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.8.6.4 Binding: Extensible
Conceptname Conceptcode Codesystem name Codesystem OID Description
Patient evaluation and management 14736009 SNOMED CT 2.16.840.1.113883.6.96 Vastgesteld op basis van het klinisch beeld en aanvullend onderzoek
History AND physical examination 63332003 SNOMED CT 2.16.840.1.113883.6.96 Vastgesteld op basis van het klinisch beeld
History taking 84100007 SNOMED CT 2.16.840.1.113883.6.96 Vastgesteld op basis van de anamnese
Vastgesteld op basis van aanvullend onderzoek NTB SNOMED CT 2.16.840.1.113883.6.96 Vastgesteld op basis van aanvullend onderzoek
Obtaining healthcare information from previous practitioner for clinical alignment 117131000146104 SNOMED CT 2.16.840.1.113883.6.96 Overgenomen uit betrouwbare rapportage
Other OTH NullFlavor 2.16.840.1.113883.5.1008 Anders

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About this information

The information in this wikipage is based on Prerelease 2024-1
SNOMED CT and LOINC codes are based on:

  • SNOMED Clinical Terms versie: 20240331 [R] (maart 2024-editie)
  • LOINC version 2.77

Conditions for use are located on the mainpage List2.png
This page is generated on 25/04/2024 12:42:05 with ZibExtraction v. 9.3.8880.19756

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