Reaction-v2.0(2024EN)

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General information

Name: nl.zorg.Reaction NL.png
Version: 2.0
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 2.16.840.1.113883.2.4.3.11.60.40.3.5.3
DCM::KeywordList
DCM::LifecycleStatus Final
DCM::ModelerList *
DCM::Name nl.zorg.Reactie
DCM::PublicationDate 15-04-2024
DCM::PublicationStatus Prepublished
DCM::ReviewerList Zib-centrum
DCM::RevisionDate 21-11-2023
DCM::Supersedes nl.zorg.Reactie-v1.0
DCM::Version 2.0
HCIM::PublicationLanguage EN

Revision History

Only available in Dutch

Publicatieversie 1.0 (01-12-2021)

Publicatieversie 2.0 (15-04-2024)

ZIB-1994 Toevoegen van element ReactieOnset aan Reactie/Overgevoeligheid
ZIB-2028 Reactie/VeroorzakendeStof - G-Standaard SNK en HPK
ZIB-2130 2023-1 nl.zorg.Reactie heeft technisch probleem in model
ZIB-2183 Toevoegen Zekerheid aan Zib AllergieIntollerantie

Concept

An adverse clinical response that is possible, probable or proven to result from exposure to a substance, group of substances or radiation.

Purpose

Information about an adverse reaction in a patient to exposure to a substance or radiation is important for the healthcare provider to determine whether or not re-exposure to that substance or radiation is desirable. An undesirable reaction may lead to a decision to start monitoring.

Evidence Base

Note on zib Reaction The zib Reaction broadly covers all diagnoses that amount to an adverse response by the patient that is possibly, probably or confirmed to be the result of exposure to a specific substance, group of substances or type of radiation. In terms of substances, the causative agent covers, among other things, medicines, food ingredients, inhalation allergens (e.g. pollen), insect poison and contact allergens (e.g. nickel and latex).

The zib Reaction is based on the zib DiagnosticInsight, because it concerns a diagnosis. Only 1 diagnosis can be recorded as a reaction and no differential diagnosis, because the reaction is linked to the cause. For this reason, CausativeAgent also has cardinality 1.
The zib Reaction has a number of elements that are specific to a reaction, such as CausativeAgent, LatencyTime and RouteOfExposure. The latter only applies to a reaction to medicines. For example, with pollen, insect poison and contact allergens, the route of exposure speaks for itself.
Just like DiagnosticInsight, if a reaction is (possibly) present, there is a reference from reaction to Condition, because it concerns the diagnostic interpretation of the condition.
In addition, there is also the possibility of a reference from Reaction to HypersensitivityIntolerance to establish the relationship between an actual reaction and the tendency to develop a reaction. Sometimes the patient is known to have a hypersensitivity or intolerance with a relatively mild risk of exposure. In that case, one can decide to administer the substance(s) in question and record the actual reactions to monitor whether the risk increases.

Functionality (informative) EHRs already offer the option to distinguish between recording a new diagnosis or changing a diagnosis. Similar functionality is also needed when it concerns a reaction. When recording a new reaction, the EHR must create a new Condition and have the new instance of Reaction refer to it.
Because a reaction is also a diagnosis, the EHR must also make it possible to change a 'normal' diagnosis to a reaction and vice versa. In the event of such a change, the EHR must have the new instance of Reaction or DiagnosticInsight refer to the same Condition as the previous instance of Reaction or DiagnosticInsight.
In order to be able to distinguish between a 'normal' diagnosis and a reaction, the EHR should preferably have meta-knowledge of whether a diagnosis concerns a reaction or not 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 reaction.

Information Model


Condition-v1.0(2024EN)Range-v1.0.1(2024EN)#ProblemNameCodelist#5189#5187#5164HypersensitivityIntolerance-v1.0(2024EN)Procedure-v5.4.1(2024EN)#RadiationCodelist#5181#WayOfDeterminationCodelist#5163#DegreeOfCertaintyCodelist#5174#5168HealthProfessional-v4.0(2024EN)#RouteOfExposureCodelist#5185#5179#5190#CausativeSubstanceHPKCodelist#CausativeSubstanceAllergicAgentCodelist#CausativeSubstanceThesaurus122Codelist#CausativeSubstanceSNKCodelist#5176#5177Reaction-v2.0Model(2024EN).png


Type Id Concept Card. Definition DefinitionCode Reference
Block.png NL-CM:5.3.1 Arrowdown.pngReaction This is a reference to the rootconcept of information model Reaction.
281647001 Adverse reaction
Verwijzing.png NL-CM:5.3.2 Arrowright.pngCondition 1 The condition that the healthcare provider has identified as a reaction.
365860008 General clinical state finding
Block.png Condition
Verwijzing.png NL-CM:5.3.5 Arrowright.pngDiagnostician::HealthProfessional 1 The health professional that acquired the diagnostic insight of the reaction. This can be a different individual than the person who recorded the diagnostic insight.
PRF performer
Block.png HealthProfessional
TS.png NL-CM:5.3.6 Arrowright.pngDiagnosticInsightDate 1 Date (and time) at which the care professional obtained the diagnostic insight.
432213005 Date of diagnosis
CD.png NL-CM:5.3.7 Arrowright.pngCertaintyStatus 1 Indicates the conviction of the care professional with respect to the reaction as interpretation of the condition.
List2.png DegreeOfCertaintyCodelist
CD.png NL-CM:5.3.8 Arrowright.pngWayOfDetermination 1 The way in which the reaction is determined.
418775008 Finding method
List2.png WayOfDeterminationCodelist
Folder.png NL-CM:5.3.9 Arrowdown.pngDiagnosis 1 Container of the Diagnosis concept involving a reaction.This container contains all data elements of the Diagnosis concept.

Represents a reaction as interpretation of the condition.

CD.png NL-CM:5.3.10 Arrowright.pngDiagnosisName 1 The term with associated code that the care professional selects from the used code list.
439401001 Diagnosis
List2.png ProblemNameCodelist
ST.png NL-CM:5.3.11 Arrowright.pngFurtherSpecificationDiagnosisName 0..1 A more detailed description of the name of the reaction in free text, when this detail is not available in the used code list.
330341000146107 Narrative comments on diagnosis
Folder.png NL-CM:5.3.12 Arrowdown.pngCausativeAagent 1 Container of the CausativeAagent concept.This container contains all data elements of the CausativeAagent concept.

It is the agent that triggered the reaction.

246075003 Causative agent
CD.png NL-CM:5.3.13 Arrowright.pngCausativeSubstance (0..1) The substance that (presumably) caused the adverse reaction.​
105590001 Substance
List2.png CausativeSubstanceAllergicAgentCodelist
List2.png CausativeSubstanceHPKCodelist
List2.png CausativeSubstanceSNKCodelist
List2.png CausativeSubstanceThesaurus122Codelist
CD.png NL-CM:5.3.14 Arrowright.pngRadiation (0..1) The radiation that (presumably) caused the reaction.
82107009 Radiation
List2.png RadiationCodelist
CD.png NL-CM:5.3.15 Arrowright.pngRouteOfExposure 1 Way in which the patient came into contact with the causative agent or the way in which the agent was administered.
410675002 Route of administration
List2.png RouteOfExposureCodelist
Verwijzing.png NL-CM:5.3.16 Arrowright.pngLatencyTime::Range 1 The period of time between the moment of exposure to the substance or radiation and the onset of the undesirable reaction.
350371000146103 Time interval between date of exposure and date of onset of symptoms
Block.png Range
Verwijzing.png NL-CM:5.3.3 Arrowright.pngCause::Procedure 0..1 The procedure that caused the reaction.
71388002 Procedure
Block.png Procedure
Verwijzing.png NL-CM:5.3.4 Arrowright.pngHypersensitivityIntolerance 0..1 Hypersensitivity or intolerance underlying the reaction.
420134006 Propensity to adverse reaction
Block.png HypersensitivityIntolerance
ST.png NL-CM:5.3.18 Arrowright.pngComment 0..1 Textual explanation of the reaction which cannot be expressed in any of the other fields.
48767-8 Annotation comment [Interpretation] Narrative

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

Reactie
DiagnostischInzichtDatum 07-10-2023
ZekerheidsStatus Waarschijnlijk
WijzeVanVaststellen Vastgesteld op basis van het klinisch beeld en aanvullend onderzoek.
WijzeVanBlootstelling Oraal
Diagnose
DiagnoseNaam Pneumonitis
NadereSpecificatieDiagnoseNaam Amiodaron geïnduceerde pneumonitis
Veroorzaker
VeroorzakendeStof Amiodaron
Toelichting Radioloog beschrijft in het CT-verslag het volgende: gemalen glas en reticulaire opaciteit of CT-scan passend bij COP. Klinisch beeld past hier ook bij.
Latentietijd::Bereik
nominaleWaarde 30 dg
Diagnosesteller::Zorgverlener
Naam H. Kuch
Specialisme Longgeneeskunde
OvergvoeligheidIntolerantie
DiagnoseNaam Neiging tot ongewenste reactie op medicatie en/of drug
Categorie Geneesmiddelen
Stof Amiodaron
AandoeningOfGesteldheid
PeriodeAanwezig
StartDatumTijd 03-10-2023
StatusDatum 07-10-2023
Ernst Ernstig
Reactie
DiagnostischInzichtDatum 12-04-2023
ZekerheidsStatus Waarschijnlijk
WijzeVanVaststellen Vastgesteld op basis van het klinisch beeld
WijzeVanBlootstelling Intraveneus
Diagnose
DiagnoseNaam Geneesmiddelbijwerking
NadereSpecificatieDiagnoseNaam
Veroorzaker
VeroorzakendeStof Rixathon
Toelichting 15 min na verhoging van de pompstand naar 5
Latentietijd::Bereik
nominaleWaarde 15 min
Diagnosesteller::Zorgverlener
Naam L. van der Hoeven
Specialisme Neurologie
AandoeningOfGesteldheid
PeriodeAanwezig
StartDatumTijd 12-04-2023 11:15
EindDatumTijd 12-04-2023 12:15
StatusDatum 12-04-2023
Ernst Matig
Reactie
DiagnostischInzichtDatum 13-08-2023
ZekerheidsStatus Bevestigd
WijzeVanVaststellen Vastgesteld op basis van het klinisch beeld
WijzeVanBlootstelling
Diagnose
DiagnoseNaam Anafylactische shock
NadereSpecificatieDiagnoseNaam
Veroorzaker
VeroorzakendeStof Bijengif
Toelichting
Latentietijd::Bereik
nominaleWaarde 5 min
Diagnosesteller::Zorgverlener
Naam G.H. Schweers
Specialisme SEH-geneeskunde
AandoeningOfGesteldheid
PeriodeAanwezig
StartDatumTijd 13-08-2023 15:20
EindDatumTijd
StatusDatum 13-08-2023 15:20
Ernst Ernstig

Instructions

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

Valuesets

CausativeSubstanceAllergicAgentCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.7 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

CausativeSubstanceHPKCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.8 Binding: Required
Conceptname Codesystem name Codesystem OID
All values G-Standaard Handels Product Kode (HPK) 2.16.840.1.113883.2.4.4.7

CausativeSubstanceSNKCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.4 Binding: Required
Conceptname Codesystem name Codesystem OID
All values G-standaard Stofnaamcode (SNK) 2.16.840.1.113883.2.4.4.1.750

CausativeSubstanceThesaurus122Codelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.6 Binding: Required
Conceptname Codesystem name Codesystem OID
All values G-standaard Ongewenste medicatiegroepen 2.16.840.1.113883.2.4.4.1.902.122

DegreeOfCertaintyCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.1 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

ProblemNameCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.3 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: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.9 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
Unknown UNK NullFlavor 2.16.840.1.113883.5.1008 Onbekend

RouteOfExposureCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.10 Binding: Required
Conceptname Codesystem name Codesystem OID
All values G-Standaard Toedieningswegen 2.16.840.1.113883.2.4.4.9

WayOfDeterminationCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.5.3.2 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 12:42:29 with ZibExtraction v. 9.3.8880.19756

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