Electronic Medicinal Product Information (ePI) FHIR Implementation Guide
1.0.0 - trial-use International flag

This page is part of the Electronic Medicinal Product Information (ePI) FHIR Implementation Guide (v1.0.0: STU1) based on FHIR v5.0.0. This is the current published version. For a full list of available versions, see the Directory of published versions

Resource Profile: ClinicalUseDefinition Indication (ePI)

Official URL: http://hl7.org/fhir/uv/emedicinal-product-info/StructureDefinition/ClinicalUseDefinition-indication-uv-epi Version: 1.0.0
Standards status: Trial-use Maturity Level: 2 Computable Name: ClinicalUseDefinitionIndicationUvEpi

ClinicalUseDefinition Indication (ePI)

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from ClinicalUseDefinition

NameFlagsCard.TypeDescription & Constraintsdoco
.. ClinicalUseDefinition 0..*ClinicalUseDefinitionA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
... identifier 0..*IdentifierBusiness identifier for this clinical use.
... type 1..1codeindication | contraindication | interaction | undesirable-effect | warning
Required Pattern: indication
... subject 1..*Reference(MedicinalProductDefinition (ePI))The medication, product, substance, device, procedure etc. for which this is an indication
... contraindication 0..0
... indication 1..1BackboneElementSpecifics for when this is an indication
.... diseaseSymptomProcedure 0..1CodeableReference(ObservationDefinition)The situation that is being documented as an indicaton for this item
Binding: MedDRA Terms for clinical diseases and symptoms (preferred)
... interaction 0..0
... undesirableEffect 0..0
... warning 0..0

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
ClinicalUseDefinition.indication.diseaseSymptomProcedurepreferredVsMeddra
NameFlagsCard.TypeDescription & Constraintsdoco
.. ClinicalUseDefinition C0..*ClinicalUseDefinitionA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... contained 0..*ResourceContained, inline Resources
... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... type Σ1..1codeindication | contraindication | interaction | undesirable-effect | warning
Binding: ClinicalUseDefinitionType (required): Overall defining type of this clinical use definition.


Required Pattern: indication
... subject Σ1..*Reference(MedicinalProductDefinition (ePI))The medication, product, substance, device, procedure etc. for which this is an indication
... status Σ0..1CodeableConceptDefines whether this clinical use is draft, active or retired
Binding: PublicationStatus (preferred): The lifecycle status of an artifact.

... indication ΣC1..1BackboneElementSpecifics for when this is an indication
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... diseaseSymptomProcedure Σ0..1CodeableReference(ObservationDefinition)The situation that is being documented as an indicaton for this item
Binding: MedDRA Terms for clinical diseases and symptoms (preferred)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
ClinicalUseDefinition.typerequiredPattern: indication
ClinicalUseDefinition.statuspreferredPublicationStatus
ClinicalUseDefinition.indication.diseaseSymptomProcedurepreferredVsMeddra

Constraints

IdGradePath(s)DetailsRequirements
cud-1errorClinicalUseDefinitionIndication, 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-2errorClinicalUseDefinitionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorClinicalUseDefinitionIf 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-4errorClinicalUseDefinitionIf 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-5errorClinicalUseDefinitionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceClinicalUseDefinitionA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()
NameFlagsCard.TypeDescription & Constraintsdoco
.. ClinicalUseDefinition C0..*ClinicalUseDefinitionA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness identifier for this clinical use.
... type Σ1..1codeindication | contraindication | interaction | undesirable-effect | warning
Binding: ClinicalUseDefinitionType (required): Overall defining type of this clinical use definition.


Required Pattern: indication
... category Σ0..*CodeableConceptA categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
Binding: ClinicalUseDefinitionCategory (preferred): A categorisation for a clinical use information item.


... subject Σ1..*Reference(MedicinalProductDefinition (ePI))The medication, product, substance, device, procedure etc. for which this is an indication
... status Σ0..1CodeableConceptDefines whether this clinical use is draft, active or retired
Binding: PublicationStatus (preferred): The lifecycle status of an artifact.

... indication ΣC1..1BackboneElementSpecifics for when this is an indication
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... diseaseSymptomProcedure Σ0..1CodeableReference(ObservationDefinition)The situation that is being documented as an indicaton for this item
Binding: MedDRA Terms for clinical diseases and symptoms (preferred)
.... diseaseStatus Σ0..1CodeableReference(ObservationDefinition)The status of the disease or symptom for the indication
Binding: DiseaseStatus (example): The status of a disease or symptom.

.... comorbidity Σ0..*CodeableReference(ObservationDefinition)A comorbidity or coinfection as part of the indication
Binding: DiseaseSymptomProcedure (example): A symptom, disease or procedure.


.... intendedEffect Σ0..1CodeableReference(ObservationDefinition)The intended effect, aim or strategy to be achieved
Binding: ProductIntendedUse (preferred): The overall intended use of a product.

.... duration[x] Σ0..1Timing or duration information
..... durationRangeRange
..... durationStringstring
.... undesirableEffect Σ0..*Reference(ClinicalUseDefinition)An unwanted side effect or negative outcome of the subject of this resource when being used for this indication
.... applicability 0..1ExpressionAn expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements
.... otherTherapy Σ0..*See otherTherapy (ClinicalUseDefinition)The use of the medicinal product in relation to other therapies described as part of the indication
... population Σ0..*Reference(Group)The population group to which this applies
... library Σ0..*canonical(Library)Logic used by the clinical use definition

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
ClinicalUseDefinition.languagerequiredAllLanguages
ClinicalUseDefinition.typerequiredPattern: indication
ClinicalUseDefinition.categorypreferredClinicalUseDefinitionCategory
ClinicalUseDefinition.statuspreferredPublicationStatus
ClinicalUseDefinition.contraindication.diseaseSymptomProcedureexampleDiseaseSymptomProcedure
ClinicalUseDefinition.contraindication.diseaseStatusexampleDiseaseStatus
ClinicalUseDefinition.contraindication.comorbidityexampleDiseaseSymptomProcedure
ClinicalUseDefinition.contraindication.otherTherapy.relationshipTypepreferredTherapyRelationshipType
ClinicalUseDefinition.contraindication.otherTherapy.treatmentexampleTherapy
ClinicalUseDefinition.indication.diseaseSymptomProcedurepreferredVsMeddra
ClinicalUseDefinition.indication.diseaseStatusexampleDiseaseStatus
ClinicalUseDefinition.indication.comorbidityexampleDiseaseSymptomProcedure
ClinicalUseDefinition.indication.intendedEffectpreferredProductIntendedUse
ClinicalUseDefinition.interaction.interactant.item[x]exampleInteractant
ClinicalUseDefinition.interaction.typeexampleInteractionType
ClinicalUseDefinition.interaction.effectexampleInteractionEffect
ClinicalUseDefinition.interaction.incidenceexampleInteractionIncidence
ClinicalUseDefinition.interaction.managementexampleInteractionManagement
ClinicalUseDefinition.undesirableEffect.symptomConditionEffectexampleUndesirableEffectSymptom
ClinicalUseDefinition.undesirableEffect.classificationexampleUndesirableEffectClassification
ClinicalUseDefinition.undesirableEffect.frequencyOfOccurrenceexampleUndesirablEffectFrequency
ClinicalUseDefinition.warning.codeexampleWarningType

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from ClinicalUseDefinition

Summary

Mandatory: 2 elements
Prohibited: 4 elements

Structures

This structure refers to these other structures:

Maturity: 2

Differential View

This structure is derived from ClinicalUseDefinition

NameFlagsCard.TypeDescription & Constraintsdoco
.. ClinicalUseDefinition 0..*ClinicalUseDefinitionA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
... identifier 0..*IdentifierBusiness identifier for this clinical use.
... type 1..1codeindication | contraindication | interaction | undesirable-effect | warning
Required Pattern: indication
... subject 1..*Reference(MedicinalProductDefinition (ePI))The medication, product, substance, device, procedure etc. for which this is an indication
... contraindication 0..0
... indication 1..1BackboneElementSpecifics for when this is an indication
.... diseaseSymptomProcedure 0..1CodeableReference(ObservationDefinition)The situation that is being documented as an indicaton for this item
Binding: MedDRA Terms for clinical diseases and symptoms (preferred)
... interaction 0..0
... undesirableEffect 0..0
... warning 0..0

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSet
ClinicalUseDefinition.indication.diseaseSymptomProcedurepreferredVsMeddra

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ClinicalUseDefinition C0..*ClinicalUseDefinitionA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... contained 0..*ResourceContained, inline Resources
... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... type Σ1..1codeindication | contraindication | interaction | undesirable-effect | warning
Binding: ClinicalUseDefinitionType (required): Overall defining type of this clinical use definition.


Required Pattern: indication
... subject Σ1..*Reference(MedicinalProductDefinition (ePI))The medication, product, substance, device, procedure etc. for which this is an indication
... status Σ0..1CodeableConceptDefines whether this clinical use is draft, active or retired
Binding: PublicationStatus (preferred): The lifecycle status of an artifact.

... indication ΣC1..1BackboneElementSpecifics for when this is an indication
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... diseaseSymptomProcedure Σ0..1CodeableReference(ObservationDefinition)The situation that is being documented as an indicaton for this item
Binding: MedDRA Terms for clinical diseases and symptoms (preferred)

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
ClinicalUseDefinition.typerequiredPattern: indication
ClinicalUseDefinition.statuspreferredPublicationStatus
ClinicalUseDefinition.indication.diseaseSymptomProcedurepreferredVsMeddra

Constraints

IdGradePath(s)DetailsRequirements
cud-1errorClinicalUseDefinitionIndication, 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-2errorClinicalUseDefinitionIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorClinicalUseDefinitionIf 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-4errorClinicalUseDefinitionIf 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-5errorClinicalUseDefinitionIf a resource is contained in another resource, it SHALL NOT have a security label
: contained.meta.security.empty()
dom-6best practiceClinicalUseDefinitionA resource should have narrative for robust management
: text.`div`.exists()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. ClinicalUseDefinition C0..*ClinicalUseDefinitionA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
... id Σ0..1idLogical id of this artifact
... meta Σ0..1MetaMetadata about the resource
... implicitRules ?!Σ0..1uriA set of rules under which this content was created
... text 0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension 0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored
... identifier Σ0..*IdentifierBusiness identifier for this clinical use.
... type Σ1..1codeindication | contraindication | interaction | undesirable-effect | warning
Binding: ClinicalUseDefinitionType (required): Overall defining type of this clinical use definition.


Required Pattern: indication
... category Σ0..*CodeableConceptA categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
Binding: ClinicalUseDefinitionCategory (preferred): A categorisation for a clinical use information item.


... subject Σ1..*Reference(MedicinalProductDefinition (ePI))The medication, product, substance, device, procedure etc. for which this is an indication
... status Σ0..1CodeableConceptDefines whether this clinical use is draft, active or retired
Binding: PublicationStatus (preferred): The lifecycle status of an artifact.

... indication ΣC1..1BackboneElementSpecifics for when this is an indication
.... id 0..1stringUnique id for inter-element referencing
.... extension 0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!Σ0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... diseaseSymptomProcedure Σ0..1CodeableReference(ObservationDefinition)The situation that is being documented as an indicaton for this item
Binding: MedDRA Terms for clinical diseases and symptoms (preferred)
.... diseaseStatus Σ0..1CodeableReference(ObservationDefinition)The status of the disease or symptom for the indication
Binding: DiseaseStatus (example): The status of a disease or symptom.

.... comorbidity Σ0..*CodeableReference(ObservationDefinition)A comorbidity or coinfection as part of the indication
Binding: DiseaseSymptomProcedure (example): A symptom, disease or procedure.


.... intendedEffect Σ0..1CodeableReference(ObservationDefinition)The intended effect, aim or strategy to be achieved
Binding: ProductIntendedUse (preferred): The overall intended use of a product.

.... duration[x] Σ0..1Timing or duration information
..... durationRangeRange
..... durationStringstring
.... undesirableEffect Σ0..*Reference(ClinicalUseDefinition)An unwanted side effect or negative outcome of the subject of this resource when being used for this indication
.... applicability 0..1ExpressionAn expression that returns true or false, indicating whether the indication is applicable or not, after having applied its other elements
.... otherTherapy Σ0..*See otherTherapy (ClinicalUseDefinition)The use of the medicinal product in relation to other therapies described as part of the indication
... population Σ0..*Reference(Group)The population group to which this applies
... library Σ0..*canonical(Library)Logic used by the clinical use definition

doco Documentation for this format

Terminology Bindings

PathConformanceValueSet / Code
ClinicalUseDefinition.languagerequiredAllLanguages
ClinicalUseDefinition.typerequiredPattern: indication
ClinicalUseDefinition.categorypreferredClinicalUseDefinitionCategory
ClinicalUseDefinition.statuspreferredPublicationStatus
ClinicalUseDefinition.contraindication.diseaseSymptomProcedureexampleDiseaseSymptomProcedure
ClinicalUseDefinition.contraindication.diseaseStatusexampleDiseaseStatus
ClinicalUseDefinition.contraindication.comorbidityexampleDiseaseSymptomProcedure
ClinicalUseDefinition.contraindication.otherTherapy.relationshipTypepreferredTherapyRelationshipType
ClinicalUseDefinition.contraindication.otherTherapy.treatmentexampleTherapy
ClinicalUseDefinition.indication.diseaseSymptomProcedurepreferredVsMeddra
ClinicalUseDefinition.indication.diseaseStatusexampleDiseaseStatus
ClinicalUseDefinition.indication.comorbidityexampleDiseaseSymptomProcedure
ClinicalUseDefinition.indication.intendedEffectpreferredProductIntendedUse
ClinicalUseDefinition.interaction.interactant.item[x]exampleInteractant
ClinicalUseDefinition.interaction.typeexampleInteractionType
ClinicalUseDefinition.interaction.effectexampleInteractionEffect
ClinicalUseDefinition.interaction.incidenceexampleInteractionIncidence
ClinicalUseDefinition.interaction.managementexampleInteractionManagement
ClinicalUseDefinition.undesirableEffect.symptomConditionEffectexampleUndesirableEffectSymptom
ClinicalUseDefinition.undesirableEffect.classificationexampleUndesirableEffectClassification
ClinicalUseDefinition.undesirableEffect.frequencyOfOccurrenceexampleUndesirablEffectFrequency
ClinicalUseDefinition.warning.codeexampleWarningType

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()

This structure is derived from ClinicalUseDefinition

Summary

Mandatory: 2 elements
Prohibited: 4 elements

Structures

This structure refers to these other structures:

Maturity: 2

 

Other representations of profile: CSV, Excel, Schematron