HL7 FHIR Implementation Guide - New Zealand Formulary/NZULM IG
1.0.0 - ci-build

HL7 FHIR Implementation Guide - New Zealand Formulary/NZULM IG, published by New Zealand Medicines Formulary LP. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7NZ/nzf/ and changes regularly. See the Directory of published versions

Resource Profile: NzfInteractionClinicalUseDefinition - Detailed Descriptions

Active as of 2024-07-17

Definitions for the NzfInteractionClinicalUseDefinition resource profile.

Guidance on how to interpret the contents of this table can be found here

0. ClinicalUseDefinition
2. ClinicalUseDefinition.category
Control0..0
4. ClinicalUseDefinition.subject
Control1..1
6. ClinicalUseDefinition.subject.extension
Control1..?
8. ClinicalUseDefinition.subject.extension:route
Slice Nameroute
Control1..*
TypeExtension(InteractionsRoute) (Extension Type: CodeableConcept)
10. ClinicalUseDefinition.contraindication
Control0..0
12. ClinicalUseDefinition.indication
Control0..0
14. ClinicalUseDefinition.interaction
Control1..?
16. ClinicalUseDefinition.interaction.extension
Control6..?
SlicingThis element introduces a set of slices on ClinicalUseDefinition.interaction.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 18. ClinicalUseDefinition.interaction.extension:severity
    Slice Nameseverity
    Control1..1
    TypeExtension(InteractionSeverity) (Extension Type: CodeableConcept)
    20. ClinicalUseDefinition.interaction.extension:warning
    Slice Namewarning
    Control1..1
    TypeExtension(InteractionWarning) (Extension Type: CodeableConcept)
    22. ClinicalUseDefinition.interaction.extension:evidence
    Slice Nameevidence
    Control1..1
    TypeExtension(InteractionEvidence) (Extension Type: CodeableConcept)
    24. ClinicalUseDefinition.interaction.extension:modificationDate
    Slice NamemodificationDate
    Control1..1
    TypeExtension(InteractionModificationDate) (Extension Type: date)
    26. ClinicalUseDefinition.interaction.extension:reviewDate
    Slice NamereviewDate
    Control1..1
    TypeExtension(InteractionReviewDate) (Extension Type: date)
    28. ClinicalUseDefinition.interaction.extension:textLink
    Slice NametextLink
    Control1..1
    TypeExtension(InteractionTextLink) (Extension Type: string)
    30. ClinicalUseDefinition.interaction.interactant
    Control1..1
    32. ClinicalUseDefinition.interaction.interactant.extension
    Control1..?
    SlicingThis element introduces a set of slices on ClinicalUseDefinition.interaction.interactant.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 34. ClinicalUseDefinition.interaction.interactant.extension:route
      Slice Nameroute
      Control1..*
      TypeExtension(InteractionsRoute) (Extension Type: CodeableConcept)
      36. ClinicalUseDefinition.interaction.type
      Control0..0
      38. ClinicalUseDefinition.interaction.incidence
      Control0..0
      40. ClinicalUseDefinition.undesirableEffect
      Control0..0
      42. ClinicalUseDefinition.warning
      Control0..0

      Guidance on how to interpret the contents of this table can be found here

      0. ClinicalUseDefinition
      Definition

      A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure.

      ShortA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
      Control0..*
      Is Modifierfalse
      Must Supportfalse
      Summaryfalse
      Invariantscud-1: Indication, 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-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If 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.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      2. ClinicalUseDefinition.implicitRules
      Definition

      A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

      ShortA set of rules under which this content was created
      Comments

      Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

      Control0..1
      Typeuri
      Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      4. ClinicalUseDefinition.modifierExtension
      Definition

      May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      ShortExtensions that cannot be ignored
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control0..*
      TypeExtension
      Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
      Must Supportfalse
      Summaryfalse
      Requirements

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      6. ClinicalUseDefinition.type
      Definition

      indication | contraindication | interaction | undesirable-effect | warning.

      Shortindication | contraindication | interaction | undesirable-effect | warning
      Control1..1
      BindingThe codes SHALL be taken from ClinicalUseDefinitionTypehttp://hl7.org/fhir/ValueSet/clinical-use-definition-type|4.3.0
      (required to http://hl7.org/fhir/ValueSet/clinical-use-definition-type|4.3.0)

      Overall defining type of this clinical use definition.

      Typecode
      Is Modifierfalse
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      8. ClinicalUseDefinition.category
      Definition

      A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy and Lactation", "Overdose", "Effects on Ability to Drive and Use Machines".

      ShortA categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
      Control0..0*
      BindingThe codes SHOULD be taken from ClinicalUseDefinitionCategoryhttp://hl7.org/fhir/ValueSet/clinical-use-definition-category
      (preferred to http://hl7.org/fhir/ValueSet/clinical-use-definition-category)

      A categorisation for a clinical use information item.

      TypeCodeableConcept
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      10. ClinicalUseDefinition.subject
      Definition

      The medication or procedure for which this is an indication.

      ShortThe medication or procedure for which this is an indication
      Control10..1*
      TypeReference(MedicinalProductDefinition, Medication, ActivityDefinition, PlanDefinition, Device, DeviceDefinition, Substance)
      Is Modifierfalse
      Must Supportfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      12. ClinicalUseDefinition.subject.extension
      Definition

      An Extension


      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

      ShortExtensionAdditional content defined by implementations
      Comments

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Control10..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on ClinicalUseDefinition.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 14. ClinicalUseDefinition.subject.extension:route
        Slice Nameroute
        Definition

        Optional Extension Element - found in all resources.

        ShortOptional Extensions Element
        Control1..*
        TypeExtension(InteractionsRoute) (Extension Type: CodeableConcept)
        Is Modifierfalse
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        16. ClinicalUseDefinition.contraindication
        Definition

        Specifics for when this is a contraindication.

        ShortSpecifics for when this is a contraindication
        Control0..01
        TypeBackboneElement
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
        19. ClinicalUseDefinition.indication
        Definition

        Specifics for when this is an indication.

        ShortSpecifics for when this is an indication
        Control0..01
        TypeBackboneElement
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
        22. ClinicalUseDefinition.interaction
        Definition

        Specifics for when this is an interaction.

        ShortSpecifics for when this is an interaction
        Control10..1
        TypeBackboneElement
        Is Modifierfalse
        Must Supportfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
        24. ClinicalUseDefinition.interaction.extension
        Definition

        An Extension


        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

        ShortExtensionAdditional content defined by implementations
        Comments

        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

        Control60..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on ClinicalUseDefinition.interaction.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 26. ClinicalUseDefinition.interaction.extension:severity
          Slice Nameseverity
          Definition

          Optional Extension Element - found in all resources.

          ShortOptional Extensions Element
          Control1..1
          This element is affected by the following invariants: ele-1
          TypeExtension(InteractionSeverity) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          28. ClinicalUseDefinition.interaction.extension:warning
          Slice Namewarning
          Definition

          Optional Extension Element - found in all resources.

          ShortOptional Extensions Element
          Control1..1
          This element is affected by the following invariants: ele-1
          TypeExtension(InteractionWarning) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          30. ClinicalUseDefinition.interaction.extension:evidence
          Slice Nameevidence
          Definition

          Optional Extension Element - found in all resources.

          ShortOptional Extensions Element
          Control1..1
          This element is affected by the following invariants: ele-1
          TypeExtension(InteractionEvidence) (Extension Type: CodeableConcept)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          32. ClinicalUseDefinition.interaction.extension:modificationDate
          Slice NamemodificationDate
          Definition

          Optional Extension Element - found in all resources.

          ShortOptional Extensions Element
          Control1..1
          This element is affected by the following invariants: ele-1
          TypeExtension(InteractionModificationDate) (Extension Type: date)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          34. ClinicalUseDefinition.interaction.extension:reviewDate
          Slice NamereviewDate
          Definition

          Optional Extension Element - found in all resources.

          ShortOptional Extensions Element
          Control1..1
          This element is affected by the following invariants: ele-1
          TypeExtension(InteractionReviewDate) (Extension Type: date)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          36. ClinicalUseDefinition.interaction.extension:textLink
          Slice NametextLink
          Definition

          Optional Extension Element - found in all resources.

          ShortOptional Extensions Element
          Control1..1
          This element is affected by the following invariants: ele-1
          TypeExtension(InteractionTextLink) (Extension Type: string)
          Is Modifierfalse
          Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          38. ClinicalUseDefinition.interaction.modifierExtension
          Definition

          May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          ShortExtensions that cannot be ignored even if unrecognized
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control0..*
          TypeExtension
          Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
          Summarytrue
          Requirements

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Alternate Namesextensions, user content, modifiers
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          40. ClinicalUseDefinition.interaction.interactant
          Definition

          The specific medication, food, substance or laboratory test that interacts.

          ShortThe specific medication, food, substance or laboratory test that interacts
          Control10..1*
          TypeBackboneElement
          Is Modifierfalse
          Must Supportfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
          42. ClinicalUseDefinition.interaction.interactant.extension
          Definition

          An Extension


          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          ShortExtensionAdditional content defined by implementations
          Comments

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Control10..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Alternate Namesextensions, user content
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on ClinicalUseDefinition.interaction.interactant.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 44. ClinicalUseDefinition.interaction.interactant.extension:route
            Slice Nameroute
            Definition

            Optional Extension Element - found in all resources.

            ShortOptional Extensions Element
            Control1..*
            This element is affected by the following invariants: ele-1
            TypeExtension(InteractionsRoute) (Extension Type: CodeableConcept)
            Is Modifierfalse
            Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            46. ClinicalUseDefinition.interaction.interactant.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            48. ClinicalUseDefinition.interaction.interactant.item[x]
            Definition

            The specific medication, food or laboratory test that interacts.

            ShortThe specific medication, food or laboratory test that interacts
            Control1..1
            BindingFor example codes, see Interactanthttp://hl7.org/fhir/ValueSet/interactant
            (example to http://hl7.org/fhir/ValueSet/interactant)

            An interactant - a substance that may have an clinically significant effect on another.

            TypeChoice of: Reference(MedicinalProductDefinition, Medication, Substance, ObservationDefinition), CodeableConcept
            [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            50. ClinicalUseDefinition.interaction.type
            Definition

            The type of the interaction e.g. drug-drug interaction, drug-food interaction, drug-lab test interaction.

            ShortThe type of the interaction e.g. drug-drug interaction, drug-lab test interaction
            Control0..01
            BindingFor example codes, see InteractionTypehttp://hl7.org/fhir/ValueSet/interaction-type
            (example to http://hl7.org/fhir/ValueSet/interaction-type)

            A categorisation for an interaction between two substances.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            52. ClinicalUseDefinition.interaction.incidence
            Definition

            The incidence of the interaction, e.g. theoretical, observed.

            ShortThe incidence of the interaction, e.g. theoretical, observed
            Control0..01
            BindingFor example codes, see InteractionIncidencehttp://hl7.org/fhir/ValueSet/interaction-incidence
            (example to http://hl7.org/fhir/ValueSet/interaction-incidence)

            A categorisation for incidence of occurence of an interaction.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            54. ClinicalUseDefinition.undesirableEffect
            Definition

            Describe the possible undesirable effects (negative outcomes) from the use of the medicinal product as treatment.

            ShortA possible negative outcome from the use of this treatment
            Control0..01
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
            57. ClinicalUseDefinition.warning
            Definition

            A critical piece of information about environmental, health or physical risks or hazards that serve as caution to the user. For example 'Do not operate heavy machinery', 'May cause drowsiness', or 'Get medical advice/attention if you feel unwell'.

            ShortCritical environmental, health or physical risks or hazards. For example 'Do not operate heavy machinery', 'May cause drowsiness'
            Control0..01
            TypeBackboneElement
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)

            Guidance on how to interpret the contents of this table can be found here

            0. ClinicalUseDefinition
            Definition

            A single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure.

            ShortA single issue - either an indication, contraindication, interaction or an undesirable effect for a medicinal product, medication, device or procedure
            Control0..*
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Invariantscud-1: Indication, 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-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
            dom-3: If 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.exists() and ('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url)))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(uri) = '#').exists()).not()).trace('unmatched', id).empty())
            dom-4: If 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-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
            dom-6: A resource should have narrative for robust management (text.`div`.exists())
            2. ClinicalUseDefinition.id
            Definition

            The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

            ShortLogical id of this artifact
            Comments

            The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

            Control0..1
            Typeid
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            4. ClinicalUseDefinition.meta
            Definition

            The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

            ShortMetadata about the resource
            Control0..1
            TypeMeta
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            6. ClinicalUseDefinition.implicitRules
            Definition

            A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

            ShortA set of rules under which this content was created
            Comments

            Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

            Control0..1
            Typeuri
            Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            8. ClinicalUseDefinition.language
            Definition

            The base language in which the resource is written.

            ShortLanguage of the resource content
            Comments

            Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

            Control0..1
            BindingThe codes SHOULD be taken from CommonLanguages
            (preferred to http://hl7.org/fhir/ValueSet/languages)

            IETF language tag

            Additional BindingsPurpose
            AllLanguagesMax Binding
            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            10. ClinicalUseDefinition.text
            Definition

            A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

            ShortText summary of the resource, for human interpretation
            Comments

            Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

            Control0..1
            TypeNarrative
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Alternate Namesnarrative, html, xhtml, display
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            12. ClinicalUseDefinition.contained
            Definition

            These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

            ShortContained, inline Resources
            Comments

            This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

            Control0..*
            TypeResource
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Alternate Namesinline resources, anonymous resources, contained resources
            Invariantsdom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems (($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic))
            14. ClinicalUseDefinition.extension
            Definition

            May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            ShortAdditional content defined by implementations
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Must Supportfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            16. ClinicalUseDefinition.modifierExtension
            Definition

            May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

            Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

            ShortExtensions that cannot be ignored
            Comments

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
            Must Supportfalse
            Summaryfalse
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            18. ClinicalUseDefinition.identifier
            Definition

            Business identifier for this issue.

            ShortBusiness identifier for this issue
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..*
            TypeIdentifier
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            20. ClinicalUseDefinition.type
            Definition

            indication | contraindication | interaction | undesirable-effect | warning.

            Shortindication | contraindication | interaction | undesirable-effect | warning
            Control1..1
            BindingThe codes SHALL be taken from ClinicalUseDefinitionType
            (required to http://hl7.org/fhir/ValueSet/clinical-use-definition-type|4.3.0)

            Overall defining type of this clinical use definition.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            22. ClinicalUseDefinition.category
            Definition

            A categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy and Lactation", "Overdose", "Effects on Ability to Drive and Use Machines".

            ShortA categorisation of the issue, primarily for dividing warnings into subject heading areas such as "Pregnancy", "Overdose"
            Control0..0
            BindingThe codes SHOULD be taken from ClinicalUseDefinitionCategory
            (preferred to http://hl7.org/fhir/ValueSet/clinical-use-definition-category)

            A categorisation for a clinical use information item.

            TypeCodeableConcept
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            24. ClinicalUseDefinition.subject
            Definition

            The medication or procedure for which this is an indication.

            ShortThe medication or procedure for which this is an indication
            Control1..1
            TypeReference(MedicinalProductDefinition, Medication, ActivityDefinition, PlanDefinition, Device, DeviceDefinition, Substance)
            Is Modifierfalse
            Must Supportfalse
            Summarytrue
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            26. ClinicalUseDefinition.subject.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typeid
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            28. ClinicalUseDefinition.subject.extension
            Definition

            An Extension

            ShortExtension
            Control1..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingThis element introduces a set of slices on ClinicalUseDefinition.subject.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
            • value @ url
            • 30. ClinicalUseDefinition.subject.extension:route
              Slice Nameroute
              Definition

              Optional Extension Element - found in all resources.

              ShortOptional Extensions Element
              Control1..*
              TypeExtension(InteractionsRoute) (Extension Type: CodeableConcept)
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              32. ClinicalUseDefinition.subject.reference
              Definition

              A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

              ShortLiteral reference, Relative, internal or absolute URL
              Comments

              Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

              Control0..1
              This element is affected by the following invariants: ref-1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              34. ClinicalUseDefinition.subject.type
              Definition

              The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

              The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

              ShortType the reference refers to (e.g. "Patient")
              Comments

              This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

              Control0..1
              BindingUnless not suitable, these codes SHALL be taken from ResourceType
              (extensible to http://hl7.org/fhir/ValueSet/resource-types)
              Typeuri
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              36. ClinicalUseDefinition.subject.identifier
              Definition

              An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

              ShortLogical reference, when literal reference is not known
              Comments

              When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

              When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

              Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

              Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

              NoteThis is a business identifier, not a resource identifier (see discussion)
              Control0..1
              TypeIdentifier
              Is Modifierfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              38. ClinicalUseDefinition.subject.display
              Definition

              Plain text narrative that identifies the resource in addition to the resource reference.

              ShortText alternative for the resource
              Comments

              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

              Control0..1
              Typestring
              Is Modifierfalse
              Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              40. ClinicalUseDefinition.status
              Definition

              Whether this is a current issue or one that has been retired etc.

              ShortWhether this is a current issue or one that has been retired etc
              Control0..1
              BindingThe codes SHOULD be taken from PublicationStatus
              (preferred to http://hl7.org/fhir/ValueSet/publication-status)

              The lifecycle status of an artifact.

              TypeCodeableConcept
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              42. ClinicalUseDefinition.contraindication
              Definition

              Specifics for when this is a contraindication.

              ShortSpecifics for when this is a contraindication
              Control0..0
              TypeBackboneElement
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
              57. ClinicalUseDefinition.indication
              Definition

              Specifics for when this is an indication.

              ShortSpecifics for when this is an indication
              Control0..0
              TypeBackboneElement
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
              69. ClinicalUseDefinition.interaction
              Definition

              Specifics for when this is an interaction.

              ShortSpecifics for when this is an interaction
              Control1..1
              TypeBackboneElement
              Is Modifierfalse
              Must Supportfalse
              Summarytrue
              Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
              71. ClinicalUseDefinition.interaction.id
              Definition

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              ShortUnique id for inter-element referencing
              Control0..1
              Typestring
              Is Modifierfalse
              XML FormatIn the XML format, this property is represented as an attribute.
              Summaryfalse
              73. ClinicalUseDefinition.interaction.extension
              Definition

              An Extension

              ShortExtension
              Control6..*
              TypeExtension
              Is Modifierfalse
              Summaryfalse
              Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingThis element introduces a set of slices on ClinicalUseDefinition.interaction.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
              • value @ url
              • 75. ClinicalUseDefinition.interaction.extension:severity
                Slice Nameseverity
                Definition

                Optional Extension Element - found in all resources.

                ShortOptional Extensions Element
                Control1..1
                This element is affected by the following invariants: ele-1
                TypeExtension(InteractionSeverity) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                77. ClinicalUseDefinition.interaction.extension:warning
                Slice Namewarning
                Definition

                Optional Extension Element - found in all resources.

                ShortOptional Extensions Element
                Control1..1
                This element is affected by the following invariants: ele-1
                TypeExtension(InteractionWarning) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                79. ClinicalUseDefinition.interaction.extension:evidence
                Slice Nameevidence
                Definition

                Optional Extension Element - found in all resources.

                ShortOptional Extensions Element
                Control1..1
                This element is affected by the following invariants: ele-1
                TypeExtension(InteractionEvidence) (Extension Type: CodeableConcept)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                81. ClinicalUseDefinition.interaction.extension:modificationDate
                Slice NamemodificationDate
                Definition

                Optional Extension Element - found in all resources.

                ShortOptional Extensions Element
                Control1..1
                This element is affected by the following invariants: ele-1
                TypeExtension(InteractionModificationDate) (Extension Type: date)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                83. ClinicalUseDefinition.interaction.extension:reviewDate
                Slice NamereviewDate
                Definition

                Optional Extension Element - found in all resources.

                ShortOptional Extensions Element
                Control1..1
                This element is affected by the following invariants: ele-1
                TypeExtension(InteractionReviewDate) (Extension Type: date)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                85. ClinicalUseDefinition.interaction.extension:textLink
                Slice NametextLink
                Definition

                Optional Extension Element - found in all resources.

                ShortOptional Extensions Element
                Control1..1
                This element is affected by the following invariants: ele-1
                TypeExtension(InteractionTextLink) (Extension Type: string)
                Is Modifierfalse
                Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                87. ClinicalUseDefinition.interaction.modifierExtension
                Definition

                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                ShortExtensions that cannot be ignored even if unrecognized
                Comments

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Control0..*
                TypeExtension
                Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                Summarytrue
                Requirements

                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                Alternate Namesextensions, user content, modifiers
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                89. ClinicalUseDefinition.interaction.interactant
                Definition

                The specific medication, food, substance or laboratory test that interacts.

                ShortThe specific medication, food, substance or laboratory test that interacts
                Control1..1
                TypeBackboneElement
                Is Modifierfalse
                Must Supportfalse
                Summarytrue
                Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                91. ClinicalUseDefinition.interaction.interactant.id
                Definition

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                ShortUnique id for inter-element referencing
                Control0..1
                Typestring
                Is Modifierfalse
                XML FormatIn the XML format, this property is represented as an attribute.
                Summaryfalse
                93. ClinicalUseDefinition.interaction.interactant.extension
                Definition

                An Extension

                ShortExtension
                Control1..*
                TypeExtension
                Is Modifierfalse
                Summaryfalse
                Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingThis element introduces a set of slices on ClinicalUseDefinition.interaction.interactant.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
                • value @ url
                • 95. ClinicalUseDefinition.interaction.interactant.extension:route
                  Slice Nameroute
                  Definition

                  Optional Extension Element - found in all resources.

                  ShortOptional Extensions Element
                  Control1..*
                  This element is affected by the following invariants: ele-1
                  TypeExtension(InteractionsRoute) (Extension Type: CodeableConcept)
                  Is Modifierfalse
                  Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  97. ClinicalUseDefinition.interaction.interactant.modifierExtension
                  Definition

                  May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                  Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                  ShortExtensions that cannot be ignored even if unrecognized
                  Comments

                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                  Control0..*
                  TypeExtension
                  Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                  Summarytrue
                  Requirements

                  Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                  Alternate Namesextensions, user content, modifiers
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  99. ClinicalUseDefinition.interaction.interactant.item[x]
                  Definition

                  The specific medication, food or laboratory test that interacts.

                  ShortThe specific medication, food or laboratory test that interacts
                  Control1..1
                  BindingFor example codes, see Interactant
                  (example to http://hl7.org/fhir/ValueSet/interactant)

                  An interactant - a substance that may have an clinically significant effect on another.

                  TypeChoice of: Reference(MedicinalProductDefinition, Medication, Substance, ObservationDefinition), CodeableConcept
                  [x] NoteSeeChoice of Data Typesfor further information about how to use [x]
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  101. ClinicalUseDefinition.interaction.type
                  Definition

                  The type of the interaction e.g. drug-drug interaction, drug-food interaction, drug-lab test interaction.

                  ShortThe type of the interaction e.g. drug-drug interaction, drug-lab test interaction
                  Control0..0
                  BindingFor example codes, see InteractionType
                  (example to http://hl7.org/fhir/ValueSet/interaction-type)

                  A categorisation for an interaction between two substances.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  103. ClinicalUseDefinition.interaction.effect
                  Definition

                  The effect of the interaction, for example "reduced gastric absorption of primary medication".

                  ShortThe effect of the interaction, for example "reduced gastric absorption of primary medication"
                  Control0..1
                  BindingFor example codes, see InteractionEffect
                  (example to http://hl7.org/fhir/ValueSet/interaction-effect)

                  A interaction effect of clinical use of a medication or other substance.

                  TypeCodeableReference(ObservationDefinition)
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  105. ClinicalUseDefinition.interaction.incidence
                  Definition

                  The incidence of the interaction, e.g. theoretical, observed.

                  ShortThe incidence of the interaction, e.g. theoretical, observed
                  Control0..0
                  BindingFor example codes, see InteractionIncidence
                  (example to http://hl7.org/fhir/ValueSet/interaction-incidence)

                  A categorisation for incidence of occurence of an interaction.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  107. ClinicalUseDefinition.interaction.management
                  Definition

                  Actions for managing the interaction.

                  ShortActions for managing the interaction
                  Control0..*
                  BindingFor example codes, see InteractionManagement
                  (example to http://hl7.org/fhir/ValueSet/interaction-management)

                  A type of management for an interaction of a medication or other substance.

                  TypeCodeableConcept
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  109. ClinicalUseDefinition.population
                  Definition

                  The population group to which this applies.

                  ShortThe population group to which this applies
                  Control0..*
                  TypeReference(Group)
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  111. ClinicalUseDefinition.undesirableEffect
                  Definition

                  Describe the possible undesirable effects (negative outcomes) from the use of the medicinal product as treatment.

                  ShortA possible negative outcome from the use of this treatment
                  Control0..0
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
                  119. ClinicalUseDefinition.warning
                  Definition

                  A critical piece of information about environmental, health or physical risks or hazards that serve as caution to the user. For example 'Do not operate heavy machinery', 'May cause drowsiness', or 'Get medical advice/attention if you feel unwell'.

                  ShortCritical environmental, health or physical risks or hazards. For example 'Do not operate heavy machinery', 'May cause drowsiness'
                  Control0..0
                  TypeBackboneElement
                  Is Modifierfalse
                  Must Supportfalse
                  Summarytrue
                  Invariantsele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)