Cardinality of manifestation

[ElienDeKoker]

The definition of BeAlergyIntolerance Version 1.2.0 limits the number to a maximum of 1 reaction.manifestation (1..1). This has been the case since Version 1.0.1. In Version 1.0.0, it was 1... However, in the default standard reaction.manifestation is repeating (1..). Can this be changed? Or what is the reason it has been limited to maximum 1?

[mlambot]

Hi Elien,

It is 1.. in the HL7 international basic profile. I don't know the reason for the change. The container reaction is 1.. so it doesn't pose a problem clinically that I see, you can still add several manifestations to the allergic propensity but you have to specify each time their route of administration and date of occurrence instead of grouping somehow the symptoms that share the same date and route of administration. If you consider that we'll switch later to coding the manifestations with a coding reference to the Observation care set of the symptom or the Condition care set of the disorder presented as a reaction, then it might be logical to have a 1..1 and import the date of occurrence automatically form the Observation/Condition data set and just add the route of adminitstartion as metadata to this link. Having a 1..1 there could avoid getting potential conflicts on which onset date to recover from the Observation care sets if there were several observations to link. Maybe that could be the reasoning? Let's see what Bart tells us!

[costateixeira]

Reaction was manifestation 0..1 from the early model - and profile follows the model, so it would explain the constraint. If there was some constraint, I presume it was discussed at the time with Business, but I don't think there was any expectation that the reference was a codeable or condition, or adding metadata and import date...  This seems a simple issue.

@ElienDeKoker Do I understand that the request is to change the allergy or intolerance to support capturing several manifestations within the same reaction? I am happy to propose that, and it will be easy to discuss if you have an immediate use case that shows the need. Or we can try to propose it anyway and see if there's a business impediment.

[ElienDeKoker]

The request is to keep the international standard without deviating when there is not need to limit it to one. Use case:

[KarlienHL7Belgium]

In the past, there were arguments to put the cardinality to 1, we think it was linked to onset (cfr Having a 1..1 there could avoid getting potential conflicts on which onset date to recover from the Observation care sets if there were several observations to link) @annenerenhausen : can you check this ? @ElienDeKoker : can you live with the workaround ?

[ElienDeKoker]

@KarlienHL7Belgium : for Datacap Project SHIFT we will communicate and use this workaround