Hierarchy | Concept type | Allowed | Exception | Examples and Notes (Note: Examples are existing concepts and may not reflect the terming patterns described in the template.) |
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| Substance base | Base | yes | none | Adverse reaction concepts representing a substance base should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|. Example: - 292392003 |Fluphenazine adverse reaction (disorder)|
Expected classification (Agreed 21-Jan-2020): - Classification results are expected to be consistent with the modeling of the concept selected as the Causative agent in the Substance hierarchy. (Agreed 21-Jan-2019)
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| Substance modification | Modification | no | yes
| Adverse reaction concepts representing a substance modification should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|. Concepts representing substance modifications are exceptions and could may be included if they meeting the following criteria.Exceptions: NEED TO ADD CRITERIAthe adverse reaction profile is significantly different from the substance base. Exception examples: - Chemical element with multiple modifications (e.g. 422232005 |Calcium lactate gluconate (substance)|)
- Liposome or lipid complex substances (e.g. 412088006 |Amphotericin B liposome (substance)|, 426490000 |Vincristine liposome (substance)|)
- Pegylated substance (e.g. 385544005 |Pegfilgrastim (substance)|, 770965008 |Pegvaliase (substance)|)
- Salt forms (e.g. 412432007 |Metoprolol succinate (substance)|, 72770009 |Metoprolol tartrate (substance)|)
Example: - 292389002 |Fluphenazine decanoate adverse reaction (disorder)|
- 292390006 |Fluphenazine enanthate adverse reaction (disorder)|
Expected classification (Agreed 21-Jan-2020): - Classification results are expected to be consistent with the modeling of the concept selected as the Causative agent in the Substance hierarchy. (Agreed 21-Jan-2019)
Substance |
| Disposition grouper | yes | none | Adverse reaction concepts representing a disposition grouper should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|. Example: - 293432006 |3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitor adverse reaction (disorder)|
- 870376001 |Adverse reaction to dopamine receptor agonist (disorder)|
Expected classification results (Agreed 21-Jan-2020): - Classification results are expected to be consistent with the modeling in the Substance hierarchy for concepts modeled with an attribute value from the Substance hierarchy.
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Substance | Role grouper | no | none | Adverse reaction concepts representing a role grouper should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|. Note that role groupers will be transitioned to the 763158003 |Medicinal product (product)| hierarchy in future release. Example: - 430136001 |Adverse reaction caused by antiparkinsonism drug (disorder)|
- 292040004 |Analgesic adverse reaction (disorder)|
Expected classification results (Agreed 21-Jan-2020): - Classification results are expected to be consistent with the modeling in the Substance hierarchy for concepts modeled with an attribute value from the Substance hierarchy.
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Product | Role + Structure grouper | no | TBD | No use case has been identified for use of this concept type for modeling in this subhierarchy. Existing groupers representing role + structure will be inactivated and replaced with structure grouper. (Agreed 11-Feb-2020) Example: - 292320000 |Barbiturate antiepileptic adverse reaction (disorder)|
- 292337007 |Barbiturate sedative adverse reaction (disorder)|
- 292916005 |Benzimidazole anthelmintic adverse reaction (disorder)|
- 292343009 |Benzodiazepine sedative adverse reaction (disorder)|
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Substance | Structure grouper | yes | none | Adverse reaction concepts representing a structure grouper should be modeled using a Causative agent that is a descendant of 105590001 |Substance (substance)|. Example: - 218638005 |Adverse reaction caused by hydantoin derivative (disorder)|
- 419885006 |Beta lactam adverse reaction (disorder)|
Expected classification (Agreed 21-Jan-2020): - Classification results are expected to be consistent with the modeling in the Substance hierarchy and with other existing concepts in the subhierarchy.
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Product or Substance | Body system grouper | no | none | Body system groupers in both the Substance and Product hierarchies will be inactivated in a future release and should no longer be used for modeling in this hierarchy. (Agreed 21-Jan-2020) Example: - 293416008 |Drug groups primarily affecting cardiovascular system adverse reaction (disorder)|
- 292670005 |Drug groups primarily affecting musculoskeletal system adverse reaction (disorder)|
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Product | Medicinal product-containing | yes | none | Example: - 292984002 |Ampicillin and cloxacillin adverse reaction (disorder)
- 292267003 |Benserazide + levodopa adverse reaction (disorder)
Expected classification results: Needs input from Drugs WG - see DRUGS-865 - 292984002 |Ampicillin and cloxacillin adverse reaction (disorder) will be modeled with Causative agent = 346320003 |Product containing ampicillin and cloxacillin (medicinal product)| and will have the the following inferred parents:
- 292968003 |Ampicillin adverse reaction (disorder)| with Causative agent = 387170002 |Ampicillin (substance)|
- 292963007 |Cloxacillin adverse reaction (disorder)| with Causative agent = 373276005 |Cloxacillin (substance)|
- 292267003 |Benserazide + levodopa adverse reaction (disorder) will be modeled with Causative agent = 418467003 |Product containing benserazide and levodopa (medicinal product)| and will have the following inferred parents:
- 292266007 |Levodopa adverse reaction (disorder)| with Causative agent = 387086006 |Levodopa (substance)|
- Note: There is not an existing concept for Adverse reaction to benserazide.
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Product | Medicinal product form-containing | yes | none | Example: - 293543001 |Oral glyceryl trinitrate adverse reaction (disorder)
- 293545008 |Parenteral glyceryl trinitrate adverse reaction (disorder)
- 293546009 |Transdermal glyceryl trinitrate adverse reaction (disorder)
Expected classification results: Needs input from Drugs WG - see DRUGS-866 - 293543001 |Oral glyceryl trinitrate adverse reaction (disorder) will be modeled with Causative agent = 346460001 |Product containing glyceryl trinitrate in oral dose form (medicinal product form)| and will have the following inferred parents:
- 293542006 |Glyceryl trinitrate adverse reaction (disorder)| with Causative agent = 387404004 |Glyceryl trinitrate (substance)|
- 293545008 |Parenteral glyceryl trinitrate adverse reaction (disorder) will be modeled with Causative agent = 346461002 |Product containing glyceryl trinitrate in parenteral dose form (medicinal product form)| and will have the following inferred parents:
- 293542006 |Glyceryl trinitrate adverse reaction (disorder)| with Causative agent = 387404004 |Glyceryl trinitrate (substance)|
- 293546009 |Transdermal glyceryl trinitrate adverse reaction (disorder) will be modeled with Causative agent = 346462009 |Product containing glyceryl trinitrate in transdermal dose form (medicinal product form)|
- 293542006 |Glyceryl trinitrate adverse reaction (disorder)| with Causative agent = 387404004 |Glyceryl trinitrate (substance)|
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