Add an introduction to explain the objective of this model and how it is based on the analysis performed (details documented in the appendix). Add a short summary of the results of this analysis.
After considering reference information models from various standards development organizations and other national or regional sources, an inclusive information model is synthesized. This purpose of the model is to provide a conceptual framework to understand and align the various models, but does not replace the individual models.
The inclusive information model is made up of three classes. The Propensity class is the centerpiece. A propensity class may be associated with zero-to-many Adverse Reaction classes and zero-to-many Adverse Sensitivity Test Result classes
The following tables depict the three classes and their data elements. Only data elements specific to the adverse sensitivity use case are shown. Generic data elements such as date, time, patient and provider identifiers are omitted. The Substance element, which is present in all three classes, can be used to link instances of the classes that are related to the same allergen.
The relationship between the three classes is as follows:
Propensity class
Table 1. Propensity class
Data element | Description | Notes |
Substance | Represents the specific allergen or other agent/substance to which the patient has an adverse reaction propensity. A substance is a physical material which can mean a drug or biologic, food, chemical agent, plants, animals, plastics etc. |
|
Substance type | Represents the type of substance related to the propensity e.g. drug, food, environment, vaccine etc. |
|
Propensity type | Indicates whether the propensity is an allergy, non-allergic hypersensitivity or intolerance. |
|
Propensity certainty | Indicates whether there is evidence that the propensity has been confirmed. For example, an allergy could be further categorized as: Confirmed - via laboratory testing or witnessed observation or other strong evidence, or Suspected (Unconfirmed) - Patient reported but not further verified by clinical history, diagnostic testing or is uncertain. |
|
Propensity criticality | Indicates the potential seriousness of the propensity for a future reaction. This represents a clinical judgment about the worst-case scenario for a future reaction. It would be based on the severity of past reactions, the dose and route of exposure that produced past reactions, and the life threatening or organ system threatening potential of the reaction type. Criticality is an attribute of the propensity, not the reaction(s). | Not the same as severity of the reaction, because a severe reaction can be non-critical and vice versa. |
Propensity status | Indicates the current status of the propensity. For example, an allergy may become ‘Resolved’ after de-sensitization (see 6.2 for the discussion about allergy desensitization). |
|
Adverse reaction class
Data element | Description | Notes |
Substance | Represents the specific allergen or other agent/substance to which the patient has an adverse reaction propensity. A substance is a physical material which can mean a drug or biologic, food, chemical agent, plants, animals, plastics etc. |
|
Reaction manifestation | Indicates the specific adverse reaction that occurred. Example: Rash, Hives | A negative entry (e.g., “no adverse reaction observed”) can be used to document an exception to a propensity to a class of substance (e.g., patient has penicillin allergy but can tolerate amoxicillin) |
Reaction severity | How severe the reaction was |
|
Exposure type (route) | How the exposure occurred. Example: oral, airborn, topical, etc. |
|
Source of information | How the observation was made e.g., patient reported, observed by family member, observed by healthcare professional |
|
Adverse sensitivity test result class
Data element | Description | Notes |
Substance | Represents the specific allergen or other agent/substance to which the patient has an adverse reaction propensity. A substance is a physical material which can mean a drug or biologic, food, chemical agent, plants, animals, plastics etc. |
|
Adverse sensitivity test performed | Represents the specific allergy test being performed ex: LOINC code 6206-7 Peanut IgE Ab [Units/volume] in Serum |
|
Adverse sensitivity test result | Represents the test result |
|
