import { Annotation } from './Annotation.js';
import { CodeableConcept } from './CodeableConcept.js';
import { CodeableReference } from './CodeableReference.js';
import { Extension } from './Extension.js';
import { FhirPrimitive } from './FhirPrimitive.js';
import { Observation } from './Observation.js';
export interface AllergyIntolerance_Reaction {
    /**
     * @description Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
     * @short Unique id for inter-element referencing
     */
    id?: string;
    /**
     * @description 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 managable, 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.
     * @comment 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.
     * @short Additional content defined by implementations
     */
    extension?: Extension[];
    /**
     * @description 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 andor the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, 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).
     * @comment 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.
     * @short Extensions that cannot be ignored even if unrecognized
     */
    modifierExtension?: Extension[];
    /**
     * @description Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'.  If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance.
     * @comment Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible.  The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identified as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.
     * @short Specific substance or pharmaceutical product considered to be responsible for event
     */
    substance?: CodeableConcept;
    /**
     * @description Clinical symptoms andor signs that are observed or associated with the adverse reaction event.
     * @comment Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines.  Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.
     * @short Clinical symptomssigns associated with the Event
     */
    manifestation: CodeableReference<Observation>[];
    /**
     * @description Text description about the reaction as a whole, including details of the manifestation if required.
     * @comment Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened beforeafter. Information, related to the event, but not describing a particular care should be captured in the note field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.
     * @short Description of the event as a whole
     */
    description?: FhirPrimitive<string>;
    /**
     * @description Record of the date andor time of the onset of the Reaction.
     * @short Date(time) when manifestations showed
     */
    onset?: FhirPrimitive<string>;
    /**
     * @description Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.
     * @comment It is acknowledged that this assessment is very subjective. There may be some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.
     * @short mild | moderate | severe (of event as a whole)
     */
    severity?: FhirPrimitive<string>;
    /**
     * @description Identification of the route by which the subject was exposed to the substance.
     * @comment Coding of the route of exposure with a terminology should be used wherever possible.
     * @short How the subject was exposed to the substance
     */
    exposureRoute?: CodeableConcept;
    /**
     * @description Additional text about the adverse reaction event not captured in other fields.
     * @comment Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.
     * @short Text about event not captured in other fields
     */
    note?: Annotation[];
}
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